Dermody Sarah S, Penta Stephanie M, Quinn Theodore Forest, Uhrig Alexandra, Wardell Jeffrey D, Hart Trevor A, Hendershot Christian S, Saewyc Elizabeth, Abramovich Alex
Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada.
Department of Psychology, York University, Toronto, Ontario, Canada.
Alcohol Clin Exp Res (Hoboken). 2025 Jul 6. doi: 10.1111/acer.70081.
This study examined how gender minority stressors and resilience experienced by transgender and gender diverse (TGD) youth relate to daily and momentary occurrences of alcohol use risk processes (e.g., alcohol craving, drinking motives, and distress), alcohol use, and alcohol-related harms. The feasibility of ecological momentary assessment (EMA) was evaluated.
Forty TGD youth (mean 22.42 years [SD = 3.03]; range 18-29) completed a baseline interview followed by 21 days of EMA. Daily morning surveys assessed stressors and resilience, alcohol risk processes, use and harms experienced "yesterday" and twice-daily random surveys assessed most of these experiences in the "past 30 min" or "right now."
Using multilevel models, at the daily (within-person) level, gender minority stressors were significantly related to increased alcohol use (incidence rate ratio (IRR) = 1.16, 95% confidence interval [CI]: 1.03-1.32), drinking to cope (B = 0.16, 95% CI: 0.06-0.26), psychological distress (B = 0.19, 95% CI: 0.03-0.35) and alcohol craving (B = 0.05, 95% CI: 0.01-0.10), but not alcohol harms or negative affect. At the momentary (within-person) level, gender minority stress was associated with increased drinking to cope (B = 0.76, 95% CI: 0.51-1.01), alcohol craving (B = 0.43, 95% CI: 0.31-0.55), and negative affect (B = 2.17, 95% CI: 1.31-3.02). Daily resilience was also associated with increased alcohol use (IRR = 1.32, 95% CI: 1.15-1.52), but not craving or negative affect. Momentary resilience was associated with reduced drinking to cope (B = -0.56, 95% CI: -0.88, -0.23) and negative affect (B = -0.52, 95% CI: -0.81, -0.23), but not craving. Adherence rates and participants' ratings about study acceptability were favorable.
Gender minority stressors are a risk factor for same-day alcohol use. Resilience factors may be associated with increased alcohol use through other mechanisms (e.g., drinking for social or conformity reasons). Interventions to reduce TGD youth's alcohol use should address gender minority stressors and support TGD youth to cope with these stressors.
本研究探讨了跨性别和性别多样化（TGD）青少年所经历的性别少数群体压力源和复原力如何与酒精使用风险过程（如酒精渴望、饮酒动机和困扰）、酒精使用及酒精相关危害的日常和即时情况相关联。评估了生态瞬时评估（EMA）的可行性。
40名TGD青少年（平均年龄22.42岁[标准差=3.03]；年龄范围18 - 29岁）完成了一次基线访谈，随后进行了21天的EMA。每日早晨调查评估压力源和复原力、酒精风险过程、“昨天”经历的酒精使用及危害，每日两次的随机调查评估“过去30分钟”或“此刻”的大部分此类经历。
使用多层次模型，在每日（个体内）水平上，性别少数群体压力源与酒精使用增加显著相关（发病率比值（IRR）=1.16，95%置信区间[CI]：1.03 - 1.32）、为应对而饮酒（B = 0.16，95% CI：0.06 - 0.26）、心理困扰（B = 0.19，95% CI：0.03 - 0.35）和酒精渴望（B = 0.05，9% CI：0.01 - 0.10），但与酒精危害或负面影响无关。在即时（个体内）水平上，性别少数群体压力与为应对而饮酒增加（B = 0.76，95% CI：0.51 - 1.01）、酒精渴望（B = 0.43，95% CI：0.31 - 0.55）和负面影响（B = 2.17，95% CI：1.31 - 3.02）相关。每日复原力也与酒精使用增加相关（IRR = 1.32，95% CI：1.15 - 1.52），但与渴望或负面影响无关。即时复原力与为应对而饮酒减少（B = -0.56，95% CI：-0.88，-0.23）和负面影响减少（B = -0.52，95% CI：-0.81，-0.23）相关，但与渴望无关。依从率和参与者对研究可接受性的评分良好。
性别少数群体压力源是当日酒精使用的一个风险因素。复原力因素可能通过其他机制（如为社交或从众原因饮酒）与酒精使用增加相关。减少TGD青少年酒精使用的干预措施应解决性别少数群体压力源，并支持TGD青少年应对这些压力源。
