Substance use variation among LGBTQ+ youth: stress, resilience and ecosystemic intervention

BACKGROUND
Research suggests that trans and non-binary (TNB) youth may experience higher rates of substance use disorders compared to cisgender youth (Eisenberg et al., 2017). According to the minority stress model proposed by Hendricks et Testa (2012), these disparities could be attributed to the victimization experiences faced by these young individuals (Day et al., 2017). However, few studies focus on the potential distinctions between young people of sexual diversity and TNB youth, and even fewer investigate the stress and resilience factors that may influence their substance use (Dyar et al., 2020). This study aims to compare the substance use of cisgender sexually diverse youth with the substance use of TNB youth in Quebec (Canada) and to explore the variance in their substance use based on stress and resilience factors.
 
METHODS
To this end, the Labo inclusif conducted a predictive correlational study involving 225 LGBTQ+ youth from Quebec (Canada), aged between 14 and 17 (mean: 15.47). They were selected as part of a broader study conducted through an online survey (n = 1283) (Cotton et al., 2021). At the time of the survey, 28.0% (n = 63) of these young individuals identified as cisgender, while 72.0% (n = 162) identified as TNB. Concerning sexual orientation, all participants declared themselves as non-exclusively heterosexual. To assess the severity of substance use, we employed the DEP-Ado score (α = 0.87), a robust tool specifically designed for adolescents aged 14 to 17 (Germain et al., 2013). Stress and resilience factors were measured using the "everyday discrimination scale" (α = 0.83) and the "community connectedness scale" (α = 0.82) from The LGBT Minority Stress Measure (Outland, 2016). Regression analyses were conducted using SPSS 29.
 
RESULTS
The findings indicate that there is no significant difference in substance use between cisgender youth of sexual diversity and TNB youth in our sample. However, young individuals who reported experiencing more everyday discrimination or having a weaker sense of belonging to their community tended to use more substances. When examining the relative contributions of the three variables (gender identity, everyday discrimination, community connectedness), both gender identity and everyday discrimination significantly contribute to explaining the variance in substance use. Then, contrary to our hypothesis, cisgender youth of sexual diversity who reported experiencing everyday discrimination were found to use significantly more substances.
 
CONCLUSIONS
The experience of everyday discrimination appears to contribute to disparities in substance use among LGBTQ+ youth. It is crucial to understand these variations from an ecosystemic perspective (Bronfenbrenner, 2000). Explanatory hypotheses will be proposed, along with concrete avenues for safe, transaffirmative interventions developed by the Labo inclusif, aimed at LGBTQ+ youth at risk of problematic substance use (Cotton et al., 2024).