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

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.