Transgender teens may turn to alcohol to cope with extra stress

  • A 2-year survey of transgender or gender minority (GM) adolescents, who have a different gender identity than the one they were assigned at birth, suggests that many use alcohol to cope with GM-related stress.
  • Internalized cissexism had associations with an increased risk of substance use in response to stress, whereas resilience and gender-related pride had associations with a lower risk.
  • Family and social support protected against alcohol use at low levels of stress, but not at high levels.
  • The researchers conclude that future interventions with GM youth should aim to reduce internalized cissexism and strengthen resilience, gender-related pride, and family functioning.

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Transgender people have a different gender identity to the sex they were assigned at birth, in contrast to cisgender individuals, who are comfortable with their assigned gender.

A recent study found that transgender and nonbinary adolescents face more emotional distress and bullying and have fewer protective factors, such as family connectedness, compared with their cisgender peers.

Another study found that the prevalence of substance use among these GM youth can be up to 4 times higher than in cisgender youth.

These findings suggest that GM adolescents use drugs, such as alcohol, to cope with the additional stressors they encounter in their everyday lives.

However, the research to date has been cross-sectional (focused on a single moment in time), making it harder to establish the root causes of substance use.

A newly published study, which surveyed the substance use of 30 GM adolescents every 6 months over a period of 2 years, supports the view that they used alcohol, in particular, to cope with GM-related stresses.

Scientists at Boston Children’s Hospital, Harvard Medical School, and the Harvard T. H. Chan School of Public Health, all in Boston, MA, conducted the research. The results appear in PLOS ONE.

risk factors and protective factors

Their study examined how stressors, such as victimization, and related risk factors, namely internalized cissexism, depressive symptoms, and anxiety affected substance use.

It also investigated potentially protective factors, such as resilience, gender-related pride, family functioning, and social support.

All the subjects, who were aged 13–17 years, were part of a community-based research project called the Trans Teen and Family Narratives Project.

Participants identified as:

  • transfeminine (11)
  • transmasculine (15)
  • nonbinary (4)

At the start of the study, 17% reported using substances, including tobacco, alcohol, and marijuana. But by the end, 56% of participants claimed that they were using one of these.

Higher exposure to GM-related stress significantly increased the likelihood that these adolescents would use alcohol, but not tobacco or marijuana.

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