Gender Conformity and Use of Laxatives and Muscle-Building Products in Adolescents and Young Adults

Pediatrics. 2016 Aug;138(2):e20154073. doi: 10.1542/peds.2015-4073. Epub 2016 Jul 14.


Background: Use of laxatives for weight loss and drugs or supplements to build muscle (eg, steroids) differs by gender and sexual orientation; little is known about factors contributing to these disparities. Conformity to gender norms concerning appearance could underlie these differences.

Methods: This study examined associations between childhood gender conformity and laxative and muscle-building product use from ages 13 to 25 years in a sample of 13 683 males and females in the US prospective Growing Up Today Study. Adjusted multivariable logistic regression models of repeated measures estimated odds of past-year laxative and muscle-building product use by quartiles of greater childhood gender conformity in heterosexual and sexual minority (eg, bisexual, gay) participants.

Results: By age 23 years, ∼20% of sexual minority females reported past-year laxative use. By age 19 years, 12% of all males reported past-year muscle-building product use. Sexual minority females had twice the odds of heterosexual females of using laxatives (P < .0001). The most gender-conforming females had 50% greater odds than the least-conforming females of using laxatives (P < .01). Moderate (odds ratio, 2.09; 95% confidence interval, 1.58-2.75) and highly (odds ratio, 1.79; 95% confidence interval, 1.38-2.33) gender-conforming males had higher odds than gender-nonconforming males of using muscle-building products.

Conclusions: Sexual minority females are at high risk for laxative abuse. Regardless of sexual orientation, gender conformity increased the odds of laxative abuse among females and muscle-building product use among males. Findings can inform prevention efforts to target youth at risk for laxative or muscle-building product use.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Anabolic Agents*
  • Body Image / psychology
  • Child
  • Female
  • Gender Identity*
  • Humans
  • Laxatives*
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Psychological Tests
  • Retrospective Studies
  • Self Report
  • Sexuality / psychology*
  • Social Conformity*
  • Social Norms*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology*
  • United States / epidemiology
  • Young Adult


  • Anabolic Agents
  • Laxatives