Aim: Students with hearing loss (HL) often fall behind hearing peers in complex language tasks such as narrative writing. This study explored the effects of school grade, gender, cognitive and linguistic predisposition and audiological factors on narrative text quality in this target group. Method: Eleven students with HL in Grades 5-6 and 7-8 (age 12-15) who took part in a writing intervention wrote four narrative texts over six months. A trained panel rated text quality. The effects of the students' working memory capacity, language comprehension, reading comprehension, school grade and gender and the intervention were analyzed as a mixed-effects regression model. Audiological factors were considered separately. Results: The analysis showed that throughout the period, texts written by female students in Grade 7-8 received the highest text quality ratings, while those written by male students in Grade 7-8 received the lowest ratings. There was no effect of the intervention, or of the linguistic and cognitive measures. The students with the lowest text quality ratings received amplification later than those with high ratings, but HL severity was not associated with text quality. Conclusion: Hearing loss severity was not a decisive factor in narrative text quality. The intervention which the students took part in is potentially effective, with some adaptation to the special needs of students with HL. The strong gender effects are discussed.