A Daily Diary Study of Discrimination and Substance Use in Transgender and Nonbinary Adults

Rates of alcohol and cannabis use are often higher among transgender and nonbinary (TNB) adults relative to cisgender adults. Prior studies indicate that increased exposure to anti-TNB discrimination may be associated with greater substance use in this population, yet few studies have investigated whether these are temporally related. This study examined whether daily experiences of anti-TNB discrimination were associated with same-day and next-day alcohol and cannabis use. We recruited 135 TNB adults (M _age = 29.1, SD = 8.6; 67.4% nonbinary, 24.4% men/male, 14.8% women/female, 8.9% other identities) for a 60-day daily diary study between January 2022 and July 2023 that assessed daily alcohol and cannabis use as well as experiences of anti-TNB discrimination. We examined whether experiencing anti-TNB discrimination was associated with alcohol use (any drinking, number of drinks, heavy episodic drinking [HED]) and cannabis use on the same-day and next-day compared to non-discrimination days. Participants experiencing more anti-TNB discrimination were more likely to engage in HED and reported consuming more alcoholic drinks on the same day. Anti-TNB discrimination did not predict any drinking outcomes on the subsequent day. Further, anti-TNB discrimination was not associated with cannabis use on the same-day or next-day. These findings suggest that TNB individuals might drink more alcohol on the same day as discrimination, potentially to cope with stress related to experiencing discrimination. Interventions that aim to improve adaptive coping with discrimination could reduce drinking among TNB adults.