Substance Use Disparities among Transgender Youth

 描述（由申请人提供）：本研究的总体目标是招募跨性别青年（TGY;认为自己的真实性别与出生时的生物性别不同的青年）进行纵向研究，并检查物质使用和相关的心理健康差异。这是一个非常新兴的领域。迄今为止，只有少数组内描述性研究报告了TGY中物质使用和心理健康问题的高比率（Garofalo等人，2006; Grossman & D 'Augelli，2006），这些研究主要集中在年龄较大的青少年和年轻人以及男性对女性的TGY。此外，文献中只有两项同行评审的差异研究（将TGY与非TGY进行比较），并且都是在过去一年内发表的（Reisner等人，2014年，Fergusson等人，2014）。这些研究的结果表明，与非TGY相比，TGY在物质使用，抑郁，焦虑和自杀倾向方面的风险增加。然而，这些开创性的研究受到其横断面设计的限制，缺乏可以描述和理解跨性别相关身份和发展过程的措施，以及其他重要的评估工具，如面对面的精神病诊断访谈和有关跨性别医疗保健的信息。因此，本研究的主要和总体目标是开始探索和填补这些空白的青少年文学。我们的具体目标是：（1）识别和描述物质使用和相关的精神和行为健康问题（例如，抑郁症，自杀，HIV危险行为）;（2）识别和检查TGY中物质使用差异的解释机制（风险和保护因素）（例如，受害、社会孤立、抑郁、家人和朋友的支持）。目前，还没有循证干预措施来指导TGY和家庭进行性别过渡护理。这项研究的结果将提供重要的初步数据，以告知与TGY合作的临床医生，并将指导TGY干预措施的制定，以促进过渡过程中的积极成果。

 DESCRIPTION (provided by applicant): The overarching goal of this study is to recruit transgender youth (TGY; youth who feel that their true gender is different than their biological sex at birth) into a longitudinal study and examine substance use and associated mental health disparities. This is a very nascent field. To date there are only a handful of within- group descriptive studies reporting high rates of substance use and mental health problems among TGY (Garofalo et al., 2006; Grossman & D'Augelli, 2006), and these studies are largely focused on older teenagers and young adults and male-to-female TGY. In addition, there are only two peer-reviewed disparities studies in the literature (comparing TGY to non-TGY) and both were published within the past year (Reisner et al., 2014, Fergusson et al., 2014). Results from these studies showed that compared with non-TGY, TGY are at increased risk for substance use, depression, anxiety, and suicidality. Yet these seminal studies are limited by their cross-sectional design, absence of measures that can describe and understand transgender-related identity and developmental processes, and other important assessment tools such as face-to-face psychiatric diagnostic interviews and information regarding transgender healthcare access. Thus the primary and overarching goal of this study is to begin to explore and fill these gaps in the adolescent literature. Our specific aims are: (1) to identify and describe substance use and associated mental and behavioral health problems (e.g., depression, suicidality, HIV risk behavior) over time among TGY; and (2) to identify and examine explanatory mechanisms (risk and protective factors) of substance use disparities among TGY (e.g., victimization, social isolation, depression, family and friend support). Currently, there are no evidence-based interventions to guide TGY and families through gender transition care. Findings from this study will provide important preliminary data to inform clinicians working with TGY and will guide the development of an intervention for TGY to promote positive outcomes during the process of transitioning.