Poor Peer Relations Predict Parent- And Self-Reported Behavioral and Emotional Problems of Adolescents With Gender Dysphoria: A Cross-National, Cross-Clinic Comparative Analysis

Eur Child Adolesc Psychiatry. 2016 Jun;25(6):579-88. doi: 10.1007/s00787-015-0764-7. Epub 2015 Sep 15.


This study is the third in a series to examine behavioral and emotional problems in children and adolescents with gender dysphoria in a comparative analysis between two clinics in Toronto, Ontario, Canada and Amsterdam, the Netherlands. In the present study, we report Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) data on adolescents assessed in the Toronto clinic (n = 177) and the Amsterdam clinic (n = 139). On the CBCL and the YSR, we found that the percentage of adolescents with clinical range behavioral and emotional problems was higher when compared to the non-referred standardization samples but similar to the referred adolescents. On both the CBCL and the YSR, the Toronto adolescents had a significantly higher Total Problem score than the Amsterdam adolescents. Like our earlier studies of CBCL data of children and Teacher's Report Form data of children and adolescents, a measure of poor peer relations was the strongest predictor of CBCL and YSR behavioral and emotional problems in gender dysphoric adolescents.

Keywords: Adolescents; Behavioral and emotional problems; Child Behavior Checklist; Gender dysphoria; Gender identity disorder; Peer relations; Transgender; Youth Self-Report Form.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology
  • Affective Symptoms / epidemiology
  • Affective Symptoms / psychology*
  • Child
  • Child Behavior Disorders / epidemiology
  • Child Behavior Disorders / psychology*
  • Female
  • Forecasting
  • Gender Dysphoria / epidemiology
  • Gender Dysphoria / psychology*
  • Humans
  • Internationality
  • Interpersonal Relations
  • Male
  • Netherlands / epidemiology
  • Ontario / epidemiology
  • Parents / psychology*
  • Peer Group*
  • Self Report*