Introduction The number of adolescents referred to specialized gender identity clinics for gender dysphoria appears to be increasing and there also appears to be a corresponding shift in the sex ratio, from one favoring natal males to one favoring natal females. Aim We conducted two quantitative studies to ascertain whether there has been a recent inversion of the sex ratio of adolescents referred for gender dysphoria. Methods The sex ratio of adolescents from two specialized gender identity clinics was examined as a function of two cohort periods (2006–2013 vs. prior years). Study 1 was conducted on patients from a clinic in Toronto, and Study 2 was conducted on patients from a clinic in Amsterdam. Results Across both clinics, the total sample size was 748. In both clinics, there was a significant change in the sex ratio of referred adolescents between the two cohort periods: between 2006 and 2013, the sex ratio favored natal females, but in the prior years, the sex ratio favored natal males. In Study 1 from Toronto, there was no corresponding change in the sex ratio of 6,592 adolescents referred for other clinical problems. Conclusions Sociological and sociocultural explanations are offered to account for this recent inversion in the sex ratio of adolescents with gender dysphoria.

Aims We tested the age‐varying associations of cannabis use (CU) frequency and disorder (CUD) with psychotic, depressive and anxiety symptoms in adolescent and adult samples. Moderating effects of early onset (≤ 15 years) and sex were tested. Design Time‐varying effect models were used to assess the significance of concurrent associations between CU and CUD and symptoms of psychosis, depression and anxiety at each age. Setting and Participants Adolescent data (V‐HYS; n = 662) were collected from a randomly recruited sample of adolescents in Victoria, British Columbia, Canada during a 10‐year period (2003–13). Adult cross‐sectional data (NESARC‐III; n = 36 309) were collected from a representative sample from the United States (2012–13). Measurements Mental health symptoms were assessed using self‐report measures of diagnostic symptoms. CU was based on frequency of past‐year use. Past‐year CUD was based on DSM‐5 criteria. Findings For youth in the V‐HYS, CU was associated with psychotic symptoms following age 22 [ b = 0.13, 95% confidence interval (CI) = 0.002, 0.25], with depressive symptoms from ages 16–19 and following age 25 ( b = 0.17, 95% CI = 0.003, 0.34), but not with anxiety symptoms. CUD was associated with psychotic symptoms following age 23 ( b = 0.51, 95% CI = 0.01, 1.01), depressive symptoms at ages 19–20 and following age 25 ( b = 0.71, 95% CI = 0.001, 1.42) and anxiety symptoms ages 26–27 only. For adults in the NESARC‐III, CU was associated with mental health symptoms at most ages [e.g. psychotic symptoms; age 18 ( b = 0.22, 95% CI = 0.10, 0.33) to age 65 ( b = 0.36, 95% CI = 0.16, 0.56)]. CUD was associated with all mental health symptoms across most ages [e.g. depressive symptoms; age 18 ( b = 0.96, 95% CI = 0.19, 1.73) to age 61 ( b = 1.11, 95% CI = 0.01, 2.21)]. Interactions with sex show stronger associations for females than males in young adulthood [e.g. V‐HYS: CUD × sex interaction on psychotic symptoms significant after age 26 ( b = 1.12, 95% CI = 0.02, 2.21)]. Findings were not moderated by early‐onset CU. Conclusions Significant associations between cannabis use (CU) frequency and disorder (CUD) and psychotic and depressive symptoms in late adolescence and young adulthood extend across adulthood, and include anxiety.

The number of students with autism spectrum disorder (ASD) pursuing postsecondary education is increasing. A mentorship program was developed to help students with ASD navigate the social and academic framework of postsecondary campus life. The present study (a) provides information about a sample of university students with ASD and (b) evaluates satisfaction with the support provided. This is the first study in Canada to report on the experience of students with ASD and to evaluate this novel approach. Students (N = 23) provided demographic information in the fall and completed surveys evaluating their satisfaction at the end of each academic year. Since beginning the program, the number of students has increased by 200%. High levels of satisfaction were reported. The majority of students reported success in achieving personal goals in part due to their participation in the program. Results better inform the development of supports for students with ASD.

Adolescence and young adulthood is a critical stage when the economic foundations for life-long health are established. To date, there is little consensus as to whether marijuana use is associated with poor educational and occupational success in adulthood. We investigated associations between trajectories of marijuana use from ages 15 to 28 and multiple indicators of economic well-being in young adulthood including achievement levels (i.e., educational attainment and occupational prestige), work characteristics (i.e., full vs part-time employment, hours worked, annual income), financial strain (i.e., debt, trouble paying for necessities, delaying medical attention), and perceived workplace stress. Data were from the Victoria Healthy Youth Survey, a 10-year prospective study of a randomly recruited community sample of 662 youth (48% male; M = 15.5), followed biennially for six assessments. Models adjusted for baseline age, sex, SES, high school grades, heavy drinking, smoking, and internalizing and oppositional defiant disorder symptoms. Chronic users (our highest risk class) reported lower levels of educational attainment, lower occupational prestige, lower income, greater debt, and more difficulty paying for medical necessities in young adulthood compared to abstainers. Similarly, increasers also reported lower educational attainment, occupational prestige, and income. Decreasers, who had high early use but quit over time, showed resilience in economic well-being, performing similar to abstainers. Groups did not differ on employment status or perceived workplace stress. The findings indicate that early onset and persistent high or increasingly frequent use of marijuana in the transition from adolescent to young adulthood is associated with risks for achieving educational and occupational success, and subsequently health, in young adulthood.

There have been significant concerns regarding the mental health impact of coronavirus disease 2019 (COVID-19) due to isolation, anxiety around the pandemic, and increased conflict in the home. The purpose of this study was to examine the rates of mental health symptoms of clinical concern and substance use, and to assess which COVID-19 related stressors were predictors of these symptoms and substance use in a large Canadian sample of adolescents, with comparisons across genders. Participants (N = 809, M age = 15.67, SD = 1.37) identified as a girl (56.2%), boy (38.7%), or trans/nonbinary individuals (TNBI; 5.1%) and were recruited via social media to complete an online survey. A high proportion of adolescents reported symptoms of clinical concern for depression (51%), anxiety (39%), and posttraumatic stress disorder (45%). Other mental health problems ranged from 9% to 20%. Adolescents were mainly concerned with the health of family members and vulnerable populations, as well as the increased family stress at home during COVID-19. Rates of substance use were higher than expected, with over 50% of youth engaging in some form of substance use in the past 90 days, and almost 20% engaging in substance use at least once a week. TNBI and girls reported higher rates of mental health problems compared to boys. Family stress due to confinement and violence at home predicted higher mental health symptoms, but not substance use problems. Increased rates of mental health problems and substance use necessitate targeted supports that encourage positive coping amidst the additional stresses of COVID-19. Public Significance StatementThe coronavirus disease 2019 (COVID-19) pandemic has put unprecedented stress on Canadian adolescence and their families. This paper found higher than expected clinically concerning number of symptoms of mental health problems including depression, anxiety, PTSD, and substance use in Canadian adolescents. Results also suggest that therapies focused on improving family functioning may help alleviate mental health problems in adolescents during and following the COVID-19 pandemic.