Cotaina Miriam, Peraire Marc, Boscá Mireia, Echeverria Iván, Benito Ana, Haro Gonzalo
TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellon de la plana, Spain.
Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, 12002 Castellon de la plana, Spain.
Brain Sci. 2022 Mar 10;12(3):366. doi: 10.3390/brainsci12030366.
(1) Background: This meta-analysis aimed to assess the relationship between identifying as transgender and substance use. (2) Methods: We searched for relevant studies in PubMed, Scopus, the Web of Science, and PsycINFO on 21 July 2021. (3) Results: Twenty studies comparing transgender and cisgender people were included in this work, accounting for a total of 2,376,951 participants (18,329 of whom were transgender). These articles included data on current tobacco use, current tobacco use disorder, current alcohol use, current alcohol use disorder, lifetime substance (all) use, current substance use (excluding tobacco and alcohol), current use of specific substances (excluding tobacco and alcohol and including cocaine, amphetamines, methamphetamines, ecstasy, stimulants, heroin, opiates, cannabis, marijuana, LSD, hallucinogens, steroids, inhalants, sedatives, Ritalin or Adderall, diet pills, cold medicine, prescription medications, polysubstance, other club drugs, and other illegal drugs), and current substance use disorder (excluding tobacco and alcohol). We used the ORs and their 95% CIs to state the association between identifying as transgender and those variables. The control reference category used in all cases was cisgender. We employed a random-effects model. Transgender people were more likely to use tobacco (odds ratio (OR) = 1.65; 95% CI [1.37, 1.98]), have used substances throughout their lives (OR = 1.48; 95% CI [1.30, 1.68]), and present current use of specific substances (OR = 1.79; 95% CI [1.54, 2.07]). When current alcohol and substance use in general and tobacco, alcohol, and substance use disorders specifically were considered, the likelihood did not differ from that of cisgender people. (4) Conclusions: The presence of substance use disorders did not differ between transgender and cisgender people. Considering this population as consumers or as addicted may be a prejudice that perpetuates stigma. Nonetheless, transgender people were more likely to use tobacco and other substances, but not alcohol. Hypothetically, this might be an emotional regulation strategy, a maladaptive mechanism for coping with traumatic experiences, or could respond to minority stress, produced by stigma, prejudice, discrimination, and harassment. It is of particular importance to implement policies against discrimination and stigmatisation and to adapt prevention and treatment services so that they are inclusive of the 2SLGBTQIA+ community.
（1）背景：本荟萃分析旨在评估认定自己为跨性别者与物质使用之间的关系。（2）方法：我们于2021年7月21日在PubMed、Scopus、科学网和PsycINFO中检索相关研究。（3）结果：本研究纳入了20项比较跨性别者和顺性别者的研究，共有2376951名参与者（其中18329人为跨性别者）。这些文章包含了当前烟草使用、当前烟草使用障碍、当前酒精使用、当前酒精使用障碍、终生物质（所有）使用、当前物质使用（不包括烟草和酒精）、当前特定物质使用（不包括烟草和酒精，包括可卡因、苯丙胺、甲基苯丙胺、摇头丸、兴奋剂、海洛因、阿片类药物、大麻、印度大麻、麦角酸二乙胺、致幻剂、类固醇、吸入剂、镇静剂、利他林或安非他命、减肥药、感冒药、处方药、多种物质、其他俱乐部药物和其他非法药物）以及当前物质使用障碍（不包括烟草和酒精）的数据。我们使用比值比（OR）及其95%置信区间（CI）来阐述认定为跨性别者与这些变量之间的关联。所有情况下使用的对照参考类别均为顺性别者。我们采用随机效应模型。跨性别者更有可能使用烟草（比值比（OR）=1.65；95%CI[1.37,1.98]）、终生使用过物质（OR = 1.48；95%CI[1.30,1.68]）以及当前使用特定物质（OR = 1.79；95%CI[1.54,2.07]）。当总体考虑当前酒精和物质使用以及具体的烟草、酒精和物质使用障碍时，其可能性与顺性别者并无差异。（4）结论：跨性别者和顺性别者在物质使用障碍方面并无差异。将这一群体视为消费者或成瘾者可能是一种延续污名的偏见。尽管如此，跨性别者更有可能使用烟草和其他物质，但不包括酒精。从理论上讲，这可能是一种情绪调节策略、应对创伤经历的适应不良机制，或者是对由污名、偏见、歧视和骚扰产生的少数群体压力的反应。实施反歧视和反污名化政策以及调整预防和治疗服务以使其包容2SLGBTQIA+群体尤为重要。
