Abstract

Objective

Pubertal gynecomastia is associated with psychosocial consequences including anxiety, depression, and body image disturbances. However systematic examination of bullying experiences and their psychological correlates in adolescents with gynecomastia remains limited. This study aims to investigate peer victimization prevalence and its relationship with psychological outcomes in this vulnerable population.

Methods

This case-control study included 155 male adolescents aged 10-17 years, comprising 78 participants with gynecomastia and 77 healthy controls.Gynecomastia diagnosis and severity were assessed using clinical examination and Rohrich classification. Participants completed validated Turkish versions of the Olweus Bully/Victim Questionnaire, Rosenberg Self-Esteem Scale, and Revised Child Anxiety and Depression Scale.

Results

Adolescents with gynecomastia demonstrated significantly elevated peer victimization rates compared to controls (34.6% versus 16.9%, p=0.012), with markedly increased victim-perpetrator status (12.8% versus 1.3%, p=0.005). Gynecomastia diagnosis increased victimization risk 2.63-fold (95% CI: 1.076-6.436, p=0.034). Victimized participants exhibited elevated anxiety and depression scores across multiple symptom domains (p < 0.05). Behavioral modifications were prevalent, including altered clothing preferences (58.9%), changing room avoidance (44.8%), and swimming avoidance (41.0%).

Conclusions

Adolescents with gynecomastia experience substantially elevated peer victimization with consequential psychological impact. These findings underscore the imperative for routine bullying assessment during clinical evaluation and implementation of comprehensive psychosocial screening protocols with early intervention strategies.