Young people who conform most strongly to norms of masculinity and femininity—the most “feminine” girls and the most “masculine” boys—are significantly more likely than their peers to engage in behaviors that pose cancer risks, according to a new study led by Harvard School of Public Health (HSPH) researchers. The most feminine teenage girls use tanning beds more frequently and are more likely to be physically inactive, while the most masculine teenage boys are more likely to use chewing tobacco and to smoke cigars, compared with their gender-nonconforming peers.

The study, the first to look at cancer risk behaviors in teens based on their gender expression, appears online April 16, 2014 in Journal of Adolescent Health.

“Our findings indicate that socially constructed ideas of masculinity and femininity heavily influence teens’ behaviors and put them at increased risk for cancer. Though there is nothing inherently masculine about chewing tobacco, or inherently feminine about using a tanning booth, these industries have convinced some teens that these behaviors are a way to express their masculinity or femininity,” said lead author Andrea Roberts, research associate in the Department of Social and Behavioral Sciences at HSPH.