Michelle M Johns, MPH, PhD Health Scientist Division of Adolescent and School Health CDC

Gender Nonconformity Strongly Associated With Substance Abuse Among Male Students

MedicalResearch.com Interview with:

Michelle M Johns, MPH, PhD Health Scientist Division of Adolescent and School Health CDC

Dr. Johns

Michelle M Johns, MPH, PhD
Health Scientist
Division of Adolescent and School Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Gender nonconformity is an under-researched area of adolescent health that is often linked to negative health outcomes. To address this gap, we analyzed Youth Risk Behavior Survey data to describe the associations between gender nonconformity and risk behaviors, including mental distress, and substance use.

Gender nonconformity was associated with feeling sad and hopeless, as well as suicidal thoughts and/or behaviors among female and male students. In addition, gender nonconformity was strongly associated with substance use among male students.

MedicalResearch.com: What should readers take away from your report?

Response: These findings suggest that developing support systems within schools and other school-based interventions such as safe spaces and supportive/knowledgeable staff for gender non-conforming students may be an important avenue to improving mental health and reducing substance use in this population.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Additional research is needed to better understand the links between gender norms, social stressors, and substance use behaviors across the spectrum of gender conformity. Also, given that transgender youth often have risk factors and experiences that overlap heavily with those of cisgender, gender nonconforming youth, it is important to investigate whether associations of mental distress and substance use with self- reported transgender identity are similar to our findings with gender-nonconforming youth.


Lowry R, Johns MM, Gordon AR, Austin SB, Robin LE, Kann LK. Nonconforming Gender Expression and Associated Mental Distress and Substance Use Among High School Students. JAMA Pediatr. Published online September 24, 2018. doi:10.1001/jamapediatrics.2018.2140 

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Last Updated on September 24, 2018 by Marie Benz MD FAAD