Abstract
The mechanisms underlying sexual orientation differences in psychopathology originating in childhood remain understudied since sexual orientation does not directly manifest in childhood. This study tested whether childhood gender nonconformity and parental maltreatment before age 6 years 9 months partly explained sexual orientation disparities in the developmental trajectories of emotional and behavioral difficulties from age 6 years 9 months to 11 years 8 months. The Avon Longitudinal Study of Parents and Children was used (2182 boys and 2422 girls, Mage = 15.5, 90% White). After controlling for early life factors, non-heterosexual boys and girls displayed significantly greater emotional and behavioral difficulties than their heterosexual counterparts at all three ages. There was a sex difference in the mediating effects. For girls, sexual orientation disparities in childhood emotional and behavioral difficulties were partially explained by childhood gender nonconformity. For boys, sexual orientation disparities in childhood emotional and behavioral difficulties were partially explained by a path through greater childhood gender nonconformity, leading to increased risk of being the targets of parental maltreatment. Childhood gender nonconformity, parental maltreatment, and other early life factors only partially explain sexual orientation disparities in childhood emotional and behavioral difficulties. The mediating effects of childhood gender nonconformity and parental maltreatment on the association between sexual orientation and childhood emotional and behavioral difficulties differ between the sexes.
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References
Achenbach, T. M., Becker, A., Döpfner, M., Heiervang, E., Roessner, V., Steinhausen, H. C., & Rothenberger, A. (2008). Multicultural assessment of child and adolescent psychopathology with ASEBA and SDQ instruments: Research findings, applications, and future directions. Journal of Child Psychology and Psychiatry, 49(3), 251–275. https://doi.org/10.1111/j.1469-7610.2007.01867.x
Alley, J., & Diamond, L. M. (2021). Early childhood adversity and women’s sexual behavior: The role of sensitivity to sexual reward. Developmental Review, 61, 100982. https://doi.org/10.1016/j.dr.2021.100982
Bailey, J. M. (2020). The minority stress model deserves reconsideration, not just extension [Commentary]. Archives of Sexual Behavior, 49(7), 2265–2268. https://doi.org/10.1007/s10508-019-01606-9
Bailey, J. M., Vasey, P. L., Diamond, L. M., Breedlove, S. M., Vilain, E., & Epprecht, M. (2016). Sexual orientation, controversy, and science. Psychological Science in the Public Interest, 17(2), 45–101. https://doi.org/10.1177/1529100616637616
Bailey, J. M., & Zucker, K. J. (1995). Childhood sex-typed behavior and sexual orientation: A conceptual analysis and quantitative review. Developmental Psychology, 31(1), 43–55. https://doi.org/10.1037/0012-1649.31.1.43
Barnett, B. E., Hanna, B., & Parker, G. (1983). Life event scales for obstetric groups. Journal of Psychosomatic Research, 27(4), 313–320. https://doi.org/10.1016/0022-3999(83)90054-5
Blashill, A. J., Fox, K., Feinstein, B. A., Albright, C. A., & Calzo, J. P. (2021). Nonsuicidal self-injury, suicide ideation, and suicide attempts among sexual minority children. Journal of Consulting and Clinical Psychology, 89(2), 73–80. https://doi.org/10.1037/ccp0000624
Bos, H., de Haas, S., & Kuyper, L. (2019). Lesbian, gay, and bisexual adults: Childhood gender nonconformity, childhood trauma, and sexual victimization. Journal of Interpersonal Violence, 34(3), 496–515. https://doi.org/10.1177/0886260516641285
Boyd, A., Golding, J., Macleod, J., Lawlor, D. A., Fraser, A., Henderson, J., et al. (2013). Cohort Profile: The ’children of the 90s’-the index offspring of the Avon Longitudinal Study of Parents and Children. International Journal of Epidemiology, 42(1), 111–127. https://doi.org/10.1093/ije/dys064
Bränström, R., Hatzenbuehler, M. L., Tinghög, P., & Pachankis, J. E. (2018). Sexual orientation differences in outpatient psychiatric treatment and antidepressant usage: Evidence from a population-based study of siblings. European Journal of Epidemiology, 33(6), 591–599. https://doi.org/10.1007/s10654-018-0411-y
Brown, G. W., & Harris, T. (1978). Social origins of depression: A study of psychiatric disorder in women. Tavistock Press.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates.
Collishaw, S., Dunn, J., O’Connor, T. G., Golding, J., Avon Longitudinal Study of Parents and Children Study Team. (2007). Maternal childhood abuse and offspring adjustment over time. Development and Psychopathology, 19(2), 367–383. https://doi.org/10.1017/S0954579407070186
Diamond, L. M., & Alley, J. (2022). Rethinking minority stress: A social safety perspective on the health effects of stigma in sexually-diverse and gender-diverse populations. Neuroscience and Biobehavioral Reviews, 138, 104720. https://doi.org/10.1016/j.neubiorev.2022.104720
Donahue, K., Långström, N., Lundström, S., Lichtenstein, P., & Forsman, M. (2017). Familial factors, victimization, and psychological health among sexual minority adolescents in Sweden. American Journal of Public Health, 107(2), 322–328. https://doi.org/10.2105/AJPH.2016.303573
Elberling, H., Linneberg, A., Olsen, E. M., Goodman, R., & Skovgaard, A. M. (2010). The prevalence of SDQ-measured mental health problems at age 5–7 years and identification of predictors from birth to preschool age in a Danish birth cohort: The Copenhagen Child Cohort 2000. European Child & Adolescent Psychiatry, 19(9), 725–735. https://doi.org/10.1007/s00787-010-0110-z
Fiedler, K., Schott, M., & Meiser, T. (2011). What mediation analysis can (not) do. Journal of Experimental Social Psychology, 47(6), 1231–1236. https://doi.org/10.1016/j.jesp.2011.05.007
Fraser, A., Macdonald-Wallis, C., Tilling, K., Boyd, A., Golding, J., Davey Smith, G., et al. (2013). Cohort profile: the avon longitudinal study of parents and children: ALSPAC mothers cohort. International Journal of Epidemiology, 42(1), 97–110. https://doi.org/10.1093/ije/dys066
Frisell, T., Lichtenstein, P., Rahman, Q., & Långström, N. (2010). Psychiatric morbidity associated with same-sex sexual behaviour: Influence of minority stress and familial factors. Psychological Medicine, 40(2), 315–324. https://doi.org/10.1017/S0033291709005996
Frost, D. M., & Meyer, I. H. (2023). Minority stress theory: Application, critique, and continued relevance. Current Opinion in Psychology, 51, 101579. https://doi.org/10.1016/j.copsyc.2023.101579
Ganna, A., Verweij, K., Nivard, M. G., Maier, R., Wedow, R., Busch, A. S., et al. (2019). Large-scale GWAS reveals insights into the genetic architecture of same-sex sexual behavior. Science, 365(6456), eaat7693. https://doi.org/10.1126/science.aat7693
Golombok, S., & Rust, J. (1993). The measurement of gender role behaviour in pre-school children: A research note. Journal of Child Psychology and Psychiatry, 34(5), 805–811. https://doi.org/10.1111/j.1469-7610.1993.tb01072.x
Goodman, A., & Goodman, R. (2011). Population mean scores predict child mental disorder rates: Validating SDQ prevalence estimators in Britain. Journal of Child Psychology and Psychiatry, 52(1), 100–108. https://doi.org/10.1111/j.1469-7610.2010.02278.x
Goodman, A., Lamping, D. L., & Ploubidis, G. B. (2010). When to use broader internalising and externalising subscales instead of the hypothesised five subscales on the Strengths and Difficulties Questionnaire (SDQ): Data from British parents, teachers and children. Journal of Abnormal Child Psychology, 38(8), 1179–1191. https://doi.org/10.1007/s10802-010-9434-x
Hancock, G. R., & Lawrence, F. R. (2006). Using latent growth models to evaluate longitudinal change. In G. R. Hancock & R. O. Mueller (Eds.), Structural equation modeling: A second course (pp. 171–196). Green-wood.
Hatzenbuehler, M. L. (2009). How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychological Bulletin, 135(5), 707–730. https://doi.org/10.1037/a0016441
Honnor, M. J., Zubrick, S. R., & Stanley, F. J. (1994). The role of life events in different categories of preterm birth in a group of women with previous poor pregnancy outcome. European Journal of Epidemiology, 10(2), 181–188. https://doi.org/10.1007/BF01730368
Ibrahim, J. G., Chen, M. H., Lipsitz, S. R., & Herring, A. H. (2005). Missing-data methods for generalized linear models: A comparative review. Journal of the American Statistical Association, 100(469), 332–346. https://doi.org/10.1198/016214504000001844
Irish, M., Solmi, F., Mars, B., King, M., Lewis, G., Pearson, R. M., et al. (2019). Depression and self-harm from adolescence to young adulthood in sexual minorities compared with heterosexuals in the UK: A population-based cohort study. The Lancet. Child & Adolescent Health, 3(2), 91–98. https://doi.org/10.1016/S2352-4642(18)30343-
la Roi, C., Kretschmer, T., Dijkstra, J. K., Veenstra, R., & Oldehinkel, A. J. (2016). Disparities in depressive symptoms between heterosexual and lesbian, gay, and bisexual youth in a Dutch cohort: The TRAILS study. Journal of Youth and Adolescence, 45(3), 440–456. https://doi.org/10.1007/s10964-015-0403-0
Lee, T., & Shi, D. (2021). A comparison of full information maximum likelihood and multiple imputation in structural equation modeling with missing data. Psychological Methods, 26(4), 466–485. https://doi.org/10.1037/met0000381
Loso, H. M., Locke Dube, S., Chaarani, B., Ivanova, M., Garavan, H., Johns, M. M., & Potter, A. S. (2023). Associations between gender nonconformity, school environments, family conflict, and emotional and behavioral health among children ages 10–11. Journal of Adolescent Health, 72(6), 869–876. https://doi.org/10.1016/j.jadohealth.2023.02.008
MacMullin, L. N., Aitken, M., Nabbijohn, A. N., & VanderLaan, D. P. (2020). Self-harm and suicidality in gender-nonconforming children: A Canadian community-based parent-report study. Psychology of Sexual Orientation and Gender Diversity, 7(1), 76–90. https://doi.org/10.1037/sgd0000353
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674
Mittleman, J. (2019). Sexual minority bullying and mental health from early childhood through adolescence. Journal of Adolescent Health, 64(2), 172–178. https://doi.org/10.1016/j.jadohealth.2018.08.020
Northstone, K., Lewcock, M., Groom, A., Boyd, A., Macleod, J., Timpson, N., & Wells, N. (2019). The Avon Longitudinal Study of Parents and Children (ALSPAC): An update on the enrolled sample of index children in 2019. Wellcome Open Research, 4, 51. https://doi.org/10.12688/wellcomeopenres.15132.1
Oginni, O. A., Jern, P., Rahman, Q., & Rijsdijk, F. V. (2022). Do psychosocial factors mediate sexual minorities’ risky sexual behaviour? A twin study. Health Psychology, 41(1), 76–84. https://doi.org/10.1037/hea0001129
Oginni, O. A., Jern, P., & Rijsdijk, F. V. (2020). Mental health disparities mediating increased risky sexual behavior in sexual minorities: A twin approach. Archives of Sexual Behavior, 49(7), 2497–2510. https://doi.org/10.1007/s10508-020-01696-w
Oginni, O. A., Lim, K. X., Purves, K. L., Lu, Y., Johansson, A., Jern, P., & Rijsdijk, F. V. (2023a). Causal influences of same-sex attraction on psychological distress and risky sexual behaviors: Evidence for bidirectional effects. Archives of Sexual Behavior, 52(3), 1213–1228. https://doi.org/10.1007/s10508-022-02455-9
Oginni, O. A., Lim, K. X., Rahman, Q., Jern, P., Eley, T. C., & Rijsdijk, F. V. (2023b). Bidirectional causal associations between same-sex attraction and psychological distress: Testing moderation and mediation effects. Behavior Genetics, 53(2), 118–131. https://doi.org/10.1007/s10519-022-10130-x
O’Reilly, L. M., Pettersson, E., Donahue, K., Quinn, P. D., Klonsky, E. D., Lundström, S., et al. (2021). Sexual orientation and adolescent suicide attempt and self-harm: A co-twin control study. Journal of Child Psychology and Psychiatry, 62(7), 834–841. https://doi.org/10.1111/jcpp.13325
Pachankis, J. E., Clark, K. A., Klein, D. N., & Dougherty, L. R. (2022). Early timing and determinants of the sexual orientation disparity in internalizing psychopathology: A prospective cohort study from ages 3 to 15. Journal of Youth and Adolescence, 51(3), 458–470. https://doi.org/10.1007/s10964-021-01532-x
Pascoe, E. A., & Smart Richman, L. (2009). Perceived discrimination and health: A meta-analytic review. Psychological Bulletin, 135(4), 531–554. https://doi.org/10.1037/a0016059
Roberts, A. L., Rosario, M., Slopen, N., Calzo, J. P., & Austin, S. B. (2013). Childhood gender nonconformity, bullying victimization, and depressive symptoms across adolescence and early adulthood: An 11-year longitudinal study. Journal of the American Academy of Child & Adolescent Psychiatry, 52(2), 143–152. https://doi.org/10.1016/j.jaac.2012.11.006
Sandnabba, N. K., & Ahlberg, C. (1999). Parents’ attitudes and expectations about children’s cross-gender behavior. Sex Roles, 40(3–4), 249–263. https://doi.org/10.1023/A:1018851005631
Semlyen, J., King, M., Varney, J., & Hagger-Johnson, G. (2016). Sexual orientation and symptoms of common mental disorder or low wellbeing: Combined meta-analysis of 12 UK population health surveys. BMC Psychiatry, 16, 67. https://doi.org/10.1186/s12888-016-0767-z
Sidebotham, P. (2000). Patterns of child abuse in early childhood, a cohort study of the ‘Children of the Nineties.’ Child Abuse Review, 9(5), 311–320. https://doi.org/10.1002/1099-0852(200009/10)9:5%3c311::AID-CAR627%3e3.0.CO;2-U
Tanaka, K., Kon, N., Ohkawa, N., Yoshikawa, N., & Shimizu, T. (2009). Does breastfeeding in the neonatal period influence the cognitive function of very-low-birth-weight infants at 5 years of age? Brain & Development, 31(4), 288–293. https://doi.org/10.1016/j.braindev.2008.05.011
Thoemmes, F., MacKinnon, D. P., & Reiser, M. R. (2010). Power analysis for complex mediational designs using Monte Carlo methods. Structural Equation Modeling, 17(3), 510–534. https://doi.org/10.1080/10705511.2010.489379
Vittinghoff, E., & McCulloch, C. E. (2007). Relaxing the rule of ten events per variable in logistic and Cox regression. American Journal of Epidemiology, 165(6), 710–718. https://doi.org/10.1093/aje/kwk052
Wang, Y., Fu, C., & Wang, M. (2021). The additive and interactive effects of parental harsh discipline and boys’ gender-related traits on boys’ externalizing problem behaviors. Children and Youth Services Review, 122, 105908. https://doi.org/10.1016/j.childyouth.2020.105908
Warren, A.-S., Goldsmith, K. A., & Rimes, K. (2019). Childhood gender-typed behavior and emotional or peer problems: A prospective birth-cohort study. Journal of Child Psychology and Psychiatry, 60(8), 888–896. https://doi.org/10.1111/jcpp.13051
Xu, Y., Ma, Y., & Rahman, Q. (2023a). Comparing asexual with heterosexual, bisexual, and gay/lesbian individuals in common mental health problems: A multivariate meta-analysis. Clinical Psychology Review, 105, 102334. https://doi.org/10.1016/j.cpr.2023.102334
Xu, Y., Norton, S., & Rahman, Q. (2019). Early life conditions and adolescent sexual orientation: A prospective birth cohort study. Developmental Psychology, 55(6), 1226–1243. https://doi.org/10.1037/dev0000704
Xu, Y., Norton, S., & Rahman, Q. (2020). Childhood maltreatment, gender nonconformity, and adolescent sexual orientation: A prospective birth cohort study. Child Development, 91(4), e984–e994. https://doi.org/10.1111/cdev.13317
Xu, Y., Norton, S., & Rahman, Q. (2021). Childhood gender nonconformity and the stability of self-reported sexual orientation from adolescence to young adulthood in a birth cohort. Developmental Psychology, 57(4), 557–569. https://doi.org/10.1037/dev0001164
Xu, Y., & Rahman, Q. (2022). Sexual orientation disparities in the developmental trajectories of emotional and behavioral difficulties from childhood to early adolescence. Journal of Child Psychology and Psychiatry, 63(12), 1505–1512. https://doi.org/10.1111/jcpp.13603
Xu, Y., Rahman, Q., Hiyoshi, A., & Montgomery, S. (2023b). Same-sex marriage and common mental health diagnoses: A sibling comparison and adoption approach. Journal of Sex Research, 60(5), 585–595. https://doi.org/10.1080/00224499.2022.2120597
Yuan, Y., & MacKinnon, D. P. (2009). Bayesian mediation analysis. Psychological Methods, 14(4), 301–322. https://doi.org/10.1037/a0016972
Zietsch, B. P., Verweij, K. J., Heath, A. C., Madden, P. A., Martin, N. G., Nelson, E. C., & Lynskey, M. T. (2012). Do shared etiological factors contribute to the relationship between sexual orientation and depression? Psychological Medicine, 42(3), 521–532. https://doi.org/10.1017/S00332917110015
Acknowledgements
We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. ALSPAC data are available through the UK Data Service. The analytic code necessary to reproduce the analyses is available from the first author upon requested. The analyses presented here were not preregistered.
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The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and they will serve as guarantors for the contents of this paper. A comprehensive list of grants funding is available on the ALSPAC website (http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). This research was specifically funded by The Fundamental Research Funds for the Central Universities (Grant No.: YJ2021164).
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Xu, Y., Ma, Y. & Rahman, Q. Childhood Gender Nonconformity and Parental Maltreatment as Mediators of Sexual Orientation Disparities in Childhood Emotional and Behavioral Difficulties. Arch Sex Behav 53, 1777–1791 (2024). https://doi.org/10.1007/s10508-024-02825-5
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DOI: https://doi.org/10.1007/s10508-024-02825-5