Behavioral and Emotional Problems in Gender-Nonconforming Children: A Canadian Community-Based Study

Anna I. R. van der Miesen, A. Natisha Nabbijohn, Alanna Santarossa, Doug P. VanderLaan

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: To examine childhood gender nonconformity (GNC) and psychological well-being in a community-based sample using measures that bridge clinical and nonclinical literature. Method: Caregivers reported on the GNC (Gender Identity Questionnaire for Children [GIQC]) and behavioral and emotional problems (Child Behavior Checklist [CBCL]) of their children aged 6 to 12 years (N = 1719, 48.8% boys). The GIQC was compared to the commonly used single-item proxy, CBCL Item 110 (“wishes to be of the opposite sex”). Results: Using the GIQC, 2.3% of boys and 2.8% of girls showed GNC levels comparable to those of children referred clinically for gender dysphoria (GD). Item 110 was endorsed for 1.7% of boys and 1.8% of girls. These measures corresponded, but Item 110 endorsement was biased toward more extreme GNC. Among boys, increased GNC on the GIQC, but not Item 110, corresponded with increased clinical-range CBCL problems. Among girls, Item 110 endorsement was associated with increased clinical-range Externalizing problems, whereas the GIQC indicated that intermediate gender expression was associated with fewer externalizing problems. Overall, rates of clinical-range CBCL problems among GNC children were consistent with those reported for GD-referred children. Conclusion: The scope of mental health risk among community children who exhibit GNC is likely considerably greater than previously recognized. A substantial minority of community children show GNC and mental health risk levels comparable to those seen among GD-referred children. Also, compared to the GIQC, a more comprehensive GNC measure, CBCL Item 110 is likely useful only for detecting extreme manifestations of GNC, which may affect associations with mental health.
Original languageEnglish
Pages (from-to)491-499
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume57
Issue number7
DOIs
Publication statusPublished - 2018

Cite this

@article{683b170b203d4107b4fc1791fa90b426,
title = "Behavioral and Emotional Problems in Gender-Nonconforming Children: A Canadian Community-Based Study",
abstract = "Objective: To examine childhood gender nonconformity (GNC) and psychological well-being in a community-based sample using measures that bridge clinical and nonclinical literature. Method: Caregivers reported on the GNC (Gender Identity Questionnaire for Children [GIQC]) and behavioral and emotional problems (Child Behavior Checklist [CBCL]) of their children aged 6 to 12 years (N = 1719, 48.8{\%} boys). The GIQC was compared to the commonly used single-item proxy, CBCL Item 110 (“wishes to be of the opposite sex”). Results: Using the GIQC, 2.3{\%} of boys and 2.8{\%} of girls showed GNC levels comparable to those of children referred clinically for gender dysphoria (GD). Item 110 was endorsed for 1.7{\%} of boys and 1.8{\%} of girls. These measures corresponded, but Item 110 endorsement was biased toward more extreme GNC. Among boys, increased GNC on the GIQC, but not Item 110, corresponded with increased clinical-range CBCL problems. Among girls, Item 110 endorsement was associated with increased clinical-range Externalizing problems, whereas the GIQC indicated that intermediate gender expression was associated with fewer externalizing problems. Overall, rates of clinical-range CBCL problems among GNC children were consistent with those reported for GD-referred children. Conclusion: The scope of mental health risk among community children who exhibit GNC is likely considerably greater than previously recognized. A substantial minority of community children show GNC and mental health risk levels comparable to those seen among GD-referred children. Also, compared to the GIQC, a more comprehensive GNC measure, CBCL Item 110 is likely useful only for detecting extreme manifestations of GNC, which may affect associations with mental health.",
author = "{van der Miesen}, {Anna I. R.} and Nabbijohn, {A. Natisha} and Alanna Santarossa and VanderLaan, {Doug P.}",
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Behavioral and Emotional Problems in Gender-Nonconforming Children: A Canadian Community-Based Study. / van der Miesen, Anna I. R.; Nabbijohn, A. Natisha; Santarossa, Alanna; VanderLaan, Doug P.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 57, No. 7, 2018, p. 491-499.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Behavioral and Emotional Problems in Gender-Nonconforming Children: A Canadian Community-Based Study

AU - van der Miesen, Anna I. R.

AU - Nabbijohn, A. Natisha

AU - Santarossa, Alanna

AU - VanderLaan, Doug P.

PY - 2018

Y1 - 2018

N2 - Objective: To examine childhood gender nonconformity (GNC) and psychological well-being in a community-based sample using measures that bridge clinical and nonclinical literature. Method: Caregivers reported on the GNC (Gender Identity Questionnaire for Children [GIQC]) and behavioral and emotional problems (Child Behavior Checklist [CBCL]) of their children aged 6 to 12 years (N = 1719, 48.8% boys). The GIQC was compared to the commonly used single-item proxy, CBCL Item 110 (“wishes to be of the opposite sex”). Results: Using the GIQC, 2.3% of boys and 2.8% of girls showed GNC levels comparable to those of children referred clinically for gender dysphoria (GD). Item 110 was endorsed for 1.7% of boys and 1.8% of girls. These measures corresponded, but Item 110 endorsement was biased toward more extreme GNC. Among boys, increased GNC on the GIQC, but not Item 110, corresponded with increased clinical-range CBCL problems. Among girls, Item 110 endorsement was associated with increased clinical-range Externalizing problems, whereas the GIQC indicated that intermediate gender expression was associated with fewer externalizing problems. Overall, rates of clinical-range CBCL problems among GNC children were consistent with those reported for GD-referred children. Conclusion: The scope of mental health risk among community children who exhibit GNC is likely considerably greater than previously recognized. A substantial minority of community children show GNC and mental health risk levels comparable to those seen among GD-referred children. Also, compared to the GIQC, a more comprehensive GNC measure, CBCL Item 110 is likely useful only for detecting extreme manifestations of GNC, which may affect associations with mental health.

AB - Objective: To examine childhood gender nonconformity (GNC) and psychological well-being in a community-based sample using measures that bridge clinical and nonclinical literature. Method: Caregivers reported on the GNC (Gender Identity Questionnaire for Children [GIQC]) and behavioral and emotional problems (Child Behavior Checklist [CBCL]) of their children aged 6 to 12 years (N = 1719, 48.8% boys). The GIQC was compared to the commonly used single-item proxy, CBCL Item 110 (“wishes to be of the opposite sex”). Results: Using the GIQC, 2.3% of boys and 2.8% of girls showed GNC levels comparable to those of children referred clinically for gender dysphoria (GD). Item 110 was endorsed for 1.7% of boys and 1.8% of girls. These measures corresponded, but Item 110 endorsement was biased toward more extreme GNC. Among boys, increased GNC on the GIQC, but not Item 110, corresponded with increased clinical-range CBCL problems. Among girls, Item 110 endorsement was associated with increased clinical-range Externalizing problems, whereas the GIQC indicated that intermediate gender expression was associated with fewer externalizing problems. Overall, rates of clinical-range CBCL problems among GNC children were consistent with those reported for GD-referred children. Conclusion: The scope of mental health risk among community children who exhibit GNC is likely considerably greater than previously recognized. A substantial minority of community children show GNC and mental health risk levels comparable to those seen among GD-referred children. Also, compared to the GIQC, a more comprehensive GNC measure, CBCL Item 110 is likely useful only for detecting extreme manifestations of GNC, which may affect associations with mental health.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/29960694

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JO - Journal of the American Academy of Child and Adolescent Psychiatry

JF - Journal of the American Academy of Child and Adolescent Psychiatry

SN - 0890-8567

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