尽管重要的研究强调了跨性别者中精神疾病和物质使用率较高,非二元和性别多样化(此后“跨”)的年轻人,很少有研究考虑模式,上下文特征,以及跨性别年轻人中精神疾病和物质使用的共同经历的相关性。利用TransPathways研究的数据,我们使用患病率比率以及年龄和性别调整的逻辑回归模型来检查并发物质使用的患病率和差异(过去六个月的香烟使用,酒精使用,和其他药物使用)和物质使用的背景特征(过去六个月单独使用酒精和/或药物,用于应对的物质使用)由精神疾病(抑郁症,焦虑症,过去12个月的自我伤害思想和行为,自杀念头,规划,和尝试/s)。年龄和性别调整模型评估了同时发生的抑郁症和焦虑症与最近吸烟之间的关联,酒精,和其他药物使用(共6个共同发生项目)和18个人际压力源。在报告抑郁症的跨性别年轻人中观察到吸烟或最近使用大麻或镇静剂的几率显着增加,焦虑症(aOR范围1.8-3.1)。跨性别的年轻人报告最近吸烟或使用大麻,吸入剂,或者镇静剂,过去12个月自我伤害想法的几率降低了40%到80%,自我伤害行为,自杀念头,和自杀企图/秒(aOR范围0.2-0.6)。另一方面,单独饮酒和/或使用其他药物和物质应对与所有精神疾病结局的几率增加显著相关.学校的问题,安全的住房,和亲密伴侣虐待是共同发生的精神不良健康和药物使用的最紧密相关因素。跨性别的年轻人使用物质,尤其是香烟,大麻,和镇静剂,尽管在更多的“社交”环境中使用有限的物质可能会对预防自我伤害和自杀的想法和行为有益,但通常与抑郁和焦虑的共同发生经历有关。有必要与跨性别年轻人合作进行持续研究,以概念化确认物质使用危害减少方法的更细致入微和精确的概念参数。
Though significant research highlights higher rates of mental ill-health and substance use among
trans, non-binary and gender diverse (henceforth \'
trans\') young people, little research has considered patterns, contextual characteristics, and correlates of co-occurring experiences of mental ill-health and substance use among trans young people. Using data from the
Trans Pathways study, we used prevalence ratios and age- and gender-adjusted logistic regression models to examine prevalence and differences of co-occurring substance use (past six-month cigarette use, alcohol use, and other drug use) and contextual characteristics of substance use (past six-month solitary alcohol and/or drug use, substance use for coping) by mental ill-health (depression disorder, anxiety disorder, past 12-month self-harm thoughts and behaviours, suicidal thoughts, planning, and attempt/s). Age- and gender-adjusted models assessed associations between co-occurring depressive and anxiety disorders and recent cigarette, alcohol, and other drug use (six co-occurring items total) and 18 interpersonal stressors. Significantly increased odds of smoking or recent use of cannabis or sedatives was observed among trans young people reporting depressive disorder, anxiety disorder (aORs ranging 1.8-3.1).
Trans young people who reported recent smoking or use of cannabis, inhalants, or sedatives, had 40% to 80% reduced odds of past 12-month self-harm thoughts, self-harm behaviours, suicidal thoughts, and suicide attempt/s (aORs ranging 0.2-0.6). On the other hand, solitary alcohol and/or other drug use and substance use for coping was significantly associated with increased odds of all mental ill-health outcomes. Issues with school, secure housing, and intimate partner abuse were the most robust correlates of co-occurring mental ill-health and substance use. Trans young people using substances, especially cigarettes, cannabis, and sedatives, often so do with co-occurring experiences of depression and anxiety though limited substance use in more \'social\' contexts may confer benefits for preventing self-harm and suicide thoughts and behaviours. Continued research in partnership with trans young people is warranted to conceptualise more nuanced and precise conceptual parameters of
trans-affirming substance use harm reduction approaches.