Gender abuse, depressive symptoms, and substance use among transgender women: A 3-year prospective study

L. Nuttbrock, W. Bockting, A. Rosenblum, S. Hwahng, M. Mason, M. Macri and J. Becker

American Journal of Public Health, 2014, vol. 104, issue 11, 2199-2206

Abstract: Objectives. We examined the effects of gender abuse (enacted stigma), depressive symptoms, and demographic, economic, and lifestyle factors on substance use among transgender women. Methods. We conducted a 3-year prospective study (December 2004 to September 2007) of 230 transgender women aged 19 to 59 years from the New York Metropolitan Area. Statistical techniques included generalized estimating equations with logistic and linear regression links. Results. Six-month prevalence of any substance use at baseline was 76.2%. Across assessment points, gender abuse was associated with alcohol, cannabis, cocaine, or any substance use during the previous 6 months, the number of days these substances were used during the previous month, and the number of substances used. Additional modeling associated changes in gender abuse with changes in substance use across time. Associations of gender abuse and substance use were mediated 55% by depressive symptoms. Positive associations of employment income, sex work, transgender identity, and hormone therapy with substance use were mediated 19% to 42% by gender abuse. Conclusions. Gender abuse, in conjunction with depressive symptoms, is a pervasive and moderately strong risk factor for substance use among trans-gender women. Improved substance abuse treatment is sorely needed for this population. © 2014, American Public Health Association Inc. All rights reserved.

Keywords: adult; depression; epidemiology; female; human; middle aged; partner violence; prevalence; prospective study; psychology; risk factor; statistical model; statistical model; statistics and numerical data; Substance-Related Disorders; transgender; United States; young adult, Adult; Depression; Female; Humans; Linear Models; Logistic Models; Middle Aged; New York City; Prevalence; Prospective Studies; Risk Factors; Spouse Abuse; Substance-Related Disorders; Transgendered Persons; Young Adult (search for similar items in EconPapers)
Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.302106_3

DOI: 10.2105/AJPH.2014.302106

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