Sexual Orientation Disparities in Substance Misuse: The Role of Childhood Abuse and Intimate Partner Violence Among Patients in Care at an Urban Community Health Center

Reisner, Sari L.; Falb, Kathryn; Wagenen, Aimee Van; Grasso, Chris; Bradford, Judith

doi:10.3109/10826084.2012.755702

Cited by 23 publications

(30 citation statements)

References 71 publications

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“…Participants completed brief measures of childhood abuse and intimate partner violence used in prior research (Reisner, Falb, Wagenen, Grasso, & Bradford, 2013). Childhood abuse was queried by asking: “Were you ever physically or sexually abused as a child under age 15 years-old?” Participants who indicated “yes” were compared to those who indicated “no.” Similarly, intimate partner violence was assessed with the item: “Have you ever been slapped, punched, kicked, beaten up, or otherwise physically or sexually hurt by your spouse (or former spouse), a boyfriend/girlfriend, or some other intimate partner?” These items are similar to other screening instruments commonly used to assess childhood abuse and IPV in clinical settings (Basile, Hertz, & Back, 2007; Hulme, 2004; McFarlane, Parker, Soeken, & Bullock, 1992).…”

Section: Methodsmentioning

confidence: 99%

Discriminatory experiences associated with posttraumatic stress disorder symptoms among transgender adults.

Reisner¹,

Hughto²,

Gamarel³

et al. 2016

Journal of Counseling Psychology

206

166

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Discrimination has been shown to disproportionately burden transgender people; however, there has been a lack of clinical attention to the mental health sequelae of discrimination, including posttraumatic stress disorder (PTSD) symptoms. Additionally, few studies contextualize discrimination alongside other traumatic stressors in predicting PTSD symptomatology. The current study sought to fill these gaps. A community-based sample of 412 transgender adults (mean age 33, SD=13; 63% female-to-male spectrum; 19% people of color; 88% sampled online) completed a cross-sectional self-report survey of everyday discrimination experiences and PTSD symptoms. Multivariable linear regression models examined the association between self-reported everyday discrimination experiences, number of attributed domains of discrimination, and PTSD symptoms, adjusting for prior trauma, sociodemographics, and psychosocial co-morbidity. The mean number of discrimination attributions endorsed was 4.8 (SD=2.4) and the five most frequently reported reasons for discrimination were: gender identity and/or expression (83%), masculine and feminine appearance (79%), sexual orientation (68%), sex (57%), and age (44%). Higher everyday discrimination scores (β=0.25; 95% CL=0.21–0.30) and greater number of attributed reasons for discrimination experiences (β=0.05; 95% CL=0.01–0.10) were independently associated with PTSD symptoms, even after adjusting for prior trauma experiences. Everyday discrimination experiences from multiple sources necessitate clinical consideration in treatment for PTSD symptoms in transgender people.

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Section: Methodsmentioning

confidence: 99%

Discriminatory experiences associated with posttraumatic stress disorder symptoms among transgender adults.

Reisner¹,

Hughto²,

Gamarel³

et al. 2016

Journal of Counseling Psychology

206

166

View full text Add to dashboard Cite

show abstract

“…We assumed that treatment occurred for actual SUDs rather than subclinical substance use. This item has been used in prior SUD research (Reisner et al, 2013). Past 3-month binge drinking was assessed by asking participants whether they reported drinking five or more drinks on at least one occasion in the past three months, with response options 1=Yes and 0=No.…”

Section: Methodsmentioning

confidence: 99%

“…All models were adjusted for survey mode and included the following variables, which were selected based on prior research indicating that comparable factors are predictive of substance use in other samples, excepting non-binary gender identity, which was included as a variable of interest due to the absence of prior research assessing its relationship to substance use: age (continuous; Kessler et al, 2005), higher educational attainment (yes/no; Gfroerer et al, 1997), higher income (yes/no; Bassuk et al, 1998), people of color (yes/no; Wallace and Muroff, 2002), MTF spectrum (yes/no; Herbst et al, 2008), non-binary gender (yes/no; Flentje et al, 2015), medical gender affirmation (yes/no; Wilson et al, 2015), lifetime intimate partner violence (yes/no; Reisner et al, 2013), lifetime PTSD diagnosis (yes/no; Jacobsen et al, 2001; Rowe et al, 2015), past 7-day clinically significant depression (yes/no; Davis et al, 2008), current mental health treatment (yes/no; Kessler et al, 1996), inability to access gender-transition care in past 12 months (yes/no; Wilson et al, 2015), public accommodations discrimination in past 12 months (yes/no; Nuttbrock et al, 2014b), past 12-month unstable housing (yes/no; Bassuk et al, 1998), and past 12-month sex work (yes/no; Rekart, 2005). Models were adjusted for recent substance use, as appropriate.…”

Section: Methodsmentioning

confidence: 99%

Substance use and treatment of substance use disorders in a community sample of transgender adults

Keuroghlian

Reisner

White

et al. 2015

Drug and Alcohol Dependence

158

100

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Background Transgender people have elevated substance use prevalence compared with the U.S. general population, however no studies have comprehensively examined the relationship of psychosocial risk factors to substance use and substance use disorder (SUD) treatment among both male-to-female (MTF) and female-to-male (FTM) transgender adults. Methods Secondary data analysis of a 2013 community-based survey of transgender adults in Massachusetts (N=452) was conducted. Adjusted multivariable logistic regression models were fit to examine the relationship of four risk factor domains with SUD treatment history and recent substance use: (1) demographics; (2) gender-related characteristics; (3) mental health; (4) socio-structural factors. Adjusted Odds Ratios (aOR) and 95% Confidence Intervals (95% CI) were estimated. Results Ten percent of the sample reported lifetime SUD treatment. Factors associated with significant increase in odds of lifetime SUD treatment alongside recent substance use (all p<0.05) were: (1) older age (aOR=1.02; 95% CI=1.01–1.04), higher educational attainment (aOR=3.59; 95% CI=2.35–5.50), low income (aOR=0.58; 95% CI=0.39–0.86); (2) MTF identity (aOR=3.03; 95% CI=1.95–4.67), gender-affirming medical care (aOR=1.99; 95% CI=1.32–3.00); (3) intimate partner violence (aOR=1.68; 95% CI=1.13–2.49), posttraumatic stress disorder (aOR = 2.56; 95% CI=1.69–3.88), depression (aOR=2.30; 95% CI=1.58–3.35), mental health treatment (aOR=1.65; 95% CI=1.11–2.45); (4) discrimination (aOR=1.90; 95% CI=1.22–2.95), unstable housing (aOR=1.80; 95% CI=1.21–2.67), and sex work (aOR=2.48; 95% CI=1.24–4.95). Conclusions Substance use and SUD treatment among transgender adults are associated with demographic, gender-related, mental health, and socio-structural risk factors. Studies are warranted that identify SUD treatment barriers, and integrate SUD treatment with psychosocial and structural interventions for a diverse spectrum of transgender adults.

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“…This theory attributes mental health disparities to added stressors that come with membership in a stigmatized minority group. For example, high rates of bullying, harassment, violence and victimization from peers and family, and discrimination from the world at large (Austin et al, 2008; Balsam, Rothblum, & Beauchaine, 2005; Berlan, Corliss, Field, Goodman, & Austin, 2010; Friedman et al, 2011; Gordon & Meyer, 2007; Reisner, Falb, VanWagenen, Grasso, & Bradford, 2013) are conceptualized as “distal” objective stressors which disproportionately affect sexual minorities relative to heterosexuals. These stressors may lead LGB youth to use substances as a coping or avoidance strategy (Meyer, 2003), thereby leading to higher prevalence of substance use among sexual minority youth on a population-level, and to potentially greater burden of substance abuse in LGB communities relative to heterosexuals.…”

Section: A Gender Minority Social Stress Perspectivementioning

confidence: 99%

Gender Minority Social Stress in Adolescence: Disparities in Adolescent Bullying and Substance Use by Gender Identity

Reisner

Greytak

Parsons

et al. 2014

The Journal of Sex Research

402

288

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Bullying and substance use represent serious public health issues facing adolescents in the U.S. Few large-sample national studies have examined differences in these indicators by gender identity. The Teen Health and Technology Study (N=5,542) sampled adolescents 13–18 years-old online. Weighted multivariable logistic regression models investigated disparities in substance use and tested a gender minority social stress hypothesis, comparing gender minority youth (i.e., who are transgender/gender nonconforming and have a gender different from their sex assigned at birth) and cisgender (i.e., whose gender identity or expression matches one’s sex assigned at birth). Overall, 11.5% of youth self-identified as gender minority. Gender minority youth had increased odds of past-12 month alcohol use, marijuana use, and non-marijuana illicit drug use. Gender minority youth disproportionately experienced bullying and harassment in the past 12 months, and this victimization was associated with increased odds of all substance use indicators. Bullying mediated the elevated odds of substance use for gender minority youth compared to cisgender adolescents. Findings support the use of gender minority stress perspectives in designing early interventions aimed at addressing the negative health sequelae of bullying and harassment.

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Sexual Orientation Disparities in Substance Misuse: The Role of Childhood Abuse and Intimate Partner Violence Among Patients in Care at an Urban Community Health Center

Abstract: This study examined disparities in lifetime substance misuse by sexual orientation among 2,653 patients engaged in care at an urban community health center in Boston, MA, as well as the potential mediating roles of childhood abuse Show more

Cited by 23 publications

References 71 publications

Discriminatory experiences associated with posttraumatic stress disorder symptoms among transgender adults.

Discriminatory experiences associated with posttraumatic stress disorder symptoms among transgender adults.

Substance use and treatment of substance use disorders in a community sample of transgender adults

Gender Minority Social Stress in Adolescence: Disparities in Adolescent Bullying and Substance Use by Gender Identity

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