Gender-diverse youth report slightly elevated emotional sensitivity and interpersonal distress

A study of young people recruited across Europe found that gender-diverse individuals (that is, those identifying with genders not corresponding to their biological sex) tend to report somewhat elevated levels of negative affect, detachment, and borderline personality features compared to their gender-conforming peers (whose gender identity corresponds to their assigned sex). The paper was published in the Journal of Psychosexual Health.

In recent years, there has been a substantial rise in the number of adolescents and young adults reporting psychological distress related to gender identity, most often in the form of gender dysphoria. Gender dysphoria is a psychological condition where a person experiences distress due to a mismatch between their gender identity and their sex assigned at birth.

This distress can manifest emotionally, socially, and physically, often leading to significant discomfort. People with gender dysphoria feel that their body does not align with who they truly are. Symptoms include anxiety, depression, irritability, and withdrawal from social situations. Some individuals seek gender-affirming treatments, such as hormone therapy or surgery, to reduce their dysphoria.

Study authors Nils Konstantinovs and Petr Weiss set out to examine the relationship between gender identity and personality trait expression among adolescents and young adults. Specifically, they investigated whether individuals who identify as gender-diverse differ in maladaptive personality traits and borderline personality features compared to gender-conforming peers. They hypothesized that gender-diverse individuals would tend to report higher levels of these traits.

“As a clinician-researcher, my work is deeply rooted in my clinical practice. Having founded the first program for youth with gender-diverse identities in Latvia, I’ve been driven to provide evidence-based support for this population. Despite the rapid increase in gender-diverse youth and services, research on their specific challenges remains limited, motivating me to address this gap,” explained Konstantinovs, a researcher at Charles University and child and adolescent psychotherapist.

Study participants included 269 young people aged 14 to 26, recruited from community-based settings across Europe, including recreational youth centers and online platforms catering to gender-diverse youth.

Participants completed assessments of maladaptive personality traits (the Personality Inventory for DSM-5 – Brief Form), borderline personality features (the 11-item Borderline Personality Features Scale for Children), and gender dysphoria (the Utrecht Gender Dysphoria Scale). They also reported demographic information, including their gender identity and sex assigned at birth.

Maladaptive personality traits were assessed across five broad domains: negative affectivity, detachment, antagonism, disinhibition, and psychoticism. Negative affectivity reflects a tendency toward frequent and intense negative emotions. Detachment captures social withdrawal and reduced positive emotionality. Antagonism involves hostility, grandiosity, and manipulativeness. Disinhibition represents impulsivity, risk-taking, and irresponsibility. Psychoticism reflects eccentric behavior, cognitive-perceptual disturbances, and unusual beliefs. These traits describe personality patterns that can become maladaptive when extreme, although they are not themselves diagnostic of a personality disorder.

The results indicated that gender-diverse participants, on average, reported slightly to moderately higher levels of negative affect, detachment, and borderline personality features compared to their gender-conforming peers.

“We anticipated more significant elevations in borderline personality features, as suggested by prior studies and the known risks in this population,” Konstantinovs told PsyPost. “Surprisingly, while we observed slight elevations compared to cisgender peers, these did not reach clinical levels, suggesting less severe differences than expected.”

Younger participants—those aged 14 to 16—tended to report modestly higher levels of antagonism, disinhibition, psychoticism, borderline personality features, and gender dysphoria compared to older age groups. Participants with more pronounced gender dysphoria also tended to report higher levels of negative affect, detachment, and borderline features.

“The study found that gender-diverse youth exhibit modest elevations in certain personality traits, such as negative affect, detachment, and borderline features,” Konstantinovs said. “However, these differences are likely due to developmental and stress-related factors, such as societal stigma, rather than inherent psychopathology. With appropriate support and environments, gender-diverse youth may demonstrate resilience and personality development comparable to their cisgender peers.”

The study sheds light on the links between gender, viewed as a socially constructed characteristic, and various maladaptive psychological trait. However, it should be noted that the design of the study does not allow any causal inferences to be derived from these results. Additionally, all data used in the study were collected using self-report measures leaving room for reporting bias to have affected the results.

“The study relied on a self-referred community sample, and we did not assess participants’ diagnoses or prior treatments,” Konstantinovs noted. “Consequently, we cannot definitively determine whether the observed elevations stem from stress, stigma, or intrinsic psychological factors. Further research is needed to clarify these causes and identify optimal support strategies. My long-term goal is to enhance care for gender-diverse youth by developing evidence-based strategies informed by longitudinal data on their real-world outcomes.”

The paper, “Examining the Relationship Between Personality Traits and Gender Dysphoria in Adolescents and Young Adults,” was authored by Nils Konstantinovs and Petr Weiss.