Budhwani Henna, Hearld Kristine R, Milner Adrienne N, McGlaughlin Elaine, Charow Rebecca, Rodriguez-Lauzurique Rosa Mayra, Rosario Santo, Paulino-Ramirez Robert
University of Alabama at Birmingham, Birmingham, Alabama.
Queen Mary University of London, London, United Kingdom.
Transgend Health. 2017 Oct 1;2(1):188-194. doi: 10.1089/trgh.2017.0032. eCollection 2017.
Studies on drug use in transgender populations, particularly those in resource-limited settings, are scarce. Considering that drug use can be a coping mechanism to deal with stigma and traumatic experiences, we examined associations between stigma, trauma, and drug use in a national sample of transgender women from the Dominican Republic. Bivariate analyses examined differences between drug users and abstainers (=287). Multivariate analyses reported odds ratios (OR) with general drug, marijuana, and cocaine use as outcomes (=243). A quarter of respondents (24.5%) experienced sexual abuse, 12.1% were tortured, and 20.1% experienced a murder attempt. More than a quarter reported using illegal drugs (26.1%). Drug users had lower socioeconomic status; 30.0% of drug users had a primary level of education or less (18.2% of abstainers) and 17.6% of drug users had higher income, defined as greater than 10,001 pesos (∼$210 United States Dollars, USD) per month (28.1% of abstainers). More than half of drug users experienced some form of trauma (51.4%) compared to 43.5% of abstainers, and 28.4% of drug users, compared to 17.1% of abstainers, experienced a murder attempt on her life. Independent sample -tests found significant differences between drug users and abstainers. Transgender women who experienced sexual abuse had three times high odds of using cocaine. Drug users were more likely to have experienced sexual abuse and attempted suicide (<0.05 for both). Respondents who attempted suicide had higher odds of using drugs generally and using marijuana specifically, compared to respondents who had not attempted suicide (OR=2.665 and 3.168, respectively). Higher scores on the stigma scale were associated with higher odds of any drug use and cocaine use (OR=1.132 and 1.325, respectively). Although some nations have implemented antidiscrimination policies protecting transgender citizens, these policies are not consistently enforced. Eliminating stigma and stigmatizing policies may reduce rates of drug use as a coping mechanism.
针对跨性别群体，尤其是资源有限环境下的跨性别群体的药物使用研究十分匮乏。鉴于药物使用可能是应对耻辱感和创伤经历的一种机制，我们在多米尼加共和国的全国跨性别女性样本中，研究了耻辱感、创伤与药物使用之间的关联。双变量分析检验了吸毒者和戒毒者（=287）之间的差异。多变量分析报告了以使用一般药物、大麻和可卡因为结果的比值比（OR）（=243）。四分之一的受访者（24.5%）遭受过性虐待，12.1%遭受过酷刑，20.1%经历过谋杀未遂。超过四分之一的受访者报告使用过非法药物（26.1%）。吸毒者的社会经济地位较低；30.0%的吸毒者接受过小学或以下教育（戒毒者为18.2%），17.6%的吸毒者收入较高，即每月超过10,001比索（约合210美元）（戒毒者为28.1%）。超过一半的吸毒者经历过某种形式的创伤（51.4%），而戒毒者为43.5%；28.4%的吸毒者经历过谋杀未遂，而戒毒者为17.1%。独立样本检验发现吸毒者和戒毒者之间存在显著差异。遭受过性虐待的跨性别女性使用可卡因的几率高出三倍。吸毒者更有可能遭受过性虐待并曾试图自杀（两者均<0.05）。与未试图自杀的受访者相比，试图自杀的受访者使用一般药物尤其是使用大麻的几率更高（OR分别为2.665和3.168）。耻辱感量表得分越高，使用任何药物和使用可卡因的几率越高（OR分别为1.132和1.325）。尽管一些国家已经实施了保护跨性别公民的反歧视政策，但这些政策并未得到持续执行。消除耻辱感和歧视性政策可能会降低作为应对机制的药物使用率。
