Capturing The Experiences Of Gender Non-Conforming Children Through The Minority Stress Model

Gender non-conforming (GNC) adolescents experience staggering rates of peer and family victimization and discrimination. Recent research suggests children who present as GNC are more likely to experience distress regardless of their gender identity (e.g. Wilson et al., 2017). Increased mental health issues experienced by GNC youth can be conceptualized using Ilan Meyer’s Minority Stress model (Meyer, 1995; Meyer, 2003). This model posits three major processes related to minority stress: (1) distal external and objective stressful conditions, (2) proximal the expectation of victimization or discrimination and (3) internalization of negative societal attitudes related to one’s minority status. Although minority stress has been examined in gender diverse adults and adolescents, there have not been studies investigating minority stress in GNC younger children. In this study we tested whether Meyer’s Minority Stress Model captures the experience of GNC children ages 10 to 12 in a large representative sample. A secondary aim of the study was to investigate if there were race and sex differences in the GNC minority stress model. We predicted that males and racial minorities would have higher minority stress and subsequently elevated mental health problems. Data was obtained from the National Institute of Mental Health data archive which includes Adolescent Brain Cognitive Development (ABCD) Study data from 21 sites across the U.S. Data used for this analysis was from the 2.0 release. For this analysis, we used data from a novel gender assessment completed at the year-1-follow-up visit (n=4,951; 48% female; Mage=11.004). MPlus mediation analyses were used to investigate the mediating role of school environment and family conflict on the relationship between gender non-conformity and mental health problems. A similar mediation analysis tested if feelings of worthlessness or inferiority (internal processes) mediated the relationship between gender non-conformity and mental health. Finally, a moderation model was used to test if proximal processes (the expectation others could not be trusted or wished harm) affected the relationship between gender non-conformity and mental health. We predicted distal, internal and proximal minority stress processes would affect mental health outcomes in 10 to 12-year-olds. In the distal model, school and family environment significantly mediated the relationship between gender presentation and mental health with more positive environments associated with reduced symptoms. In the internal processes model, feelings of worthlessness and inferiority mediated the relationship between GNC and total mental health problems. Expectation of rejection was not a significant predictor of mental health outcomes. There were no racial differences in any of the models. There were sex differences in the expectation of rejection model but not in the distal or internalization of society’s negative views models. Specifically, there was a significant interaction between the expectation of rejection variables and gender non-conformity for males but not for females. Our results indicate partial support for Meyer’s Model in GNC youth. This study has important clinical and policy implications suggesting areas for intervention to improve outcomes for GNC youth.