title: Childhood gender nonconformity: a risk indicator for childhood abuse and posttraumatic stress in youth.
abstract: OBJECTIVE
  Childhood gender nonconformity has been associated with poorer relationships with parents, but it is unknown if childhood gender nonconformity is associated with childhood abuse or risk of posttraumatic stress disorder (PTSD) in youth.
  
  
  METHODS
  We examined whether gender nonconformity before age 11 years was associated with childhood sexual, physical, and psychological abuse and lifetime risk of probable PTSD by using self-report questionnaire data from the 2007 wave of the Growing Up Today Study (n = 9864, mean age = 22.7 years), a longitudinal cohort of US youth. We further examined whether higher exposure to childhood abuse mediated possible elevated prevalence of PTSD in nonconforming children. Finally, we examined whether association of childhood gender nonconformity with PTSD was independent of sexual orientation.
  
  
  RESULTS
  Exposure to childhood physical, psychological, and sexual abuse, and probable PTSD were elevated in youth in the top decile of childhood gender nonconformity compared with youth below median nonconformity. Abuse victimization disparities partly mediated PTSD disparities by gender nonconformity. Gender nonconformity predicted increased risk of lifetime probable PTSD in youth after adjustment for sexual orientation.
  
  
  CONCLUSIONS
  We identify gender nonconformity as an indicator of children at increased risk of abuse and probable PTSD. Pediatricians and school health providers should consider abuse screening for this vulnerable population. Further research to understand how gender nonconformity might increase risk of abuse and to develop family interventions to reduce abuse risk is needed.
authors.affiliation: Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA. aroberts@hsph.harvard.edu
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Roberts
authors.forename: Margaret
authors.initials: M
authors.lastname: Rosario
authors.forename: Heather L
authors.initials: HL
authors.lastname: Corliss
authors.forename: Karestan C
authors.initials: KC
authors.lastname: Koenen
authors.forename: S Bryn
authors.initials: SB
authors.lastname: Austin
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D015331:Cohort Studies; D016001:Confidence Intervals; D019548:Crime Victims / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D005783:Gender Identity; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D010287:Parent-Child Relations; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012737:Sex Factors; D012725:Sexual Behavior / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult