Peer bullying in adolescents with gender dysphoria: a comparison with clinical and non-clinical controls

Background and Objectives

Gender dysphoria is characterised by a marked incongruence between an individual’s experienced gender and sex assigned at birth. Existing literature indicates that transgender and gender diverse youth experience peer bullying victimization at rates two to three times higher than their cisgender peers[1], [2]; however, most studies rely on community samples and lack clinical comparison groups. Studies specifically examining gender dysphoria as a clinical diagnosis alongside appropriate controls remain scarce. This study aims to examine the frequency, roles, and psychological correlates of peer bullying among adolescents with gender dysphoria, compared to both clinical and healthy controls.

Methods

This ongoing descriptive study presents preliminary findings from 70 adolescents (target n=90) recruited from the Child and Adolescent Psychiatry clinic of Pendik Training and Research Hospital, Marmara University. Three groups were formed: adolescents with gender dysphoria (n=22), clinical controls (n=24; most commonly presenting with ADHD [37.5%] and depression [25.0%]), and healthy controls (n=24). Groups were comparable in age (mean=16.0±1.9 years; p=0.269) and sex distribution (p=0.665). Participants were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), the Child Behavior Checklist (CBCL), the Revised Children’s Anxiety and Depression Scale (RCADS), and the Olweus Bullying Questionnaire. Statistical analyses included chi-square tests and Welch’s one-way ANOVA with Tukey post-hoc comparisons.

Results

In this preliminary sample, peer victimization rates differed significantly across groups (χ²(2)=11.5, p=0.003): adolescents with gender dysphoria showed the highest victimization rate (54.5%), followed by clinical controls (31.8%) and healthy controls (8.3%). Bullying perpetration was lowest in the gender dysphoria group (4.5%) compared to clinical controls (27.3%) and healthy controls (16.7%), though this difference did not reach statistical significance (p=0.123). These preliminary findings indicate that adolescents with gender dysphoria are most likely to be victimized while being least likely to act as perpetrators. RCADS depression scores differed significantly across groups (F(2,43.4)=4.99, p=0.011), with post-hoc analysis revealing significantly higher depression scores in the gender dysphoria group compared to healthy controls (p=0.016). The most common comorbid diagnoses in the gender dysphoria group were depression (59.1%) and anxiety disorder (36.4%). No significant group differences were found for total anxiety, social phobia, or panic scores.

Conclusions

These preliminary findings suggest that adolescents with gender dysphoria exhibit a distinct bullying profile characterised by high victimization vulnerability and low perpetration — an internalizing pattern consistent with existing literature on gender diverse youth and the minority stress framework. Elevated depression scores and high rates of comorbid psychopathology further underscore the psychological burden in this population. As participant recruitment is ongoing, confirmatory analyses with the full sample will be presented. The preliminary nature and modest sample size should be noted as limitations. Taken together, these findings highlight the need for gender-sensitive bullying prevention programs targeting this clinically vulnerable group.

Keywords:gender dysphoria, peer bullying, adolescent, victimization, depression, preliminary findings

References

Sares-Jäske, L., Czimbalmos, M., Majlander, S., Siukola, R., Klemetti, R., Luopa, P., & Lehtonen, J. (2023). Gendered differences in experiences of bullying and mental health among transgender and cisgender youth. Journal of Youth and Adolescence, 52, 1531–1548. https://doi.org/10.1007/s10964-023-01786-7
Huang, J., Kaufman, T. M. L., Baams, L., & Branje, S. (2024). Peer bullying victimization trajectories for sexually and gender diverse youth from early childhood to late adolescence. Journal of Youth and Adolescence, 53, 2589–2609. https://doi.org/10.1007/s10964-024-02020-8