of use among males was twice as high as among females (18% versus 9%). Rates of regular HED also showed notable gender differences across age, with females reporting significantly lower rates of regular HED than males at all ages 16 to 31. Furthermore, the trajectories for males and females were notably different. Among males, regular HED increased from age 12 to a peak prevalence of 56% at approximately age 22 and then steadily decreased to age 31. In contrast, females showed a more variable HED trajectory, with a plateau near 10% from age 15 to 17 and two peaks during their 20s (43% prevalence at ages 21 and 27).
