Substance Use among Trans and Gender Diverse Adolescents: The Risk of Emotional Problems and Social Support as a Protective Factor

Abstract

The current research mainly aimed to examine the relationship between gender identity and substance use, and the mediating role of emotional problems. Secondly, the moderating role of social support from friends and family in the relationships between 1) gender identity and emotional problems, and 2) between emotional support and substance abuse was examined. It is important to understand the mechanisms of emotional problems, substance use, and social support in trans and gender diverse (TGD) youth, as there is a lack of knowledge of risk and protective factors of the mental health disparities among TGD adolescents. The mechanisms were assessed by conducting multiple linear regression analyses on the 2021/22 Health Behavior in School-aged Children (HBSC) survey data. Results showed that TGD youth reported substantially more emotional problems compared to their cisgender peers. Furthermore, in the general population, youth who report more emotional problems are more likely to engage in substance use, and social support from friends and family is a buffer in this relationship. However, TGD youth did not engage in more substance use than cisgender youth. Because adolescents with non-conforming gender identities experience worrying mental health disparities, it is crucial for future interventions and policies to focus on minimizing the amount of emotional problems they experience. Future research is also needed to gain more insights into the risk and protective factors in mental health problems of TGD youth.