ArticlemedRxiv : the preprint server for health sciences2025
Association between bullying, state-level policy and mental health symptoms in gender diverse youth.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Importance: As the percentage of young people in the United States identifying as transgender and gender diverse increases, more youth face identity-linked social and structural stigma and discrimination. Little is known about the impact of stigma on psychotic-like experiences in gender diverse youth. Objective: To assess the impact of bullying victimization and state-level policies on psychotic-like experiences among gender diverse youth. Design: In this prospective cohort study, cross-sectional and longitudinal analyses were conducted using data collected between 2017-2022 across 17 states. Setting: The Adolescent Brain Cognitive Development (ABCD) Study is a U.S. population-based longitudinal study that follows and deeply phenotypes adolescents from the age of 9 to 18. Participants: Cross-sectional analyses included data from 9,112 participants (mean age=13 ± 0.6) collected between 2019 and 2022. Longitudinal analyses comprised 4,529 participants with data collected across 5 waves between 2017 and 2022. Exposures: Self-reported frequency of bullying victimization and data on annual state-level policies related to gender identity. Main Outcomes: Self-reported psychotic-like experiences and associated distress, measured by the Prodromal Questionnaire - Brief Child Version. Results: Based on a dimensional measure of gender, 689 adolescents were identified as most gender diverse (i.e., least congruent with birth-assigned sex) and 8,240 as least gender diverse (i.e., most congruent with birth-assigned sex). Rates of bullying victimization and psychotic-like experiences were significantly elevated in the most vs. least gender diverse group, with bullying partially mediating the difference in psychotic-like experiences (indirect effect = 0.11, p < 2×10 Conclusions: These findings indicate that bullying victimization and unsupportive legislation may explain greater and increasing rates of psychotic-like experiences in gender diverse youth.
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