Transgender College Students Show Higher Cannabis Use and More Related Problems
Transgender and gender diverse college students had 58% higher odds of cannabis use compared to cisgender peers, and those who used cannabis were significantly more likely to report substance-related problems.
Quick Facts
What This Study Found
After controlling for confounders, TGD students had significantly higher odds of using cannabis (OR=1.58), hallucinogens (OR=1.87), prescription stimulants (OR=1.32), and cocaine (OR=1.24) compared to cisgender peers, with significantly higher proportions of TGD cannabis users reporting consequent problems (p<0.05).
Key Numbers
N=102,802; TGD vs cisgender odds: cannabis OR=1.58, hallucinogens OR=1.87, stimulants OR=1.32, cocaine OR=1.24; significantly higher problem rates among TGD substance users (p<0.05)
How They Did This
Secondary analysis of 102,802 undergraduates from the Fall 2020 and Spring 2021 American College Health Association's National College Health Assessments, using logistic regression adjusted for confounding factors.
Why This Research Matters
Transgender students face unique stressors (discrimination, identity-related distress) that may drive substance use, and their higher rate of cannabis-related problems suggests they need tailored harm reduction support.
The Bigger Picture
Campus substance use prevention programs designed for the general student population may miss the distinct needs of transgender students, who face intersecting challenges of identity, stigma, and substance use.
What This Study Doesn't Tell Us
Cross-sectional design; 2020-2021 data collected during COVID-19; self-report measures; TGD identification may vary; cannot determine causality; food insecurity also elevated suggesting broader structural vulnerability.
Questions This Raises
- ?Would trans-affirming substance use programs reduce disparities?
- ?Is cannabis use in TGD students primarily coping-motivated?
- ?Do campus policies on gender identity affect substance use rates?
Trust & Context
- Key Stat:
- Evidence Grade:
- Very large nationally representative college sample with adjusted analyses, though cross-sectional design and COVID-era data limit interpretation.
- Study Age:
- Published 2026; uses 2020-2021 ACHA-NCHA data.
- Original Title:
- Prevalence of substance use and food insecurity among transgender and gender diverse college students.
- Published In:
- Journal of American college health : J of ACH, 1-8 (2026)
- Authors:
- Kane, Tyler, Han, Ho, Lee, Seunghwan, Grant, Elysia, McMaughan, Darcy Jones, Jones, Richard, Ryu, Yoonji
- Database ID:
- RTHC-08374
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Do transgender students use more cannabis?
Yes — this national survey of over 100,000 college students found transgender and gender diverse students had 58% higher odds of cannabis use, and those who used cannabis were more likely to experience substance-related problems.
Why might transgender students use more substances?
Higher rates may reflect coping with gender-related discrimination, identity distress, and structural barriers. The study also found elevated food insecurity among TGD students, suggesting broader vulnerability that interacts with substance use risk.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-08374APA
Kane, Tyler; Han, Ho; Lee, Seunghwan; Grant, Elysia; McMaughan, Darcy Jones; Jones, Richard; Ryu, Yoonji. (2026). Prevalence of substance use and food insecurity among transgender and gender diverse college students.. Journal of American college health : J of ACH, 1-8. https://doi.org/10.1080/07448481.2025.2611280
MLA
Kane, Tyler, et al. "Prevalence of substance use and food insecurity among transgender and gender diverse college students.." Journal of American college health : J of ACH, 2026. https://doi.org/10.1080/07448481.2025.2611280
RethinkTHC
RethinkTHC Research Database. "Prevalence of substance use and food insecurity among transg..." RTHC-08374. Retrieved from https://rethinkthc.com/research/kane-2026-prevalence-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.