Peer Victimization and Psychological Outcomes in Adolescents with Pubertal Gynecomastia: A Case-Control Study

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. The aim of this study was to investigate peer victimization prevalence and its relationship with psychological outcomes in this vulnerable population.

This case-control study included male adolescents aged 10-17 years, comprising half with gynecomastia and half 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.

A total of 155 adolescents were included, with 78 (50.3%) having gynecomastia and the remaining 77 being healthy. Adolescents with gynecomastia demonstrated significantly higher 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% confidence interval: 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%).

Adolescents with gynecomastia experienced substantially elevated peer victimization with consequential psychological impact in this cohort. These findings suggest the importance of routine bullying assessment during clinical evaluation and implementation of comprehensive psychosocial screening protocols with early intervention strategies.