New research suggests that gender nonconforming behaviors in early childhood may be a risk factor for the development of depressive symptoms in adolescence. The study has been published in the journal Sex Roles.

“I became interested in this topic thanks to Jennifer Birnkrant, who was a research assistant in our lab,” said study author David Bennett, a psychiatry professor at Drexel University College of Medicine.

“Just prior to beginning her doctoral studies, Jennifer was curious as to whether we had any data from one of our longitudinal studies that might be able to examine the relationship between gender nonconforming behavior and later adjustment.”

The researchers analyzed data from 125 adolescents and their mothers, who were participants in a longitudinal study on child adjustment. During the study, mothers rated the gender nonconforming behavior of their child at age 4 and 5, while the adolescents reported their own depressive symptoms at age 16 and 17.

After controlling for gender, environmental risks such as family life stress and household instability, prenatal substance exposure, and neonatal medical problems, the researchers found that gender nonconforming behavior was associated with an increased risk of depressive symptoms.

“Our findings indicate that children who exhibit gender nonconforming behaviors (e.g., boys playing with dolls, girls playing with trucks) in early childhood as rated by mothers appear to be at increased risk for depressive symptoms during adolescence,” Bennett told PsyPost.

It’s not the first time gender nonconformity has been linked to depression. A previous study of 6,082 high school students, published in JAMA Pediatrics in 2018, found that gender nonconformity was associated with mental distress.

Another study of 10,655 individuals found that gender nonconformity in childhood was a “strong predictor” of depressive symptoms across adolescence and early adulthood. That study, which was published in the Journal of the American Academy of Child and Adolescent Psychiatry in 2013, also found that elevated levels of physical and emotional bullying and abuse in children who were nonconforming accounted for much of the increased risk.

The findings from multiple studies indicate that “a consistent relationship between [gender nonconforming behavior] and depressive symptoms is beginning to emerge,” the researchers said.

“As such, children who exhibit gender nonconforming behaviors may benefit from having parents who are accepting of their behaviors and professionals (e.g., teachers and healthcare providers) who are both accepting and knowledgeable regarding how to facilitate healthy adjustment among youth who exhibit gender nonconforming behaviors,” Bennett told PsyPost

But the new study — like all research — includes some limitations.

“We used a single item to assess gender nonconforming behavior, whereas a more comprehensive measure of gender nonconforming behavior would be preferable. In addition, our sample was an urban, low socio-economic status group and further research is needed to see if these findings generalize to other groups of youth,” Bennett said.

“Research is also needed to better understand the mechanisms (e.g., parental rejection; stigma from peers) by which gender nonconforming behavior may lead to increased depressive symptoms for youth. In addition, research with a larger sample could better address whether gender nonconforming behavior is equally a risk factor for boys and girls.”

The study, “Does Gender Nonconforming Behavior in Early Childhood Predict Adolescents’ Depressive Symptoms?“, was authored by David S. Bennett, Eileen Borczon, and Michael Lewis.