Arch Sex Behav (2006) 35:685–697 DOI 10.



Gender Nonconformity and Psychological Distress in Lesbians and Gay Men
W. Christopher Skidmore · Joan A. W. Linsenmeier · J. Michael Bailey

Received: 23 December 2005 / Revised: 10 July 2006 / Accepted: 28 July 2006 / Published online: 16 November 2006 C Springer Science+Business Media, LLC 2006

Abstract Some lesbians and gay men tend to be more gender nonconforming, on average and for certain traits, than their heterosexual counterparts. Gender nonconformity in childhood has also been linked to adult homosexuality. Studies of both lesbians and gay men also find elevated rates of psychological distress. We hypothesized that these facts may be related. Individuals who violate social norms for genderappropriate behavior may suffer from stigmatization by both heterosexual and homosexual people, leading to higher levels of psychological distress. We examined whether several measures of gender nonconformity were related to psychological distress in a community-based sample of gay men and lesbians. These included self-reports of childhood and adulthood gender nonconformity, as well as observer ratings of current behavior. Several measures of gender nonconformity were related to each other for both lesbians and gay men. In addition, gender nonconformity was related to psychological distress, but only for gay men. Finally, both lesbian and gay male participants reported more positive attitudes towards gender conformity than nonconformity, although the pattern was somewhat different for each group. We discuss the implications of these results for future studies of gender nonconformity and for the promotion of psychological health in lesbians and gay men. Keywords Gender nonconformity . Homosexuality . Psychological distress . Depression . Stigmatization
W. C. Skidmore ( ) · J. A. W. Linsenmeier · J. M. Bailey Department of Psychology, Northwestern University, Swift Hall 102, 2029 Sheridan Road, Evanston, Illinois 60208-2710, USA e-mail:

Introduction On average and in certain respects, homosexual adults tend to be more gender nonconforming, or sex-atypical, than their heterosexual peers. For example, some lesbians and gay men report occupational and hobby interests that are more typical of the opposite sex (Lippa, 2000, 2002; Pillard, 1991). They also show more gender nonconformity in traits such as voice, movement, and appearance (Ambady, Hallahan, & Conner, 1999; Bailey, 2003). Homosexual people also tend to have been more gender nonconforming as children. The typical playstyles and behavior of girls and boys differ in important ways. For example, young girls often play with dolls and act out family roles, while boys tend to engage more in rough-and-tumble play that emphasizes themes of dominance and competition (Maccoby, 1998). Thus, childhood gender nonconformity consists of behaviors such as rough-and-tumble play in girls or a preference for playing with dolls in boys. In a meta-analysis of studies on this topic, Bailey and Zucker (1995) found that homosexual adults on average reported more childhood gender nonconformity than heterosexual adults. These findings have been replicated across cultural groups (Lippa & Tan, 2001; Whitam, 1983; Whitam & Mathy, 1986, 1991). In addition, prospective studies have confirmed that very feminine boys tend to become gay men (Green, 1974, 1987; Zucker, 1990), and recent evidence suggests that very masculine girls also tend to become lesbians at higher-than-expected rates (Drummond, 2006). Although gender nonconformity and sexual orientation appear to be related, not all lesbians and gay men are gender nonconforming. For example, not all gay men report that they were feminine boys (Bailey & Zucker, 1995). Also, some researchers argue that the majority of gay men, even those who were very feminine boys, defeminize as they

& Schnabel. & Underwood. 1993. increasing their visibility as targets for victimization. 1995. Mickelson. & Hammersmith. Cohen. Lebson. even the vicarious experience of victimization or the anticipation of negative social reactions may cause significant stress and mental health problems for some lesbians and gay men (Balsam et al. sexual orientation has been linked to measures of psychological distress (Cochran & Mays.. Herek & Berrill. even at young ages (de Graaf. 2003). & Beautrais. 2005). Furthermore. Friedman & Downey. 1983a. Whitley. Savin-Williams. 1997. Gillis. 1995. and some lesbian and gay adolescents may monitor and modify cues of gender nonconformity in order to hide or reveal their sexual orientation (Lasser & Tharinger. 1992). mood. The National Comorbidity Survey also found support for the association between a homosexual sexual orientation and increased risk for anxiety. 1992. Sandfort. Paul et al.. heterosexual people do tend to expect lesbians to be masculine and gay men to be feminine (Haddock. 1980. 2000b. Fergusson. 2005. 1999). 326). 1992. 2005.. Laner & Laner. Meyer. 1990. & Williams. 1985).686 Arch Sex Behav (2006) 35:685–697 reach adulthood. Rates of threatened physical violence in such studies range from 24% to 48%. 1979. Sexual orientation and psychological distress In addition to its relationship with gender nonconformity. is complex and not yet fully understood. Zucker (1994) suggested that particularly gender nonconforming individuals may be most at risk for stigmatization. many investigations find that a higher percentage of gay men than lesbians experience such verbal abuse (Berrill. Nemeroff. Resnick. stigmatization appears to have significant affective.. 1999). Bijl. sex differences in victimization of lesbians versus gay men may depend partially on the type of victimization measured.g. Most relevant here. rejection. and suicidal behavior compared with heterosexual men (Bancroft. These include direct experiences of victimization and rejection. & Blum. & Vukadinovic. Thus. Mays & Cochran. Saghir & Robins. 1999. 2001). 1978. 2001). and hate crimes despite (and perhaps because of) increased visibility in recent decades (Herek. Storms. Rothblum. Kim. gender nonconforming people may be ostracized simply for violating gender norms. but some studies including lesbian samples have yielded similar results (Fergusson et al. In fact. although documented in many studies. Story. 1998. Other studies have supported the link between homosexual orientation and suicidality. 1995. however. typically demonstrating a similar gender difference (Berrill. Page & Yee. 1991.. Taywaditep. 2001. Hills. Gender nonconformity and psychological distress As members of a stigmatized minority group. Gilman et al. 1991. 1994). 2004.. 2001).. cognitive. over and above any implication that they are more likely to be homosexual (Herek. primarily as a reaction to persistent social pressure (Bell. discrimination. 2001. 1998). p. 2001). possibly due to greater rates of childhood sexual abuse and adult sexual assault (Balsam. 2001. & Esses. 1999. several large national surveys of adult lesbians and gay men in the United States have documented lifetime rates of sexuality-based verbal harassment ranging from 52% to 91%. Moreover. Gottlieb.. 1997. which can serve as a buffer against the negative consequences of stressful experiences (e. & Davis.. Wills. Remafedi. 1990. 2001. 1995. French. 2002. & ten Have. 2003). and substance abuse disorders as defined by DSM-III-R criteria.. Gender nonconforming homosexual individuals may more often be labeled as lesbian or gay. 1973. 2000a. However. Martin. Bartholomew. identifying the causes and correlates of psychological distress in homosexual samples remains an important area of study. Studies have found that gay men have increased rates of depression. Helgeson. 1983b. 1977). 1987. the relationship between gender nonconformity and sexual orientation. Weinberg. Horwood. Kessler. & Perlman.g. Janssen. 1981. Bailey & Zucker. Oram. Sandfort. & Cogan. 2006. which may reinforce their stigmatized status further. Zanna. Kite & Deaux. 2003. Gender nonconformity may partly mediate the relationship between sexual orientation and psychological distress. Thus. Meyer. Landolt. King & Bartlett. and behavioral consequences for lesbians and gay men (Mays & Cochran. de Graaf. Thus. political intolerance. Ross. & Beauchaine. Herek. 2003. anxiety disorders. Whitam. Finally. 2000. 1999. Madon. Sandfort et al. victimization. 2003. Negative attitudes toward lesbians and gay men may be related to decreased social support. Sandfort et al. & Linsenmeier. in terms of higher rates of suicidal ideation and completed suicides. Strong. 1999. Springer . 1992). Russell & Joyner. Hershberger & D’Augelli. Saffrey. as well as increased risk for suicidal thoughts and plans (Gilman et al. homosexual individuals generally are raised in what has been called a “culture of bias” (Friedman & Downey. Paul et al. other investigations have found that lesbians experience more lifetime victimization than gay men. Fergusson et al. many lesbians and gay men report sex-typical behavior and interests (Bailey. Studies in this area have typically focused more on the mental health of gay men. Aside from specific instances of victimization. Research suggests that discrimination based on minority group membership can increase risk for psychological distress through a variety of processes (Huebner. 2002. 2001). 1999. Laner & Laner. 2002). even more subtle perceptions of discrimination may be related to increased psychological distress (e. For example.. Harry. 2006). some lesbians and gay men may experience verbal and physical abuse.

For example. 2003. 2006. Bradley. 1983b. Yunger. Beard & Bakeman. 1998). 1978. Next.. Grant. Tomsen. particularly feminine boys. Laner. may suffer ridicule and rejection by peers and parents early in childhood (Bailey. 2004. 2000. some evidence suggests that. 2000. gender nonconformity in men may be interpreted as weakness (Haddock & Zanna. We hypothesized that gender nonconformity would be positively correlated with psychological distress. & McCutchan. & Perry. Furthermore. studies of lesbians do not reliably find similar associations (e. Bell & Weinberg. Saghir & Robins.. Zucker. For example. 2005. 1980). & Sproule. 2001. 2002) described a complex process whereby stigmatization of childhood gender nonconformity may become linked to adult psychological distress for some gay men.” while girls do not have to go through as rigorous a process of other-gender devaluation to be acceptably feminine. If gender nonconforming lesbians and gay men are subject to greater stigmatization. Robinson. For example. Maccoby. although adult gender nonconformity may be linked to negative treatment for gay men. Theodore & Basow. Atkinson. Taywaditep. and suicidality (Harry.g. 327). Bailey and Zucker (1995) reviewed several studies finding an association between childhood gender nonconformity and adult psychological distress in gay men. 1998. 1977. may become internalized and tied to their homosexual identity. on average. Non-clinic populations may face similar problems (Carver. at least for gay men. Egan & Perry. & Tolman. Similarly. 1998. Smith & Leaper. Jacobson.g. They argued that gay men are especially likely to experience. parents (especially fathers) tend to be more concerned about gender nonconformity in their sons than in their daughters (Fagot. 1983a. The current research measured the relationships among several aspects of gender nonconformity and psychological distress in a sample of lesbians and gay men. In addition to assessing recollections of gender nonconformity in childhood. & Perry. 1997. Fagot. Young boys reject other boys who act in feminine ways. we examined relationships between measures of gender nonconformity and psychological distress. Owen. lesbians and gay men themselves have negative attitudes towards gender nonconformity. & Stern. In contrast. 1992. 2003. Springer . Kettlewell. 1983b).. 1997). & Sanikhani. Gender nonconformity may also be associated with increased risk for suicide attempts in gay adolescents (Remafedi. stigmatization of childhood gender nonconformity. Weinrich. In addition to heterosexuals’ negative attitudes towards gender nonconformity. This stigmatization of their femininity. 1990. particularly in gay men. Carter & McCloskey. Yunger.Arch Sex Behav (2006) 35:685–697 687 1987). Oliver & Toner. Zucker. Friedman and Downey (1999. Gender nonconforming children. experience greater psychological distress than gender conforming homosexual people. Bradley. Wilson-Smith. 2004. Landolt et al. Maccoby (1998) further noted that an essential element in boys becoming acceptably “masculine” appears to be becoming “not feminine. 2001. we also measured participants’ current occupational and hobby interests and the degree to which they thought of themselves as relatively feminine or masculine. 1997. Weinrich. Kaijser. 1976. Maccoby. Kurita. Egan. Laner & Laner. & Zucker.. In addition. 2003. Negative attitudes within lesbian and gay communities may contribute additional problems for gender nonconforming women and men (Bailey et al. 1983. 2002). and to be negatively affected by. & Grant. Thornton & Leo. 1995. Fridell. we hypothesized that lesbians and gay men in our sample would report negative attitudes towards gender nonconformity. Landolt et al. causing some to develop internalized homophobia with an additional element of “gender-values self-condemnation” (Friedman & Downey. Beard & Bakeman. several studies of the personals ads of lesbians and gay men have suggested that they prefer sex-typical romantic partners (Bailey et al. Stigmatization of gender nonconformity also occurs at other developmental stages. This discrepancy in tolerance of gender nonconformity in girls versus boys may continue into adulthood. 1995). Psychological problems in adulthood associated with recalled childhood gender nonconformity include lower self-esteem. They further argued that a similar process does not happen for gender nonconforming heterosexual men. 1977. most often by other males. 1992. The rejection that many lesbians and gay men may have faced as children because of their gender nonconformity could plausibly affect their development in important ways (e. & Perry. as a consequence. Green. Kane. p. 2006. they may.. We examined correlations among the various measures of gender nonconformity. Carver. Schooler. 1995). 2000. Carver. 1985). Similarly. but girls are generally accepting of other girls’ tomboyish behavior.. For example. 1979. A general asymmetry in the strength of gender boundaries for girls versus boys may contribute to these findings. we collected observer ratings of participants’ degree of gender nonconformity based on a brief videotaped interview. Wong. at least some aspects of more typically masculine behaviors or interests may actually benefit women (Impett. Bailey and Zucker (1995) suggested that this pattern might be due to greater mistreatment of feminine boys by parents and peers. extremely feminine boys referred to clinics for treatment of gender identity issues have been found to exhibit significant difficulties with peer relationships and rejection (Cohen-Kettenis. 1999. Green. 1999). McCutchan. Friedman & Downey. higher rates of mood and anxiety disturbances. 2004). 2001). 1978. Some evidence does support the hypothesis that gender nonconformity may be associated with increased risk for psychological problems. Harry. 2004). 1973. 1999. Laner & Kamel. 1987. 1995.

79 for men. Each rater watched all clips of participants of one gender and then all clips of participants of the other gender.0001) and gay men (r = . but we also advertised in a free local newspaper available throughout the city and on an internet website listing local classifieds and advertisements. Two female undergraduates and one male undergraduate served as raters. Lippa & Connelly.1 percent Hispanic.” and the version for men included statements such as. and 4 percent reported an “other” ethnic group membership. Coefficient alphas for the Occupational Preferences scale in this sample were . 1997) was used to assess the degree of gender nonconformity of participants’ recalled childhood behavior. p < .” Coefficient alphas for the CGIS in this sample were . Before rating actual study data. the “Bayesian probability that an individual is predicted to be male or female based on some set of genderrelated indicators” (Lippa & Connolly. “I am much less masculine than the average lesbian. and 7. Participants reported on educational level on the following scale: “1 = no high school.” and “I was a feminine boy. 2. Bailey. Clips from popular media and from previous studies were used. respectively. 31 percent African American. 5 = strongly like).77. “As a child. were placed in Chicago area newspapers.” using a 5-point scale (1 = strongly dislike.1 percent reported an “other” ethnic group membership. p < . 2 = some high school.” and “I was a masculine girl.4 percent were Caucasian. 1990. 7. I was called a tomboy by my peers. Some publications targeted gay. such as “going to car shows” and “romance novels. each rater underwent a brief training period in which he or she rated sample videos of women and men separately. 2 percent Asian. I was called a ‘sissy’ by my peers. There were two versions (one for men and one for women). and/or transsexual populations. responses to the two scales were standardized and added to form an “interests” composite variable.90 for women and . 5 = strongly agree). After each rater had rated all of the training clips. I feel more similar to women than to men.. Mean ages for female and male participants were 31 (SD = 9. bisexual.0) years.. Measures Gender nonconformity Participants completed three measures of self-reported gender nonconformity.94 for men. Participants rated how much they liked or disliked various occupations. 5 = college graduate. Participants also reported on their relationship status. 30 percent African American.688 Arch Sex Behav (2006) 35:685–697 Method Participants A total of 44 lesbians and 50 gay men were recruited using advertisements in Chicago community publications. These scales have been used in previous research to measure gender diagnosticity.5% of women and 25% of men reported currently being in a serious relationship. Blackwelder. The first two Springer were the Occupational Preferences and Hobby Preferences questionnaires (e.61. The occupations and hobbies included in these questionnaires have been found to be generally more appealing either to women or to men in contemporary American society. “As a child. and 7 = graduate degree. The version for women included statements such as.84 for men.0001).g. Summed responses on the two scales were highly correlated for both lesbians (r = .79 for women and . Using a . 1998). The 10-item Continuous Gender Identity Scale (CGIS. respectively. 1998) was used to measure several aspects of participants’ subjective assessments of their current masculinity or femininity. As a result.” and “college graduate” for women and men.” and the version for men included items such as. one for women and one for men. 52 percent were Caucasian.87 for men. they discussed them as a group. a group of raters made observer ratings of gender nonconformity for participants who agreed to an optional videotaped interview at the beginning of the session. 52. “In many ways. Participants also completed three measures designed to assess current levels of gender nonconformity. which was used in subsequent analyses.” with the promise of compensation. of the gay men. & Bailey. Responses were summed with higher scores indicating more gender nonconformity. Separate advertisements requesting lesbians and gay men for “a study about masculinity and femininity. and participants rated their agreement with items on a 5-point scale (1 = strongly disagree.” Coefficient alphas for the CGNS in this sample were .3) and 35 (SD = 9. Bailey & Oberschneider. 77. There were two versions.” and various hobbies.92 for women and . lesbian. such as “football player” and “librarian. 6 = some postgraduate work. The seven-item Childhood Gender Nonconformity Scale (CGNS. Of the lesbians. 5 = strongly agree). p. 12 percent Hispanic. Scores on this scale have been shown to correlate moderately with partners’ assessments of lesbians’ and gay men’s gender nonconformity (Bailey et al. in order to reach consensus on use of the rating scales before rating the videos of actual participants. Responses were summed with higher scores indicating more gender nonconformity. 4 = some college or trade school. 1051).88 for women and . Finally.” and “I don’t feel very feminine. The version for women included statements such as. Coefficient alphas for the Hobby Preferences scale in this sample were . Finkel.” Median responses were “some college or trade school. both of which are intended for the general public.” and “I pride myself on being feminine. 1990).4 percent Asian. 3 = high school graduate. and participants rated their agreement with items on a 5-point scale (1 = strongly disagree.

the researcher returned to the room. education. Campbell.83 and . and gave them a check for $20. movement.94 and . Participants were asked to provide a number between 0 and 100 to indicate their general liking of four groups of people: masculine women. and overall impression ratings. 7 = very masculine). Participants completed paper-and-pencil versions of the Beck Depression Inventory II (BDI-II. they rated each participant’s voice.73. 1971) that assessed the degree to which participants generally liked gender nonconforming and conforming women and men. there were no significant differences between participants who did or did not agree to be videotaped in self-reported gender nonconformity.80.81. and overall impression ratings. For example. . 7 = strongly agree). 2006).Arch Sex Behav (2006) 35:685–697 689 7-point scale (1 = very feminine. collected them. “I like feminine lesbians more than masculine lesbians. or attitudes towards feminine men.91 for lesbians and gay men. For the analyses. appearance. . butchphobia. Beck & Steer. The STAI consists of two scales designed to assess symptoms of anxiety. including demographic questions about age. respectively. Coefficient alphas for the femiphobia subscale were . Total scores can range from 0 to 63. Attitudes towards gender nonconformity Participants completed two measures of attitudes towards gender nonconformity. with 0 being not at all and 100 being extremely. Previous research using a similar approach showed that such observer ratings can distinguish reliably between homosexual and heterosexual participants (Rieger.10). respectively.90 for women and men.93 for lesbians and gay men. feminine men. movement. Gygax. For gay men. respectively. and spoke for an average of about three to five minutes.93 and . After all participants had completed the study. respectively. Spielberger. ethnic background. or psychological distress (all ps > . Consenting participants answered an open-ended question about their thoughts on the issue of coming out. respectively. with higher scores indicating higher levels of state and trait anxiety. Participants rated their degree of agreement with items such as.” Responses to each part of the scale were summed to provide a state anxiety index and a trait anxiety index. Springer .” on the butchphobia subscale and “Feminine men disgust me” on the femiphobia subscale Participants completed the study individually in a private room. Participants also responded to four “feeling thermometer” items (cf. . the researcher moved participants to a desk and handed them paper copies of the BDI-II and STAI. with higher scores indicating the presence of more depressive symptoms. The researcher reminded participants of the confidentiality of responses and then left them alone in the room to complete the questionnaires. how much do you like feminine men?” Procedure Two scales assessed participants’ psychological health. Responses were summed with higher scores on each subscale indicating more negative attitudes towards gender nonconformity in either women or men. ratings for the men were reverse-scored.84 and .84. respectively. and started the computer program that presented the remaining measures. & Bailey. Participants were first offered the option to participate in a videotaped interview. and femiphobia. so that higher ratings for both women and men indicated a higher degree of gender nonconformity.80.95 for lesbians and gay men. femiphobia. and . feminine women. agreed to be videotaped. Psychological distress using a 7-point scale (1 = strongly disagree. The “state” scale consists of 20 statements that measure how participants report feeling “right now.88 for voice. The first was a 50-item Attitudes Towards Gender Nonconformity Scale designed by the researchers to measure butchphobia. thanked them. Ratings of each dimension were standardized separately for each sex and then averaged to obtain four measures of observerrated gender nonconformity for each participant. and masculine men. Linsenmeier.86 and . Participants completed these measures in private. “On a scale from 0 to 100. The BDI-II assesses the amount and degree of current depressive symptoms. appearance.95 for lesbians and gay men. or attitudes towards masculine or “butch” women. movement. and . For both women and men. coefficient alphas were . 1987) and the State-Trait Anxiety Inventory (STAI.86. Finally. Coefficient alphas for the state scale were . Results The majority of participants. At the end of the interview. respectively. Coefficient alphas for the BDI in this sample were . the “feminine men” item asked. and coefficient alphas for the trait scale were . . For ratings of lesbian participants.7%) of the lesbians and 35 (70%) of the gay men. or 32 (72.84 for voice. The researcher returned to the room when participants had completed the psychological distress measures. Coefficient alphas for the butchphobia subscale were . and appearance. as well as their “overall impression” of that participant.” and the “trait” scale consists of 20 statements that measure how participants report feeling “generally. debriefed participants. They rated each participant on the four dimensions of observer-rated gender nonconformity as described above. 1983). coefficient alphas were . at this moment. and relationship status. the undergraduate raters watched the videotaped interviews of participants. that is.

As a result.10. all of the self-report measures of gender nonconformity were significantly positively correlated.07 − .18 .42∗ .14 −. Most correlations were based on data from all female participants (N = 44). For gay men. Most correlations were based on data from all male participants (N = 50).02 −.09 −. Gender nonconformity Tables 1 and 2 show correlations among out major variables of interest for lesbians and gay men. This observer-rated gen- der nonconformity composite was used in the remaining analyses. Observer and participant ratings of gender nonconformity showed moderate to high agreement. ∗∗ p < . attitudes toward gender nonconformity.04 .01 −.41∗∗ .01 − . We assigned the mean observer-rating score for the relevant group (lesbians Table 2 gay men Correlations among measures of gender nonconformity (GN).23 . we created an overall gender nonconformity composite variable by standardizing and adding scores on the four measures of gender nonconformity for lesbians and gay men separately: childhood gender nonconformity.66∗∗∗ −. For lesbians. only the correlation of adult continuous gender identity and childhood gender nonconformity was statistically significant.19 −.22 . the observer-rated composite was significantly and positively related to all measures of self-reported gender nonconformity.73∗∗∗ . ∗∗ p < .77∗∗∗ .27 Note.23 . appearance. adult continuous gender identity. Thus.47∗∗ .40∗ Note. occupational and hobby interests. The four dimensions of observer-rated gender nonconformity (voice. we created an observerrated gender nonconformity composite variable by standardizing and adding the four dimensions of observer ratings for lesbians and gay men separately.01).75∗∗∗ .06 −. ∗∗∗ p < .46∗∗∗ . many of the measures of self-reported gender nonconformity were related for both groups.11 Self-rated GN Childhood GN Adult continuous gender identity (CGI) Interests Observer-rated GN Overall GN composite Attitudes toward GN Butchphobia Femiphobia .32∗ −. For lesbians. and overall impression) were all highly positively correlated for both lesbians and gay men (all ps < .23 Self-rated GN Childhood GN Adult continuous gender identity (CGI) Interests Observer-rated GN Overall GN composite Attitudes toward GN Butchphobia Femiphobia .76∗∗∗ .001.38∗∗ .11 −.07 −.56∗∗∗ . and correlations with the other self-report measures of gender nonconformity were in the expected direction. the observer-rated composite was significantly and positively related to childhood gender nonconformity. and psychological distress for Childhood Adult ObserverGN CGI Interests rated GN GN Psychological Composite Butchphobia Femiphobia distress .14 − .41∗ . and psychological distress for Childhood Adult ObserverGN CGI Interests rated GN GN Psychological Composite Butchphobia Femiphobia distress .05. Springer .53∗∗∗ . respectively.07 −.24 .03 − . attitudes toward gender nonconformity. and the observerrated gender nonconformity composite. Correlations involving observer-rated GN (except for its correlation with the overall GN composite) were based on data from male participants who agreed to be videotaped (N = 35).23 . however.22 −.62∗∗∗ .34∗ .03 −.01.33# .18 −. For gay men. movement.12 − . ∗∗∗ p < .47∗∗ .01.690 Table 1 lesbians Arch Sex Behav (2006) 35:685–697 Correlations among measures of gender nonconformity (GN).38∗ .05.68∗∗∗ −.17 .03 .07 . As predicted. Correlations involving observer-rated GN (except for its correlation with the overall GN composite) were based on data from female participants who agreed to be videotaped (N = 32).001. # p < . ∗ p < .04 .54∗∗∗ .72∗∗∗ .10 .05 . ∗ p < .

t(92) = 2.035. there were significant positive correlations between psychological distress and various selfreport indices of gender nonconformity for gay men. Of note. psychological distress. Attitudes toward gender nonconformity Figure 1 shows the mean ratings for lesbians and gay men separately on the four feeling thermometer items. it might be considered a negative trait.13. We also considered the possibility that a response bias might influence participant responses.40.052. z = − 2. total scores on the measures of psychological distress were all highly positively correlated. Although educational level was. Consistent with our hypothesis. Gender nonconformity and psychological distress Gay men reported significantly higher levels of psychological distress than lesbians on measures of both depression. R2 = . we tested for an interaction between psychological distress and observer ratings of gender nonconformity in predicting self-reports of gender nonconformity. observer ratings of gender nonconformity were not significantly related to psychological distress for either lesbians or gay men. The correlation between gender nonconformity and psychological distress in gay men was significantly different from that in lesbians. lowdistress individuals might have self-reports of gender nonconformity that are more consistent with observer ratings. t(92) = 2. These results did not change when controlling for age. 2002). 100 = extremely) Springer . If true. To examine this possibility.Arch Sex Behav (2006) 35:685–697 691 or gay men) to participants for whom observer ratings were missing. negatively correlated with gender nonconformity for gay men. Mulatu & Schooler. p = . If gay men who are more gender nonconforming also tend to be lower in socioeconomic status.017. Psychological distress was not significantly related to gender nonconformity for lesbians (see Table 1). r = − . This overall gender nonconformity composite was used in subsequent analyses.24. and trait anxiety. It seemed possible that the pattern found for gay men might be due in part to socioeconomic status. To address this possibility. A 2 Feeling Thermometer Ratings by Lesbians 100 90 Mean Likeability Rating 80 70 60 50 40 30 20 10 0 Target's Conformity Conforming Nonconforming Female Male Target's Gender Feeling Thermometer Ratings by Gay Men 100 90 Mean Likeability Rating 80 70 60 50 40 30 20 10 0 Target's Conformity Conforming Nonconforming Female Male Target's Gender Fig.001.28. in fact. or for gay men. Prior research has found greater psychological distress in individuals lower in socioeconomic status (Lorant et al. when examining individual measures of gender nonconformity. p = . then individuals experiencing high levels of distress might show self-reported gender nonconformity that exceeds their observer-rated gender nonconformity. β = − . but not state anxiety. R2 < .029 (two-tailed). However. p = . 1 Lesbians’ and gay men’s liking of gender conforming and gender nonconforming women and men (0 = not at all. One way to address this with these data was to test for the possibility that gender nonconforming individuals who were more distressed might have a negatively distorted view of their own nega- tive traits compared to nondistressed gender nonconforming individuals. We focused on scores on the BDI and the trait scale in these analyses because we reasoned that depression and trait anxiety better corresponded to the latent variable of interest. We thus created a psychological distress composite variable by standardizing and adding the depression and trait anxiety scores for lesbians and gay men separately.10. but not for lesbians. p = .. β = . we used education level as an indicator of socioeconomic status. For both lesbians and gay men. In contrast.18.14. this could partly explain our findings.” which was measured by the State subscale. β = . p = . 2003. R2 = .046.44. psychological distress was positively correlated with the overall gender nonconformity composite for gay men (see Table 2). Because both heterosexual and homosexual people in general have negative attitudes towards gender nonconformity. gender nonconformity still significantly predicted distress in gay men when controlling for educational level.0059. This interaction was not significant for lesbians. than did anxiety “at this moment. this composite was used in the remaining analyses.

nor was psychological distress significantly related to any of the measures of gender nonconformity for lesbians. t(43) = − . 2002. 2002). 2003). F(1. gay men also reported a preference for gender conformity over gender nonconformity in women. Friedman & Downey. 1991. p < . 92) = 8. In-group minority social support may protect minority group members to some extent from the negative effects of stigma (e.g. 2003). Socioeconomic status might also partially explain these results. Meyer. p < . Herek. those gay men who reported more psychological distress may be more open about reporting negative traits in Discussion Consistent with our hypothesis and prior research. however. p < . We were partially able to rule out this explanation.08.0001. Gender nonconformity and psychological distress in gay men Several mechanisms could be responsible for the link found in gay men between gender nonconformity and psychological distress. we did not find a similar relationship between psychological distress and observerrated gender nonconformity. and adult gender nonconformity also tended to report more psychological distress.. respectively. we first reverse-scored these two subscales so that higher scores reflected more positive attitudes towards masculine women and feminine men. Interpretation of this main effect was qualified by a three-way interaction among rater sex. responses on the butchphobia subscale were negatively correlated with the “masculine women” feeling thermometer question. 1999. Elizur & Ziv. This suggests that more gender nonconforming participants may have less positive attitudes toward gender nonconformity in those of their own sex.. 1984. That is.g. Because homosexual individuals continue to face widespread victimization.. lesbians liked gender conforming women more than gender nonconforming women. For ease of interpretation. In contrast. 1999). Grossman & Kerner. the correlation between the overall GN composite and attitude toward gender nonconformity in one’s own sex was negative. Finally. future studies including more detailed demographic information should further address this issue. and responses on the femiphobia subscale were negatively correlated with the “feminine men” question.0001. Specifically. A response bias also could have influenced our results. although the more educated men in our sample did tend to report less gender nonconformity on average. among both lesbians and gay men. gay men preferred gender conformity over gender nonconformity in both women. there were no significant relationships between participants’ attitudes and their degree of psychological distress.. 1990). Haddock et al.. Gay men who reported more childhood Springer . 1993.19. A related pathway involves the importance of social support to stigmatized minority populations. 1997) and socially. and because feminine men are often perceived to be homosexual (Deaux & Lewis. Lorant et al. 92) = 56. Interestingly. the negative attitudes toward gender nonconformity found among gay men in our study and in other research suggest that gender nonconforming gay men may face rejection from others even within their own minority group. 1993. the relationship between gender nonconformity and distress remained significant after controlling for education. Thus. A potential lack of such support thus may play a role in the relationship between gender nonconformity and psychological distress in gay men.84. both romantically (Bailey et al. target sex. and lower socioeconomic status is associated with greater psychological distress (e. Next. F(1. 1998. t(43) = 3. More gender nonconforming gay men may receive less social support from others because of other people’s negative attitudes towards gender nonconformity. & Hershberger. Mulatu & Schooler. However. Butchphobia and femiphobia scores were positively correlated for both lesbians and gay men (see Tables 1 and 2). 2003. but did not have a preference in men. and target gender nonconformity. p < . Martin. In addition. both lesbians and gay men reported greater liking for gender conforming than for gender nonconforming members of their own sex. Attitudes towards gender nonconformity were not significantly related to the overall gender nonconformity composite for either lesbians or gay men. p = . gender nonconforming gay men may experience more stigmatization than more gender-typical gay men. which were used in the remaining analyses. both subscales and both feeling thermometer questions were standardized and added for lesbians and gay men separately to form composite scores of butchphobia and femiphobia. t(49) = 7. nonconforming) mixed design analysis of variance revealed that ratings of gender conforming individuals were more positive than ratings of gender nonconforming individuals. and this may result in more psychological distress (D’Augelli.. However.001. t(49) = 6. selfreported gender nonconformity was related to psychological distress in gay men. For both lesbians and gay men. Pilkington. and men. and this lack of social support may make them more susceptible to psychological distress (D’Augelli & Hershberger. Herek et al.001. Moreover. suggesting that attitudes towards gender nonconformity in females tend to be related to attitudes towards gender nonconformity in males.692 Arch Sex Behav (2006) 35:685–697 (sex of participant) × 2 (sex of target) × 2 (gender behavior: conforming vs. More gender nonconforming men might tend to have lower socioeconomic status on average.

we found no significant interaction between observer ratings of gender nonconformity and participants’ psychological distress in predicting self-reported gender nonconformity. For example. Consistent with this. rather than gender nonconformity in and of itself. Friedman & Downey. Bailey (1999) hypothesized that the higher rate of distress among gay men compared with heterosexual men may result from a higher. which is viewed negatively by many homosexual individuals. Perhaps the relationship between gender nonconformity and psychological distress is more attributable to personality factors or moodbiased memory and perception as discussed above. observer ratings of gender nonconformity were not significantly related to psychological distress in our sample. 1999. Clarification of the relationship. Furthermore. Some participants may have intentionally suppressed observable cues of gender nonconformity while being videotaped in the laboratory (Ambady & Hallahan. It may also be that those aspects of gender nonconformity most likely to prompt negative reactions from other people were not apparent in the videos we used.. implying that a person must be closer to one than the other on a given trait. then the traits that our observers assessed may not be the ones that are most stigmatized. We used “masculine” and “feminine” endpoints on a bipolar scale for our observer ratings in order to best correspond to lay terminology. One final possibility is that the characteristics related to femininity that we measured may be associated with an underlying risk for mood and anxiety problems. Thus. Thus. Our measure of observable gender nonconformity was but one indicator of what is likely a multidimensional latent construct. Another possibility is that our measure of observerrated gender nonconformity did not capture the variable of interest as effectively as we believed it would. It is also possible that psychological distress is more related to individuals’ subjective perceptions of their own gender nonconformity than to the ways that other people treat them. gay men had more symptoms of depression and anxiety on average than lesbians. and thus would be expected to correlate more weakly with psychological distress. an interesting reversal of the sex difference in heterosexual women and men for mood and anxiety problems (American Psychiatric Association. 1987).Arch Sex Behav (2006) 35:685–697 693 general (Larsen & Diener. between observable aspects of gender nonconformity and psychological distress in gay men thus deserves further study using different methods for assessing observer-rated gender nonconformity. the ways in which individuals identify and think about their own gender nonconformity. This explanation bears further exploration. could be related to risk for psychological distress. Assuming that the lower correlations between observerrated gender nonconformity and distress than between selfreported gender nonconformity and distress are meaningful. In our sample. Given that individuals can be masculine in some respects and feminine in others. This seems inconsistent with the idea that psychological distress may be partly due to stigmatization of gender nonconformity. Landolt et al. level of neuroticism in the former. there are several possible explanations. Self-reports versus observer ratings of gender nonconformity Contrary to our expectations. including gender nonconformity. more female-typical.. 2000). a bipolar scale oversimplifies the full spectrum and complexity of behavior that individuals can display. 2005). Gender nonconforming men who are more distressed might also have a distorted view of their own gender nonconformity and see themselves as even more gender nonconforming than they actually are. the observer ratings in our study may not be accurate reflections of the way participants are perceived outside the laboratory. Springer . Finally. There are other possible explanations for the absence of a significant relationship between observer-rated gender nonconformity and distress. 2002). 2000. However. if any. If so. it could be that the childhood play behavior of gender nonconforming boys is more likely to provoke consistently negative reactions from others compared to gender nonconformity in adult voice and movement. one study found that the association between perceived discrimination and distress weakened but remained significant after controlling for neuroticism (Huebner et al. We may have had too few participants in the final sample of 35 men who agreed to be videotaped to detect a relationship. the possible roles of stigmatization and social support might be less important than we originally hypothesized. as we found in this sample. 2002. However. The evidence suggests that gay men who are experiencing high levels of psychological distress are not distorting reports of their own gender nonconformity compared to gay men who are experiencing low levels of distress. the significant relationship between distress and self-perceived gender nonconformity is certainly consistent with this hypothesis. Savin-Williams (1994) found that individuals’ perceptions of their own traits may be related to psychological distress. suicide attempters were significantly more likely than non-attempters to describe themselves as feminine. and/or a decrease in social support. the correlation between distress and observerrated gender nonconformity was in the predicted direction and was not significantly lower than the correlation between distress and self-reported gender nonconformity. If this is the case. a single short assessment may contain substantial measurement error compared with the average of multiple assessments at different times. In his sample of gay and bisexual young males. 2004). as discussed above (Beard & Bakeman.

Interpersonal factors Springer such as stigmatization and social support may mediate or moderate this relationship. such as clinical diagnoses or measures of daily functioning such as occupational status. much as some lesbians and gay men can develop a strong dislike of their own sexual orientation. A sex difference in the social consequences of adult gender nonconformity might partially explain the sex differences in psychological distress and its correlation with gender nonconformity.. Therefore. our study had several limitations. gender nonconforming girls may not be rejected as much or even at all compared to gender nonconforming boys (Friedman & Downey. Preliminary exploratory factor analyses of this instrument have yielded a two-factor solution with the expected items loading on factors that correspond to butchphobia and femiphobia. Several factors could account for these differences. Interpersonal factors in childhood may also contribute to these sex differences.. These might include experimental manipulations of stigmatization using confederates in laboratory settings. despite some evidence of negative attitudes towards gender nonconformity in women as well as men. For example. Studies incorporating measures of social support will also assist in better understanding how social factors impact the relationship between gender nonconformity and psychological distress in gay men specifically and psychological health among lesbians and gay men in general. Martin. Limitations Although some of our hypotheses were supported. Friedman & Downey. 1998). Given a possibly more favorable view of gender nonconforming women than men. 1992).. One might be greater acceptance of gender nonconformity in women than in men. The cross-sectional design of our study is another limitation. greater societal acceptance of gender nonconformity in girls than in boys leads to differences in how gender nonconforming girls are treated compared to gender nonconforming boys (Maccoby. However. 1998). As noted above. Some gay men may develop a dislike of their own degree of femininity. but many questions remain. further validation of this instrument will be necessary before firm conclusions can be drawn about results based on this measure. Studies exploring the role of stigmatization experiences of lesbian and gay individuals more directly are also important. 1998.694 Arch Sex Behav (2006) 35:685–697 Sex differences in the relation between psychological distress and gender nonconformity Lesbians reported significantly less psychological distress than did gay men. Longitudinal studies following large groups of children showing a range of gender conforming and nonconforming behaviors into adulthood could provide a more thorough examination of the relationship between gender nonconformity and psychological health. 2005). Gender nonconforming boys might then be deprived of the benefits of affirmative relationships with girls for various reasons. has yet to be fully validated. visible lesbian and gay population could also limit generalizability of these findings. it is striking that our lesbian and gay participants on average reported greater liking for feminine women than for masculine women. 1995. One might predict that this might be both stronger and more likely to occur for more gender . such as girls’ attitudes towards boys generally. would also be useful additions to such research. Another limitation is that our Attitudes Towards Gender Nonconformity Scale. the correlation between selfreported gender nonconformity and psychological distress among gay men in our study was not found for lesbian participants. Although young children’s attitudes towards gender nonconformity may be complex (Zucker et al. 1990). Potential problems with our observer ratings of gender nonconformity have already been discussed. In addition. Our use of a volunteer sample from a city with a large. or internalized homophobia. They may be evaluating gender nonconformity in women less positively because masculine characteristics in women may be associated with a decrease in perceived attractiveness (Bailey et al. However. Multiple measurements of psychological distress at several time points would further strengthen such a study. although specifically developed to measure butchphobia and femiphobia. Berrill. 1995).. such as observations by the parents or peers of participants. and we did not assess psychological distress through approaches less susceptible to self-report biases. 1999. or the reactions of girls’ parents to gender nonconformity specifically. Further research on such factors might clarify the reasons for these sex differences. Rejection experienced by feminine boys may lead to distress about both their gender and their atypical behavior.g. Maccoby. alternatively. this explanation alone may not be sufficient to explain these differences. Corroborative information. Future directions This study provided an investigation into the relationship between gender nonconformity and psychological distress. 1997). young boys generally appear to reject gender nonconforming boys (Fagot. 1999). other studies have found greater lifetime victimization in lesbians compared to gay men (Balsam et al. perhaps gender nonconforming women still experience less negative treatment than do gender nonconforming men. this might explain the sex difference in the relationship between gender nonconformity and distress. who then may only be partially accepted into girls’ groups (Maccoby. certain types of victimization may relate more strongly to distress than others. This would be consistent with findings that lesbians experience less verbal harassment and threats than do gay men (e. However.

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