Purpose

Research has identified persistent disparities in alcohol, e-cigarette, and marijuana use, by sexual orientation, gender identity, and race/ethnicity. Using an intersectionality framework, the present study analyzes three large datasets to identify intersecting social positions bearing the highest burden of substance use.

Methods

Data from adolescents in grades 9–12 in three samples (2019 Minnesota Student Survey, 2017–2019 California Healthy Kids Survey, and 2017 National Teen Survey) were harmonized for an analysis (N = 602,470). A Chi-squared Automatic Interaction Detection analysis compared the prevalence of four types of substance use across all combinations of four social positions (six racial/ethnic identities, five sexual orientations, three gender identities, and two sexes assigned at birth). For each substance, 10 intersectional groups with the highest prevalence of use were examined.

Results

In the full sample, 12%–14% of participants reported past 30-day alcohol, e-cigarette, or marijuana use and 7% reported past 30-day binge drinking. Several intersecting marginalized social positions were consistently found to bear a high burden of substance use. For example, transgender and gender diverse (TGD) Latina/x/o young people, particularly those assigned male at birth, were in the high prevalence groups for alcohol use, binge drinking, and marijuana use. Black TGD or gender-questioning youth were commonly in the high prevalence groups.

Discussion

Findings suggest that support, resources, and structural changes specifically tailored to youth with multiple marginalized identities (especially TGD) may be needed. The results argue for intersectional efforts that explicitly address racial/ethnic and cultural differences, while also integrating awareness and understanding of sexual and gender diversity.

中文翻译：

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有色人种 LGBTQ+ 青年的物质使用行为：三个大样本中负担最大的人群的鉴定

目的

研究发现，性取向、性别认同和种族/族裔在酒精、电子烟和大麻使用方面存在持续差异。使用交叉性框架，本研究分析了三个大型数据集，以确定承担最高物质使用负担的交叉社会职位。

方法

三个样本（2019 年明尼苏达学生调查、2017-2019 年加州健康儿童调查和 2017 年全国青少年调查）中来自 9-12 年级青少年的数据被统一分析（N = 602,470）。卡方自动交互检测分析比较了四种社会地位（六种种族/族裔身份、五种性取向、三种性别身份和两种出生时指定的性别）的所有组合中四种物质使用的流行程度。对于每种物质，检查了 10 个使用率最高的交叉组。

结果

在完整样本中，12%–14% 的参与者报告过去 30 天饮酒、电子烟或吸食大麻，7% 的参与者报告过去 30 天酗酒。一些交叉的边缘化社会地位一直被发现承受着沉重的物质使用负担。例如，跨性别和性别多样化 (TGD) 拉丁裔/x/o 年轻人，尤其是那些出生时被指定为男性的年轻人，属于酗酒、酗酒和吸食大麻的高发人群。黑人 TGD 或对性别有疑问的青年通常属于高患病率群体。

讨论

调查结果表明，可能需要专门针对具有多重边缘化身份（尤其是 TGD）的青年量身定制的支持、资源和结构变化。结果支持明确解决种族/族裔和文化差异的交叉努力，同时也整合对性和性别多样性的认识和理解。