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Problematic substance use among trans and non-binary people in Spain: An overlooked reality
Cristina García-Marín1, Paule Gonzalez-Recio2, Sara Moreno-García3
1Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario La Paz, Madrid, Spain.
Drug and Alcohol Dependence
|March 10, 2026
Summary
Problematic substance use (PSU) affects 18.6% of trans and non-binary people in Spain, linked to social vulnerability and mental health. Targeted public health interventions are crucial to address these health inequities.
Area of Science:
- Public Health
- Sociology
- Psychiatry
Background:
- Trans and non-binary people (TNBP) face significant structural discrimination, increasing vulnerability to problematic substance use (PSU).
- Understanding the prevalence and factors associated with PSU in this population is critical for targeted interventions.
Purpose of the Study:
- To analyze the prevalence of PSU among TNBP in Spain.
- To identify factors associated with PSU in this demographic.
Main Methods:
- A cross-sectional online survey was conducted with 1562 TNBP (aged ≥15) in Spain.
- PSU was assessed for 13 substances using DSM-5-TR criteria; Poisson regression identified associated factors.
Main Results:
- 18.6% of TNBP reported PSU in the past year, with cannabis, non-prescribed tranquilizers, and cocaine being most common.
- Factors associated with PSU included age 25-34, lower education, experiencing violence, mental health issues, sex work, and prior substance use.
Conclusions:
- A high prevalence of PSU exists among TNBP in Spain, strongly linked to social vulnerability and mental health.
- Urgent public health interventions are needed to address TNBP's specific needs and combat health inequities stemming from discrimination.
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