title: Gender Conformity and Use of Laxatives and Muscle-Building Products in Adolescents and Young Adults.
abstract: Use of laxatives for weight loss and drugs or supplements to build muscle (eg, steroids) differs by gender and sexual orientation; little is known about factors contributing to these disparities. Conformity to gender norms concerning appearance could underlie these differences.
  
  
  
  This study examined associations between childhood gender conformity and laxative and muscle-building product use from ages 13 to 25 years in a sample of 13 683 males and females in the US prospective Growing Up Today Study. Adjusted multivariable logistic regression models of repeated measures estimated odds of past-year laxative and muscle-building product use by quartiles of greater childhood gender conformity in heterosexual and sexual minority (eg, bisexual, gay) participants.
  
  
  
  By age 23 years, ∼20% of sexual minority females reported past-year laxative use. By age 19 years, 12% of all males reported past-year muscle-building product use. Sexual minority females had twice the odds of heterosexual females of using laxatives (P < .0001). The most gender-conforming females had 50% greater odds than the least-conforming females of using laxatives (P < .01). Moderate (odds ratio, 2.09; 95% confidence interval, 1.58-2.75) and highly (odds ratio, 1.79; 95% confidence interval, 1.38-2.33) gender-conforming males had higher odds than gender-nonconforming males of using muscle-building products.
  
  
  
  Sexual minority females are at high risk for laxative abuse. Regardless of sexual orientation, gender conformity increased the odds of laxative abuse among females and muscle-building product use among males. Findings can inform prevention efforts to target youth at risk for laxative or muscle-building product use.
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; jerel.calzo@childrens.harvard.edu.
authors.forename: Jerel P
authors.initials: JP
authors.lastname: Calzo
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan;
authors.forename: Kendrin R
authors.initials: KR
authors.lastname: Sonneville
authors.affiliation: Department of Data Science, Geisel School of Medicine, Dartmouth University, Hanover, New Hampshire;
authors.forename: Emily A
authors.initials: EA
authors.lastname: Scherer
authors.affiliation: Department of Psychology, Smith College, Northampton, Massachusetts;
authors.forename: Benita
authors.initials: B
authors.lastname: Jackson
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; and Channing Division of Network Medicine, The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: S Bryn
authors.initials: SB
authors.lastname: Austin
mesh_terms: D000293:Adolescent; D000328:Adult; D045930:Anabolic Agents; D001828:Body Image / Q000523:psychology; D002648:Child; D005260:Female; D005783:Gender Identity; D006801:Humans; D054368:Laxatives; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011581:Psychological Tests; D012189:Retrospective Studies; D057566:Self Report; D019529:Sexuality / Q000523:psychology*; D012925:Social Conformity; D066262:Social Norms; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D045930:Anabolic Agents; D054368:Laxatives