Compared to teens whose gender expression matches societal expectations, gender nonconforming adolescents may be more likely to experience mental health problems, a U.S. study suggests.

Four in five high school students in the study described themselves in terms that conformed with traditional gender expectations; they were either female students who said they were mostly feminine or male students who said they were mostly masculine.

About one in five students, however, described themselves as being either “moderately” gender nonconforming because they were either equally masculine and feminine, or “highly” gender nonconforming, because their gender self-expression didn’t match the gender they were assigned at birth.

“Our study found that gender nonconformity was associated with feeling sad and hopeless, as well as suicidal thoughts and/or behaviors,” said study co-author Michelle Johns, a scientist at the Division of Adolescent and School Health at the Centers for Disease Control and Prevention in Atlanta.

Gender nonconformity is increasingly also being tied to negative health outcomes, which may be related to stress from exposure to prejudice, discrimination, harassment and violence, researchers note. Less is known, however, about the ways that gender nonconformity may shape health in adolescence.

For the current study, researchers examined survey data collected from 6,082 high school students in three large urban districts — two in California and one in Florida. Overall, about one in five students described themselves as either equally masculine and feminine, as females who were more masculine, or as males who were more feminine.

Moderate gender nonconformity was associated with a higher likelihood of mental health problems. Compared to gender-conforming youngsters, the risk of feeling sad and hopeless was 22 percent higher for females who described themselves as masculine and 55 percent greater for males who described themselves as feminine, the study found.

Read the full article in Reuters Health online.

Source: Reuters Health | Gender Nonconforming Teens Face Higher Risk of Mental Distress, https://www.reuters.com/article/us-health-high-school-gender-expression/gender-nonconforming-teens-face-higher-risk-of-mental-distress-idUSKCN1M42IA | © 2018 Reuters. Last reviewed May 2026.

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