LGBTQ+ Youth in Brazil Started Using Substances Earlier and More Often Than Peers

Brazilian LGBTQ+ adolescents, especially those assigned female at birth, had nearly twice the odds of cannabis use and started using substances earlier than cisgender heterosexual peers.

Figueiredo, Caio Petrus Monteiro et al.·International review of psychiatry (Abingdon·2025·Moderate EvidenceLongitudinal Cohort
RTHC-06455Longitudinal CohortModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
N=1,492

What This Study Found

LGBTQ+ adolescents in Brazil had significantly higher lifetime prevalence of cannabis use (OR=1.94) and tobacco use (OR=1.66) compared to cisgender heterosexual peers. These differences were driven entirely by participants assigned female at birth, with no significant differences among males.

Key Numbers

Cannabis OR=1.94 (95% CI 1.42-2.64). Tobacco OR=1.66 (95% CI 1.22-2.26). Differences driven by those assigned female at birth. LGBTQ+ females reported earlier initiation of alcohol (p=0.001), tobacco (p<0.05), and cannabis (p<0.001).

How They Did This

Longitudinal community-based cohort study (Brazilian High-Risk Cohort Study) following 1,492 participants aged 9-21 across two waves. Assessed sexual orientation, gender identity, and lifetime use of alcohol, tobacco, cannabis, and cocaine.

Why This Research Matters

This is one of few studies from a low- or middle-income country examining substance use disparities among LGBTQ+ youth, revealing that the pattern seen in US/European data also holds in Brazil, with a striking sex-assigned-at-birth difference.

The Bigger Picture

Minority stress theory suggests that the psychosocial stressors facing LGBTQ+ youth may drive higher substance use. The sex-assigned-at-birth difference suggests these stressors may disproportionately affect certain subgroups.

What This Study Doesn't Tell Us

Self-reported substance use. Brazilian cultural context may not generalize to all LMICs. Lifetime prevalence doesn't capture current use patterns. Sexual orientation and gender identity categories may not capture full diversity.

Questions This Raises

  • ?Why were differences concentrated among those assigned female at birth?
  • ?Would targeted prevention programs reduce these disparities?
  • ?How does intersectionality with race and socioeconomic status affect these patterns in Brazil?

Trust & Context

Key Stat:
LGBTQ+ youth had 1.94x odds of lifetime cannabis use
Evidence Grade:
Longitudinal cohort study with reasonable sample size, but relies on self-reported data.
Study Age:
2025 study
Original Title:
Patterns of substance use and initiation among LGBTQIAPN+ youth in Brazil: Evidence from a population-based cohort.
Published In:
International review of psychiatry (Abingdon, England), 37(6-7), 639-650 (2025)
Database ID:
RTHC-06455

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Why were differences only seen in those assigned female at birth?

The study didn't fully explain this, but it may relate to different stressor profiles, coping mechanisms, or social environments faced by LGBTQ+ individuals assigned female vs male at birth.

Is this pattern unique to Brazil?

No. Similar disparities have been found in US and European studies. This study is notable for confirming the pattern in a Latin American context where data has been limited.

Read More on RethinkTHC

Cite This Study

RTHC-06455·https://rethinkthc.com/research/RTHC-06455

APA

Figueiredo, Caio Petrus Monteiro; Alves Bezerra, Henrique; Miguel, Euripedes Constantino; Rohde, Luis Augusto; Salum, Giovanni Abrahão; Pan, Pedro Mario; Caye, Arthur. (2025). Patterns of substance use and initiation among LGBTQIAPN+ youth in Brazil: Evidence from a population-based cohort.. International review of psychiatry (Abingdon, England), 37(6-7), 639-650. https://doi.org/10.1080/09540261.2025.2573758

MLA

Figueiredo, Caio Petrus Monteiro, et al. "Patterns of substance use and initiation among LGBTQIAPN+ youth in Brazil: Evidence from a population-based cohort.." International review of psychiatry (Abingdon, 2025. https://doi.org/10.1080/09540261.2025.2573758

RethinkTHC

RethinkTHC Research Database. "Patterns of substance use and initiation among LGBTQIAPN+ yo..." RTHC-06455. Retrieved from https://rethinkthc.com/research/figueiredo-2025-patterns-of-substance-use

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.