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The Homosexuality Factor is Associated with Higher Risk for Suicidality Experienced by Heterosexually Identified Males and Females

The First "Alert" on the Subject - Noted Below - is Available as a Word Document Download (As Given Out at the Conference) or as a Webpage With Additional Information: More links to Full Text Referenced Documents, Links to Abstract for Cited Paper and Additional Tabulated Research Results.

Practice / Research Suicidality Alert

The Heterosexual Homosexuality Factor
Implicated: Homophobia, Gender Nonconformity
& The Possible ‘No Man’s Land’ Effect

Dimensions of Suicide Conference: Exploring Cause and Effect
Waterloo, Ontario: November 8, 2007

This Webpage is Under Construction....

Gender nonconformable GLBTTs and Transgender Males at Greater Risk for Attempting Suicide: The Tabulated Results for Studies Highlighted Below.
Remafedi et al. (1991) were the first to report that the more feminine gay/bisexual male youth were about 3-times more at risk for having attempted suicide compared to the others. (Result of regression analysis.) The "Attempted Suicide" incidence was as follows for males in the BEM (1974) gender role categories: Masculine (3/28: 11%), Androgynous & Undifferentiated (23/77 = 30%), and Feminine (15/31: 48%).

Tremblay & Ramsay (2002) wondered if a similar association with "Attempting Suicide" was present in the Bell & Weinberg (1978) / Bell, Weinberg & Hammersmith (1981) data (Sample taken in 1969) for white predominantly homosexual males who had been asked to rank themselves - as they had been from childhood to age 17 - on a femininity to masculinity scale: 0 to 6. At the Kinsey Institute - where the data set is located - the following results were generated for the associations between "Femininity to Masculinity" ratings (0 to 6) and "Attempting Suicide" incidences to the age of 20:  Very Masculine (4-6) - 12/244: 4.9%. Moderately Masculine/Feminine (2-3)... 30/274: 10.9%. Very Feminine (0-1)... 12/55: 21.6%.
Similar Research Results or Research Outcomes Suggesting that Similar Results are to be Expected:
D'Augelli et al. (2005): "Factors that differentiated [lesbian, gay, and bisexual (LGB)] youth reporting suicide attempts and those not reporting attempts were greater childhood parental psychological abuse and more childhood gender atypical behavior."

Fitzpatrick et al (2005): “Cross-gendered [college students], regardless of sexual orientation, appear to have higher risk for suicidal symptoms. Researchers and clinicians should assess gender role in evaluations of youth samples.”

Skidmore et al (2006): "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."
Research Indicating that Adolescents Harassed/Abused/Threatened with Violence Because they are Assumed to be Homosexually Oriented are at Higher Risk for Suicidality.  Heterosexual adolescents reporting such harassment are at increasing risk for the more serious suicidal behaviors.
Russell et al. (2006): "Finding 1 [From 2000-01 California Healthy Kids Survey]: Harassment based on actual or perceived sexual orientation is pervasive. 7.5 percent of California students [17,815 of 237,544 students surveyed] reported being harassed on the basis of actual or perceived sexual orientation…   Further, this type of harassment is often a repeat occurrence: 32% of student harassed on the basis of actual or perceived sexual were harassed more than four times in the past twelve months... Finding 2: Students who are harassed based on actual or perceived sexual orientation report weaker connections to school, adults, and community... Finding 3: Students who are harassed based on actual or perceived sexual orientation, reported higher levels of risk on a wide array of academic, health, and safety measures."  Risk Ratio for a "Depression" related item experienced by Harassed Group versus Others in the past year: 2.4: 55% vs. 23%; for having "Seriously Considered Suicide" in the past year: 3.2: 45% vs.14%; and for having "Made a Plan for Suicide" in the past year: 3.9: 35% vs. 9%. NOTE: Information about adolescents having "Attempted Suicide" in the past year was solicited in the CHK Survey, along with suicide attempts for which medical attention was obtained, but related results were not reported for the Harassed Group compared to Other Students.

Reis & Saewyc (1999) reported some results from the 1995 Seattle Youth Risk Behavior Survey. For Grade 9 to 12 heterosexual identified adolescents, those targeted for anti-GLB harassment were not only more at risk for the 4 measures of suicidality experienced in the past year, but they were also at increasing risk for the more serious forms of suicidality. The results: Seriously Considering Suicide, 33.2% vs. 15.5%, Risk Ratio (RR) = 2.1 -- Planning Suicide, 35.2% vs. 14.3%, RR = 2.5 -- Attempting Suicide one or more times, 20.5% vs. 5.7%, RR = 3.6 -- Medical Attention was received for at least one Suicide Attempt, 8.6% vs. 1.7%, RR = 5.0.
A total of 185 males (who responded to the Attempted Suicide" question) reported Anti-GB Harassment: "Heterosexual" = 125 (67.6%),  "Unsure" of the sexual orientation = 24 (13.0%), and Gay/Bisexual = 36 (19.4%).
A total of 388 females (who responded to the Attempted Suicide" question) reported Anti-GB Harassment: "Heterosexual" = 292 (75.3%),  "Unsure" of the sexual orientation = 30 (7.7%), and Gay/Bisexual = 66 (17.0%).
Interestingly, the tabulated results for the 1995 Seattle Youth Risk Behavior Survey reveal that the greatest suicidality effects associated with anti-GLB harassment are heterosexual identified adolescents (generally ignored in Anti-GLB Harassment/Abuse research, even if they form the great majority of those experiencing Anti-GLB Harassment), followed by those who are "Unsure" about their sexual orientation (also ignored in research). The data also suggests that the effects of Anti-GLB Harassment/Abuse on the suicidality of GLB adolescents is non-existent, or almost non-existent. (Note: These results require a discussion with possible explanations that will eventually be the subject of a new webpage.)

Research Indicating that Adolescents are Reprimanded/Harassed Because they are Deemed to not be Masculine Enough (are too feminine) for Boys, or not Feminine Enough (too masculine) for Girls.
California Safe Schools Coalition & 4-H Center for Youth Development (2004): "Many students reported harassment based on gender non-conformity and unsafe school climates for gender non-conforming students. 27 percent of students surveyed reported being harassed because they were “not masculine enough” or “not feminine enough.” 53 percent of students said their schools were unsafe for “guys who aren’t as masculine as other guys,” and 34 percent said their schools were unsafe for “girls who aren’t as feminine as other girls.”

Research Reporting that Gender Nonconforming Children are Often Disliked - or at Least not Approved of - by Peers (beginning is preschool), and Even by Adults, often Including their Parents.

Horn SS (2007): "This study investigated tenth- and twelfth-grade adolescents’ (N ≤ 264) judgments about the acceptability of same-sex peers who varied in terms of their sexual orientation (straight, gay or lesbian) and their conformity to gender conventions or norms in regard appearance and mannerisms or activity. Overall, the results of this study suggest that adolescents’ conceptions of the acceptability of their peers are related not just to sexual orientation but also conformity to gender conventions. Both straight and gay or lesbian individuals who were non-conventional in their appearance and mannerisms were rated as less acceptable than individuals who conformed to gender conventions or those who participated in non-conventional activities. Most surprisingly, for boys, the straight individual who was non-conforming in appearance was rated less acceptable than either the gay individual who conformed to gender norms or was gender non-conforming in choice of activity...In a series of studies on early adolescents’ judgments of others based on gender conformity, Lobel and colleagues (Lobel, 1994; Lobel et al., 1993; Lobel et al., 1999) found that cross-gender behavior in individuals was judged harshly by adolescents, particularly for boys. Further, there is some evidence to suggest that in adolescence cross-gender behavior is seen as maladaptive and that individuals who exhibit "non-normative" behavior regarding gender appearance, activities, or preferences are often sanctioned by both peers and adults (Carr, 1998; Carter and Patterson, 1982; Martin, 1990; Plummer, 2001; Stoddart and Turiel, 1985). Further, individuals who fall outside the range of what is considered acceptable for their gender in terms of mannerisms, appearance, or activities are often the targets of much ridicule, teasing, and harassment from their peers (Eder et al., 1995; Kimmel and Mahler, 2003; Lobel, 1994; Lobel et al., 1993; Lobel et al., 1999). Additionally, research with adolescents on homophobia and anti-gay prejudice suggest that anti-gay attitudes are in place by early adolescence (Baker and Fishbein, 1998; Mandel and Shakeshaft, 2000) and that individuals who hold conventional beliefs about gender roles are more likely to be prejudiced and less likely to befriend agay or lesbian person ( Marsiglio, 1993). Moreover, a growing body of literature on sexual minority youth and risk speculates that much of the stigma and victimization faced by sexual minority youth is related to gender-atypicality (Russell, 2003; Savin-Williams and Ream, 2003)..."

Smith TE, Campbell L (2005)
: "Participants were 229 adolescents who completed questionnaire measures of self-concept and multidimensional gender identity. Regression analysis indicated peer acceptance partially mediated the relation between self-perceived gender typicality and self-worth. Cluster analysis revealed four groups of adolescents with differing profiles of selfperceived gender typicality, felt peer pressure for gender conformity, and peer acceptance. Findings highlight the inherently social and contextual nature of gender identity. Also, the pathologizing of gender-nonconforming youth is discussed... As our data indicate, multiple patterns of gender identity and adjustment exist for adolescents with peer acceptance being a critical mediator. Importantly, there was no difference in the self-worth of nonconforming and conforming adolescents if they felt accepted by their peers. Moreover, this pattern was seen when girls and boys were tested separately. Thus, peer acceptance is likely more fundamental to adolescent adjustment than is their gender conformity. In closing, we propose redirecting some of the focus away from the person and toward the social context when considering the relation between gender conformity and adjustment. In many instances, a genderatypical child is classified as abnormal..."

Blakemore JEO (2003)
: "This research examined 3- to 11-year-old children’s knowledge of and beliefs about violating several gender norms (e.g., toys, play styles, occupations, parental roles, hairstyles, and clothing) as compared to social and moral norms... Boys with feminine hairstyles or clothing were evaluated more negatively than girls with masculine hairstyles or clothing. On the other hand, girls who played in masculine play styles were devalued relative to boys who played in feminine styles. Evaluations of norm violations were not consistently related to age."

Martin CL (1990): "Cross-sex behavior in boys generally is viewed more negatively than crosssex behavior in girls. The two goals of this study were to assess attitudes toward tomboys and sissies, and to explore possible causes for differential evaluations of tomboys and sissies. Eighty undergraduates completed  uestionnaires assessing their attitudes toward tomboys and sissies, and their expectations for the future adult behavior of typical boys, typical girls, tomboys, and sissies. Results revealed that sissies were more negatively evaluated than tomboys. Women were more accepting of, and perceived more societal acceptance for cross-sex children, than were men. One reason for the negative evaluation of sissies may be that there is more concern for their future outcomes than for tomboys. Analyses of predictions concerning future behavior showed that sissies, more so than tomboys, were expected to continue to show cross-gender behavior into adulthood. Also, sissies were rated as likely to be less well adjusted and more likely to be homosexual when they grow up than other children. The accuracy of these beliefs and their implications for child-rearing practices are discussed."

Smetana JG (1986): "48 preschool children, 24 boys and 24 girls, reasoned and made judgments about counterstereotypical sex-role behaviors and appearances in comparison to judgments regarding moral and conventional transgressions. Sex-role transgressions were judged to be more flexible, permissible, and subject to subordinate jurisdiction than moral or conventional transgressions. Children were more strongly committed to the maintenance of male than female sex-role expectations and to female sex-typed appearances than activities. Boys also considered male cross-gender appearances more serious than male cross-gender activities. Children reasoned about sex-role violations as personal or conventional issues; male sex-role deviations were more likely to be seen as violations of social norms than were female sex-role deviations. Personal reasoning about sex roles was significantly correlated with greater flexibility and less commitment to sex-role expectations. Thus, young children were flexible but committed to sex-role expectations, and sex-role concepts were multifaceted, entailing different types of social concepts."

Anti-Crossgender Attitudes Exist (Are Instilled) in Childhood Before Children Have Any Awareness/Understanding of Homosexuality.
Plummer (2001): "This paper explores the use of homophobic terms by boys and young men and the meanings they invoke when using them. Highly detailed interviews were conducted with young men from diverse backgrounds about their own experiences while growing up and their observations of schools, teachers, family and peers. Homophobia was found to be more than a simple prejudice against homosexuals. Homophobic terms like ‘‘poofter’’ and ‘‘faggot’’ have a rich developmental history and play a central role in adolescent male peer-group dynamics. Homophobic terms come into currency in primary school. When this happens, words like poofter and faggot rarely have sexual connotations. Nevertheless, far from being indiscriminate terms of abuse, these terms tap a complex array of meanings that are precisely mapped in peer cultures, and boys quickly learn to avoid homophobia and to use it decisively and with great impact against others. Significantly, this early, very powerful use of homophobic terms occurs prior to puberty, prior to adult sexual identity and prior to knowing much, if anything, about homosexuality. An effect of this sequence is that early homophobic experiences may well provide a key reference point for comprehending forthcoming adult sexual identity formation (gay or not) because powerful homophobic codes are learned first.

The 'Crossgender Equal to Homosexuality' Obsession. OR: If One is a 'Real Male' or 'Real Female', then One Must be Heterosexual: Sexually Attracted to - and Sexual Desiring of - Opposite Sex Individuals.
Carr (2005): "Social scientists distinguish among the interrelated constructs of sex, gender, and sexuality. Yet both scholars and lay persons commonly conflate the three. Here sex is defined as the anatomical, biological, and genetic aspects of persons by which they are socially assigned into the categories of male and female. Gender includes social practices organized in relation to biological sex (cf. Connell, 1987). Sexuality consists of social practices regarding erotic desire, pleasure, and reproduction. Sex/gender/sexual conflation is a fusion or confusion of terms, including beliefs that sex is the same as gender, that gender connotes sexuality, or that sexuality is equal to sex. Sex/gender/sexual conflation emerges from what Ponse (1978) termed the "principle of consistency," a presumed natural and inevitable connection among sex, gender, and sexuality, where "deviation from gender ... is an indication of deviance, either latent or actual, from heterosexuality" (Phelan, 1993, p. 775). In accord with this principle, for example, people suppose that females are or should be heterosexual and relatively "feminine," that noncompliance with gender norms signifies homosexuality, and that detours from heterosexuality indicate "masculinity" or "maleness" in women. [With similar conclusions applying to males: 'In accord with this principle, for example, people suppose that males are or should be heterosexual and relatively "masculine," that noncompliance with gender norms signifies homosexuality, and that detours from heterosexuality indicate "femininity" or "femaleness" in men.']  Despite their relatedness, confusing, merging, and equating sex, gender, and sexuality is often problematic. Sex/gender conflation promotes terminological confusion and political problems by reducing the social to the biological (cf. Pryzgoda & Chrisler, 2000). Sex/sexual conflation encourages the view that bisexuals, lesbians, and gay men are abnormal females and males--an idea reinforced by scientists who continue to search for biological differences between homosexuals and heterosexuals (cf. Fausto-Sterling, 1985; Peplau & Garnets, 2000; Veniegas & Conley, 2000)..."

Baker & Fishbein (1998): "The authors studied the development of gay and lesbian prejudice in white, suburban adolescents in grades 7, 9, and 11. Results parallel several major findings with adults: males were more prejudiced than females; this difference was greater towards gay males than lesbians; and same-sex prejudice was greater than opposite-sex prejudice. For males and females prejudice increased between grades 7 and 9, but from grades 9 to 11 it decreased for females and increased for males. These differences were explained by the increased vulnerability of males to defensive reactions in response to the prospect of intimate relationships. None of the personality measures were significantly correlated with prejudice."

Eliason MJ (1997). "Little scientific attention has been paid to bisexuality or to societal attitudes about bisexual people. Often, biphobia has been assumed to be identical to homophobia. In this study, 229 heterosexual undergraduate students rated their degree of agreement to stereotypical statements about bisexuality and provided information on their attitudes about the acceptability of bisexual, gay, and lesbian people. Although there was a high degree of correlation between biphobia and homophobia, negative attitudes about bisexuals, men in particular, were more prevalent than negative attitudes about lesbians or gay men. Biphobia and homophobia should be considered related, but distinct, phenomena."

Mohr JJ, Sedlacek WE (2000): "Survey data from 2,925 incoming college freshmen at a state university revealed that nearly 40% of the participants reported that they might like to have a lesbian or gay friend, despite anticipations of discomfort. Perceived barriers were significantly related to gender, diversity orientation, shyness, and religious commitment. Implications for research and intervention are discussed."

Shakeshaft et al. (1997): "Boys who don’t fit the stereotypic male mold. Harassment of boys often took the form of homophobic insult, in which boys were called queer, old lad girl, sissy, or any name tint linked them to a female or feminine behavior. Fear of being labeled a homosexual was much more common than fear of actually being one. Boys didn’t want others to believe they were homosexual and worked bird to make sure that their behavior fit an imagined norm. Such insults were hurled at boys for any perceived weakness. Many boys told us that the most common verbal assault among their male peers was to equate the boy with femininity. “You’d  call a person a pussy if they were afraid to do something,” said one middle school boy. “Like if we were drinking and they were afraid to drink.” This description of treatment by 7th and 8th grade boys was typical of the homophobic club wielded againt boys who didn’t conform to a macho Image:  “If they were quiet, if they acted different in the way they walked or acted in the hall - like hyper or something - or if they were into karate, or acted in any way different from the rest, they’d get laughed about. Kids make up nicknames like gay and faggot." A 7th grade boy told us that if a boy didn't talk about having sex with girls, then his peers assumed he was a homosexual. If he is not interested in girls. they might call him gay. "When we’re talking about girls there is this one kid who is silent and we wonder why he is not talking about having sex with girls. We say, ‘What’s wrong with him?'" Boys who didn’t excel in athletics became targets. A 9th grader told us, “If someone isn’t good in sports, They’ll call him a faggot. One time a kid missed the ball and he did something stupid. and they called him a f____ fag." Our study showed that the fear of being labeled a homosexual was central to male adolescent life and was a strong influence on male behavior."

Shakeshaft  (2001): "Peer male to male sexual violence uses homophobia as the club. Anti-homosexual bigotry depends upon traditional stereotypic gender roles.6 Females must be soft and compliant and males strong and silent. It is estimated that students hear anti-gay comments at least 26 times a day and teachers fail to respond to at least 97% of the incidents (Jennings, 2000). As Jennings points out, "our culture teaches boys that being a man is the most important thing in life, even if you have to kill someone to prove it. Killing someone who calls you a faggot is not aberrant behavior but merely the most extreme expression of a belief that is beaten (sometimes literally) into boys at an early age in this country: Be a man, don't be a faggot." (1998) Given these attitudes and the lack of intervention in homes and schools, it's not surprising that the horrific school shootings in the past five years have been by males, mostly white, who have been harassed by other males and called "faggots". As we would expect, none of the shooters identified as homosexual; all identified as heterosexual and believed that a violent response to being labeled a homosexual was appropriate. Interestingly, and in stark contrast to white heterosexual male responses, gay males and lesbians have not turned to guns to even the score when harassed and harmed by homophobic bigots and others." [6. These stereotypes still exist, particularly the male gender role expectations. See Mandel and Shakeshaft (1999) which details the ways that heterosexism and homophobia work hand-in-hand to limit the options of boys.]

Feinman (1984): "The greater disapproval of cross-sex-role behavior performed by males than by females (Bullough, 1974; Feinman, 1974; Fling & Manosevitz, 1972; Hesselbart, 1977; Lansky, 1967) and the lower frequency of cross-sex-role behavior by males than by females (Bem, 1974; Bern & Lenney, 1976; Hartup & Moore, 1963; Ross & Ross, 1972)..." [See also: Aumann et al., 2001]

Sugawara et al. (1986): "Results revealed that children with more stereotypic child activity preferences had significantly higher (more positive) self-concepts than children with less stereotypic child activity preferences. On the other hand, children who were less aware of the sex-trait stereotypes had significantly higher self-concepts than children who were more aware of the stereotypes.

Harding T (2007): "Despite the participants’ beliefs that the majority of male nurses are heterosexual, the stereotype persists. A paradox emerged between the ‘homosexual’ general nurse and the ‘heterosexual’ psychiatric nurse. The stigma associated with homosexuality exposes male nurses to homophobia in the workplace. The heterosexual men employed strategies to avoid the presumption of homosexuality; these included: avoiding contact with gay colleagues and overt expression of their heterosexuality. There is a paradox between widespread calls for men to participate more in caring and discourses which stereotype male nurses as gay and conflate homosexuality and sexual predation. These stigmatizing discourses create a barrier to caring and, aligned with the presence of homophobia in the workplace, deter men’s entry into the profession and may be important issues with respect to their retention.

Jennings (1975): 32 preschool boys and girls heard 2 stories: 1 about a character of their sex and 1 about a character of the opposite sex. A significant number of subjects preferred the story where the character displayed accurate behavior for the sex. Higher mean scores for recall were recorded for the story where the character's sex role was atypical. The scores were significant for both male and female subjects.

Grant J (2004): "This essay charts the changing definitions and experiences of sissy boys in early twentieth century America. At this time the term sissy, which had emerged out of the boy culture of mid nineteenth century America, evolved to encompass not only social but familial and clinical opprobium. In the nineteenth century, sissies might be castigated by their peers but celebrated by their families. Little boys were considered to be the province of their mothers and were not expected to adhere to strict gender boundaries. By the turn of the century, both little and older boys were held to a higher gender standard due to major transformations in child rearing, peer culture, and adult masculinity..."

Gomes D (1995): The distinction between "normal" sexuality and sexual "deviance" was critical for postwar Americans shocked by the revelations of "The Kinsey Report." The childrearing magazines reinforced the belief that masculinity, femininity, and normal heterosexuality were essential traits in healthy, well-adjusted boys and girls. Using their ability to define sexual normalcy, the experts warned that homosexuality did not just "afflict" adults, but that such deviant traits as "sissiness" in boys and "unhappiness" in girls appeared in childhood, and should be detected and corrected by alert, informed parents... Domestic containment, Elaine Tyler May reminds us, was designed not only to curtail female work force participation but to limit expressions of sexuality to heterosexual marital intercourse. Popular parenting literature affirms that the postwar impetus to educate children about sex was intended to regulate childhood and adolescent expressions of sexuality. Evident in the experts' insistence that boys remained masculine and not "sissies" and that girls projected femininity and not "unhappiness" was the national preoccupation with homosexuality. "Sissy" boys and "unhappy" girls were perceived to be potential homosexuals and therefore potential threats to national security.

Sandfort et al. (2007): "This study found that compared with genderconforming gay and bisexual Latino men, gendernonconforming gay and bisexual Latino men reported more childhood sexual abuse, had been verbally/physically abused and raped by relatives and/or lovers more frequently, and reported more experiences with homophobia. Gay and bisexual Latino men who considered themselves effeminate also had higher levels of mental distress. These higher levels of mental distress in effeminate men seemed to primarily result from more experiences of homophobia, as suggested by the outcomes of our mediation analysis.... Although the assessed homophobic experiences will have primarily resulted from interactions with heterosexual individuals, they might also come from within the gay community. Studies have described the idealization of masculinity in the gay community and the related rejection of femininity (Altman, 1982; Gough, 1989; Levine 1992, 1998) even resulting in the introduction of the concept of "sissyphobia," indicating the negative attitude in the gay community toward effeminate men as sexual partners (Bergling, 2001; see also Taywaditep, 2001). Such experiences were, however, not assessed in this study.

Landolt MA, Bartholomew K, Saffrey C, Oram D, Perlman D (2004): "A community sample of 191 gay and bisexual men completed questionnaires and an attachment interview. Gender nonconformity was significantly associated with paternal, maternal, and peer rejection in childhood.

Bem papers download:

Altman D (1982). The homosexualization of America. Boston: Beacon Press.

Aumann N, Baker BD, Kusadokoro H, Soriano J (2001). Cross-Gendered Activities: Fighting an ancient urge. Working Paper. Full Text: Download Page.

Baker J, Fishbein H (1998). The development of prejudice towards gays and lesbians by adolescents. Journal of Homosexuality, 36: 89–100. Abstract.

Bartlett NH, Vasey PL (2006). A retrospective study of childhood gender-atypical behavior in Samoan fa'afafine. Archives of Sexual Behavior, 35(6): 659-66. Full Text.

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Bem SL, Lenney E (1976). Sex typing and the avoidance of cross sex behavior. Journal of Personality and Social Psychology, 33: 48-54. Full text: .

Bergling T (2001). Sissyphobia: Gay men and effeminate behavior. New York: Harrington Park Press.

Blakemore JEO (2003). Children’s beliefs about violating gender norms: Boys shouldn’t look like girls, and girls shouldn’t act like boys. Sex Roles, 48(9): 411–19. Full Text:

Bontempo DE, D'Augelli AR (2002). Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths' health risk behavior. Journal of Adolescent Health, 30(5): 364-74. Full Text:

Bullough VL (1974). Transvestites in the Middle Ages. American Journal of Sociology, 79: 1381-1394.
Abstract & First Page.

California Safe Schools Coalition & 4-H Center for Youth Development (2004). Safe Place  to Learn: Consequences of Harassment Based on Actual or Perceived Sexual Orientation and Gender Non-Conformity and Steps for Making Schools Safer.

Carr CL (2005). Tomboyism or lesbianism? Beyond sex/gender/sexual conflation. Sex Roles,  53(1/2): 119-131. Full Text:

Carr CL (1998). Tomboy resistance and conformity: Agency in social psychological gender theory. Gender and Society, 12: 528–553.
Abstract & First Page.

Carter DB, Patterson C (1982). Sex-roles as social conventions: The development of children’s conceptions of sex-role stereotypes. Developmental Psychology, 18: 812–824.

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D'Augelli AR, Grossman AH, Salter NP, Vasey JJ, Starks MT, Sinclair KO (2005). Predicting the suicide attempts of lesbian, gay, and bisexual youth.  Suicide & Life Threatening Behavior, 35(6): 646-60. Full Text:

Crosby RA, Pitts NL (2007). Caught Between Different Worlds: How Transgendered Women May Be "Forced" Into Risky Sex. Journal of Sex Research, 44(1): 43-48. Abstract. Abstract. Full Text. "Finally, women experienced multiple forms of societal discrimination. By being caught between worlds (straight, gay, male, and female), transgendered women may be placed into situations in which avoiding HIV risk is extremely difficult."

Eliason MJ (1997). The Prevalence and Nature of Biphobia in Heterosexual Undergraduate Students. Archives of Sexual Behavior, 26(3): 317-326. Abstract.

Evans L, Davies K (2000). No sissy boys here: A content analysis of the representation of masculinity in elementary school reading textbooks. Sex Roles, 41: 255-270. Full Text:

Fausto-Sterling A. (1985). Myths of gender: Biological theories about women and men (2nd ed.). New York: Harper Collins.

Feinman S (1974). Approval of cross-sex-role behavior. Psychological Reports, 35: 643-648.

Feinman S (1984). A Status Theory of the Evaluation of Sex-Role and Age-Role Behavior. Sex Roles, 10(5/6): 445-456. Abstract.

Feinman S (1981). Why is cross-sex-role behavior more approved for girls than for boys? A status characteristic approach. Sex Roles, 7(3): 289-300.

Fitzpatrick KK, Euton SJ, Jones JN, Schmidt NB (2005). Gender role, sexual orientation and suicide risk. Journal of Affective Disorders, 87(1): 35-42. Abstract.

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Frable DES, Bem SL (1985). If You're Gender-Schematic, All Members of the Opposite Sex Look Alike. Journal of Personality and Social Psychology, 49(2): 459-468. Full Text:

Gomes D (1995). "Sissy" Boys And "Unhappy" Girls: Childrearing During The Cold War. Thresholds: Viewing Culture, 9: 7-18 [
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Grant J (2004). 'Real Boy' and not a sissy: gender, childhood, and masculinity, 1890-1940. Journal of Social History, 37(4): 829-851. Summary:

Harding T (2007). The construction of men who are nurses as gay. Journal of Advanced Nursing, 60(6): 636–644.

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Horn SS (2007). Adolescents’ Acceptance of Same-Sex Peers Based on Sexual Orientation and Gender Expression. Journal of Youth and Adolescence, 36(3): 363-371. Abstract.

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Abstract & First Page.

Landolt MA, Bartholomew K, Saffrey C, Oram D, Perlman D (2004). Gender Nonconformity, Childhood Rejection, and Adult Attachment: A Study of Gay Men. Archives of Sexual Behavior, 33(2), 117-128. Full Text:

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Data Tables

1995 Seattle Youth Risk Behavior Survey Results

Attempted Suicide: Males - 1995 Seattle Youth Risk Behavior Survey

Attempted Suicide: Females - 1995 Seattle Youth Risk Behavior Survey

*Attempted suicide incidence in the past 12 months by heterosexual, gay (G), and bisexual (B) adolescent males (Table 1) - or heterosexual, lesbian (L), and bisexual (B) females (Table 2) - who were or were not the "target of offensive comments or attacks" related to their presumed homosexual orientation at school or on the way to school. "Attempt(s) with Med. Attention" means one or more suicide attempts associated with having received medical attention. Saewyc (2002: 17) made the data on males and females available to the authors. About 89% of students answered both the questions related to sexual orientation and anti-GLB harassment.
Ethic Composition of Study Sample: 34% European-American, 26% Asian American, 18% African-American, 1% American Indian, 14% multi-ethnic, and 3% other. Respondents were evenly distributed from Grades 9 to 12. Almost equal numbers of males and females (Saewyc, 2000: 18).
1. Risk Ratios are calculated with a 95% Confidence Interval by the authors of the Alert. They represent comparisons with "not targeted" heterosexual male values or heterosexual female values for the Row Variable. "ns" = not significant.
2. Risk Ratios (95% Confidence Intervals) for being targeted for anti-GLB harassment, compared to Heterosexual males or Heterosexual females. For GB Males compared to "Unsure" Males: RR = 1.6<2.6<4.1. For LB Females compared to "Unsure" Females: RR = 2.1<3.0<4.4

Suicidality Results: University of Washington Students

Information related to victimization in the past year was solicited: victimization types & number, on and off campus, including on the basis of the assumption that one is non-heterosexual (GLB). Generally, non 100% heterosexual were most at risk for suicidality, with some exceptions, noting also a low count problem (subgroup sizes and suicidality counts). Result from regression analyses revealed that victimization on the basis of the assumption that one is GLB was implicated in suicidality for both sexual minority and heterosexual identified students.

It is doubted that heterosexual identified individuals reporting same-sex attractions or same-sex sexual activities would be “out” about this aspect of their lives, but some were nonetheless targeted for anti-gay comments / harassment. This likely happened because they were manifesting some gender nonconformable attributes, as such individuals were reported to have in the Dunne et al. (2000) study of Twins in Australia: “A continuous measure of childhood gender nonconformity (CGN) was sensitive to slight variations in homosexual attraction and behavior. In particular, among both men and women who identified as heterosexual, there were significant differences between “complete” heterosexuals and those who admitted to only one or a few same-sex behaviors but no homosexual attraction. Among men, CGN scores distinguished between heterosexuals who admitted to same-sex behavior only and those who admitted to some homosexual attraction. The sexual subgroups also differed on a measure of gender atypicality in adulthood.” (21)

Note: Only 12 of the 528 students had attempted suicide in the past year: 2 males and 10 females. “The Homosexuality Factor” is associated with the 2 male suicide attempters (100%) and 5 out of the 10 female suicide attempters (50%), for a total of 7 out of 12 suicide attempters (58.2%). Suicide attempts requiring medical attention were reported by 2 females, both also acknowledging some same-sex attraction or behavior.  A similar result was reported by Bagley & Tremblay (1997) from a random sample of 750 young adult males in Calgary: Five out of the 8 serious suicide attempters (62.5%) were either homosexual or bisexual identified (n = 3) or they were heterosexual identified and reported same-sex sex in the past 6 months (n = 2) (22).

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