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<p>Previous studies have demonstrated high prevalence of alcohol and substance use behaviors among transgender and gender-diverse (TGD) communities. Considering the recency of anti-trans policies in the US, it is critical to understand whether structural anti-trans factors are associated with substance use outcomes. To fill this gap, we examined the associations between factors that make up a structurally anti-trans policy environment and unhealthy alcohol use and drug use among TGD adults. Using data from the Priority Assessment in Trans Health (PATH) Project (<i>n</i> = 797), multivariable regression modeling using nonparametric bootstrapping methods (resampling = 1000) were used to assess associations between structurally anti-trans policy environment indicators and harmful alcohol use (HAU) and harmful drug use (HDU) (abuse, dependence, disorders, etc.). The sample was predominately comprised of young adult trans women (81.9%), ages 25–34 (81.7%). Over one-third identified as people of color (39.7%). Overall, 52.8% reported HAU and 5.6% reported HDU. Accurate knowledge of state-level anti-hate-crime laws was associated with reduced odds of HAU (OR = 0.69 [95% CI: 0.53, 0.90]; <i>p</i> = 0.006). In a separate model, higher awareness of anti-trans bills was associated with increased odds of reporting HDU (OR = 1.62 [95% CI: 1.09, 2.40]; <i>p</i> = 0.02). There were no significant differences between concerns about trans rights being taken away and alcohol or drug use. Findings indicate that awareness of anti-trans bills is associated with increased unhealthy drug use, while knowledge of state-level anti-hate-crime laws is associated with decreased unhealthy alcohol use. Protecting social safety should be prioritized for TGD individuals, as this may serve as a protective factor against risk behaviors.</p>

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Impact of structurally transphobic policy environment on harmful alcohol and substance use among transgender and nonbinary adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月5日

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  • Abby Baker,
  • Teresa DeAtley,
  • Adedotun Ogunbajo,
  • Ruby Lucas,
  • Emerson Dusic,
  • Jessie M. Garcia Gutiérrez,
  • Audren J.K. Bambilla,
  • Nathaniel M. Widmann,
  • Daphne Suen,
  • Aleks Martin,
  • Alic Shook,
  • Deborah Schwarz,
  • Genya Shimkin,
  • Vanessa Grandberry,
  • Xero Xanadu,
  • Don Operario,
  • Trace Kershaw,
  • Kristi E. Gamarel,
  • Arjee Restar

摘要

Previous studies have demonstrated high prevalence of alcohol and substance use behaviors among transgender and gender-diverse (TGD) communities. Considering the recency of anti-trans policies in the US, it is critical to understand whether structural anti-trans factors are associated with substance use outcomes. To fill this gap, we examined the associations between factors that make up a structurally anti-trans policy environment and unhealthy alcohol use and drug use among TGD adults. Using data from the Priority Assessment in Trans Health (PATH) Project (n = 797), multivariable regression modeling using nonparametric bootstrapping methods (resampling = 1000) were used to assess associations between structurally anti-trans policy environment indicators and harmful alcohol use (HAU) and harmful drug use (HDU) (abuse, dependence, disorders, etc.). The sample was predominately comprised of young adult trans women (81.9%), ages 25–34 (81.7%). Over one-third identified as people of color (39.7%). Overall, 52.8% reported HAU and 5.6% reported HDU. Accurate knowledge of state-level anti-hate-crime laws was associated with reduced odds of HAU (OR = 0.69 [95% CI: 0.53, 0.90]; p = 0.006). In a separate model, higher awareness of anti-trans bills was associated with increased odds of reporting HDU (OR = 1.62 [95% CI: 1.09, 2.40]; p = 0.02). There were no significant differences between concerns about trans rights being taken away and alcohol or drug use. Findings indicate that awareness of anti-trans bills is associated with increased unhealthy drug use, while knowledge of state-level anti-hate-crime laws is associated with decreased unhealthy alcohol use. Protecting social safety should be prioritized for TGD individuals, as this may serve as a protective factor against risk behaviors.