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. 2023 Aug:326:115339.
doi: 10.1016/j.psychres.2023.115339. Epub 2023 Jul 7.

Prevalence of substance use and mental health problems among transgender and cisgender U.S. adults: Results from a national probability sample

Jeremy D Kidd  1 , Nicky A Tettamanti  2 , Roma Kaczmarkiewicz  3 , Thomas E Corbeil  3 , Jordan D Dworkin  4 , Kasey B Jackman  5 , Tonda L Hughes  6 , Walter O Bockting  6 , Ilan H Meyer  7
Affiliations

Prevalence of substance use and mental health problems among transgender and cisgender U.S. adults: Results from a national probability sample

Jeremy D Kidd et al. Psychiatry Res. 2023 Aug.

Abstract

Transgender individuals experience numerous health disparities relative to cisgender individuals. However, most transgender-health studies have focused on convenience samples with limited generalizability. This study utilized data from the 2016-2018 TransPop Study, the first national probability sample of transgender adults (n=274) with a cisgender comparison sample (n=1162). Using multivariable logistic regression, adjusted for demographics, we compared the prevalence of hazardous drinking, problematic drug use, serious psychological distress, suicidality, and non-suicidal self-injury between transgender and cisgender individuals and among transgender men (n=78), transgender women (n=120), and transgender nonbinary individuals (n=76). Among transgender individuals, 28.2% (95%CI 21.2-35.2) and 31.2% (95%CI 23.8-38.7) reported hazardous drinking and problematic drug use, respectively; 44.4% (95% CI 35.8-53.0) reported recent suicidal ideation, 6.9% (95% CI 2.3-11.5) reported a recent suicide attempt, and 21.4% (95% CI 14.5%-28.4%) reported recent non-suicidal self-injury. In their lifetime, 81.3% (95%CI 75.1-87.5) of transgender respondents had suicidal ideation, 42.0% (95%CI 34.2-49.8) had attempted suicide, and 56.0% (95% CI 48.2-63.8) reported non-suicidal self-injury. Most (81.5%; 95%CI 75.5-87.5) had utilized formal mental health care and 25.5% (95%CI 18.5-32.4) had sought informal mental health support. There were no differences in alcohol or drug-use outcomes between transgender and cisgender adults. Compared to cisgender adults, transgender adults had higher odds of serious psychological distress (aOR=3.1; 95%CI 1.7-5.7), suicidal ideation (recent: aOR=5.1, 95%CI 2.7-9.6); lifetime: aOR=6.7, 95%CI 3.8-11.7), lifetime suicide attempts (aOR=4.4, 95%CI 2.4-8.0), and non-suicidal self-injury (recent: aOR=13.0, 95%CI 4.8-35.1); lifetime: aOR=7.6, 95%CI 4.1-14.3). Transgender nonbinary adults had the highest odds for all outcomes, including substance use outcomes. Findings from these national probability samples support those of earlier convenience-sample studies showing mental health disparities among transgender adults relative to cisgender adults, with nonbinary individuals at highest risk. These findings also highlight variations in risk across sub-groups of transgender individuals.

Keywords: Alcohol; Drugs; Gender identity; Self-injurious behaviors; Suicidal ideation.

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Conflict of interest statement

Declaration of Competing Interest The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Adjusted prevalence estimates of substance use and mental health problems and treatment-seeking among U.S. transgender and cisgender adults *Adjusted for age (continuous), race and ethnicity, income, and education
See this image and copyright information in PMC

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