Minority Stress: Understanding Alcohol Behaviors, Suicidality, and Non-Suicidal Self-Injury among Transgender Adults

Abstract

Transgender (trans) individuals are at high risk for health-related problems including alcohol misuse, suicidality - suicide ideation, attempts, and deaths – and non-suicidal self-injury (NSSI). Relatively little research has investigated alcohol behaviors specifically among trans adults. High rates of suicidality and NSSI among trans adults have been established by previous research; however, there is a dearth of studies that attempt to understand predictors of these health-related problems. One hypothesized explanation for health disparities between trans individuals and the general population is that trans individuals experience high rates of minority stress related to their marginalized status. For the current two studies, a sample of trans adults was recruited nationally to complete a cross-sectional battery of online measures. Study 1 was a descriptive study that examined alcohol quantity and frequency, alcohol-related problems, and drinking to cope motives across trans subgroups. Differences in alcohol behaviors were found according to gender expression, but not sex assigned at birth or gender identity. Study 2 examined associations among minority stress, alcohol-related problems, suicidality and NSSI, while controlling for differences in gender expression and gender identity. Increased minority stress was found to increase suicidality, but not alcohol-related problems or NSSI. Increased alcohol-related problems were found to increase NSSI. Taken together, the findings suggest that individual and societal-level interventions targeting minority stress and alcohol misuse may be an effective way to decrease rates of health-related problems among trans adults.