Exploring alcohol use and harm reduction techniques among transgender and gender diverse youth in Canada: A...

Background: Compared to their cisgender peers, transgender and gender-diverse (TGD) youth and young adults report problematic drinking patterns (e.g. frequency of use, greater likelihood of use, and elevated risks for harmful use), as well as increased-risk of experiencing alcohol-related harms. Previous research suggests that increases in drinking among TGD populations may be motivated by experiences of gender minority stress (GMS). This study examines the lived/living experiences of Canadian TGD youth (ages 18-29), focusing on their experiences of GMS and resilience as it pertains to alcohol use, related harms, and harm reduction techniques. Methods: Semi-structured interviews with a peer researcher were conducted between November 2022 and May 2023, and in total, nineteen youth were interviewed. Questions focused on themes of GMS, resilience, and alcohol use. Data was coded and analyzed using an inductive thematic analysis approach. Results: Findings demonstrate that experiences of GMS (e.g. gender non-affirmation, discrimination, gender dysphoria, etc.), including difficulty accessing healthcare, was a primary drinking motivation among TGD youth. That is, alcohol was often used as a means to cope with GMS, and experiencing such stressors often similarly resulted in increased alcohol use. Conclusions: Our findings highlight the necessity of gender-affirming care, programming, and practices for TGD youth, as well as the important role of positive supports (e.g. family, community connections), all of which may serve to mitigate the heightened risks of increased alcohol use and related harms among TGD youth.