Substance use & misuse · 2025
Associations of Sexual Identity and Gender Identity with Substance Use and Mental Health in Young Adulthood.
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Bae Dayoung, Leventhal Adam M, Harlow Alyssa F, Han Dae-Hee, Krueger Evan A, Barrington-Trimis Jessica L, Conn Bridgid M, Cho Junhan
Аннотация
BACKGROUND: Research showing that sexual and gender minority (SGM) young adults are at increased risk of substance use and mental health symptoms have insufficiently accounted for SGM identity diversity. This study examined differences in substance use and mental health symptoms among young adults with diverse sexual (heterosexual, lesbian/gay, asexual, bisexual, pansexual, and queer) and gender (cisgender, transgender, and on-binary) identities.
METHODS: Five longitudinal survey waves (2019-2023) of young adults (n = 2724; mean age = 21.7) from Southern California were used to estimate time-varying contemporaneous associations of SGM identities with eight outcomes. Outcomes were: past 30-d alcohol, combustible cigarette, e-cigarette, or other drug (e.g., prescription painkillers, stimulants) use and binge drinking, and depression and anxiety symptoms.
RESULTS: Young adults with transgender and non-binary identities (vs. cisgender female) reported higher cigarette, e-cigarette, and other drug use, and greater depression. Bisexual identities showed higher use in all six substance outcomes, gay/lesbian identities reported increased alcohol and combustible cigarette use, and pansexual identities reported higher e-cigarette and other drug use (vs. heterosexual). All sexual minority identities displayed higher depression and anxiety levels, except asexual identities, who showed positive associations with depression symptoms only. Associations did not vary by time, stable vs. dynamic identity status, or sexual identity-gender identity intersections.
CONCLUSION: Young adults with SGM identities report significantly higher levels of substance use and mental health problems compared to cisgender and heterosexual identities, with heterogeneity in associations across diverse SGM identities. Inclusive SGM assessment could inform precise and tailored young adult behavioral health prevention and treatment.
METHODS: Five longitudinal survey waves (2019-2023) of young adults (n = 2724; mean age = 21.7) from Southern California were used to estimate time-varying contemporaneous associations of SGM identities with eight outcomes. Outcomes were: past 30-d alcohol, combustible cigarette, e-cigarette, or other drug (e.g., prescription painkillers, stimulants) use and binge drinking, and depression and anxiety symptoms.
RESULTS: Young adults with transgender and non-binary identities (vs. cisgender female) reported higher cigarette, e-cigarette, and other drug use, and greater depression. Bisexual identities showed higher use in all six substance outcomes, gay/lesbian identities reported increased alcohol and combustible cigarette use, and pansexual identities reported higher e-cigarette and other drug use (vs. heterosexual). All sexual minority identities displayed higher depression and anxiety levels, except asexual identities, who showed positive associations with depression symptoms only. Associations did not vary by time, stable vs. dynamic identity status, or sexual identity-gender identity intersections.
CONCLUSION: Young adults with SGM identities report significantly higher levels of substance use and mental health problems compared to cisgender and heterosexual identities, with heterogeneity in associations across diverse SGM identities. Inclusive SGM assessment could inform precise and tailored young adult behavioral health prevention and treatment.