LGBQT+
Alexis Ceja, B.A.
Assistant Clinical Research Coordinator
University of California San Francisco
Richmond, California
Mitchell R. Lunn, M.D., Other
Assistant Professor in Division of Nephrology of the Department of Medicine
Stanford University
Palo Alto, California
Juno Obedin-Maliver, M.P.H., M.D., Other
Assistant Professor in the Department of Obstetrics and Gynecology at the School of Medicine
Stanford University
Palo Alto, California
Nadra E. Lisha, Ph.D.
Specialist statistician
University of California, San Francisco
San Francisco, California
Zubin Dastur, M.P.H., M.S.
LGBTQ Digital Clinical Research Manager of The PRIDE Study
Department of Obstetrics and Gynecology at Stanford University
Palo Alto, California
Micah E. Lubensky, Ph.D.
Participant Engagement Director of The PRIDE Study/PRIDEnet
University of California, San Francisco
San Francisco, California
Torsten B. Neilands, Ph.D.
Professor of Medicine
University of California, San Francisco
San Francisco, California
Gowri Sunder, Other
Clinical Research Coordinator
University of California, San Francisco
San Francisco, California
Annesa Flentje, Ph.D.
Associate Professor
University of California San Francisco
San Francisco, California
Sexual minority people (i.e., individuals with a non-heterosexual sexual orientation) and gender minority people (i.e.,individuals whose gender identity differs from that commonly associated with their sex assigned at birth) experience unique stress, termed minority stress, that can impact mental health and substance use (Meyer, 2003). Although minority stress has been tied to substance use (Hatzenbuehler et al., 2008), little is known about gender identity, sexual orientation, and other demographic differences in substance use among Latina/o/x sexual and gender minority (SGM) people and how demographic characteristics relate to patterns of substance use while accounting for minority stress. Doing so would allow identification of demographic differences in substance use that occur only in the presence of minority stress. We examined past 30-day alcohol and cannabis use among Latina/o/x SGM participants in The PRIDE Study, a national longitudinal cohort of SGM people in the U.S., while accounting for minority stress. Using data collected from the 2020 Annual Questionnaire, 337 Latina/o/x SGM people were included. Minority stress was measured using the adapted sexual minority stress subscale of the Cultural Assessment of Risk for Suicide (CARS) (Chu et al., 2013) with separate scales for sexual minority- or gender minority-related stress. Alcohol use was dichotomized (yes/no) and assessed by asking participants “In the past 30 days, on how many days have you had 5 or more drinks containing alcohol on one occasion?” Cannabis use was dichotomized (yes/no) and assessed by asking participants “In the past 30 days, on how many days have you used cannabis (marijuana, pot, grass, hash, etc.)?” Logistic regressions were conducted to examine the associations between sexual orientation, age, gender group, minority stress, and substance use. Transmasculine people had lower odds of past 30-day cannabis use, compared with cisgender men (OR: 0.33, 95% CI [0.122, 0.895]). Asexual participants had lower odds of past 30-day cannabis use compared with non-asexual participants (OR: 0.371, 95% CI [0.149, 0.923]). Demographic characteristics were not related to past 30-day alcohol use. Further, greater CARS scores (OR: 1.087, 95% CI [1.006, 1.174]) were associated with significantly higher odds of past 30-day use of 5 or more alcoholic drinks only, and not past 30-day cannabis use. Findings highlight the importance of examining differences in sexual orientation and gender identity while accounting for minority stress. These results suggest that Latina/o/x asexual people and transmasculine people are less likely to report past 30-day cannabis use compared to Latina/o/x non-asexual people and cisgender men; these differences are not attributed to variability in levels of minority stress. In addition, findings suggest that CARS scores were predictive of past 30-day use of 5 or more alcoholic drinks, but not cannabis use, among Latina/o/x SGM people.