title: Gender expression associated with BMI in a prospective cohort study of US adolescents.
abstract: OBJECTIVE
  To examine the relationship between gender expression (GE) and BMI in adolescence.
  
  
  METHODS
  Repeated measures of weight-related behaviors and BMI were collected from 1996 to 2011 via annual/biennial self-report surveys from youth aged 10 to 23 years (6,693 females, 2,978 males) in the longitudinal Growing Up Today Study. GE (very conforming [referent], mostly conforming, nonconforming) was assessed in 2010/11. Sex-stratified, multivariable linear models estimated GE group differences in BMI and the contribution of sexual orientation and weight-related exposures to group differences. Models for males included interaction terms for GE with age.
  
  
  RESULTS
  In females, mostly conforming youth had 0.53 kg m(-2) and nonconforming had 1.23 kg m(-2) higher BMI; when adding adjustment for sexual orientation and weight-related exposures, GE group estimates were attenuated up to 8% and remained statistically significant. In males, mostly conforming youth had -0.67 kg m(-2) and nonconforming had -1.99 kg m(-2) lower BMI (age [in years]) interactions were between -0.09 and -0.14 kg m(-2) ; when adding adjustment for sexual orientation and weight-related exposures, GE group estimates were attenuated up to 11% and remained statistically significant.
  
  
  CONCLUSIONS
  GE is a strong independent predictor of BMI in adolescence. Obesity prevention and treatment interventions with youth must address ways that gender norms may reinforce or undermine healthful behaviors.
authors.affiliation: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.|Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.|Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
authors.forename: S
authors.initials: S
authors.lastname: Bryn Austin
authors.affiliation: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Najat J
authors.initials: NJ
authors.lastname: Ziyadeh
authors.affiliation: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Jerel P
authors.initials: JP
authors.lastname: Calzo
authors.affiliation: Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
authors.forename: Kendrin R
authors.initials: KR
authors.lastname: Sonneville
authors.affiliation: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Grace A
authors.initials: GA
authors.lastname: Kennedy
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Roberts
authors.affiliation: Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
authors.forename: Jess
authors.initials: J
authors.lastname: Haines
authors.affiliation: Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Scherer
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D005260:Female; D005783:Gender Identity; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000523:psychology; D011446:Prospective Studies; D057566:Self Report; D012725:Sexual Behavior / Q000502:physiology*; D014481:United States; D055815:Young Adult
references.citation: Annu Rev Psychol. 2009;60:549-76
references.pmid: 18652544
references.citation: J Nutr. 2009 Feb;139(2):323-8
references.pmid: 19091799
references.citation: NCHS Data Brief. 2014 Jul;(158):1-7
references.pmid: 25052533
references.citation: Obes Rev. 2008 Sep;9(5):474-88
references.pmid: 18331423
references.citation: Glob Public Health. 2010;5(5):539-53
references.pmid: 19513910
references.citation: Int J Eat Disord. 2008 Mar;41(2):124-33
references.pmid: 18008319
references.citation: Int Perspect Sex Reprod Health. 2015 Mar;41(1):31-42
references.pmid: 25856235
references.citation: BMC Public Health. 2014 Nov 26;14:1224
references.pmid: 25427573
references.citation: J Adolesc Health. 2014 Sep;55(3):373-9
references.pmid: 24746678
references.citation: Obesity (Silver Spring). 2009 Sep;17(9):1776-82
references.pmid: 19300430
references.citation: J Health Commun. 2015 Aug;20(8):869-78
references.pmid: 25950187
references.citation: Pediatrics. 2000 Jul;106(1 Pt 1):52-8
references.pmid: 10878149
references.citation: J LGBT Health Res. 2007;3(3):55-71
references.pmid: 19042905
references.citation: Int J Eat Disord. 2006 Dec;39(8):729-40
references.pmid: 16927386
references.citation: Sex Roles. 2010 Aug 1;63(3-4):264-276
references.pmid: 24077680
references.citation: Health Psychol. 2013 Jan;32(1):42-51
references.pmid: 23316852
references.citation: J Prim Prev. 2009 Jan;30(1):27-41
references.pmid: 19051035
references.citation: Int J Eat Disord. 2001 Apr;29(3):314-8
references.pmid: 11262511
references.citation: J Adolesc Health. 2003 Jan;32(1):66-72
references.pmid: 12507803
references.citation: Am J Public Health. 2013 Oct;103(10):1882-7
references.pmid: 23947324
references.citation: Am J Public Health. 2012 Aug;102(8):1587-93
references.pmid: 22698034
references.citation: Ann Behav Med. 2014 Feb;47(1):17-27
references.pmid: 24347406
references.citation: J Obes. 2014;2014:537242
references.pmid: 24872890
references.citation: J LGBT Health Res. 2007;3(1):55-65
references.pmid: 18029316
references.citation: J Res Adolesc. 2010 Jun;20(2):389-419
references.pmid: 22675240
references.citation: Ethn Dis. 2008 Autumn;18(4):496-504
references.pmid: 19157256
references.citation: Am J Prev Med. 2013 Jul;45(1):108-112
references.pmid: 23790995
references.citation: Int J Pediatr Obes. 2009;4(4):353-9
references.pmid: 19922052
references.citation: BMC Public Health. 2009 Aug 27;9:313
references.pmid: 19712443
references.citation: Am J Public Health. 2013 Feb;103(2):e16-22
references.pmid: 23237207
references.citation: Ann Epidemiol. 2007 Jan;17(1):44-50
references.pmid: 17140812