Gender Nonconformity, Peer Victimization, and Internalizing Problems Among Youth: Differential Moderating Effects of School Climate by Sex Assigned at Birth

Objective: Gender-nonconforming youth are often subjected to bullying and harassment as their gender expression does not conform to traditional societal expectations of their sex assigned at birth. The present study aimed to examine whether gender nonconformity would be linked to peer victimization and internalizing problems and investigate whether perceptions of a structured and supportive school climate would protect gender-nonconforming youth from victimization. Method: This study included a national sample of 3,020 youth in China. The survey assessed gender expression, peer victimization, school avoidance, depressive symptoms, and perceptions of school climate. Results: The study found that 38.5% of the gender-nonconforming youth reported exposure to peer victimization, and 41.1% exhibited clinically significant depressive symptoms. Gender nonconformity was associated with peer victimization, which was linked to heightened levels of school avoidance and depressive symptoms. The associations were stronger among youth assigned male at birth (AMAB) than youth assigned female at birth (AFAB). Among youth who perceived their school climate as structured and supportive, their gender nonconformity was not significantly related to peer victimization and internalizing problems. Nevertheless, fewer dimensions of perceived school climate were protective for AFAB youth than AMAB youth. Conclusion: Given the prevalence and effects of peer victimization, schools should develop effective policies and procedures to prevent and handle incidents of victimization. It is also important to cultivate a structured and supportive campus environment that promotes the acceptance of diverse gender expressions. There remains an urgent and unmet need for gender-affirming mental health care in Chinese educational settings.