Grant: Project Grant

More than 75% of Canadians (age 15+) drank alcohol in the last year, making alcohol the most widely used substance. Drinking heavily can worsen physical and mental health, and lead to death. This research, however, is based on cisgender individuals. We know very little about the alcohol use patterns and alcohol harms experienced by transgender adults, whose gender identity differs from the sex they were assigned at birth. It is important to understand their alcohol use because they are at risk for experiencing stressors in their day-to-day lives, such as victimization and discrimination. These stressful experiences can increase their drinking and put them at risk for additional harms. This study will use a mixed methods design in order to refine and test a clinically-informative model to explain alcohol use and harms experienced by transgender people. Specifically, we will use ecological momentary assessment (EMA), involving completing brief surveys on their phones in their day-to-day lives, with 100 transgender adults who drink. The surveys will ask questions about experiences leading up to times that they drink (such as victimization, discrimination), experiences while they drink (such as mood and drug effects), and experiences after they drink (such as harms, like a hangover, missing work, having a fight). At the conclusion of their participation, qualitative interviews will be used to further contextualize the provided EMA responses. Using the quantitative and qualitative data, we will consider how some factors may increase risk for drinking and harms (like stress related to being a minority in society) and protect transgender individuals from drinking when experiencing minority stress (such as social and community support). These findings will improve our understanding of the health risks and contributors of alcohol use among transgender adults, which can help us develop gender-inclusive public health policies and interventions to prevent alcohol-related harms.