Substance Use Disparities among Transgender Youth

 描述(由申请人提供)：这项研究的首要目标是招募变性人青年(TGY；感觉自己的真实性别与出生时的生物性别不同的青年)进入一项纵向研究，并检查药物使用和相关的心理健康差距。这是一个非常新的领域。迄今为止，只有为数不多的几项群体内描述性研究报告了TGY中的高药物使用率和精神健康问题(Garofalo等人，2006年；Grossman&D‘Augelli，2006年)，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TGY。此外，文献中只有两项同行评议的差异研究(比较TGY和非TGY)，而且都是在过去一年内发表的(Reisner等人，2014年，Fergusson等人，2014年)。这些研究的结果表明，与非TGY相比，TGY使用药物、抑郁、焦虑和自杀的风险更高。然而，这些开创性的研究受到以下因素的限制：它们的横截面设计，缺乏能够描述和理解与变性人相关的身份和发展过程的措施，以及其他重要的评估工具，如面对面的精神病学诊断访谈和关于变性人医疗保健获得的信息。因此，这项研究的首要目标是开始探索和填补青少年文学中的这些空白。我们的具体目标是：(1)识别和描述TGY中随着时间的推移而出现的物质使用和相关的心理和行为健康问题(例如抑郁、自杀、艾滋病毒危险行为)；以及(2)识别和研究TGY之间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、家庭和朋友支持)。目前，没有基于证据的干预措施来指导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，为从事TGY工作的临床医生提供信息，并将指导TGY干预措施的开发，以促进TGY在过渡过程中的积极结果。

 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.