Pellicane Michael J, Quinn Madison E, Ciesla Jeffrey A
Department of Psychological Sciences, Kent State University, Kent, Ohio, USA.
Transgend Health. 2025 Feb 10;10(1):7-21. doi: 10.1089/trgh.2023.0025. eCollection 2025 Feb.
The goal of this preregistered study was to systematically review and meta-analyze quantitative research examining relationships between minority stress (distal stress, expectations of gender-based rejection, concealment of gender identity, and internalized transphobia) and substance use (alcohol use frequency and problems, and drug use frequency and problems) in transgender and gender-diverse (TGD) samples. Searches of PsycInfo, MEDLINE, Gender Studies, and LGBTQ+ Source databases were conducted for quantitative articles that included effect sizes for cross-sectional associations between TGD-based minority stress and substance use outcomes. Random-effects meta-analyses were used to compute effect sizes for 16 minority stressor-substance use variable pairs. Moderator analyses were conducted for publication year and proportion of the sample assigned female sex at birth, identified as Black, Indigenous, or people of color (BIPOC), or identified as a sexual minority. Thirty-six studies with 76 effect sizes were included. Significant correlations were observed for relationships between distal stress and alcohol use frequency (=0.13; 95% confidence interval [CI]=0.06 to 0.20) and problems (=0.09; 95% CI=0.03 to 0.14), and drug use frequency (=0.16; 95% CI=0.11 to 0.21) and problems (=0.14; 95% CI=0.05 to 0.23). No associations for proximal minority stress-substance use variable pairs were significant. Effect sizes for associations between distal stress and alcohol use frequency were higher in samples with more BIPOC participants (=4.27, <0.001, =0.740). Findings indicate that distal, but not proximal, minority stress was significantly associated with drug and alcohol use frequency and problems. Theoretical and clinical implications are discussed.
这项预先注册研究的目的是系统回顾和荟萃分析定量研究，这些研究考察了跨性别和性别多样化（TGD）样本中少数群体压力（远端压力、基于性别的被排斥预期、性别认同的隐瞒以及内化的恐跨症）与物质使用（酒精使用频率和问题、药物使用频率和问题）之间的关系。我们在PsycInfo、MEDLINE、性别研究和LGBTQ+源数据库中进行检索，查找包含基于TGD的少数群体压力与物质使用结果之间横断面关联效应量的定量文章。采用随机效应荟萃分析来计算16对少数群体压力源 - 物质使用变量的效应量。针对发表年份以及出生时被指定为女性、被认定为黑人、原住民或有色人种（BIPOC）或被认定为性少数群体的样本比例进行了调节分析。纳入了36项研究，共76个效应量。观察到远端压力与酒精使用频率（=0.13；95%置信区间[CI]=0.06至0.20）、问题（=0.09；95%CI=0.03至0.14）、药物使用频率（=0.16；95%CI=0.11至0.21）和问题（=0.14；95%CI=0.05至0.23）之间存在显著相关性。近端少数群体压力 - 物质使用变量对之间的关联均不显著。在BIPOC参与者较多的样本中，远端压力与酒精使用频率之间关联的效应量更高（=4.27，<0.001，=0.740）。研究结果表明，远端而非近端少数群体压力与药物和酒精使用频率及问题显著相关。文中讨论了理论和临床意义。
