Alcohol and Cannabis Use in Relation to Daily Marginalization in Transgender Individuals

As part of a larger study on minority stress with transgender and gender diverse (TGD) participants, this daily diary study explored associations between daily marginalization and gender non-affirmation with alcohol and cannabis use, as well as general and TGD-specific coping motives for use. We examined the mediating effects of general (e.g., rumination) and identity-specific (e.g., internalized stigma) processes that may help explain how stigma impacts alcohol or cannabis use. There were 167 participants (M age = 25.4; 82.2% White), including trans men (49.1%), trans women (18.6%), genderqueer (10.2%), and nonbinary participants (22.2%). Participants completed 56 consecutive daily surveys reflecting on their alcohol and cannabis use, reasons for use, and related variables. Reporting more daily marginalization and gender non-affirmation was associated with an increased likelihood of endorsing both general and TGD-specific motives for use on the same day. Higher levels of gender non-affirmation were associated with an increased likelihood of drinking on the same day. There were no significant prospective associations with alcohol or cannabis use related variables. At the between-person level, TGD people who experienced higher levels of daily marginalization also reported an increased likelihood of using cannabis and consumed more alcohol on average. In concurrent analyses, the association between daily marginalization and gender non-affirmation with general or TGD-specific coping motives was partially explained by increases in internalized stigma, rumination, and isolation. Future research is needed to identify other intervening variables that may help to explain these associations.