在一个全国性的跨性别和性别非二元成年人样本中，过去 12 个月处方药滥用的流行率和少数群体压力相关因素：来自美国跨性别调查的结果。
Prevalence and minority-stress correlates of past 12-month prescription drug misuse in a national sample of transgender and gender nonbinary adults: Results from the U.S. Transgender Survey.
机构信息
Columbia University Irving Medical Center, 622 W. 168(th) Street, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
Columbia University Irving Medical Center, 622 W. 168(th) Street, New York, NY 10032, USA.
出版信息
Drug Alcohol Depend. 2021 Feb 1;219:108474. doi: 10.1016/j.drugalcdep.2020.108474. Epub 2020 Dec 21.
BACKGROUND
Prescription drug (PD) misuse, particularly opioid misuse, is a major US public health concern. While transgender and gender nonbinary (TGNB) individuals experience numerous health disparities, including substance use disparities, little research has focused on PD misuse in this population.
METHODS
Data for this secondary analysis come from the US Transgender Survey (N = 26,689). First, we examined bivariate differences in past 12-month PD misuse among binary transgender women, binary transgender men, nonbinary individuals assigned-female-at-birth (AFAB), and nonbinary individuals assigned-male-at-birth (AMAB). We then used multivariable logistic regression (separately based on sex-assigned-at-birth) to examine the relationship between gender-identity related discrimination and PD misuse.
RESULTS
PD misuse was significantly more common among binary transgender men (17.3 %), nonbinary AFAB individuals (18.7 %), and nonbinary AMAB individuals (18.0 %); compared to binary transgender women (13.5 %). In multivariable analyses, nonbinary identity was associated with higher odds of PD misuse among TGNB AFAB individuals (OR = 1.121; 95 %CI 1.021-1.232) and AMAB individuals (OR = 1.315; 95 % CI 1.133-1.527). Controlling for overall health status and psychological distress, public accommodations discrimination was associated with PD misuse among TGNB AMAB individuals (OR = 1.578, 95 %CI 1.354-1.839). Among both groups, healthcare discrimination was associated with PD misuse (AFAB OR = 1.388, 95 %CI 1.255-1.534; AMAB OR = 1.227, 95 %CI 1.073-1.404).
CONCLUSION
In this national sample of TGNB individuals, nonbinary individuals were at greater risk for PD misuse than binary individuals, possibly due to less societal affirmation. Similar to other TGNB health disparities, discrimination based on gender identity/expression was associated with PD misuse. This highlights the importance of interventions to reduce discrimination against TGNB individuals.
背景
处方药物（PD）滥用，尤其是阿片类药物滥用，是美国一个主要的公共卫生关注点。尽管跨性别和性别多样化（TGNB）个体经历了许多健康差异，包括物质使用方面的差异，但很少有研究关注这个群体中的 PD 滥用问题。
方法
本二次分析的数据来自美国跨性别者调查（N=26689）。首先，我们检查了二元跨性别女性、二元跨性别男性、出生时被指定为女性（AFAB）的非二元个体和出生时被指定为男性（AMAB）的非二元个体在过去 12 个月 PD 滥用方面的单变量差异。然后，我们使用多变量逻辑回归（分别基于出生时的性别分配）来检查性别认同相关歧视与 PD 滥用之间的关系。
结果
PD 滥用在二元跨性别男性（17.3%）、非二元 AFAB 个体（18.7%）和非二元 AMAB 个体（18.0%）中明显更为常见；而二元跨性别女性的 PD 滥用率为 13.5%。在多变量分析中，非二元性别认同与 TGNB AFAB 个体（OR=1.121；95%CI 1.021-1.232）和 AMAB 个体（OR=1.315；95%CI 1.133-1.527）的 PD 滥用风险增加相关。在控制整体健康状况和心理困扰后，公共场所歧视与 TGNB AMAB 个体的 PD 滥用相关（OR=1.578，95%CI 1.354-1.839）。在这两个群体中，医疗保健歧视与 PD 滥用相关（AFAB OR=1.388，95%CI 1.255-1.534；AMAB OR=1.227，95%CI 1.073-1.404）。
结论
在这个全国性的 TGNB 个体样本中，非二元个体比二元个体更有可能滥用 PD，这可能是由于他们较少得到社会的认可。与其他 TGNB 健康差异一样，基于性别认同/表达的歧视与 PD 滥用相关。这突显了减少针对 TGNB 个体的歧视的干预措施的重要性。
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