背景:对负担的研究非常匮乏,澳大利亚跨性别年轻人中物质使用的相关性和动机。
方法:使用澳大利亚跨性别年轻人的全国调查数据(N=859,Mage=19.4),我们估计了过去6个月物质使用的患病率(烟草,酒精,大麻,其他药物)和终生物质使用障碍诊断。协变量调整的多变量逻辑回归模型测试了物质使用类型与18个人际关系因素之间的关联。使用主题分析和解释性现象学方法对有关物质使用动机的开放式响应(n=489)进行了定性分析。
结果:终生物质使用障碍诊断的患病率为13.5%(95%置信区间[CI]11.1,16.1)。报告最多的是酒精使用(72.4%;95%CI68.9,75.6),其次是烟草(31.1%;95%CI27.7,34.6)和大麻(30.6%;95%CI27.2,34.2)。跨性别女性报告的酒精和大麻使用率最高;跨性别男性中其他药物的使用率最高。在经历歧视的跨性别青年中观察到使用药物的风险最高,亲密伴侣虐待,同伴拒绝和缺乏家庭支持(调整后的优势比在1.5到3.0之间)。确定了物质使用动机的四个多层次主题:间接使用,躯体使用,对自己和自己的生活感觉更好,和减少伤害。
结论:虽然跨性别年轻人的物质使用在很大程度上是间接的,享乐主义和利他主义,促进自我探索,友谊和社区联系,跨性别年轻人中的物质使用非常普遍,可以用来应对睡眠困难,抑郁/焦虑和顺规范性,包括获得性别确认护理的延误和候补名单。
BACKGROUND: There is a dire paucity of research into the burden, correlates and motives of substance use among trans young people in Australia.
METHODS: Using data from a national survey of Australian trans young people (N = 859, Mage = 19.4), we estimated prevalence of past 6-month substance use (tobacco, alcohol, cannabis, other drugs) and lifetime substance use disorder diagnoses. Covariate-adjusted multivariate logistic regression models tested associations between substance use types with 18 interpersonal factors. Open-ended responses regarding substance use motives (n = 489) were qualitatively analysed using thematic analysis with an interpretative phenomenological approach.
RESULTS: Prevalence of lifetime substance use disorder diagnosis was 13.5% (95% confidence interval [CI] 11.1, 16.1). Alcohol use was most reported (72.4%; 95% CI 68.9, 75.6) followed by tobacco (31.1%; 95% CI 27.7, 34.6) and cannabis (30.6%; 95% CI 27.2, 34.2). Trans women reported highest rates of alcohol and cannabis use; use of other drugs was highest among trans men. Highest risk of substance use was observed among trans youth who experienced discrimination, intimate partner abuse, peer rejection and lack of family support (adjusted odds ratios ranging 1.5 to 3.0). Four multi-levelled themes of substance use motives were identified: circumstantial use, somatic use, feeling better about oneself and one\'s life, and harm reduction.
CONCLUSIONS: While substance use among trans young is largely circumstantial, hedonistic and altruistic, facilitating self-exploration, friendship and community connectedness, substance use among trans young people is highly prevalent and may be used to cope with sleep difficulties, depression/anxiety and cisnormativity, including delays and waitlists for accessing gender-affirming care.