title: The impact of childhood gender expression on childhood sexual abuse and psychopathology among young men who have sex with men.
abstract: Young men who have sex with men (MSM) are a risk group highly vulnerable to HIV infection and psychiatric symptoms are direct predictors of sexual risk behavior in MSM. Childhood sexual abuse (CSA) is associated with psychiatric symptomology in adolescence, and MSM are disproportionately impacted by CSA compared to heterosexuals. Some evidence suggests that childhood gender nonconformity, a natural variation of human gender expression, is more common in MSM than heterosexual males and places MSM at greater risk for CSA. This study examined whether or not childhood gender expression moderated the association between incidents of unwanted, early sexual experiences occurring before age 13 (ESE) and current psychiatric symptomology in a community-based sample of 449 young MSM aged 16-20. Analyses revealed significant bivariate associations between ESE and psychological symptoms, and significant multivariable associations between ESE, gender nonconformity and psychiatric outcomes. Young MSM with childhood gender nonconformity may be disproportionately victimized by CSA thereby increasing their likelihood of developing psychiatric symptoms in adolescence. Early intervention addressing these factors may help reduce lifetime negative sequelae.
authors.affiliation: Division of Adolescent Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Hidalgo
authors.affiliation: Division of Adolescent Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kuhns
authors.affiliation: Division of Adolescent Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Soyang
authors.initials: S
authors.lastname: Kwon
authors.affiliation: IMPACT Program, Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Mustanski
authors.affiliation: Division of Adolescent Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Garofalo
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology; D005783:Gender Identity; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology; D055815:Young Adult
keywords: Childhood sexual abuse; Gender expression; PTSD; Psychopathology; Young MSM