1. Cannabis use trajectories over time in relation to minority stress and gender among sexual and gender minority people
- Author
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Flentje, Annesa, Sunder, Gowri, Ceja, Alexis, Lisha, Nadra E, Neilands, Torsten B, Aouizerat, Bradley E, Lubensky, Micah E, Capriotti, Matthew R, Dastur, Zubin, Lunn, Mitchell R, and Obedin-Maliver, Juno
- Subjects
Biological Psychology ,Clinical and Health Psychology ,Public Health ,Health Sciences ,Psychology ,Cannabinoid Research ,Clinical Research ,Drug Abuse (NIDA only) ,Minority Health ,Mental Health ,Sexual and Gender Minorities (SGM/LGBT*) ,Substance Misuse ,Social Determinants of Health ,Prevention ,Behavioral and Social Science ,Women's Health ,Health Disparities ,Humans ,Male ,Female ,Sexual and Gender Minorities ,Adult ,Longitudinal Studies ,Stress ,Psychological ,Marijuana Use ,United States ,Crime Victims ,Social Stigma ,Young Adult ,Middle Aged ,Sex Factors ,Adolescent ,Minority Groups ,Cannabis use ,Sexual and gender minority ,Minority stress ,Substance use risk ,Longitudinal ,Public Health and Health Services ,Substance Abuse ,Public health ,Biological psychology ,Clinical and health psychology - Abstract
Substance use disparities among sexual and gender minority (SGM) people are attributed to minority stress, but few studies have examined minority stress and cannabis use over time or investigated differences in cannabis use trajectories by less-studied gender subgroups. We examined if longitudinal cannabis use trajectories are related to baseline minority stressors and if gender differences persisted after accounting for minority stress. Cannabis use risk was measured annually over four years (2017-2021) within a longitudinal cohort study of SGM adults in the United States (N = 11,813). Discrimination and victimization, internalized stigma, disclosure and concealment, and safety and acceptance comprised minority stress (n = 5,673). Latent class growth curve mixture models identified five cannabis use trajectories: 'low or no risk', 'low moderate risk', 'high moderate risk', 'steep risk increase', and 'highest risk'. Participants who reported past-year discrimination and/or victimization at baseline had greater odds of membership in any cannabis risk category compared to the 'low risk' category (odds ratios [OR] 1.17-1.33). Internalized stigma was related to 'high moderate' and 'highest risk' cannabis use (ORs 1.27-1.38). After accounting for minority stress, compared to cisgender men, gender expansive people and transgender men had higher odds of 'low moderate risk' (ORs 1.61, 1.67) or 'high moderate risk' (ORs 2.09, 1.99), and transgender men had higher odds of 'highest risk' (OR 2.36) cannabis use. This study indicates minority stress is related to prospective cannabis use risk trajectories among SGM people, and transgender men and gender expansive people have greater odds of trajectories reflecting cannabis use risk.
- Published
- 2024