跨性别成年人中的跨性别歧视与酒精滥用的关联：来自美国跨性别调查的结果。
Association of transphobic discrimination and alcohol misuse among transgender adults: Results from the U.S. Transgender Survey.
机构信息
Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States.
Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, United States; Addiction Center, Department of Psychiatry, Rachel Upjohn Building, University of Michigan, Ann Arbor, MI, United States; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States.
出版信息
Drug Alcohol Depend. 2020 Oct 1;215:108223. doi: 10.1016/j.drugalcdep.2020.108223. Epub 2020 Aug 2.
BACKGROUND
Alcohol misuse remains a leading preventable risk factor for morbidity and mortality in the United States. Evidence suggests that alcohol misuse is more prevalent among transgender populations. This study examined the association between transphobic discrimination and alcohol use/misuse among a large sample of transgender people.
METHODS
Using the 2015 U.S. Transgender Survey (N = 27,715), logistic regression models were conducted to estimate the adjusted odds ratios (AOR) and 95 % confidence intervals (CI) of current alcohol use, past-month binge drinking (≥1 occasion of consuming ≥5 alcoholic beverages within the past month), and past-month frequent binge drinking (≥5 occasions of binge drinking within the past month) among transgender people.
RESULTS
Of the respondents, 60.4 % reported current alcohol use, 24.3 % reported past-month binge drinking, and 8.5 % reported past-month frequent binge drinking. The majority (70.1 %) had experienced some form of past-year transphobic discrimination. Experiencing 3+ forms of transphobic discrimination was significantly associated with past-month binge drinking (AOR = 1.49, 95 % CI = 1.37-1.62) and past-month frequent binge drinking (AOR = 1.57, 95 % CI = 1.37-1.79) than individuals who did not experience transphobic discrimination. Persons who cross-dress showed higher odds of current alcohol use (AOR = 1.52, 95 % CI = 1.32-1.74), past-month binge drinking (AOR = 2.51, 95 % CI = 2.21-2.85), and past-month frequent binge drinking (AOR = 4.13, 95 % CI = 3.45-4.94) than transgender women. Discrimination within public spaces and housing domains had the most robust associations with alcohol misuse.
CONCLUSIONS
Experiencing transphobic discrimination increased the odds of alcohol misuse among transgender people. Stakeholders and providers should be cognizant of the multifaceted nature of transphobic discrimination as unique social stressors that many transgender persons experience.
背景
在美国，酒精滥用仍是导致发病和死亡的主要可预防风险因素。有证据表明，跨性别群体中酒精滥用更为普遍。本研究调查了在美国 Trans 生活状况调查（2015 年）（N=27715）中，对大量跨性别者进行逻辑回归模型分析，以估计当前饮酒、过去一个月内狂饮（过去一个月内有≥1 次饮酒≥5 次）和过去一个月内频繁狂饮（过去一个月内有≥5 次狂饮）的调整后的优势比（AOR）和 95%置信区间（CI）。
结果
在受访者中，60.4%的人报告称当前饮酒，24.3%的人报告过去一个月内狂饮，8.5%的人报告过去一个月内频繁狂饮。大多数（70.1%）在过去一年中经历过某种形式的跨性别歧视。经历过 3 种或更多形式的跨性别歧视与过去一个月内狂饮（AOR=1.49，95%CI=1.37-1.62）和过去一个月内频繁狂饮（AOR=1.57，95%CI=1.37-1.79）显著相关，而没有经历过跨性别歧视的个体。穿异性服装的人更有可能目前饮酒（AOR=1.52，95%CI=1.32-1.74）、过去一个月内狂饮（AOR=2.51，95%CI=2.21-2.85）和过去一个月内频繁狂饮（AOR=4.13，95%CI=3.45-4.94）。与跨性别女性相比，在公共场所和住房领域经历歧视与酒精滥用的关联最紧密。
结论
经历跨性别歧视会增加跨性别者发生酒精滥用的几率。利益相关者和提供者应认识到跨性别歧视的多面性，因为这是许多跨性别者所经历的独特的社会压力源。
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