Early expression of gambling disorder is more common among males than among fe­males. Individuals who begin gambling in youth often do so with family members or friends. The development of early-life gambling disorder appears to be associated with impulsivity and substance abuse. Many high school and college students who develop gambling disorder grow out of the disorder over time, although it remains a lifelong problem for some. Mid- and later-life onset of gambling disorder is more common among females than among males.