Longitudinal effects of gender minority stressors on substance use and related risk and protective factors among gender minority adolescents.

Sabra L Katz-Wise,Sion Kim Harris,Vishnudas Sarda,S Bryn Austin,José C Perales

doi:10.1371/journal.pone.0250500

Sabra L Katz-Wise, Sion Kim Harris + Show 3 more

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https://doi.org/10.1371/journal.pone.0250500

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Journal: PloS one	Publication Date: Jun 2, 2021
Citations: 23	License type: CC BY 4.0

Affiliation: Harvard University, Boston Children's Hospital

Abstract

PurposeGender minority (GM) adolescents, who have a different gender identity than their sex assigned at birth, may use substances as a coping strategy in response to GM-related stressors. This study examined longitudinal effects of gender minority stressors on substance use in GM adolescents, and related risk factors (internalized transphobia, depressive symptoms, anxious symptoms) and protective factors (resilience, gender-related pride, family functioning, social support, gender-related community connectedness).MethodsParticipants were 30 GM adolescents, ages 13–17 years, from the U.S. community-based longitudinal Trans Teen and Family Narratives Project. Participants completed an online survey every 6 months across 2 years (5 waves; data collected 2015–2019).ResultsExposure to gender minority stressors was associated with higher odds of alcohol use. Across models, internalized transphobia (risk factor), resilience (protective factor), and gender-related pride (protective factor) were the most significant mediators of associations between gender minority stressors and substance use. Family functioning and social support (protective factors) significantly moderated the association between gender minority stressors and alcohol use, such that family functioning and social support were protective for alcohol use at lower levels of gender minority stress, but not at higher levels.ConclusionResults suggest that GM adolescents engage in substance use as a coping strategy in response to gender minority stressors. A number of hypothesized risk and protective factors mediated or moderated these associations. Future interventions with GM adolescents should focus efforts on addressing internalized transphobia as a risk factor and strengthening resilience, gender-related pride, and family functioning as protective factors for substance use.

Highlights

Increased substance use is common among adolescents, as youth experiment with strategies to cope with life stressors
Results suggest that GM adolescents engage in substance use as a coping strategy in response to gender minority stressors
We found that family functioning and social support both significantly moderated the effect of gender minority stressor exposure on alcohol use across two years (Table 6), with family functioning and social support protective for alcohol use at lower levels of gender minority stress, but not at higher levels of gender minority stress (Fig 2A and 2B)

Summary

Introduction

Increased substance use is common among adolescents, as youth experiment with strategies to cope with life stressors. For gender minority (GM) adolescents, who have a different gender identity than their sex assigned at birth, exposure to GM-related stressors, such as victimization, may result in substance use as a coping mechanism [1, 2], which may negatively affect GM adolescents’ health. GM adolescents are at higher risk for substance use than cisgender adolescents [2, 3]. Previous research indicated the prevalence of substance use was 2.5–4 times higher for GM youth compared to cisgender youth.. Substance use among GM adolescents may be linked to experiencing GM-related stressors, such as stigma-based prejudice [1, 2, 4]. A recent study of cisgender sexual minority and GM adolescents found that experiencing multiple types of victimization was more common among GM than cisgender sexual minority youth [1]

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