Minority stress and drug use among transgender and gender diverse adults: A daily diary study

Wolford‐Clevenger, Caitlin; Flores, Leticia Y.; Bierma, Shannon; Cropsey, Karen L.; Stuart, Gregory L.

doi:10.1016/j.drugalcdep.2021.108508

Cited by 23 publications

(11 citation statements)

References 26 publications

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“…Furthermore, the scarcity of specific resources aimed at the transgender demographic, as a consequence of institutional discrimination, would act as a trigger for consumption in this context [65][66][67]. In this sense, other studies indicate that substance abuse is linked to symptoms of depression in transgender women [68], increased stigma [69], and being a victim of transphobic discrimination [70].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, specialised substance abuse interventions must take gender minorities into consideration, and the professionals delivering them must have sufficient training to provide this demographic with appropriate care by, for example, considering the influence of minority stress [65]. This is especially important for prevention, as our findings showed that transgender people do not have higher odds of substance use disorder, but rather are more likely to use substances, especially at younger ages (since much of the sample was middle/high school students).…”

Section: Discussionmentioning

confidence: 99%

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Substance Use in the Transgender Population: A Meta-Analysis

et al. 2022

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(1) Background: This meta-analysis aimed to assess the relationship between identifying as transgender and substance use. (2) Methods: We searched for relevant studies in PubMed, Scopus, the Web of Science, and PsycINFO on 21 July 2021. (3) Results: Twenty studies comparing transgender and cisgender people were included in this work, accounting for a total of 2,376,951 participants (18,329 of whom were transgender). These articles included data on current tobacco use, current tobacco use disorder, current alcohol use, current alcohol use disorder, lifetime substance (all) use, current substance use (excluding tobacco and alcohol), current use of specific substances (excluding tobacco and alcohol and including cocaine, amphetamines, methamphetamines, ecstasy, stimulants, heroin, opiates, cannabis, marijuana, LSD, hallucinogens, steroids, inhalants, sedatives, Ritalin or Adderall, diet pills, cold medicine, prescription medications, polysubstance, other club drugs, and other illegal drugs), and current substance use disorder (excluding tobacco and alcohol). We used the ORs and their 95% CIs to state the association between identifying as transgender and those variables. The control reference category used in all cases was cisgender. We employed a random-effects model. Transgender people were more likely to use tobacco (odds ratio (OR) = 1.65; 95% CI [1.37, 1.98]), have used substances throughout their lives (OR = 1.48; 95% CI [1.30, 1.68]), and present current use of specific substances (OR = 1.79; 95% CI [1.54, 2.07]). When current alcohol and substance use in general and tobacco, alcohol, and substance use disorders specifically were considered, the likelihood did not differ from that of cisgender people. (4) Conclusions: The presence of substance use disorders did not differ between transgender and cisgender people. Considering this population as consumers or as addicted may be a prejudice that perpetuates stigma. Nonetheless, transgender people were more likely to use tobacco and other substances, but not alcohol. Hypothetically, this might be an emotional regulation strategy, a maladaptive mechanism for coping with traumatic experiences, or could respond to minority stress, produced by stigma, prejudice, discrimination, and harassment. It is of particular importance to implement policies against discrimination and stigmatisation and to adapt prevention and treatment services so that they are inclusive of the 2SLGBTQIA+ community.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Substance Use in the Transgender Population: A Meta-Analysis

et al. 2022

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“…Minority stress theory-which describes how the multiple stressors experienced by TGD people negatively impacts their health-provides a model to understand a range of TGD health disparities, including in substance use. 11,12 Estimates of substance use within TGD populations are limited, and further research is needed to elucidate patterns of use as well as treatment. The majority of research documenting SUDs among TGD individuals rely on survey-based data, often focusing specifically on high-risk groups (ie, youth or trans-feminine individuals).…”

mentioning

confidence: 99%

“…Minority stress theory—which describes how the multiple stressors experienced by TGD people negatively impacts their health—provides a model to understand a range of TGD health disparities, including in substance use. 11,12…”

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confidence: 99%

Characterizing Substance Use Disorders Among Transgender Adults Receiving Care at a Large Urban Safety Net Hospital

Braun

Jones

Walley

et al. 2021

Journal of Addiction Medicine

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ObjectivesIn the midst of the opioid crisis, increasing attention has been given to assessing and addressing substance use disorders (SUDs) among transgender and gender diverse (TGD) populations. As electronic health records begin to more uniformly collect gender identity data, clinicians and public health professionals are better able to examine the prevalence of SUDs and the receipt of SUD treatment services in these populations.MethodsWe utilized cross-sectional electronic health records data from January 2005 to December 2019 from a large safety-net hospital in Massachusetts. A cohort of TGD patients was identified using self-reported gender identity data as well as diagnostic and procedures codes associated with receipt of gender-affirming care (n = 2000). We calculated odds of SUD diagnosis and receipt of medications for SUD among TGD patients.ResultsAmong a cohort of 2000 TGD patients, 8.8% had a SUD diagnosis. SUD diagnoses were more common among older, Black, and transmasculine patients, as well as those holding public health insurance. SUD diagnoses were less likely among those reporting college-level education. Of those with an opioid use disorder (OUD), 46% were prescribed an FDA-approved medication for OUD.ConclusionsSUD diagnoses among TGD patients were associated with demographic, socioeconomic, and gender-related factors. We found a modestly lower prevalence of non-tobacco SUD among our cohort of TGD patients than the national average of 7.4%. Despite a relatively better receipt of prescription treatment services than the national average, the low rate of treatment overall represents a missed opportunity to address SUDs in these vulnerable populations.

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“…Daily discrimination was also associated with momentary anxious and depressed mood among SGM people (Livingston et al, 2020), and daily minority stress was related to lower positive and higher negative affect among sexual minority men (Eldahan et al, 2016). Among gender minority people, daily distal minority stressors predicted daily drug use (Wolford-Clevenger et al, 2021). Finally, daily sexual and gender identity-related discrimination was linked to daily nicotine and substance use (Livingston et al, 2017).…”

Section: A Daily Diary Approachmentioning

confidence: 99%

Sexual and Gender Minority Youth’s Mental Health and Substance Use

Kiekens¹

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PART I. Studies on Disparities CHAPTER 2. Sexual Identity Disparities in Mental Health Among UK Adults, US Adults, and US Adolescents: Examining Heterogeneity by Race/Ethnicity 2.1. Introduction 2.2. Method 2.3. Results 2.4. Discussion 2.5. Conclusion CHAPTER 3. Associations of Dating Experiences, Dating Violence, Sexual Harassment, and Assault with Alcohol Use Among Sexual and Gender Minority Adolescents3.1. Introduction 3.2. Methods 3.3. Results 3.4. Discussion 3.5. Conclusion PART II. Studies on Mechanisms CHAPTER 4. Sexual and Gender Identity-Based Microaggressions: Differences by Sexual and Gender Identity, and Sex Assigned at Birth Among Dutch Youth 4.1. Introduction 4.2. Study 1 4.3. Study 2 4.4. Discussion 4.5. Conclusion CHAPTER 5. Explaining Health Disparities Between Heterosexual and LGB Adolescents by Integrating the Minority Stress and Psychological Mediation Frameworks: Findings from the TRAILS Study 5.1. Introduction 5.2. Methods 5.3. Results 5.4. Discussion 5.5. Conclusion CHAPTER 6.

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Minority stress and drug use among transgender and gender diverse adults: A daily diary study

Cited by 23 publications

References 26 publications

Substance Use in the Transgender Population: A Meta-Analysis

Substance Use in the Transgender Population: A Meta-Analysis

Characterizing Substance Use Disorders Among Transgender Adults Receiving Care at a Large Urban Safety Net Hospital

Sexual and Gender Minority Youth’s Mental Health and Substance Use

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