Addressing Research Gaps in Sexual and Gender Minority Adolescents' Substance Use and Misuse

Abstract

Sexual and gender minority (SGM) adolescents report higher rates of substance use and misuse compared with their heterosexual and cisgender peers [1,2]. These disparities span across several substances, including alcohol, tobacco, marijuana, and prescription and illicit drugs, as well as more recent popular substances such as electronic cigarettes [3]. Disparities in substance use are well documented among sexual minority adolescents, and a growing body of research has more recently documented disparities among gender minority adolescents [2,4]. Risk for disparities in substance use is conferred by sex and sexual identity, with sexual minority girls and bisexual adolescents being at greatest risk [1]. Moreover, longitudinal studies demonstrate that higher rates of substance use and misuse among SGM adolescents are pervasive and persist into adulthood [5][6][7][8][9]. Given the extant literature and emerging evidence showing that these disparities are not declining [10,11], SGM adolescents' substance use and misuse are a serious public health concern.In this issue of the Journal of Adolescent Health, Coulter et al.[12] make an important contribution and address several gaps in the literature. In a large sample of adolescents in California, the authors documented disparities in tobacco and alcohol use between sexual minority and heterosexual adolescents and between transgender and cisgender adolescents. Providing support for the minority stress model [13,14], they also found that genderand sexual orientation-based harassment partially explained these disparities.There is a dearth of research on gender minority adolescents' substance use. Coulter et al. [12] documented disparities in substance use between transgender and cisgender adolescents, with transgender adolescents being at greater risk. Although their study did not utilize a representative sample, they had a sizeable sample of gender minority adolescents that contributed to our knowledge of gender minority disparities. Overcoming challenges of inadequate sexual orientation and gender identity measures in existing datasets, the findings echo the need for the inclusion of more rigorous gender identity measures into nationally representative samples to better understand the unique health needs and disparities of gender minority adolescents.Despite greater disparities in substance use in early adolescence [7,15], research on SGM substance use is predominately on See Related Article on p. 688

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