Risk and protective factors for transgender youths' substance use.

Elizabeth M Saewyc,Jaimie F Veale,Allegra R Gordon,Ryan J Watson,Beth A Clark

doi:10.1016/j.pmedr.2019.100905

Abstract

Research at the intersection of substance use and protective factors among transgender youth is scarce; emerging evidence suggests high risk for substance use for transgender youth. We analyzed data from 323 transgender youth aged 14–18 (Mage = 16.67) to investigate the extent that risk (enacted stigma) and protective factors (support from family, school, friends) were related to substance use (i.e., cannabis and tobacco use, binge drinking). Enacted stigma was linked to higher odds of substance use behaviors, family connectedness was related to lower levels of tobacco and cannabis use, and more than one protective factor significantly lowered the probability of engaging in substance use behaviors. Support from multiple sources may be differentially protective against substance use for transgender youth.

Highlights

Though the prevalence of substance use has declined among youth in the past decade, there is evidence that the declines are not the same among sexual and gender minority youth (Hughes and Eliason, 2002; Ramirez-Valles et al, 2008), and some evidence that health disparities may be widening (Homma et al, 2016; Watson et al, 2017a)
For each of the outcomes, higher numbers of enacted stigma experiences were positively associated with odds of substance use, while protective factors were mostly negatively related to these behaviors, with the exception of perception of friends caring for binge drinking
Each additional one experience on the enacted stigma index corresponded to an 11% increase in the odds of past month cannabis use among transgender youth

Summary

Introduction

Though the prevalence of substance use has declined among youth in the past decade, there is evidence that the declines are not the same among sexual and gender minority youth (e.g., lesbian, gay, bisexual, queer, and transgender) (Hughes and Eliason, 2002; Ramirez-Valles et al, 2008), and some evidence that health disparities may be widening (Homma et al, 2016; Watson et al, 2017a). Other studies with comparison groups confirm higher rates for gender minority populations: using US data, Reisner and colleagues (Reisner et al, 2015) found that almost half of transgender or gender nonconforming youth reported past-year drinking of alcohol, compared to about 38% of cisgender boys and girls (a statistically significant difference), and that transgender and gender nonconforming youth were more likely to have ever smoked cigarettes (28.6%) and cannabis (27.7%) compared to their cisgender counterparts (about 20% and 12.5%, respectively). Similar to research from a decade ago conducted in Chicago, Illinois (Garofalo et al, 2006), Veale et al (2015) found that substance use rates were high in a 2014 Canadian sample: 49% of youth aged 19–25 reported smoking cigarettes and 69% reported using marijuana in their lifetime. In a sample of 28,662 adult participants in Massachusetts, scholars found that transgender adults had nearly 3 times the odds of smoking compared to cisgender adults (Conron et al, 2012)

Methods

Results

Conclusion