Hill L Wolfe1, Katie B Biello2, Sari L Reisner3, Matthew J Mimiaga4, Sean R Cahill5, Jaclyn M W Hughto2. 1. Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, United States; Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, 200 Springs Road (152), Building 70, Bedford, MA, 02903, United States. Electronic address: HLW64@BU.EDU. 2. Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, United States; Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, United States; Center for Health Promotion and Health Equity, Brown University, Box G-121-8, Providence, RI, 02912, United States; The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, United States. 3. The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, United States; General Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, United States; Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, United States. 4. The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, United States; Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, BOX 951772, 71-267 CHS, Los Angeles, CA, 90095, United States; Department of Psychiatry and Biobehavioral Science, David Geffen School of Medicine, University of California Los Angeles, BOX 951772, 71-267 CHS, Los Angeles, CA, 90095, United States; UCLA Center for LGBTQ Advocacy, Research & Health, BOX 951772, 71-267 CHS, Los Angeles, CA, 90095, United States. 5. Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, United States; The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, United States; Bouve College of Health Sciences, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, United States.
Abstract
BACKGROUND: Substantial research gaps exist regarding the relationship between transgender-related discrimination and substance use outcomes for transgender adults, with few studies accounting for other experiences of victimization. METHODS: Transgender adults (N = 600) from Massachusetts and Rhode Island completed a survey online or in-person. Multivariable linear and logistic regression models examined the association between lifetime experiences of transgender-related discrimination using the validated 11-item Everyday Discrimination Scale (theoretical range = 0-44) and substance use outcomes: past 12-month substance use frequency, lifetime substance use disorder (SUD) diagnosis, and substance use treatment (SUTx) history. All models were adjusted for age, gender identity, race, survey modality, childhood physical/sexual abuse, intimate partner violence, and discrimination attributable to other reasons than being transgender. RESULTS: The mean transgender-related discrimination score was 20.8 (SD = 9.6, range = 0-44). Overall, 11.8 % of the sample had a SUD diagnosis and 11.0 % had received SUTx. In separate multivariable models adjusted for sociodemographic and victimization experiences, the highest quartile of transgender-related discrimination was significantly associated with higher past 12-month substance use (B = 1.44; aR2 = 0.13; p = .009), SUD diagnosis (aOR = 3.64; 95 % CI = 1.46-9.07; p = .006), and lifetime treatment history (aOR = 3.93; 95 % CI = 1.50-10.21; p = .005). CONCLUSIONS: There was a significant positive association between experiencing high levels of transgender-related discrimination and substance use outcomes among the transgender adults sampled. Longitudinal research is needed to understand the specific mediators driving these relationships and to address the implications of transgender-related discrimination on SUD treatment utilization. Published by Elsevier B.V.
BACKGROUND: Substantial research gaps exist regarding the relationship between transgender-related discrimination and substance use outcomes for transgender adults, with few studies accounting for other experiences of victimization. METHODS: Transgender adults (N = 600) from Massachusetts and Rhode Island completed a survey online or in-person. Multivariable linear and logistic regression models examined the association between lifetime experiences of transgender-related discrimination using the validated 11-item Everyday Discrimination Scale (theoretical range = 0-44) and substance use outcomes: past 12-month substance use frequency, lifetime substance use disorder (SUD) diagnosis, and substance use treatment (SUTx) history. All models were adjusted for age, gender identity, race, survey modality, childhood physical/sexual abuse, intimate partner violence, and discrimination attributable to other reasons than being transgender. RESULTS: The mean transgender-related discrimination score was 20.8 (SD = 9.6, range = 0-44). Overall, 11.8 % of the sample had a SUD diagnosis and 11.0 % had received SUTx. In separate multivariable models adjusted for sociodemographic and victimization experiences, the highest quartile of transgender-related discrimination was significantly associated with higher past 12-month substance use (B = 1.44; aR2 = 0.13; p = .009), SUD diagnosis (aOR = 3.64; 95 % CI = 1.46-9.07; p = .006), and lifetime treatment history (aOR = 3.93; 95 % CI = 1.50-10.21; p = .005). CONCLUSIONS: There was a significant positive association between experiencing high levels of transgender-related discrimination and substance use outcomes among the transgender adults sampled. Longitudinal research is needed to understand the specific mediators driving these relationships and to address the implications of transgender-related discrimination on SUD treatment utilization. Published by Elsevier B.V.
Entities:
Keywords:
Discrimination; Drugs; Stigma; Substance use; Substance use treatment; Transgender
Authors: Olivia V Fletcher; Jessica A Chen; Jenna van Draanen; Madeline C Frost; Anna D Rubinsky; John R Blosnich; Emily C Williams Journal: SSM Popul Health Date: 2022-06-28
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