(039) Social Support Significantly Mediates the Relationship Between Gender Role Nonconformity and Sexual Dysfunction
Authors: Irvin M , Sparpana A , Sullivan E , Parincu Z , Arnold M , Tural  , Collins K , Hoptman M , Iosifescu D 
Published: May 2023

Abstract

Introduction
Uncertainty remains about the psychological and sexual implications of gender role nonconformity (GRNC), generally defined as men endorsing or performing femininity, and women endorsing or performing masculinity. Previous studies have demonstrated that variance in gender presentation is associated with negative psychological consequences. Homophobic stigmatization and internalized homophobia partially mediate this association, suggesting it is not the practice of GRNC that causes distress, but internal or external reactions to it.

Objective
Here, we test the hypothesis that people reporting higher levels of GRNC will have more sexual dysfunction, and that social support will mediate this relationship.

Methods
We analyzed data from the Nathan Kline Institute Rockland Sample. The sample we selected includes 781 subjects (age= 48.99 ± 17.42, sex= 67% female). All subjects completed the Sex Role Identity Scale (SRIS) and the Trauma Symptom Checklist (TSC-40). GRNC was quantified by SRIS questions-subjective GRNC was assessed using the question “How feminine/masculine do you think you are?”, behavioral GRNC was assessed with “How feminine/masculine do you act or behave?”, and perceived GRNC with “How feminine/masculine do you think you appear and come across to others?” A composite variable was created to assess overall GRNC. Sexual dysfunction was measured with the relevant TSC-40 subscale. Because the distribution of GRNC scores were not normally distributed, we performed a quantile regression analysis using the quantreg and mediation packages in R to understand the mediation effect of social support on the relationship between GRNC and sexual dysfunction, while controlling for sex, age, sexual orientation, and socioeconomic status.

Results
In the quantile regression model, GRNC significantly predicted sexual dysfunction (β = 0.86, 95%CI [0.52, 1.20]) and social support significantly predicted sexual dysfunction (β = -3.63, 95%CI [-4.30, -2.42]). In the mediation analysis, there was a significant mediation effect of social support on the relationship between GRNC and sexual dysfunction (β = 0.17, 95%CI [0.04, 0.31], p&lt;0.001), controlling for sex, age, sexual orientation, and socioeconomic status. The mediation effect accounted for 16.56% (95%CI [0.05-0.28], p&lt;0.001) of the variance in sexual dysfunction.

Conclusions
GRNC significantly predicts sexual dysfunction, and social support significantly mediates this relationship, accounting for a substantial percentage of its variance. These results suggest that although GRNC can be associated with negative psychological and sexual consequences, the impacts are significantly mediated by the quality and strength of social relationships. This supports previous literature suggesting that negative reactions to nonconformity, both personal and systemic, may account for decreased well-being in people exhibiting GRNC. Although the findings are limited by the nature of secondary analyses, these results highlight the clinical significance of understanding GRNC to better treat patients with sexual dysfunction and promote healthy sexual functioning for all individuals.

Disclosure
No