TY - JOUR
T1 - Transgender Youth Substance Use Disparities
T2 - Results From a Population-Based Sample
AU - Day, Jack K.
AU - Fish, Jessica N.
AU - Perez-Brumer, Amaya
AU - Hatzenbuehler, Mark L.
AU - Russell, Stephen T.
N1 - Funding Information:
The Biennial Statewide California Student Survey was developed by WestEd under contract to the California Department of Education. The authors acknowledge generous support from the Communities for Just Schools Fund Project at the New Venture Fund and support for Russell from the Priscilla Pond Flawn Endowment at the University of Texas at Austin .
Funding Information:
Administrative support for this research was also provided by grant, R24HD042849, Population Research Center, awarded to the Population Research Center at the University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Support for J.N.F. comes from the National Institute on Alcohol Abuse and Alcoholism ( F32AA023138 ).
Funding Information:
Administrative support for this research was also provided by grant, R24HD042849, Population Research Center, awarded to the Population Research Center at the University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Support for J.N.F. comes from the National Institute on Alcohol Abuse and Alcoholism (F32AA023138).
Publisher Copyright:
© 2017 Society for Adolescent Health and Medicine
PY - 2017/12
Y1 - 2017/12
N2 - Purpose The purpose of this study was to examine rates of substance use between transgender and nontransgender youth using a representative population-based sample and to examine mediating risk factors. Methods A statewide cross-sectional sample of California middle and high schools collected between 2013 and 2015. This representative sample of students in California included 335 transgender and 31,737 nontransgender youth. Using multivariate linear and logistic regression, we assessed differences between transgender and nontransgender youth in substance use behaviors related to alcohol, cigarette, marijuana, other illicit drugs, polysubstance use, and heavy episodic drinking. Substance use was assessed with lifetime use, age of onset, and past 30-day use for alcohol, cigarettes, and marijuana. Past 30-day use was also assessed for other illicit drugs and polysubstance use. Models were adjusted for demographics and risk factors including victimization, depressive symptoms, and perceived risk of substance use. Results The prevalence of substance use was 2.5–4 times higher for transgender youth compared with their nontransgender peers (depending on the substance). Transgender youth were also at greater risk for early age of onset and recent substance use than nontransgender youth. In addition, psychosocial risk factors related to victimization, depressive symptoms, and perceived risk of substance use partially mediated the relationship between gender identity and substance use. Conclusions Using data from the first representative study of youth to include a measure of gender identity, we show that transgender youth are at heightened risk for substance use compared with nontransgender peers. Future research is needed to identify the structural and psychosocial mechanisms that drive these disparities.
AB - Purpose The purpose of this study was to examine rates of substance use between transgender and nontransgender youth using a representative population-based sample and to examine mediating risk factors. Methods A statewide cross-sectional sample of California middle and high schools collected between 2013 and 2015. This representative sample of students in California included 335 transgender and 31,737 nontransgender youth. Using multivariate linear and logistic regression, we assessed differences between transgender and nontransgender youth in substance use behaviors related to alcohol, cigarette, marijuana, other illicit drugs, polysubstance use, and heavy episodic drinking. Substance use was assessed with lifetime use, age of onset, and past 30-day use for alcohol, cigarettes, and marijuana. Past 30-day use was also assessed for other illicit drugs and polysubstance use. Models were adjusted for demographics and risk factors including victimization, depressive symptoms, and perceived risk of substance use. Results The prevalence of substance use was 2.5–4 times higher for transgender youth compared with their nontransgender peers (depending on the substance). Transgender youth were also at greater risk for early age of onset and recent substance use than nontransgender youth. In addition, psychosocial risk factors related to victimization, depressive symptoms, and perceived risk of substance use partially mediated the relationship between gender identity and substance use. Conclusions Using data from the first representative study of youth to include a measure of gender identity, we show that transgender youth are at heightened risk for substance use compared with nontransgender peers. Future research is needed to identify the structural and psychosocial mechanisms that drive these disparities.
KW - Gender minority youth
KW - Heavy episodic drinking
KW - Illicit drugs
KW - Tobacco
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U2 - 10.1016/j.jadohealth.2017.06.024
DO - 10.1016/j.jadohealth.2017.06.024
M3 - Article
C2 - 28942238
AN - SCOPUS:85029598029
SN - 1054-139X
VL - 61
SP - 729
EP - 735
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 6
ER -