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Mereish EH, Abramson JR, Lee H, Watson RJ. Intersectional Oppression-Based Stress, Drinking to Cope Motives, and Alcohol Use and Hazardous Drinking Among Sexual and Gender Minority Adolescents Who Are Black, Indigenous, and People of Color. LGBT Health 2024. [PMID: 38973422 DOI: 10.1089/lgbt.2024.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Purpose: This study examined the associations between intersectional oppression-based stress and recent alcohol use and hazardous drinking among sexual and gender minority (SGM; e.g., queer or transgender) adolescents who were Black, Indigenous, and People of Color (BIPOC), also known as queer and transgender BIPOC (QTBIPOC) adolescents, and the mediating role of coping motives (i.e., drinking to cope) on these associations. Methods: Data were from a subsample of QTBIPOC adolescents who used alcohol in the past year (n = 1365) from a national U.S. sample of SGM adolescents aged 13-18 years. Results: Intersectional oppression-based stressors were associated with greater odds of recent alcohol use and hazardous drinking, as well as greater coping motives. Coping motives mediated the associations between intersectional-based stressors and both recent alcohol use and hazardous drinking among the aggregate sample of QTBIPOC adolescents, as well as among some subgroups of BIPOC adolescents. Conclusions: The results of this study highlight that intersectional oppression-based stressors are prevalent among QTBIPOC adolescents and serve as a risk factor for alcohol use and hazardous drinking. Multilevel interventions are needed to target and dismantle intersectional oppressions to address alcohol inequities impacting QTBIPOC adolescents. Drinking to cope motives mediated the associations between intersectional oppression-based stress and drinking outcomes, underscoring another important mechanism to target within a context of oppression in drinking interventions.
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Affiliation(s)
- Ethan H Mereish
- Lavender Lab, Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Jessica R Abramson
- Lavender Lab, Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Hyemin Lee
- Lavender Lab, Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Ryan J Watson
- Department of Human Development And Family Sciences, University of Connecticut, Storrs, Connecticut, USA
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2
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Connolly DJ, Coduri-Fulford S, Tugulu C, Yalew M, Moss E, Yang JC. Sexual Orientation and Gender Identity Reporting in Highly Cited Current Alcohol Research. LGBT Health 2024; 11:340-347. [PMID: 37862224 DOI: 10.1089/lgbt.2023.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023] Open
Abstract
Purpose: This study aimed to measure the frequency of high-quality and transparent sexual orientation and gender identity (SOGI) data collection and reporting in highly cited current alcohol use research, using the extant literature to identify community-informed priorities for the measurement of these variables. Methods: A single search to identify alcohol use literature was conducted on PubMed with results restricted to primary research articles published between 2015 and 2022. The 200 most highly cited studies from each year were identified and their titles and abstracts reviewed against inclusion criteria after deduplication. After full-text review, study characteristics and data indicating quality of SOGI reporting were extracted. The fidelity of the results was verified with a random sample before analyses. Results: The final sample comprised 580 records. Few studies reported gender identity (n = 194; 33.4%) and, of these, 7.2% reported the associated gender identity measure. A two-stage approach to measure gender was adopted in 3 studies, one study used an open-ended question with a free-text response option, and 13 studies recorded nonbinary gender identities (reported by 0.9% of the whole sample). Nineteen (3.3%) studies reported sexual orientation and more than half of these provided the sexual orientation measure. Eight of the 20 studies that reported sexual orientation and/or gender identity measures were classified as sexual and gender minority specialist research. Conclusions: Culturally competent SOGI reporting is lacking in highly cited current alcohol research. SOGI measures should be disclosed in future research and should provide free-text response options.
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Affiliation(s)
- Dean J Connolly
- Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, United Kingdom
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Santino Coduri-Fulford
- Queen Elizabeth The Queen Mother Hospital, East Kent Hospitals University NHS Foundation Trust, Margate, United Kingdom
| | - Connor Tugulu
- Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Meron Yalew
- UCL Medical School, University College London, London, United Kingdom
| | - Elizabeth Moss
- Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
| | - Justin C Yang
- UCL Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
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3
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Ziegler E, Slotnes-O'Brien T, Peters MDJ. Cancer Screening and Prevention in the Transgender and Gender Diverse Population: Considerations and Strategies for Advanced Practice Nurses. Semin Oncol Nurs 2024; 40:151630. [PMID: 38622043 DOI: 10.1016/j.soncn.2024.151630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 03/09/2024] [Accepted: 03/15/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES This discussion paper presents recent evidence regarding cancer screening and prevention among the transgender and gender diverse (TGD) community and highlights where and how advanced practice nurses (APNs), particularly those in primary care, can better contribute to closing the gap between healthcare disparities between TGD and cisgendered populations. METHODS Relevant publications on the topic and professional guidelines and evidence have formed the basis for this discussion paper. RESULTS TGD individuals are a vulnerable population with unique needs. They remain at risk of cancer and might be at greater risk of developing some cancers compared to cisgendered people but are underscreened. Barriers to gender-affirming care need to be addressed to improve access to prevention and screening services and improve the cancer care experiences and outcomes of TGD people. CONCLUSION APNs can work in collaboration with TGD individuals and the healthcare system to improve access to culturally safe cancer screening and more effective prevention of cancer and poor cancer outcomes. IMPLICATIONS FOR NURSING PRACTICE APNs have the potential to improve access to cancer screening for TGD people by increasing their understanding of the needs of the population, providing culturally safe care, and advocating for more preventative care and cancer screening. With greater knowledge and understanding of the needs and preferences of TGD people both broadly and in relation to cancer screening and prevention, targeted interventions and care approaches can be implemented. APNs should also aim to conduct evaluations and research into cancer prevention and screening to build the currently limited evidence base and nursing knowledge in this important field.
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Affiliation(s)
- Erin Ziegler
- Associate Professor, Daphen Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada.
| | - Toni Slotnes-O'Brien
- Senior Lecture, UniSA Clinical & Health Science, University of South Australia, Adelaide, Australia
| | - Micah D J Peters
- Associate Professor, UniSA Clinical & Health Science, University of South Australia, Adelaide, Australia
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4
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Kissel HA, Lee GH, McFarland S, Berger D, Enneking E, Dunham J, Brumback T. Participant diversity in ACER: 2010-2022. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:1189-1204. [PMID: 38653579 DOI: 10.1111/acer.15324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/06/2024] [Accepted: 03/21/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Increasing diversity has become a priority for all fields working with human subjects due to historic exclusions and misrepresentations of participants with minoritized identities. To create a more representative and generalizable science of alcohol use, the Research Society on Alcohol (RSA) and its official journal, Alcohol: Clinical and Experimental Research (ACER), have increasingly incorporated diversity and inclusion into their posted values and programming. METHODS We analyzed the content of articles published in ACER from 2010 through 2022 (6 years before and after the formation of RSA's Diversity Committee) to assess the reporting of participants' demographic information and whether there has been increased inclusion of diverse samples in alcohol research over time. Our team screened 3292 abstracts for data extraction; studies were included if they were primary analyses of data collected from human subjects (n = 1043). RESULTS Reporting of all demographic variables increased over time, with significant increases in reporting for race/ethnicity, sexual orientation, gender identity, socioeconomic status (SES), income, and educational attainment. Demographic variables were also increasingly used in analyses. However, representation of research outside the United States diminished significantly over time. CONCLUSIONS We provide recommended journal article reporting standards for ACER to continue the positive progress in reporting demographics in alcohol research and facilitate meta-analyses examining demographic modulation and the impact of social determinants of health.
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Affiliation(s)
- Heather A Kissel
- Department of Psychological Sciences, Northern Kentucky University, Highland Heights, Kentucky, USA
| | - Ga Hee Lee
- Department of Psychological Sciences, Northern Kentucky University, Highland Heights, Kentucky, USA
| | - Sara McFarland
- Department of Psychological Sciences, Northern Kentucky University, Highland Heights, Kentucky, USA
| | - Dexton Berger
- Department of Psychological Sciences, Northern Kentucky University, Highland Heights, Kentucky, USA
| | - Elizabeth Enneking
- Department of Psychological Sciences, Northern Kentucky University, Highland Heights, Kentucky, USA
| | - Jenna Dunham
- Department of Psychological Sciences, Northern Kentucky University, Highland Heights, Kentucky, USA
| | - Ty Brumback
- Department of Psychological Sciences, Northern Kentucky University, Highland Heights, Kentucky, USA
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5
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Stanmyre JF, Nower L, Malkin ML. Problem Gambling and Sexual Minority Individuals: Evaluating Influence of Age and Comorbid Mental Health and Substance Use Problems. J Gambl Stud 2024; 40:957-969. [PMID: 37978097 DOI: 10.1007/s10899-023-10264-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
Little is known about the prevalence of problem gambling among sexual minority individuals. The present study utilized an epidemiological sample, including individuals identifying as lesbian, gay, bisexual, asexual, and pansexual, to explore gambling behavior and problems and associated mental health and comorbid conditions that may contribute to elevated risk. Bivariate comparisons found that sexual minority individuals had higher rates of problem gambling, alcohol and substance use problems, anxiety, depression, and a wide range of problem behaviors (e.g., binge eating, prostitution, excessive video gaming) than heterosexuals. In a logistic regression, age moderated the relationship between sexual minority status and problem gambling, such that the risk for high-risk problem gambling increased with age for sexual minority individuals while it decreased for heterosexuals. Additionally, a logistic regression of sexual minority individuals who gamble found anxiety (OR = 3.80, 95% CI = 1.03, 13.97) and drug problems (OR = 8.57, 95% CI = 1.79, 41.05) predicted high-risk problem gambling. Findings suggest that prevention and screening protocols are needed in systems accessed by sexual minority individuals, particularly those middle age and older, as well as in settings where anxiety and substance use disorders are treated.
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Affiliation(s)
- Jackie F Stanmyre
- Center for Gambling Studies, School of Social Work, Rutgers University, 120 Albany Street, Tower 1, Suite 300, New Brunswick, NJ, 08901, USA.
| | - Lia Nower
- Center for Gambling Studies, School of Social Work, Rutgers University, 120 Albany Street, Tower 1, Suite 300, New Brunswick, NJ, 08901, USA
| | - Michelle L Malkin
- Department of Criminal Justice, East Carolina University, Greenville, NC, USA
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6
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Connolly DJ, Thayne B, Bayliss J, Hughes X, Holloway Z, O'Callaghan S, Davies E. Transgender and non-binary people's experiences with alcohol reduction in the UK: A cross-sectional study. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 158:209246. [PMID: 38072383 DOI: 10.1016/j.josat.2023.209246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Transgender (trans) and non-binary people experience disproportionate harm from alcohol use, have a greater likelihood of developing dependence, and experience exclusion from both clinical and peer-based support systems. This study aimed to understand experiences with and preferences for alcohol reduction support among UK-based transgender and non-binary people. METHODS The study team and community stakeholders co-produced a cross-sectional survey and administered it to a purposive sample of trans and non-binary people from 1st February to 31st March 2022. The study recruited participants through social media, mailing lists, blog posts, and news articles. Participants (n = 565) had a lifetime history of alcohol use, were in one of five gender categories, and were classified as people who drink or formerly drank alcohol. Open- and closed-ended questions measured motivations for alcohol reduction and views surrounding various support modalities. RESULTS More than 15 % of the sample no longer drink alcohol and reported long-term abstinence, achieved without support, and were motivated by a loss of control over drinking behaviour and a desire to improve both physical and mental health. Mental illness, gender dysphoria, and a culture of alcohol excess were common antecedents of alcohol use. Thirty percent of participants who drink alcohol wanted to reduce their consumption. They suggested that this could be achieved with self-help tools, specialist trans and non-binary or LGBT+ services, access to both gender-affirming medical services, and sober queer social spaces. CONCLUSIONS UK-based trans and non-binary people face unique gender minority-related stressors which contribute to patterns of alcohol use that are perceived to be out of control and harmful to health. While many wanted access to self-help tools, there was interest in the availability of specialist alcohol reduction services and more inclusive general services. Conducting needs assessments to inform Needs assessments should inform the development of such services and trans-affirmative training should be mandated for all who provide support with alcohol reduction.
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Affiliation(s)
- Dean J Connolly
- Centre for Psychological Research, Oxford Brookes University, Oxford, United Kingdom; Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, United Kingdom.
| | | | | | - Xan Hughes
- St George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | | | | | - Emma Davies
- Centre for Psychological Research, Oxford Brookes University, Oxford, United Kingdom
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7
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Buch K, Fitzke RE, Davis JP, Tran DD, Hummer JF, Pedersen ER. An Examination of Pregaming Behavior and Motives among Sexual and Gender Minority College Students. Subst Use Misuse 2024; 59:953-961. [PMID: 38321769 PMCID: PMC11125522 DOI: 10.1080/10826084.2024.2310498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Introduction: Pregaming is a popular but high-risk drinking behavior common among college students. Although sexual and gender minority (SGM) college students are a vulnerable population with regards to hazardous alcohol use and alcohol consequences, there is currently limited research investigating the pregaming behavior of this group. The present study aimed to (1) examine mean level differences in pregaming behaviors and motives between SGM and non-SGM college students and (2) explore how SGM status was associated with pregaming behaviors and if SGM status moderated the association between motives and pregaming behaviors. Methods: The sample consisted of 485 college student drinkers in the US, with 19% (n = 93) identifying as SGM. All participants completed measures of past 30-day pregaming frequency and quantity (yielding a total pregaming drinks outcome) and drinking consequences experienced on pregaming days. Results: SGM participants consumed significantly fewer pregaming drinks than non-SGM participants, but did not significantly differ on alcohol-related consequences or drinking motives. The pregaming motive of intimate pursuit moderated the association between SGM status and total pregaming drinks, such that non-SGM participants with high intimate pursuit motives drank the heaviest. Conclusions: Our findings suggest that SGM students consume significantly fewer pregaming drinks than their non-SGM counterparts. However, they may be at a similar risk of experiencing pregaming consequences as non-SGM students. SGM students were less susceptible to the effect of intimate pursuit motives on pregaming drink consumption. This study offers support for past research regarding the effects of certain pregaming motives on pregaming drink consumption and consequences.
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Affiliation(s)
- Keegan Buch
- Department of Psychiatry and the Behavioral Sciences, Keck
School of Medicine, University of Southern California
| | - Reagan E. Fitzke
- Department of Psychiatry and the Behavioral Sciences, Keck
School of Medicine, University of Southern California
| | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work, University of
Southern California
| | - Denise D. Tran
- Department of Psychiatry and the Behavioral Sciences, Keck
School of Medicine, University of Southern California
| | | | - Eric R. Pedersen
- Department of Psychiatry and the Behavioral Sciences, Keck
School of Medicine, University of Southern California
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8
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Lindley L, Bauerband L. The Mediating Role of Avoidant and Facilitative Coping on the Relation Between Discrimination and Alcohol Use Among Transgender and Gender-Diverse Individuals. Transgend Health 2023; 8:500-508. [PMID: 38130979 PMCID: PMC10732159 DOI: 10.1089/trgh.2021.0173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose The motivational model of alcohol use indicates that there is a relation between chronic stress and alcohol use, and that this relation is mediated by substance use to cope. However, this model has not been applied to the experiences of transgender and gender-diverse (TGD) individuals. In response, this study investigated whether facilitative (e.g., active and interpersonal coping) and avoidant (e.g., cognitive avoidance and substance use to cope) coping mediate the relation between discrimination and alcohol use. Methods Participants include 496 TGD individuals (97 trans women, 126 trans men, and 273 nonbinary), 18-68 years of age (mean=32.09 and standard deviation=12.47), who completed a survey about health behaviors and stress. An exploratory factor analysis and confirmatory factor analysis of the Brief Coping Orientation to Problems Experienced (COPE) were conducted to determine the coping patterns of TGD individuals and multiple mediation analyses were conducted to examine whether distinct coping strategies mediated the relation between discrimination and alcohol use. Results Both facilitative and avoidant coping strategies were significantly related to discrimination; however, only active coping and substance use to cope were related to alcohol use. Mediation results showed that substance use to cope (i.e., an avoidant coping strategy) was the only significant mediator. Descriptive results showed nonsignificant differences between TGD gender identities regarding levels of alcohol use and engagement with coping strategies. Conclusion The results indicate a clear need for interventions to reduce utilization of avoidant coping strategies among TGD individuals.
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Affiliation(s)
- Louis Lindley
- Department of Counseling Psychology, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Loren Bauerband
- Department of Health Sciences, University of Missouri, Columbia, Missouri, USA
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9
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Heinz A, Költő A, Taylor AB, Chan A. "Are You a Boy or a Girl?"-A Missing Response Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1695. [PMID: 37892357 PMCID: PMC10605027 DOI: 10.3390/children10101695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
Many adolescent health surveys ask if respondents are male or female. Non-response may be due to fear of de-anonymisation or being a gender-nonconforming youth. The present study investigates the frequency of non-response and its potential reasons. To this end, data from 54,833 adolescents aged 11-18 from six countries, participating in the 2018 Health Behaviour in School-aged Children (HBSC) study, were analysed. Respondents were divided into three groups: (1) "Responders" who answered both questions on age and gender, (2) "Age non-responders" who did not answer the question on age, and (3) "Gender non-responders" who answered the question on age but not the one on gender. These groups were compared regarding their non-response to other questions and regarding their health. Overall, 98.0% were responders, 1.6% were age non-responders and 0.4% were gender non-responders. On average, age non-responders skipped more questions (4.2 out or 64) than gender non-responders (3.2) and responders (2.1). Gender non-responders reported more psychosomatic complaints, more frequent substance use and lower family support than responders. This study shows that age and gender non-responders differ in their response styles, suggesting different reasons for skipping the gender question. The health disparities found between the groups suggest that further research should use a more nuanced approach, informed by LGBT+ youth's insights, to measure sex assigned at birth and gender identity.
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Affiliation(s)
- Andreas Heinz
- Department of Health, IU International University of Applied Sciences, Juri-Gagarin Ring 152, 99084 Erfurt, Germany
| | - András Költő
- Health Promotion Research Centre, National University of Ireland, University Rd., H91 TK33 Galway, Ireland;
| | - Ashley B. Taylor
- Stigma and Resilience Among Vulnerable Youth Centre, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Ace Chan
- Stigma and Resilience Among Vulnerable Youth Centre, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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10
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Dermody SS, Uhrig A, Moore A, Raessi T, Abramovich A. A narrative systematic review of the gender inclusivity of measures of harmful drinking and their psychometric properties among transgender adults. Addiction 2023; 118:1649-1660. [PMID: 37070479 DOI: 10.1111/add.16212] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/28/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND AND AIMS Experiencing higher rates of stigma, marginalization and discrimination puts transgender individuals at risk for alcohol use and associated harms. Measures of harmful drinking were designed with cisgender people in mind, and some rely on sex- and gender-based cut-offs. The applicability of these measures for gender diverse samples remains unknown. The present study had two aims: (i) identify gender-non-inclusive language and cut-offs in measures of harmful drinking, and (ii) systematically review research reporting psychometric properties of these measures in transgender individuals. METHODS We reviewed 22 measures of harmful drinking for gendered language and sex- and gender-based cut-off values and provided suggestions for revision when warranted. We also conducted a systematic narrative review, including eight eligible studies, summarizing the psychometric properties of measures of harmful drinking in transgender populations. RESULTS Six of 22 measures of harmful drinking were not gender inclusive, because of gendered language in the measure itself or use of sex- or gender-based cut-off scores. Only eight published studies reported psychometric data for these measures in transgender people. Apart from in one study, the Alcohol Use Disorders Identification Test (AUDIT) and Alcohol Use Disorders Identification Test Consumption (AUDIT-C) appear reliable for transgender adults (Cronbach's α: AUDIT [0.81-0.87] and AUDIT [0.72-0.8)]). There is initial support for using uniform cut-offs for transgender people for the AUDIT-C (≥3) and binge drinking (≥5 drinks in a sitting). CONCLUSIONS Most existing measures of harmful drinking appear to be gender inclusive (containing gender neutral language and uniform cut-off scores across sex and gender groups) and some that are not easily adapted to be gender inclusive.
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Affiliation(s)
- Sarah S Dermody
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Alexandra Uhrig
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Annabelle Moore
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Tara Raessi
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Alex Abramovich
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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11
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Mammadli T, Whitfield DL, Betz G, Mack LJM. Protocol for a systematic review of substance use and misuse prevalence and associated factors among transgender and non-binary youth living in the USA. BMJ Open 2023; 13:e073877. [PMID: 37640466 PMCID: PMC10462946 DOI: 10.1136/bmjopen-2023-073877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Transgender and gender non-binary (TNB) youth living in the USA report elevated levels of substance use compared with their cisgender counterparts, with previous literature pointing to minority stressors as some of the factors that could facilitate such elevated levels. Yet, substance use and misuse prevalence and associated modifiable factors among TNB youth are not fully known. The current paper details the protocol for a systematic review aimed at (1) identifying substance use and misuse prevalence among TNB youth (ages <25) and related demographic disparities (based on racial, ethnic and gender identity, and sexual orientation), (2) examining factors associated with substance use and misuse among TNB youth and (3) examining protective factors against substance use and misuse among TNB youth. METHODS AND ANALYSIS Systematic searches will be conducted across four databases: PubMed, LGBTQ+ Source, CINAHL and PsycInfo to identify quantitative, qualitative and mixed-methods peer-reviewed research publications. An exhaustive list of keywords and corresponding MeSH (Medical Subject Headings) terms representing the concepts of 'TNB' (the population of interest) and 'substance use and misuse' (outcome) will be employed. Identified records will be initially screened via a review of titles and abstracts. Full text of the remaining records will be reviewed corresponding to the inclusion and exclusion criteria. Extracted data will be synthesised in table and narrative format. A meta-analysis will be considered contingent on the existence of sufficient data. Methodological quality and risk of bias of studies will be assessed. ETHICS AND DISSEMINATION This review does not require approval from the Institutional Review Board as it involves no interactions with human subjects. We will disseminate our findings via peer-reviewed manuscripts and academic conference presentations. PROSPERO REGISTRATION NUMBER CRD42023394985.
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Affiliation(s)
- Tural Mammadli
- School of Social Work, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Darren L Whitfield
- School of Social Work, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Gail Betz
- Health Sciences and Human Services Library, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Linda-Jeanne M Mack
- School of Social Work, University of Maryland Baltimore, Baltimore, Maryland, USA
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12
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Lauckner C, Haney K, Sesenu F, Kershaw T. Interventions to Reduce Alcohol Use and HIV Risk among Sexual and Gender Minority Populations: a Systematic Review. Curr HIV/AIDS Rep 2023; 20:231-250. [PMID: 37225923 PMCID: PMC10436179 DOI: 10.1007/s11904-023-00660-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE OF REVIEW Sexual and gender minority (SGM) individuals are diagnosed with HIV at disproportionate rates, and hazardous alcohol use can increase their HIV risk. This review assessed the state of the literature examining interventions for addressing alcohol use and sexual HIV risk behaviors among SGM individuals. RECENT FINDINGS Fourteen manuscripts from 2012 to 2022 tested interventions that address both alcohol use and HIV risk behaviors among SGM populations, with only 7 randomized controlled trials (RCTs). Virtually all the interventions targeted men who have sex with men, with none focused on transgender populations or cisgender women. While they demonstrated some evidence of effectiveness in reducing alcohol use and/or sexual risk, the outcomes varied widely between studies. More research is needed that tests interventions in this area, particularly for transgender individuals. The use of larger-scale RCTs with diverse populations and standardized outcome measures are needed to strengthen the evidence base.
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Affiliation(s)
- Carolyn Lauckner
- Center for Health Equity Transformation, University of Kentucky, 465 Healthy Kentucky Research Bldg, 760 Press Ave., Lexington, KY, 40536, USA.
| | - Kimberly Haney
- Center for Health Equity Transformation, University of Kentucky, 465 Healthy Kentucky Research Bldg, 760 Press Ave., Lexington, KY, 40536, USA
| | - Fidelis Sesenu
- Center for Health Equity Transformation, University of Kentucky, 465 Healthy Kentucky Research Bldg, 760 Press Ave., Lexington, KY, 40536, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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13
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Shepherd CB, Berry KA, Ye X, Li K. Food and alcohol disturbance among US college students: a mixed methods scoping review. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1715-1731. [PMID: 34292851 DOI: 10.1080/07448481.2021.1947300] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 05/05/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Conduct a scoping review of food and alcohol disturbance (FAD) in US college students to overview the literature within this population and identify research opportunities. METHODS Studies (n = 39) were selected using systematic searches of databases and references. Search terms included: drunkorexia, "food and alcohol disturbance," and "compensatory behavior" AND alcohol AND eating. RESULTS Issues with methodological quality were noted. Most studies used quantitative methods and cross-sectional designs with small, biased samples. Terminologies, conceptualizations, and measures varied; however, 30% of studies neglected enhanced intoxication effects. Prevalence ranged from approximately 10-55%, with greater risk for women. Alcohol use and disordered eating were primary predictors. Personality, affective, and social factors are potential correlates. Alcohol-related consequences were higher for those with FAD. CONCLUSIONS While the literature is inconsistent and unclear, FAD appears to be common among college students and associated with negative consequences. Suggestions and considerations for future research are provided.
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Affiliation(s)
- Caitlin B Shepherd
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Katherine A Berry
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Xian Ye
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Kathie Li
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
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14
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Mammadli T, Siegel J, Negi N. Examining Differences in Substance Use Outcomes and Related Correlates among Transfeminine and Transmasculine Adults Using the 2017 New York State Patient Characteristics Survey. Subst Use Misuse 2023; 58:1668-1677. [PMID: 37486040 DOI: 10.1080/10826084.2023.2238305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Background: Transgender persons in the U.S. experience high levels of violence and discrimination which have been linked to adverse substance use outcomes. Despite transgender women's higher exposure to such deleterious events compared to transgender men, studies have often aggregated both transgender women and men, obfuscating potentially unique differences between these groups. The current study, guided by the Minority Stress Model, examines differences in substance use outcomes and related correlates among transfeminine and transmasculine adults. Methods: A secondary data analysis was conducted using the 2017 Patient Characteristics Survey of public mental health facilities in the state of New York (N = 1387). Controlling for theoretically relevant factors, logistic regression models were estimated to examine differences between transfeminine and transmasculine adults in alcohol-related disorder (ARD) and drug use-related disorder (DURD) diagnoses, and tobacco use. Correlates of substance use disparities were also examined within gender identity groups. Results: Overall, 35% of participants were documented as using tobacco products whereas 14 and 19% were diagnosed with ARDs and DURDs, respectively. Transfeminine participants were 1.44-times more likely to be diagnosed with ARDs relative to transmasculine adults. Compared to transmasculine and White participants, transfeminine and Black participants were 1.64- and 1.59-times more likely to be diagnosed with DURDs. Conclusions: Recognizing the observed higher hazardous substance use risk among transfeminine and Black participants, findings indicate the potential role of minority stress in health outcomes of stigmatized communities. Our findings emphasize the need for identifying prevention and treatment strategies aimed at mitigating the implications of minority stress.
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Affiliation(s)
- Tural Mammadli
- University of Maryland School of Social Work, Baltimore, Maryland, USA
| | - Jennifer Siegel
- University of Maryland School of Social Work, Baltimore, Maryland, USA
| | - Nalini Negi
- University of Maryland School of Social Work, Baltimore, Maryland, USA
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15
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Chapa Montemayor AS, Connolly DJ. Alcohol reduction interventions for transgender and non-binary people: A PRISMA-ScR-adherent scoping review. Addict Behav 2023; 145:107779. [PMID: 37348175 DOI: 10.1016/j.addbeh.2023.107779] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/17/2023] [Accepted: 06/14/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION Transgender and non-binary people use more alcohol and report a greater need for help to reduce their consumption than their cisgender counterparts. They experience anticipated and enacted discrimination when seeking alcohol reduction healthcare. This study aimed to identify any alcohol reduction interventions for trans and non-binary people. METHODS A systematic scoping review was completed according to PRISMA-ScR guidelines. Following an extensive search across five databases, two independent reviewers carried out abstract screening, full-text screening, data extraction and quality assessment. Findings were synthesised narratively. RESULTS The search generated 1399 unique records. Ten texts were reviewed in full, and the final sample comprised six studies of moderate quality. Included records all reported adaptations of various psychosocial interventions including individual therapies, group therapy, a trans-affirmative clinical environment, and a specialist inpatient rehabilitation service. Four interventions resulted in alcohol reduction with modest effect size. However, the change in alcohol consumption was not statistically significant in two studies. Trans women were disproportionately investigated through the lens of HIV risk reduction. CONCLUSION Interventions developed for one population cannot be presumed effective in another, particularly those as heterogeneous as trans and non-binary communities. There is some suggestion that psychosocial interventions adapted for the needs of the trans community are effective in achieving alcohol reduction. However, it is unclear how these will fare with trans men and non-binary people and specialist interventions may be needed.
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Affiliation(s)
- Ana Sofia Chapa Montemayor
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dean J Connolly
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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16
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Chapa Montemayor AS, Connolly DJ. Alcohol screening tools are not validated for use with transgender and non-binary people. Addict Behav 2023; 144:107750. [PMID: 37167884 DOI: 10.1016/j.addbeh.2023.107750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/29/2023] [Accepted: 05/01/2023] [Indexed: 05/13/2023]
Affiliation(s)
- Ana Sofia Chapa Montemayor
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dean J Connolly
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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17
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Meads C, Zeeman L, Sherriff N, Aranda K. Prevalence of alcohol use amongst sexual and gender minority (LGBTQ+) communities in the UK: a systematic scoping review. Alcohol Alcohol 2023:7145918. [PMID: 37114766 DOI: 10.1093/alcalc/agad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/20/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND globally, alcohol use rates vary by sexual orientation and gender identity (SOGI), but UK government statistics on alcohol use in the LGBTQ+ population are missing. AIM this systematic scoping review determined the prevalence of alcohol use amongst gender and sexual minority people in the UK. METHODS empirical UK studies from 2010 onwards reporting the prevalence of alcohol use in SOGI compared with heterosexual/cisgender people were included. Searches in MEDLINE, Embase, Web of Science, PsycINFO, CINAHL, Cochrane Library, Google Scholar, Google, charity websites and systematic reviews were conducted in October 2021, using SOGI, alcohol and prevalence terms. Citation checking was done by two authors, with disagreements resolved through discussion. Data extraction was done by one author (CM) and checked by another (LZ). Quality assessment was performed by study design, sample type and statistical analysis of results. A narrative synthesis was qualitatively combined with a tabular presentation of results. RESULTS database and website searches found 6607 potentially relevant citations, and 505 full texts were reviewed with 20 studies included, found in 21 publications and grey literature reports. Most were on sexual orientation, including 12 from large cohort studies. Harmful alcohol use is higher in LGBTQ+ people than heterosexual people in the UK, a result similar to that found in other countries. Qualitative data reflected alcohol's role as emotional support. Fewer asexual people drank alcohol compared with allosexual people, and there were no data available regarding intersex people. CONCLUSION funded cohort studies and service providers should routinely collect SOGI data. Standardized reporting of SOGI and alcohol use would improve comparability across studies.
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Affiliation(s)
- Catherine Meads
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, CB1 2LZ, UK
- Centre for Transforming Sexuality and Gender, University of Brighton, BN2 0JG, Brighton, UK
| | - Laetitia Zeeman
- Centre for Transforming Sexuality and Gender, University of Brighton, BN2 0JG, Brighton, UK
- School of Sport and Health Sciences, University of Brighton, Brighton, BN1 9PH, UK
| | - Nigel Sherriff
- Centre for Transforming Sexuality and Gender, University of Brighton, BN2 0JG, Brighton, UK
- School of Sport and Health Sciences, University of Brighton, Brighton, BN1 9PH, UK
| | - Kay Aranda
- Centre for Transforming Sexuality and Gender, University of Brighton, BN2 0JG, Brighton, UK
- School of Sport and Health Sciences, University of Brighton, Brighton, BN1 9PH, UK
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18
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Anderson KG, Garrison E, Clifton RL, Harper L, Zapolski TCB, Khazvand S, Carson I. Measures of self-reported identity associated with sex and gender: Relations with collegiate drinking. Alcohol Clin Exp Res 2023; 47:501-511. [PMID: 36930036 DOI: 10.1111/acer.15013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 12/24/2022] [Accepted: 12/31/2022] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Quantitative research has typically relied on categorical measures of sex assigned at birth (SAAB) and gender, with heterogeneous findings in terms of their associations with alcohol-related behavior. This investigation examined continuous indices of self-identification as an alternative to categorical operationalizations in alcohol research. METHOD Eight hundred ninety-three undergraduate students (74.6% cisgender women, 20.3% cisgender men, 3.9% nonbinary, and 1.2% transgender), recruited from the Midwest and Pacific Northwest of the United States, completed online measures of SAAB (male/female), gender (categorical), continuous indices of identification (femaleness, maleness, and bidirectional), and alcohol consumption (Cahalan Indices; Daily Drinking Questionnaire-Revised; Alcohol Use Disorders Identification Test [AUDIT]). RESULTS Novel continuous measures of identification were associated with categorical indices of SAAB and gender as predicted. While none of the self-identification indices (continuous or categorical) predicted current drinking (consumption in the past 30 days), they evidenced relatively consistent, albeit small effects, across quantity-frequency of drinking and AUDIT scores for current drinkers. Higher scores on maleness and bidirectional indices of identification were associated with greater consumption, while greater endorsement of femaleness and being a cisgender woman (vs. a cisgender man) were related to less drinking. CONCLUSIONS Continuous self-reported identification items performed well when describing drinking behavior in college students. The inclusion of dimensional scales of identity broadens our ability to capture differing self-conceptualizations in research.
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Affiliation(s)
| | - Elise Garrison
- Department of Psychology, Reed College, Portland, Oregon, USA
| | - Richelle L Clifton
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Leia Harper
- Department of Psychology, Reed College, Portland, Oregon, USA
| | - Tamika C B Zapolski
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Shirin Khazvand
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Ian Carson
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
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19
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Connolly DJ, Davies E, Lynskey M, Maier LJ, Ferris JA, Barratt MJ, Winstock AR, Gilchrist G. Differences in Alcohol and Other Drug Use and Dependence Between Transgender and Cisgender Participants from the 2018 Global Drug Survey. LGBT Health 2022; 9:534-542. [PMID: 35878065 DOI: 10.1089/lgbt.2021.0242] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose: The purpose of this study was to compare five gender groups (cisgender women, cisgender men, transgender women, transgender men, people with nonbinary/other identities) on measures of use of and dependence on seven substances. Methods: A two-stage approach to assessing gender allowed 126,648 participants from the 2018 Global Drug Survey (GDS) to be classified to one of these five gender groups. Participants were asked to disclose use of each substance in the preceding 12 months. The Alcohol Use Disorders Identification Test and the Severity of Dependence Scale were used to assess dependence. Multivariable logistic regression generated odds ratios (ORs) to measure the association between gender and each substance use/dependence outcome, with cisgender women as the reference group. Results: The sample comprised 43,331 cisgender women, 81,607 cisgender men, 215 transgender women, 254 transgender men, and 1241 people with nonbinary/other identities. Relative to cisgender women, nonbinary/other participants reported greater odds of last 12-month use of all substances (adjusted odds ratio [AOR] = 1.66-2.30), except alcohol (lower odds; AOR = 0.42), and greater odds of dependence on cannabis (AOR = 2.39), 3,4-methylenedioxymethamphetamine (AOR = 1.64) and alcohol (AOR = 3.28), adjusting only for age (all p < 0.05). Conclusion: Transgender 2018 GDS respondents, particularly those with nonbinary/other identities, had greater odds of reporting most substance use outcomes than cisgender women. These findings suggest that a nuanced approach to gender reporting in surveys and treatment centers is required to understand the needs of transgender people who use substances.
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Affiliation(s)
- Dean J Connolly
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Early Intervention Service, Newham Centre for Mental Health, East London NHS Foundation Trust, London, United Kingdom
| | - Emma Davies
- Department of Psychology, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Michael Lynskey
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Larissa J Maier
- Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, California, USA.,Early Postdoc Mobility Grantee (P2ZHP1_174812), Swiss National Science Foundation, Bern, Switzerland
| | - Jason A Ferris
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Monica J Barratt
- Social and Global Studies Centre and Digital Ethnography Research Centre, RMIT University, Melbourne, Australia.,National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Adam R Winstock
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom.,Global Drug Survey, London, United Kingdom
| | - Gail Gilchrist
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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20
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Ott MQ, Clark MA, Balestrieri SG, Gamarel KE, Barnett NP. Social Networks and Sexual and Gender Minority Disparities in Alcohol Use and Consequences Among First-Year College Students. LGBT Health 2022; 9:489-495. [PMID: 35727117 PMCID: PMC9587779 DOI: 10.1089/lgbt.2019.0225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: In this work, we investigate the association between social relationships and alcohol use and the related consequences of sexual and gender minority (SGM) college students, and we highlight the importance of SGM social networks as a potential protective factor among SGM college students. Methods: The study used data from 1340 students (47.2% White and non-Hispanic, 55.4% assigned female at birth, 16.3% SGM), which were collected during the 2016 fall semester of the first year of college at one university. The study collected information about alcohol use and related consequences and about the social networks of participants through a peer nomination survey. Results: Regardless of SGM status, students who nominated at least one SGM peer reported significantly lower drinks per week (β = -0.69, p = 0.04) and heavy drinking frequency (β = -0.38, p = 0.02) after adjusting for relevant covariates including peer drinking. SGM participants showed a significantly stronger negative association between having an SGM peer and heavy drinking frequency and alcohol-related consequences than their cisgender heterosexual counterparts (β = -0.90, p = 0.04; β = -1.32, p = 0.03). Conclusion: These findings highlight the importance of SGM social networks as a potential protective factor for reducing alcohol use and related consequences among SGM college students. College campuses should identify ways to support connections among SGM students. Clinical trials registration number is NCT02895984.
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Affiliation(s)
- Miles Q. Ott
- Program in Statistical and Data Sciences, Smith College, Northampton, Massachusetts, USA
| | - Melissa A. Clark
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Sara G. Balestrieri
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Kristi E. Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Nancy P. Barnett
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
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21
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Swartzwelder RA, Burns BJ, Maultsby L, Zhao M, Looney JG, Acheson S. Risk and protective factors for heavy episodic drinking among college students: Influence of mental health service use. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-6. [PMID: 36084210 DOI: 10.1080/07448481.2022.2115298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/22/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
Objective: This study was designed to assess the relationship between mental health service utilization and heavy episodic drinking (HED) after controlling for demographic and student-level variables. Participants: A national sample of college undergraduate respondents to the 2017-2018 Healthy Minds Study survey (n = 67,427). Methods: Hierarchical logistic regression entering all variables on a single step. Subsequent logistic regression was used to assess interactions between mental health service variables and select demographic and student level variables. Results: Twenty-two demographic and student-level variables were associated with current HED (9 protective and 11 risk factors). Current mental health therapy was associated with a lower risk of current HED while mental health medication use in the past 12 months (but not currently) was associated with a higher risk of HED. Conclusions: Findings provide guidance to college/university community professionals given the responsibility of designing and implementing programs for mitigation of alcohol misuse on their campus.
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Affiliation(s)
- Rita A Swartzwelder
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Barbara J Burns
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Linda Maultsby
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Megan Zhao
- Duke University College of Arts and Sciences, Durham, North Carolina, USA
| | - John G Looney
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Shawn Acheson
- Duke University School of Medicine, Durham, North Carolina, USA
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22
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Fisher S, Hsu WW, Adams Z, Arsenault C, Milich R. The effect of impulsivity and drinking motives on alcohol outcomes in college students: a 3-year longitudinal analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1624-1633. [PMID: 33048641 PMCID: PMC8232038 DOI: 10.1080/07448481.2020.1817033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 03/16/2020] [Accepted: 05/05/2020] [Indexed: 06/11/2023]
Abstract
Objective: Substance use is a public health concern and cross-sectional studies have found that impulsivity and drinking motives influence substance use in emerging adults. Despite these findings, longitudinal studies with nuanced measures of impulsivity and drinking motives are needed. Participants: The current study investigated the three-year relationship between impulsivity-related traits, drinking motives, sex, and drinking outcomes in a sample of 509 college students (47.47% male; 81% White). Methods: The effects of impulsivity traits and drinking motives on problematic drinking outcomes were evaluated using linear mixed effects models. Results: The results confirmed the hypothesized relationship between traits of impulsivity, drinking motives, and alcohol outcomes over time. Further, sex significantly interacted with drinking motives longitudinally in its relationship with alcohol use outcomes. Conclusions: These results indicate that intervention efforts may need to be tailored to specific individual attributes to target direct correlates of alcohol use behavior to increase effectiveness.
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Affiliation(s)
- Sycarah Fisher
- Department of Educational Psychology, University of Georgia, Athens, GA USA
| | - Wei-Wen Hsu
- Department of Statistics, Kansas State University, Manhattan KS, USA
| | - Zachary Adams
- Department of Psychiatry, Indiana University, Indianapolis, IN USA
| | - Chelsea Arsenault
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, USA
| | - Richard Milich
- Department of Psychology, University of Kentucky, Lexington, KY USA
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23
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Gilmore AK, Leone RM, Oesterle DW, Davis KC, Orchowski LM, Ramakrishnan V, Kaysen D. Web-Based Alcohol and Sexual Assault Prevention Program With Tailored Content Based on Gender and Sexual Orientation: Preliminary Outcomes and Usability Study of Positive Change (+Change). JMIR Form Res 2022; 6:e23823. [PMID: 35867393 PMCID: PMC9356330 DOI: 10.2196/23823] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 04/30/2021] [Accepted: 05/19/2022] [Indexed: 12/03/2022] Open
Abstract
Background Alcohol use and sexual assault are common on college campuses in the United States, and the rates of occurrence differ based on gender identity and sexual orientation. Objective We aimed to provide an assessment of the usability and preliminary outcomes of Positive Change (+Change), a program that provides integrated personalized feedback to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention among cisgender heterosexual men, cisgender heterosexual women, and sexual minority men and women. Methods Participants included 24 undergraduate students from a large university in the Southwestern United States aged between 18 and 25 years who engaged in heavy episodic drinking in the past month. All procedures were conducted on the web, and participants completed a baseline survey, +Change, and a follow-up survey immediately after completing +Change. Results Our findings indicated that +Change was acceptable and usable among all participants, despite gender identity or sexual orientation. Furthermore, there were preliminary outcomes indicating the benefit for efficacy testing of +Change. Conclusions Importantly, +Change is the first program to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention within the same program and to provide personalized content based on gender identity and sexual orientation. Trial Registration ClinicalTrials.gov NCT04089137; https://clinicaltrials.gov/ct2/show/NCT04089137
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Affiliation(s)
- Amanda K Gilmore
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Ruschelle M Leone
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Daniel W Oesterle
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, United States
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, AZ, United States
| | - Lindsay M Orchowski
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | | | - Debra Kaysen
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, United States
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24
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Prevalence of heavy episodic drinking and alcohol use disorder diagnosis among US college students: results from the national Healthy Minds Study. Addict Behav 2022; 135:107452. [PMID: 35964391 DOI: 10.1016/j.addbeh.2022.107452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/11/2022] [Accepted: 07/26/2022] [Indexed: 11/22/2022]
Abstract
Alcohol use is a common, recognized problem on college campuses. This study examined alcohol use in a national sample of US college students across 78 campuses. Using four waves of data from the Healthy Minds Study (2015-2019), we explored variations by student demographics in prevalence of recent: alcohol consumption, heavy episodic drinking (HED, 4/5 + drinks in one sitting), frequent HED (3 + HED events), and lifetime alcohol use disorder (AUD) diagnosis. Stratified analyses and logistic regression with response propensity weights were used. Two-thirds of students consumed alcohol and roughly-one-third engaged in HED in the past 2 weeks. Alcohol use was more common among students who: identified as cis women/men, bisexual or gay/lesbian/queer, white non-Hispanic, lived in Greek housing or off-campus, were not first generation, or those not rating religion as important. Prevalence of HED among recent drinkers was high (56.7%) but varied by gender identity, race-ethnicity, living situation, and religiosity. In addition, higher HED prevalence was reported among: international, undergraduate, and underage (under 21) students. There was little variation in HED by sexual orientation identity or first generation status among recent drinkers. In a sub-sample of students engaging in frequent HED, AUD diagnosis was uncommon (1.4%) and less likely among students identifying as: cis women/men, heterosexual, racial-ethnic minorities (particularly Asian/Asian American or Pacific Islander), international, religious, or living in Greek housing. Alcohol use continues to be a part of college life, while screening and treatment remains rare. There are opportunities for improved programming and outreach acknowledging college student diversity.
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25
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Pinna F, Paribello P, Somaini G, Corona A, Ventriglio A, Corrias C, Frau I, Murgia R, El Kacemi S, Galeazzi GM, Mirandola M, Amaddeo F, Crapanzano A, Converti M, Piras P, Suprani F, Manchia M, Fiorillo A, Carpiniello B. Mental health in transgender individuals: a systematic review. Int Rev Psychiatry 2022; 34:292-359. [PMID: 36151828 DOI: 10.1080/09540261.2022.2093629] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Several lines of evidence indicate the prevalence of mental health disorders in Transgender (TG) individuals is higher than that of cisgender individuals or the general population. In this systematic review, we aim to propose a summary of some of the most significant research investigating mental health disorders' prevalence among this population. We performed a double-blind systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting (PRISMA) on PUBMED/MEDLINE and SCOPUS, specifically using peer-reviewed articles examining the mental health status of transgender (TG) individuals. This review did not exclude any research based on publication date. The last search was performed in February 2022. The employed search strategy led to the selection of 165 peer-reviewed articles. The majority of these papers presented a cross-sectional design with self-reported diagnoses and symptoms, signaling a significant prevalence of mental health disorders amongst TG Individuals. Of the reviewed articles, 72 examined the prevalence of mood and anxiety disorders; 8 examined eating disorders; 43 examined the prevalence of suicidal or self-harm ideation or behaviors; 5 papers examined the prevalence of trauma and stress-related disorders; 10 examined the frequency of personality disorders; 44 examined substance use disorders; and 9 papers examined the prevalence of autism spectrum disorder. Finally, 22 studies reported on the prevalence of TG individuals diagnosed with co-morbid mental health disorders or unspecified mental disorders. Our findings coincide with existing research, which indicates TG individuals do experience a higher prevalence of mental health disorders than that of the general population or cisgender individuals. However, further research is needed to address the existing gaps in knowledge.
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Affiliation(s)
- Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Giulia Somaini
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Alice Corona
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Carolina Corrias
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Ilaria Frau
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Roberto Murgia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Sabrina El Kacemi
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Dipartimento ad attività integrata di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy.,School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Andrea Crapanzano
- Department of Counseling, San Francisco State University, San Francisco, California, USA
| | - Manlio Converti
- Dipartimento di salute mentale, ASL Napoli 2 Nord, Naples, Italy
| | - Paola Piras
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
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Greaves L, Poole N, Brabete AC. Sex, Gender, and Alcohol Use: Implications for Women and Low-Risk Drinking Guidelines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084523. [PMID: 35457389 PMCID: PMC9028341 DOI: 10.3390/ijerph19084523] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 02/06/2023]
Abstract
Alcohol use is coming under increasing scrutiny with respect to its health impacts on the body. In this vein, several high-income countries have issued low-risk drinking guidelines in the past decade, aiming to educate the public on safer levels of alcohol use. Research on the sex-specific health effects of alcohol has indicated higher damage with lower amounts of alcohol for females as well as overall sex differences in the pharmacokinetics of alcohol in male and female bodies. Research on gender-related factors, while culturally dependent, indicates increased susceptibility to sexual assault and intimate partner violence as well as more negative gender norms and stereotypes about alcohol use for women. Sex- and gender-specific guidelines have been issued in some countries, suggesting lower amounts of alcohol consumption for women than men; however, in other countries, sex- and gender-blind advice has been issued. This article reports on a synthesis of the evidence on both sex- and gender-related factors affecting safer levels of drinking alcohol with an emphasis on women’s use. We conclude that supporting and expanding the development of sex- and gender-specific low-risk drinking guidelines offers more nuanced and educative information to clinicians and consumers and will particularly benefit women and girls.
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Affiliation(s)
- Lorraine Greaves
- Centre of Excellence for Women’s Health, Vancouver, BC V6H 3N1, Canada;
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Correspondence: (L.G.); (A.C.B.)
| | - Nancy Poole
- Centre of Excellence for Women’s Health, Vancouver, BC V6H 3N1, Canada;
| | - Andreea C. Brabete
- Centre of Excellence for Women’s Health, Vancouver, BC V6H 3N1, Canada;
- Correspondence: (L.G.); (A.C.B.)
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Schipani-McLaughlin AM, Nielsen KE, Mosley EA, Leone RM, Oesterle DW, Orchowski LM, Davis KC, Gilmore AK. Alcohol use and alcohol-related consequences based on gender and sexual orientation among college students. Am J Addict 2022; 31:189-199. [PMID: 35385599 PMCID: PMC9117501 DOI: 10.1111/ajad.13283] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 03/10/2022] [Accepted: 03/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Research has not yet investigated how the association between alcohol and alcohol-related consequences differs across cisgender heterosexual women (CHW), cisgender heterosexual men (CHM), and sexual and gender minority (SGM) college students. METHODS Participants were N = 754 college students (34.5% CHW [n = 260]; 34.5% CHM [n = 260]; 31.0% SGM [n = 234]) between the ages 18 and 25 who completed a survey on sexual orientation, gender identity, alcohol use (i.e., average drinks per week), and alcohol-related consequences. RESULTS Among individuals who reported alcohol use, CHM reported significantly more drinks per week compared to CHW and SGM. The logistic model of a zero-inflated negative binomial regression indicated that excess zeros in the alcohol-related consequences were more likely among (1) nondrinkers and (2) SGM compared to CHM. The count portion of the model indicated that, among drinkers, there was a positive association between drinks per week and alcohol-related consequences. Estimated alcohol-related consequences per drink were 1.90% higher among CHW than CHM and 2.76% higher among SGM than CHM. Exploratory analyses did not find significant differences in outcomes between cisgender female and male sexual minority students. DISCUSSION AND CONCLUSION Findings suggest that although CHW and SGM students consume less alcohol than CHM, these students experience more alcohol-related consequences per drink. SCIENTIFIC SIGNIFICANCE This study advances the field's knowledge of alcohol use patterns and consequences among SGM college students. There is a need for alcohol education programming that is tailored to the unique experiences, identities, and minority stressors of SGM college students.
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Affiliation(s)
- Anne Marie Schipani-McLaughlin
- Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta, Georgia, USA.,Center for Research on Interpersonal Violence, Georgia State University, Atlanta, Georgia, USA
| | - Karen E Nielsen
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Elizabeth A Mosley
- Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta, Georgia, USA.,Center for Research on Interpersonal Violence, Georgia State University, Atlanta, Georgia, USA.,Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Ruschelle M Leone
- Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta, Georgia, USA.,Center for Research on Interpersonal Violence, Georgia State University, Atlanta, Georgia, USA.,Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Daniel W Oesterle
- Department of Psychological Sciences, Purdue University, West Lafayette, Illinois, USA
| | - Lindsay M Orchowski
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | | | - Amanda K Gilmore
- Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta, Georgia, USA.,Center for Research on Interpersonal Violence, Georgia State University, Atlanta, Georgia, USA.,Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, Georgia, USA
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Cotaina M, Peraire M, Boscá M, Echeverria I, Benito A, Haro G. Substance Use in the Transgender Population: A Meta-Analysis. Brain Sci 2022; 12:brainsci12030366. [PMID: 35326322 PMCID: PMC8945921 DOI: 10.3390/brainsci12030366] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 02/06/2023] Open
Abstract
(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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Affiliation(s)
- Miriam Cotaina
- TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellon de la plana, Spain; (M.C.); (M.P.); (I.E.); (G.H.)
- Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, 12002 Castellon de la plana, Spain;
| | - Marc Peraire
- TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellon de la plana, Spain; (M.C.); (M.P.); (I.E.); (G.H.)
- Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, 12002 Castellon de la plana, Spain;
| | - Mireia Boscá
- Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, 12002 Castellon de la plana, Spain;
| | - Iván Echeverria
- TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellon de la plana, Spain; (M.C.); (M.P.); (I.E.); (G.H.)
- Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, 12002 Castellon de la plana, Spain;
| | - Ana Benito
- TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellon de la plana, Spain; (M.C.); (M.P.); (I.E.); (G.H.)
- Torrente Mental Health Unit, Hospital General de Valencia, 46900 Torrente, Spain
- Correspondence:
| | - Gonzalo Haro
- TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellon de la plana, Spain; (M.C.); (M.P.); (I.E.); (G.H.)
- Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, 12002 Castellon de la plana, Spain;
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Somé NH, Shokoohi M, Shield KD, Wells S, Hamilton HA, Elton-Marshall T, Abramovich A. Alcohol and cannabis use during the COVID-19 pandemic among transgender, gender-diverse, and cisgender adults in Canada. BMC Public Health 2022; 22:452. [PMID: 35255847 PMCID: PMC8899793 DOI: 10.1186/s12889-022-12779-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study examined whether heavy episodic drinking (HED), cannabis use, and subjective changes in alcohol and cannabis use during the COVID-19 pandemic differ between transgender and gender-diverse (TGD) and cisgender adults. METHODS Successive waves of web-based cross-sectional surveys. SETTING Canada, May 2020 to March 2021. PARTICIPANTS 6,016 adults (39 TGD, 2,980 cisgender men, 2,984 cisgender women, and 13 preferred not to answer), aged ≥18 years. MEASUREMENTS Measures included self-reported HED (≥5 drinks on one or more occasions in the previous week for TGD and cisgender men and ≥4 for cisgender women) and any cannabis use in the previous week. Subjective changes in alcohol and cannabis use in the past week compared to before the pandemic were measured on a five-point Likert scale (1: much less to 5: much more). Binary and ordinal logistic regressions quantified differences between TGD and cisgender participants in alcohol and cannabis use, controlling for age, ethnoracial background, marital status, education, geographic location, and living arrangement. RESULTS Compared to cisgender participants, TGD participants were more likely to use cannabis (adjusted odds ratio (aOR)=3.78, 95%CI: 1.89, 7.53) and to have reported subjective increases in alcohol (adjusted proportional odds ratios (aPOR)= 2.00, 95%CI: 1.01, 3.95) and cannabis use (aPOR=4.56, 95%CI: 2.13, 9.78) relative to before the pandemic. Compared to cisgender women, TGD participants were more likely to use cannabis (aOR=4.43, 95%CI: 2.21, 8.87) and increase their consumption of alcohol (aPOR=2.05, 95%CI: 1.03, 4.05) and cannabis (aPOR=4.71, 95%CI: 2.18, 10.13). Compared to cisgender men, TGD participants were more likely to use cannabis (aOR=3.20, 95%CI: 1.60, 6.41) and increase their use of cannabis (aPOR=4.40, 95%CI: 2.04, 9.49). There were no significant differences in HED between TGD and cisgender participants and in subjective change in alcohol between TGD and cisgender men; however, the odds ratios were greater than one as expected. CONCLUSIONS Increased alcohol and cannabis use among TGD populations compared to before the pandemic may lead to increased health disparities. Accordingly, programs targeting the specific needs of TGD individuals should be prioritized.
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Affiliation(s)
- Nibene H Somé
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. .,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Mostafa Shokoohi
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Kevin D Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,World Health Organization/Pan American Health Organization Collaborating Centre in Addiction and Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Samantha Wells
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Hayley A Hamilton
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Tara Elton-Marshall
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada
| | - Alex Abramovich
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Connolly D, Aldridge A, Davies E, Maier LJ, Ferris J, Gilchrist G, Winstock A. Comparing Transgender and Cisgender Experiences of Being Taken Advantage of Sexually While Under the Influence of Alcohol and/or Other Drugs. JOURNAL OF SEX RESEARCH 2021; 58:1112-1117. [PMID: 33908334 DOI: 10.1080/00224499.2021.1912692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A small body of literature suggests that transgender people are more frequently exposed to sexual violence while they are under the influence of alcohol than cisgender counterparts. The goal of this study was to report any differences between transgender (n = 1,136) and cisgender (n = 74,277) respondents to the Global Drug Survey on their experiences of being taken advantage of sexually while under the influence of alcohol and/or other drugs. We found that transgender people were more likely than cisgender people to have experienced being taken advantage of in the last year (9.3% vs 4.2%) and more than 12 months preceding the survey (24.9% vs 14.3%). Non-binary participants were more likely than binary transgender participants (27.7% vs 17.8%) to report being taken advantage of sexually more than a year preceding the survey. Similarly, trans respondents assigned female at birth were more likely than trans respondents assigned male at birth to report this (30.0% vs 19.7%). Nonspecialist services for survivors of sexual violence should be adequately prepared for and accommodating toward transgender clients. Future research should explore their unique needs. Moreover, clinicians who assess transgender people should remain mindful of their increased likelihood of being taken advantage of sexually while under the influence of alcohol and other drugs and consider trauma-informed interventions.
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Affiliation(s)
- Dean Connolly
- Addictions Sciences Building, Institute of Psychiatry, Psychology and Neuroscience, King's College London
- Whipps Cross University Hospital, Barts Health NHS Trust
| | | | - Emma Davies
- Faculty of Health and Life Sciences, Oxford Brookes University
| | - Larissa J Maier
- Department of Clinical Pharmacy, University of California
- Early Postdoc Mobility Grantee (P2ZHP1_174812), Swiss National Science Foundation
| | - Jason Ferris
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland
| | - Gail Gilchrist
- Addictions Sciences Building, Institute of Psychiatry, Psychology and Neuroscience, King's College London
| | - Adam Winstock
- Institute of Epidemiology & Health Care, University College London
- Global Drug Survey
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Ruppert R, Kattari SK, Sussman S. Review: Prevalence of Addictions among Transgender and Gender Diverse Subgroups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168843. [PMID: 34444595 PMCID: PMC8393320 DOI: 10.3390/ijerph18168843] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 12/25/2022]
Abstract
We conducted an analysis of the prevalence of substance and behavioral addictions across different transgender and gender diverse (TGD) subgroups. We performed a scoping review using MEDLINE and Google Scholar databases and examined 12 addictions, including alcohol, nicotine, cannabis, illicit drugs, gambling, eating/food, internet, sex, love, exercise, work, and shopping. We presented prevalence rates for each addiction as a function of an individual’s gender identity (stratified into transgender females, transgender males, and gender nonconforming), and used cisgender women and men as reference groups. We included 55 studies in our final analysis, the majority of which investigated substance use disorders among TGD subgroups. Overall findings indicated that substantial differences in substance use exist among US TGD subgroups. There were far fewer publications that examined the prevalence of behavioral addictions across TGD subgroups. However, despite limited research in this area, findings still suggest that notable differences in behavioral addictions may exist between individual TGD subgroups. The conclusions of our review may provide clinicians with a better ability to screen for and treat at-risk individuals within the TGD community.
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Affiliation(s)
- Ryan Ruppert
- Keck School of Medicine of USC, Los Angeles, CA 90033, USA;
- Correspondence: or ; Tel.: +1-302-358-6852
| | - Shanna K. Kattari
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Steve Sussman
- Keck School of Medicine of USC, Los Angeles, CA 90033, USA;
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Lindley L, Bauerband L, Galupo MP. Using a Comprehensive Proximal Stress Model to Predict Alcohol Use. Transgend Health 2021; 6:164-174. [PMID: 34414271 DOI: 10.1089/trgh.2020.0042] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The gender minority stress model has been proposed by researchers to explain the high rates of substance use found within transgender communities, but its explanatory power has never been directly tested. Further, qualitative research has noted that premedically transitioned and nonbinary individuals are more likely to engage in avoidant coping such as drinking to cope. As such, the current study tested the relationship between proximal stress (comprised of internalized transphobia, anticipated stigma, concealment, and gender dysphoria), drinking to cope, and problematic alcohol use. Methods: Transgender and nonbinary participants over the age of 18 (N=297) completed an online survey on alcohol use. To test for differences in drinking to cope across gender identity and medical transition, analysis of variance and independent t-tests were conducted. Further, a structural equation model of proximal stress was developed to test whether drinking to cope mediated the relationship between proximal stress and alcohol use. Results: There were no significant differences across gender identity or medical transition status in severity of drinking to cope. Proximal stress was significantly related to problematic alcohol use and the relationship was explained by an indirect relationship with drinking to cope. Conclusion: Findings from this study suggest that drinking to cope is an important aspect of high rates of alcohol use found in the transgender community. Implications for clinical practice with transgender individuals are discussed.
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Affiliation(s)
- Louis Lindley
- Psychology Department, Towson University, Towson, Maryland, USA
| | - Loren Bauerband
- Health Sciences Department, University of Missouri Health, Columbia, Missouri, USA
| | - M Paz Galupo
- Psychology Department, Towson University, Towson, Maryland, USA
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Kittaneh AA, Patel S, Sidhu NK, Lechner WV, Kenne DR. Tobacco Use Status as a Function of Transgender Identity: The Mediating Role of Psychological Distress. Tob Use Insights 2021; 14:1179173X211004267. [PMID: 33854393 PMCID: PMC8013634 DOI: 10.1177/1179173x211004267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/19/2021] [Indexed: 11/15/2022] Open
Abstract
Aim The current study examined differences between individuals identifying as transgender and people identifying as cisgender in terms of (1) psychological distress (eg, anxiety, depression, and suicidal ideation), (2) rates of combustible and e-cigarette use, and (3) the potential for elevated psychological distress stemming from transgender identification to be associated with increased rates of smoking and vaping. Method This was a secondary analysis of data from a study examining behavioral health, perceptions and behaviors associated with alcohol and other drug use, and mental health status at a large mid-western university. Differences in current use of cigarette and e-cigarette products were examined between self-identified transgender (n = 253) and cisgender (n = 18 371) respondents. Results Overall, 17.2% (n = 2727) of the sample endorsed past 30-day use of cigarettes or e-cigarettes. Results demonstrated a significant effect of gender identity, with individuals identifying as transgender reporting higher odds of using cigarettes or e-cigarettes (AOR = 2.82, 95% CI 1.26-6.31). Regression analyses revealed significant effects of transgender identity on symptoms of anxiety (b = 3.45, 95% CI = 1.64, 5.25, P < .001.); depression, (b = 4.14, 95% CI = 2.21, 6.07, P < .001); and suicidal ideation, (b = 2.51, 95% CI = 1.48, 3.55, P < .001.), respectively. Finally, we observed significant indirect effects of transgender identity on cigarette and e-cigarette product use via increased symptoms of depression (indirect effect = 0.13, 95% CI [0.07, 0.19], P < .05), and suicidal ideation (indirect effect = 0.22, 95% CI [0.15, 0.28], P < .05), but not symptoms of anxiety. Discussion This is the first study of our knowledge to examine the association between psychological symptoms and smoking and vaping products with transgender identity. The results of this study support previous findings that transgender individuals are at risk for elevated substance use and extend the literature by demonstrating this this risk is associated with elevated psychological distress.
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Affiliation(s)
- Ahmad A Kittaneh
- Department of Psychological Sciences, Kent State University, OH, USA
| | - Sweta Patel
- Center for Public Policy and Health, Kent State University, OH, USA
| | - Natasha K Sidhu
- Department of Psychological Sciences, Kent State University, OH, USA
| | - William V Lechner
- Department of Psychological Sciences, Kent State University, OH, USA
| | - Deric R Kenne
- Center for Public Policy and Health, Kent State University, OH, USA
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Prevalence and correlates of substance use among transgender adults: A systematic review. Addict Behav 2020; 111:106544. [PMID: 32717497 DOI: 10.1016/j.addbeh.2020.106544] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 06/23/2020] [Accepted: 07/05/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Minority stress theories suggest that high rates of discrimination experienced by transgender people are precipitants of substance use. This risk is likely exacerbated by an inadequate provision of trans-inclusive substance misuse services. However, the exclusion of transgender people from the general substance misuse literature makes it difficult to determine the extent to which transgender status influences substance use. A systematic review was undertaken to better understand the prevalence, patterns and correlates of substance use among this group. METHODS In accordance with the PRISMA guidance, a literature search was conducted to 29th May 2019 on PubMed, PsycINFO, Embase and Global Health databases. Primary quantitative studies, published in English, that reported the prevalence, patterns or correlates of substance use by transgender people were included, with no restriction on methodological design. RESULTS 653 unique records were identified, and 41 studies were included. Half the studies reported on both transgender men and transgender women and half transgender women only. There was high and excess prevalence of substance use among transgender compared with cisgender people, but insufficient evidence to estimate prevalence or quantify the risk for substance use. Correlates of substance use included transphobic discrimination or violence, unemployment and sex work, gender dysphoria, high visual gender non-conformity and intersectional sexual minority status. CONCLUSIONS The sparse findings lend support to the minority stress model. However, the overreliance of the literature on disproportionate investigation of transgender women with multiple intersectional disadvantages, means there are significant gaps regarding the wider transgender community. To ensure substance use treatment services are inclusive, gender identity should be recorded and targeted interventions available. Clinicians should be aware of the multiple, complex drivers of substance use and be prepared to ask about substance use and offer support. Given the high prevalence of trauma experienced by transgender people, trauma-informed psychosocial interventions may be useful in the management of problematic substance use in transgender adults.
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Rozga M, Linsenmeyer W, Cantwell Wood J, Darst V, Gradwell E. Hormone therapy, health outcomes and the role of nutrition in transgender individuals: A scoping review. Clin Nutr ESPEN 2020; 40:42-56. [DOI: 10.1016/j.clnesp.2020.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/21/2020] [Accepted: 08/22/2020] [Indexed: 02/06/2023]
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Dinger MK, Brittain DR, Patten L, Hall KC, Burton S, Hydock DS, Stellino MB. Gender Identity and Health-related Outcomes in a National Sample of College Students. AMERICAN JOURNAL OF HEALTH EDUCATION 2020. [DOI: 10.1080/19325037.2020.1822242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | | | - Luke Patten
- Colorado School of Public Health
- Center for Innovative Design and Analysis
| | | | - Steven Burton
- Colorado School of Public Health
- University of Northern Colorado
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Kcomt L, Evans-Polce RJ, Boyd CJ, McCabe SE. Association of transphobic discrimination and alcohol misuse among transgender adults: Results from the U.S. Transgender Survey. Drug Alcohol Depend 2020; 215:108223. [PMID: 32777693 PMCID: PMC7502497 DOI: 10.1016/j.drugalcdep.2020.108223] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Alcohol misuse remains a leading preventable risk factor for morbidity and mortality in the United States. Evidence suggests that alcohol misuse is more prevalent among transgender populations. This study examined the association between transphobic discrimination and alcohol use/misuse among a large sample of transgender people. METHODS Using the 2015 U.S. Transgender Survey (N = 27,715), logistic regression models were conducted to estimate the adjusted odds ratios (AOR) and 95 % confidence intervals (CI) of current alcohol use, past-month binge drinking (≥1 occasion of consuming ≥5 alcoholic beverages within the past month), and past-month frequent binge drinking (≥5 occasions of binge drinking within the past month) among transgender people. RESULTS Of the respondents, 60.4 % reported current alcohol use, 24.3 % reported past-month binge drinking, and 8.5 % reported past-month frequent binge drinking. The majority (70.1 %) had experienced some form of past-year transphobic discrimination. Experiencing 3+ forms of transphobic discrimination was significantly associated with past-month binge drinking (AOR = 1.49, 95 % CI = 1.37-1.62) and past-month frequent binge drinking (AOR = 1.57, 95 % CI = 1.37-1.79) than individuals who did not experience transphobic discrimination. Persons who cross-dress showed higher odds of current alcohol use (AOR = 1.52, 95 % CI = 1.32-1.74), past-month binge drinking (AOR = 2.51, 95 % CI = 2.21-2.85), and past-month frequent binge drinking (AOR = 4.13, 95 % CI = 3.45-4.94) than transgender women. Discrimination within public spaces and housing domains had the most robust associations with alcohol misuse. CONCLUSIONS Experiencing transphobic discrimination increased the odds of alcohol misuse among transgender people. Stakeholders and providers should be cognizant of the multifaceted nature of transphobic discrimination as unique social stressors that many transgender persons experience.
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Affiliation(s)
- Luisa Kcomt
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States.
| | - Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States.
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, United States; Addiction Center, Department of Psychiatry, Rachel Upjohn Building, University of Michigan, Ann Arbor, MI, United States; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States.
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, United States; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States; Institute for Social Research, University of Michigan, Ann Arbor, MI, United States; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States; Center for Sexuality and Health Disparities School of Nursing, University of Michigan, Ann Arbor, MI, United States.
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Connolly D, Davies E, Lynskey M, Barratt MJ, Maier L, Ferris J, Winstock A, Gilchrist G. Comparing intentions to reduce substance use and willingness to seek help among transgender and cisgender participants from the Global Drug Survey. J Subst Abuse Treat 2020; 112:86-91. [DOI: 10.1016/j.jsat.2020.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/26/2020] [Accepted: 03/02/2020] [Indexed: 01/25/2023]
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Jun HJ, Webb-Morgan M, Felner JK, Wisdom JP, Haley SJ, Austin SB, Katuska LM, Corliss HL. Sexual orientation and gender identity disparities in substance use disorders during young adulthood in a United States longitudinal cohort. Drug Alcohol Depend 2019; 205:107619. [PMID: 31678835 PMCID: PMC7437659 DOI: 10.1016/j.drugalcdep.2019.107619] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/29/2019] [Accepted: 09/04/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND This study examined associations of sexual orientation and gender identity with prevalence of substance use disorders (SUDs) and co-occurring multiple SUDs in the past 12-months during young adulthood in a United States longitudinal cohort. METHODS Questionnaires self-administered in 2010 and 2015 assessed probable past 12-month nicotine dependence, alcohol abuse and dependence, and drug abuse and dependence among 12,428 participants of an ongoing cohort study when they were ages 20-35 years. Binary or multinomial logistic regressions using generalized estimating equations were used to estimate differences by sexual orientation and gender identity in the odds of SUDs and multiple SUDs, stratified by sex assigned at birth. RESULTS Compared with completely heterosexuals (CH), sexual minority (SM; i.e., mostly heterosexual, bisexual, lesbian/gay) participants were generally more likely to have a SUD, including multiple SUDs. Among participants assigned female at birth, adjusted odds ratios (AORs) for SUDs comparing SMs to CHs ranged from 1.61 to 6.97 (ps<.05); among participants assigned male at birth, AORs ranged from 1.30 to 3.08, and were statistically significant for 62% of the estimates. Apart from elevated alcohol dependence among gender minority participants assigned male at birth compared with cisgender males (AOR: 2.30; p < .05), gender identity was not associated with prevalence of SUDs. CONCLUSIONS Sexual and gender minority (SGM) young adults disproportionately evidence SUDs, as well as co-occurring multiple SUDs. Findings related to gender identity and bisexuals assigned male at birth should be interpreted with caution due to small sample sizes. SUD prevention and treatment efforts should focus on SGM young adults.
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Affiliation(s)
- Hee-Jin Jun
- School of Public Health, San Diego State University, San Diego, CA, USA,Institute for Behavioral and Community Health, San Diego State University, San Diego, CA
| | - Megan Webb-Morgan
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Jennifer K. Felner
- School of Public Health, San Diego State University, San Diego, CA, USA,Institute for Behavioral and Community Health, San Diego State University, San Diego, CA
| | | | - Sean J. Haley
- Department of Health Policy and Management, School of Public Health, City University of New York, New York, NY, USA
| | - S. Bryn Austin
- Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Laura M. Katuska
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Heather L. Corliss
- School of Public Health, San Diego State University, San Diego, CA, USA,Institute for Behavioral and Community Health, San Diego State University, San Diego, CA,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA
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Mereish EH. Substance use and misuse among sexual and gender minority youth. Curr Opin Psychol 2019; 30:123-127. [PMID: 31202102 PMCID: PMC6859198 DOI: 10.1016/j.copsyc.2019.05.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/25/2019] [Accepted: 05/11/2019] [Indexed: 12/13/2022]
Abstract
Sexual and gender minority youth are at greater risk for substance use and misuse compared to their heterosexual and cisgender peers. This select review of the literature found that recent studies continue to document disparities in substance use. These disparities are partially explained by general and unique stressors as well as social, interpersonal, and cultural factors experienced by sexual and gender minority youth. There are many gaps in the literature, including limited research on protective factors or interventions to prevent or decrease substance use. Despite emerging empirical literature over the past two years, more research is needed to address sexual and gender minority youth's greater risk for substance use. Innovative methodologies and interdisciplinary efforts are needed to help advance our understanding of disparities in substance use in order to reduce and eliminate them and create more affirming experiences for sexual and gender minority youth.
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Affiliation(s)
- Ethan H Mereish
- Department of Health Studies, American University, Washington, DC, United States of America.
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Straka BC, Gaither SE, Acheson SK, Swartzwelder HS. “Mixed” Drinking Motivations: A Comparison of Majority, Multiracial, and Minority College Students. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2019. [DOI: 10.1177/1948550619883294] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Social exclusion is associated with substance use, but the specific link between majority and minority racial group membership and substance use is unknown. We examined how social exclusion among racial majority (White), Multiracial, and racial minority (Native American, Latino, Asian, and Black) college students relates to self-reported alcohol use and motivations. Using the AlcoholEdu for College™ survey, Study 1a reports five factors related to motives for initiating or inhibiting alcohol use. Study 1b analyzes majority, Multiracial, and minority college students’ comparative endorsement of these motivations. Study 2 compares these factors with established belonging scales using a separate undergraduate sample. White, Multiracial, Native American, and Latino students displayed the highest proportion of problematic alcohol use. White students endorsed belonging-based drinking motivations, while Multiracial and Asian students endorsed motivations similar to both majority and minority groups. Native American, Latino, and Black students endorsed abstaining motivations more than other groups.
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Affiliation(s)
- Brenda C. Straka
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Sarah E. Gaither
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Samuel DuBois Cook Center on Social Equity, Center on Health and Society, Duke University, Durham, NC, USA
| | - Shawn K. Acheson
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - H. S. Swartzwelder
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
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Kidd JD, Levin FR, Dolezal C, Hughes TL, Bockting WO. Understanding predictors of improvement in risky drinking in a U.S. multi-site, longitudinal cohort study of transgender individuals: Implications for culturally-tailored prevention and treatment efforts. Addict Behav 2019; 96:68-75. [PMID: 31039507 PMCID: PMC6571154 DOI: 10.1016/j.addbeh.2019.04.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE While transgender people report higher rates of risky drinking than the general population, no studies have examined transgender alcohol use longitudinally. This study investigated minority stress and identity development predictors of improvement in risky drinking among transgender individuals. METHODS Data come from a multi-site, longitudinal cohort study of U.S. transgender individuals (N = 330) and include measures of enacted stigma, felt stigma, identity development, and risky alcohol use. Theory-driven, hierarchical multivariable logistic regression was used to investigate the hypothesis that minority stress and identity development factors are related to improvement in risky drinking between baseline and 1-year follow-up. RESULTS Baseline risky drinkers (n = 106; 37.1%) were younger and more likely to have female sex assigned at birth. At 1-year follow-up, 68 baseline risky drinkers (64.2%) reported persistent risky drinking, while 38 (35.8%) reported improved drinking. Controlling for demographics and study site, female sex assigned at birth and enacted stigma were associated with lower odds of improved drinking. Non-white/Hispanic race/ethnicity, felt stigma, change in gender role/expression for 1-5 years, and diffuse-avoidant identity style were associated with higher odds of improvement. CONCLUSIONS/IMPORTANCE This is the first study to identity predictors of improvement in risky drinking among transgender individuals. Compared to trans-feminine individuals (assigned male at birth), trans-masculine individuals (assigned female at birth) were more likely to report risky drinking at baseline and had lower odds of improvement at 1-year follow-up. Improved drinking may be facilitated by preventing anti-transgender discrimination. Felt stigma and diffuse-avoidant identity style may lower alcohol risk via avoidance of drinking venues. Further research is needed to explicate these relationships and to inform culturally-tailored alcohol interventions for this at-risk population.
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Affiliation(s)
- Jeremy D Kidd
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States of America; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States of America.
| | - Frances R Levin
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States of America; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States of America.
| | - Curtis Dolezal
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States of America.
| | - Tonda L Hughes
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States of America; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States of America; Columbia University School of Nursing, 560 W. 168th Street, New York, NY 10032, United States of America.
| | - Walter O Bockting
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States of America; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States of America; Columbia University School of Nursing, 560 W. 168th Street, New York, NY 10032, United States of America.
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Jackman KB, Bosse JD, Eliason MJ, Hughes TL. Sexual and gender minority health research in nursing. Nurs Outlook 2019; 67:21-38. [DOI: 10.1016/j.outlook.2018.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 10/24/2018] [Accepted: 10/27/2018] [Indexed: 01/15/2023]
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Risk and Protective Factors for Substance Use among Sexual and Gender Minority Youth: A Scoping Review. CURRENT ADDICTION REPORTS 2018; 5:158-173. [PMID: 30393591 DOI: 10.1007/s40429-018-0196-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Purpose of Review Alcohol and drug use are common among youth. Rates are especially high among sexual and gender minority youth (SGMY; lesbian, gay, bisexual, transgender). We conducted a scoping review of research on risk and protective factors for substance use among SGMY published between 2013-2017. Recent Findings Ninety-seven studies met our inclusion criteria. Most focused on individual-level minority stress risk factors, particularly stigma. Fewer studies addressed protective factors such as social support or affirming policies, and few focused on gender minority youth (GMY). We identified important, yet understudied differences by race/ethnicity, sex assigned at birth, and sexual orientation. Summary Findings highlight growing interest in this topic as well as methodological/topical gaps in the literature. Research is needed to examine SGMY substance use in nationally representative samples; expand information about GMY; investigate racial/ethnic and sex/gender differences; improve measurement; and increase translation of findings to support prevention and treatment interventions for this at-risk population.
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Gilbert PA, Pass LE, Keuroghlian AS, Greenfield TK, Reisner SL. Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies. Drug Alcohol Depend 2018; 186:138-146. [PMID: 29571076 PMCID: PMC5911250 DOI: 10.1016/j.drugalcdep.2018.01.016] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/05/2018] [Accepted: 01/09/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is a recent and growing research literature on alcohol use and related harms among transgender and other gender minority populations; however, current definitions and measures of hazardous drinking do not consider the complexity of physiological sex characteristics and socially constructed gender, raising doubts regarding their validity, applicability, and use with these populations. To address this, we reviewed current research on alcohol-related outcomes in transgender populations and critically summarized key issues for consideration in future research. METHODS We conducted a systematic review of transgender alcohol research in English language, peer-reviewed journals, published 1990-2017, and extracted key details (e.g., sample composition, alcohol measures, results). RESULTS Forty-four studies met all inclusion criteria for the review, the majority of which were conducted in the United States. The prevalence of hazardous drinking was high; however, estimates varied widely across studies. We noted frequent methodological weaknesses, including few attempts to differentiate sex and gender, poor attention to appropriate definitions of hazardous drinking, and reliance on cross-sectional study designs and non-probability sampling methods. CONCLUSION Given findings that suggest high need for ongoing public health attention, we offer recommendations to improve future alcohol studies with transgender and other gender minority populations, such as being explicit as to whether and how sex and/or gender are operationalized and relevant for the research question, expanding the repertoire of alcohol measures to include those not contingent on sex or gender, testing the psychometric performance of established screening instruments with transgender populations, and shifting from descriptive to analytic study designs.
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Affiliation(s)
- Paul A. Gilbert
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Lauren E. Pass
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Alex S. Keuroghlian
- Harvard Medical School, Boston, MA, USA,The Fenway Institute, Fenway Health, Boston, MA, USA,Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Tom K. Greenfield
- Division of General Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Sari L. Reisner
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
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