Substance use in early adulthood is associated with a multitude of negative effects including poorer physical and mental health and lower educational achievement. Young adults that identify as sexual and gender minority (SGM) individuals have shown higher rates of alcohol, cannabis, and other substance use, in comparison to their non-SGM peers, putting them at increased risk of negative health and psychosocial outcomes. The minority stress theory, which proposes that minority groups experience higher rates of discrimination and violence which may lead to coping-related substance use, may provide one potential explanation for the association of substance use and SGM identity. This study examines multiple trajectories of alcohol and cannabis use in young adults who identify as SGM or non-SGM from early adolescence into young adulthood.

The study’s sample consisted of 2,534 participants in California who were assessed from middle school to young adulthood. Participants were asked about alcohol and cannabis use, sexual orientation, sexual behavior, gender identity, assigned sex at birth, and non-concordance between sex assigned at birth and current gender identity. Other factors that were assessed included education, employment and economic status, transition to independence/adulthood, criminal justice involvement, social functioning, physical health, behavioral health, and unmet treatment need for alcohol/drug use or mental health conditions. Data was analyzed using unadjusted bivariant tests to examine frequencies for all variables by the SGM group. Latent growth modeling was used to assess trajectories of alcohol and cannabis use.

Results of the data analysis found that the SGM group had higher rates of alcohol use (69% vs. 63%, p=0.01) and cannabis use (46% vs. 28%, p<0.0001) in the past month compared to non-SGM individuals during the last phase of the study. When adjusting for covariates there were no differences by SGM status in probability of alcohol use or rate of change in alcohol use overtime. When controlling for alcohol and cannabis use trajectories, participants who identified as SGM experienced more disparities related to unemployment and economic instability, loneliness, behavioral health, and subjective physical health in comparison to their non-SGM peers.

Takeaway: Young adults who identify as sexual and gender minorities may experience more disparities and hardships than their peers who do not identify as sexual and gender minorities, even at similar levels of alcohol and cannabis use.

Dunbar M, Siconolfi D, Rodriguez A, Seelam R, Davis J, Tucker J, D’Amico E. Alcohol use and cannabis use trajectories and sexual/gender minority disparities in young adulthood. Psychology of Addictive Behaviors. 20220113. Doi.org/10.1037/adb0000806