In the ABCD study, sexual and gender minority youth had higher odds of future marijuana use and past suicide attempts, but family conflict, discrimination, and trauma did not mediate these disparities.
LGBTQ+ youth health researchers, substance use prevention researchers, minority stress theory researchers
SGM identity predicted marijuana use but stress did not mediate it
What the researchers found
SGM youth had higher odds of past suicide attempts, major depressive disorder, and future marijuana use, but not future nicotine use. Contrary to the minority stress hypothesis, family conflict, discrimination, and trauma did not mediate the SGM-marijuana use association. However, these stressors were independently associated with outcomes: discrimination predicted all outcomes, trauma predicted suicide, nicotine, and marijuana use, and family conflict predicted all outcomes except depression.
Why it matters
The finding that stress does not explain the SGM-marijuana use link challenges the dominant minority stress framework and suggests other mechanisms are at play. This matters for intervention design: reducing discrimination and family conflict will help but may not close the marijuana use disparity.
The numbers in context
ABCD Study participants; SGM identity predicted future marijuana use (but not nicotine); no mediation by family conflict, discrimination, or trauma; each stressor independently predicted outcomes
How the study worked
ABCD Study data with SGM identity reported at baseline. Structural equation modeling (SEM) tested direct and indirect pathways linking SGM identity to mental health and behavioral outcomes including future marijuana and nicotine use.
What this study cannot tell us
ABCD Study participants are children/adolescents; SGM identity may still be emerging. Stressor measures may not capture all relevant minority stress experiences. Marijuana use was measured at follow-up but initiation timing is uncertain. SEM assumes causal ordering that may not reflect the actual temporal sequence.
How to read the evidence
Large nationally representative longitudinal dataset with sophisticated SEM analysis provides moderate evidence, limited by the still-developing nature of SGM identity in the child/adolescent sample.
When this study was published
2025 publication from the ongoing ABCD Study
The bigger picture
The minority stress model predicts that stressors experienced by SGM youth explain their elevated substance use. This study's failure to find mediation suggests the pathway from SGM identity to marijuana use involves additional mechanisms, possibly including peer networks, identity exploration, or biological factors not captured by stress measures.
Questions still open
- What alternative mechanisms explain elevated marijuana use among SGM youth if not stress? Would peer network factors or identity exploration better explain the association?
Common questions
Does being SGM cause marijuana use?
Why did nicotine and marijuana show different patterns?
Read the original research
Does Stress Explain the Effects of Sexual/Gender Minority Status on Children's Behavioral and Emotional Risk?
Open journal of psychology, 5(1), 38-51
Citation
Assari, Shervin; Donovan, Alexandra; Pallera, John Ashley; Assari, Gandom; Najand, Babak; Alaei, Kamiar; Alaei, Arash. (2025). Does Stress Explain the Effects of Sexual/Gender Minority Status on Children's Behavioral and Emotional Risk?. Open journal of psychology, 5(1), 38-51. https://doi.org/10.31586/ojp.2025.6188
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