Decrements in health-related quality of life associated with gender nonconformity among US adolescents and young adults

被引:32
作者
Gordon, Allegra R. [1 ,2 ]
Krieger, Nancy [3 ]
Okechukwu, Cassandra A. [3 ]
Haneuse, Sebastien [4 ]
Samnaliev, Mihail [5 ,6 ,7 ]
Charlton, Brittany M. [1 ,2 ]
Austin, S. Bryn [1 ,3 ,6 ,8 ]
机构
[1] Boston Childrens Hosp, Div Adolescent & Young Adult Med, 300 Longwood Ave,AU Box 17,BCH 3189, Boston, MA 02115 USA
[2] Harvard Med Sch, Dept Pediat, Boston, MA 02115 USA
[3] Harvard TH Chan Sch Publ Hlth, Dept Social & Behav Sci, Boston, MA USA
[4] Harvard TH Chan Sch Publ Hlth, Dept Biostat, Boston, MA USA
[5] Boston Childrens Hosp, Dept Clin Res Ctr, Boston, MA USA
[6] Harvard Med Sch, Boston, MA USA
[7] Boston Childrens Hosp, Div Gen Pediat, Dept Med, Boston, MA USA
[8] Brigham & Womens Hosp, Channing Div Network Med, 75 Francis St, Boston, MA 02115 USA
关键词
Masculinity; Femininity; Stigma; EQ5D; Gender nonconformity; Health-related quality of life; SEXUAL ORIENTATION; SUBSTANCE USE; RACIAL-DISCRIMINATION; SCHOOL VICTIMIZATION; DEPRESSIVE SYMPTOMS; TRANSGENDER YOUTH; ALCOHOL-USE; GAY; STRESS; EQ-5D;
D O I
10.1007/s11136-017-1545-1
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Gender nonconformity, that is, transgressing conventionally "masculine" vs. "feminine" characteristics, is often stigmatized. Stigmatization and discrimination are social stressors that raise risk of adverse mental and physical health outcomes and may drive health inequities. However, little is known about the relationship between such social stressors and health-related quality of life (HRQOL). This paper aimed to examine associations between perceived gender nonconformity and HRQOL in a cohort of U.S. adolescents and young adults. Using data from 8408 participants (18-31 years) in the U.S. Growing Up Today Study (93% white, 88% middle-to-high income), we estimated risk ratios (RRs) for the association of gender nonconformity (three levels: highly gender conforming, moderately conforming, and gender nonconforming) and HRQOL using the EuroQol questionnaire (EQ-5D-5L). Models were adjusted for demographic characteristics, including sexual orientation identity. Gender nonconformity was independently associated with increased risk of having problems with mobility [RR (95% confidence interval): 1.76 (1.16, 2.68)], usual activities [2.29 (1.67, 3.13)], pain or discomfort [1.59, (1.38, 1.83)], and anxiety or depression [1.72 (1.39, 2.13)], after adjusting for sexual orientation and demographic characteristics. Decrements in health utility by gender nonconformity were observed: compared to persons who were highly gender conforming, mean health utility was lower for the moderately gender conforming [beta (SE): -0.011 (.002)] and lowest for the most gender nonconforming [-0.034 (.005)]. In our study, HRQOL exhibited inequities by gender nonconformity. Future studies, including in more diverse populations, should measure the effect of gender-related harassment, discrimination, and violence victimization on health and HRQOL.
引用
收藏
页码:2129 / 2138
页数:10
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