Transgender veterans may be more likely to use amphetamine, cocaine, and cannabis than cisgender veterans

1. This quantitative study found that transgender Veterans Health Administration (VA) patients were more likely to use certain drugs than cisgender VA patients.

2. Opioid and sedative use disorder did not differ significantly between transgender and cisgender VA patients.

Evidence Rating Level: 2 (Good)

Drug use disorders in the United States (US) are a major problem, especially among vulnerable groups. One example of a vulnerable group is transgender people, defined as people whose genders are different from those assigned at birth. Few studies compare substance use disorder prevalence rates between transgender and cisgender patients, and most of these studies have been small. As the largest national provider of substance use treatment, the US Veterans Health Administration (VA) provides a large dataset to study this important question.

This retrospective quantitative study was a secondary analysis of electronic health record data from the VA Corporate Data Warehouse, which is a parent study examining patterns of alcohol use among transgender versus cisgender VA outpatients from October 1^st, 2009 to July 31^st,2017. Patients were included if they had a documented alcohol use disorder (n=8,872,793). Patients were excluded if they did not answer all study questions. The measured outcome variables were the documented drug use disorder diagnoses.

Amongst 8,872,793 included patients, 8619 were transgender. From the analyses, the research demonstrated that transgender VA patients were more likely to have amphetamine, cocaine, and cannabis use disorders compared to cisgender patients, but were equally likely to have opioid and sedative use disorders. Furthermore, there was no significant association with having a mental health condition. This study did have its limitations including possible misclassification of certain transgender patients as well as not distinguishing between men and women. Despite these limitations, this study furthered our understanding of struggles and barriers transgender people may face in regards to substance use disorders.

Click to read the study in the Journal of Addiction Medicine

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