We tested the association between gender nonconformity and common mental health outcomes, including generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts using an exhaustive meta-analysis. PsycInfo, ProQuest Central, EBSCOhost, and PubMed were searched for eligible articles using either cross-sectional or longitudinal designs on 11th July 2024. A total number of 1975 articles were identified and selected following PRISMA. Twenty-five, 48, 32, seven, and nine studies were included on generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts, reaching a total sample size of 142,069, 188,681, 27,488, 47,523, and 25,573, respectively. Meta-analyses were performed using a random-effects model stratified by mental health outcomes. We found that higher levels of gender nonconformity were associated with higher levels of generalized anxiety ( = 0.06) and depressive symptoms ( = 0.11), lower levels of self-esteem ( = 0.18), and increased risk of self-harm ( = 0.17) and suicide attempts ( = 0.14). Gender nonconformity had stronger links to generalized anxiety symptoms, depressive symptoms, and self-esteem in men than in women. Behaviors-based gender nonconformity showed stronger links to depressive symptoms and self-esteem compared to traits-based gender nonconformity. The effect size for the association between gender nonconformity and depressive symptoms was significantly larger in adolescent samples than in childhood samples. There was no significant moderation by sexual orientation. While gender nonconformity is robustly associated with a range of common mental health problems, the magnitude of this association varies depending on the specific mental health outcomes considered and sex. Interventions to mitigate mental health differences and improve overall well-being among individuals who display greater gender nonconformity are needed.

中文翻译：

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性别不一致和常见的心理健康问题：荟萃分析


我们使用详尽的荟萃分析测试了性别不一致与常见心理健康结局之间的关联，包括广泛性焦虑症状、抑郁症状、自尊、自残企图和自杀未遂。2024 年 7 月 11 日，使用 PsycInfo、ProQuest Central、EBSCOhost 和 PubMed 检索了使用横断面或纵向设计搜索符合条件的文章。在 PRISMA 之后确定和选择了 1975 篇文章。纳入了 25 项、48 项、32 项、7 项和 9 项关于广泛性焦虑症状、抑郁症状、自尊、自残企图和自杀未遂的研究，总样本量分别为 142,069、188,681、27,488、47,523 和 25,573。使用按心理健康结果分层的随机效应模型进行荟萃分析。我们发现，较高水平的性别不一致与较高水平的广泛性焦虑 （ = 0.06） 和抑郁症状 （ = 0.11）、较低的自尊水平 （ = 0.18） 以及自残 （ = 0.17） 和自杀未遂的风险增加 （ = 0.14） 有关。与女性相比，男性的性别不一致与广泛性焦虑症状、抑郁症状和自尊的联系更强。与基于特征的性别不一致相比，基于行为的性别不一致与抑郁症状和自尊的联系更强。青少年样本中性别不一致与抑郁症状之间关联的效应量显著大于儿童样本。性取向没有显着的调节。 虽然性别不一致与一系列常见的心理健康问题密切相关，但这种关联的程度取决于所考虑的具体心理健康结果和性别。需要采取干预措施来减轻心理健康差异并改善性别不一致程度较高的个体的整体健康状况。