Gender-diverse teens who experience bullying and live in states with persistently unsupportive gender identity laws are significantly more likely to suffer from increased psychological distress than their peers, according to new research from UCLA Health.
Conclusion, published in jama networkThe results of the study, based on one of the largest, most comprehensive adolescent brain development studies in the US, show that the mental health burden borne by gender-diverse youth is not an inherent result of gender diversity, but is shaped by the social and political environment in which these youth live.
What we are seeing is that stigma has measurable neuropsychiatric consequences. Bullying and unsupported laws are not abstract policy concerns; “They translate real and serious symptoms into the daily lives of teens.”
Cary Bearden, senior author of the study, is a professor of psychiatry at the UCLA Semel Institute of Neuroscience and Human Behavior and the UCLA Brain Research Institute.
Specifically, researchers found that gender-diverse adolescents reported higher rates of subtle but clinically meaningful warning signs of psychological stress. These experiences, known clinically as psychotic-like experiences (PLE), are subtle, disturbing internal experiences such as feeling unusually suspicious of others, thinking others are talking to them or laughing at them, feeling threatened, or hearing voices that others do not. PLEs are not clinical psychoses. However, if left untreated, these experiences can increase the risk of developing mental disorders such as depression, anxiety, self-harming behavior, and psychotic disorders.
about the study
UCLA researchers analyzed data from the Adolescent Brain Cognitive Development (ABCD) study, a large, population-based longitudinal study that tracked adolescents at 21 sites in 17 U.S. states from the time they were 9 years old. The researchers used data to analyze point-in-time analyzes of 8,463 participants with an average age of 13, and a longitudinal analysis followed 4,200 participants across five data collection waves between 2017 and 2022.
Participants were assessed for gender diversity, bullying victimization and PLE. Gender diversity was measured dimensionally by considering how consistent or inconsistent each adolescent’s sense of gender was with their birth-assigned gender, rather than solely depending on whether the participant identified themselves as transgender or gender non-conforming. Bullying victimization was captured through self-reported frequency of bullying experiences. Psychotic-like experiences (PLE) were measured using the Prodromal Questionnaire-Brief Child Version, a validated screening tool that asks adolescents about the presence of subtle psychotic symptoms and related distress.
The researchers also used state-level policy data from the Movement Advancement Project (MAP) nonprofit group to determine whether a participant’s state maintained supportive or non-supportive laws related to gender identity in a given year.
What was found in the research
Gender-diverse youth reported significantly higher rates of both bullying victimization and PLE compared to their peers. Bullying acted as a mediator between gender-diversity and PLE and accounted for 18% of that variance.
State policy told a more gradual story. No differences emerged at any single point in time, but in states that lacked consistently supportive gender identity laws, adolescents experienced significantly greater increases in PLE over four years. In all other groups, PLE declined or remained stable, regardless of gender diversity.
The proportion of American teens aged 13 to 17 who identify as transgender or gender diverse has doubled from 0.73% to 1.43% between 2017 and 2022, according to a UCLA study. Separate research cited by the authors found that the passage of unsupported laws between 2018 and 2020 was associated with a 7% to 72% increase in suicide attempt rates among transgender people. Gender-diverse youth. In 2025, more than 600 anti-LGBTQ+ bills were introduced across the US, double the number in 2022, according to ACLU data cited in the study.
Researchers hypothesize that frequent exposure to bullying and an unsupportive political environment may promote hypervigilance, a core feature of psychotic-spectrum symptoms, in gender-diverse adolescents.
“Without physicians asking the right questions about the patient’s social environment, we may miss strong treatment goals,” said study first author Dylan Hughes, a clinical psychology graduate student at UCLA. “At the same time, policy makers – and voters – also play an important role. Voting on any policy intended to help our youth must include consideration of the negative impacts of the policy on the mental health of these children.”
Funding for the study was provided by the National Institute of Neurological Disorders and Stroke and the National Institute of Mental Health, NIH.
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