Transgender College Students Show Higher Cannabis Use and More Related Problems | Research

The takeaway

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.

College health professionals, LGBTQ+ student services, substance use prevention designers, and campus mental health providers.

What the researchers 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).

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

Very large nationally representative college sample with adjusted analyses, though cross-sectional design and COVID-era data limit interpretation.

When this study was published

Published 2026; uses 2020-2021 ACHA-NCHA data.

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.

Questions still open

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?

Common 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 the original research

Prevalence of substance use and food insecurity among transgender and gender diverse college students.

Journal of American college health : J of ACH, 1-8

View on PubMed ↗Publisher’s paper ↗

Citation

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