In the realm of adolescent mental health, a new study from UCLA Health highlights the significant impact of bullying and unfavorable state policies on the psychological well-being of gender-diverse youth. Findings published in JAMA Network reveal that adolescents facing bullying in states with non-supportive gender identity laws experience markedly increased mental health distress compared to their peers.
The research, which represents one of the largest examinations of adolescent brain development in the United States, suggests that the anguish endured by gender-diverse teens is not an inherent consequence of gender diversity but is largely shaped by the social and political contexts surrounding them.
“Stigmatization has measurable neuropsychiatric effects. Bullying and non-supportive laws are not abstract political issues; they lead to real and significant symptoms in the daily lives of adolescents,”
Carrie Bearden, lead author of the study and a professor at UCLA’s Semel Institute of Neuroscience and Human Behavior.
The study found that gender-diverse teenagers reported significantly higher rates of psychotic-like experiences (PLEs)—subtle but clinically relevant signs of mental distress, including unusual distrust towards others, fears of being talked about or laughed at, feelings of threat, and auditory hallucinations. While PLEs do not equate to clinical psychosis, if left untreated, they may elevate the risk for developing mental health disorders such as depression, anxiety, self-harm, and psychotic disorders.
About the Study
Researchers utilized data from the Adolescent Brain Cognitive Development (ABCD) study, a large, population-based longitudinal investigation tracking adolescents since the age of nine across 21 locations in 17 US states. The study involved a point-in-time analysis of 8,463 participants with an average age of 13, as well as a longitudinal analysis involving 4,200 participants followed over five waves of data collection from 2017 to 2022.
Participants were evaluated for gender diversity, bullying victimization, and PLEs. Gender diversity was measured on a continuum, assessing the alignment or misalignment of each youth’s gender identity with their assigned sex at birth, rather than relying solely on whether a participant identified as transgender or gender nonconforming. Bullying victimization was self-reported, while PLEs were evaluated using the Prodromal Questionnaire-Brief Child Version, a validated screening tool for identifying subtle psychological symptoms.
The researchers also consulted state policy data from the nonprofit organization Movement Advance Project (MAP) to determine whether participants resided in states with supportive or non-supportive gender identity laws during the study period.
Research Findings
Gender-diverse youth reported significantly elevated rates of both bullying and PLEs compared to their peers. Bullying acted as a mediator between gender diversity and PLEs, accounting for 18% of the observed differences. Notably, adolescents in states lacking supportive legislation consistently exhibited a more pronounced increase in PLE rates over the study period, while in other states, PLE rates either declined or remained stable regardless of gender diversity status.
According to a separate UCLA study from 2022, the percentage of American adolescents aged 13-17 identifying as transgender or gender nonconforming doubled from 0.73% in 2017 to 1.43% in 2022. Another cited investigation indicated that the enactment of non-supportive laws between 2018 and 2020 correlated with a 7% to 72% increase in suicide attempt rates among transgender and gender-diverse youth. The American Civil Liberties Union reported that by 2025, over 600 anti-LGBTQ laws had been introduced across the United States, double the number seen in 2022.
Researchers believe that chronic exposure to bullying and a hostile political environment can induce hypervigilance in gender-diverse teens, a core feature of psychotic symptoms. “Without clinicians addressing the social context of a patient’s life, we might miss critical treatment opportunities,” stated Dylan Hughes, lead author and a clinical psychology PhD candidate at UCLA. “At the same time, policymakers and voters must consider the downstream effects of their decisions on the mental health of our youth.”
This study was funded by the National Institute of Neurological Disorders and Stroke and the National Institute of Mental Health, NIH.
