Among over 10,000 twelve- and thirteen-year-olds, multiple dimensions of gender diversity were associated with higher odds of lifetime and new cannabis experimentation.
Adolescent health providers, prevention researchers, and anyone working with gender-diverse youth
4 of 5 gender diversity dimensions linked to cannabis experimentation
What the researchers found
More gender-diverse responses on gender identity, felt gender, gender non-contentedness, and gender expression were associated with higher odds of both lifetime and new cannabis experimentation. Different dimensions of gender diversity were associated with different substance use patterns, with gender non-contentedness showing the most consistent associations across substances.
Why it matters
Gender-diverse youth face unique stressors including discrimination and minority stress. Understanding substance use patterns in this population can inform targeted prevention efforts during the critical period of early adolescence when experimentation begins.
The numbers in context
10,092 adolescents aged 12-13. Five dimensions of gender diversity assessed. Four of five dimensions (identity, felt gender, non-contentedness, expression) associated with higher odds of cannabis experimentation. Gender non-contentedness associated with higher odds across all three substances (alcohol, nicotine, cannabis).
How the study worked
Cross-sectional analysis of 10,092 adolescents aged 12-13 from the Adolescent Brain Cognitive Development (ABCD) study. Gender diversity was measured across five dimensions. Logistic regression adjusted for sociodemographic factors assessed associations with self-reported substance experimentation.
What this study cannot tell us
Cross-sectional design cannot establish causation. Self-reported substance use among 12-13 year olds may be unreliable. The ABCD study, while large, may not be representative of all US early adolescents. Cannabis "experimentation" at this age is very rare, leading to small cell sizes.
How to read the evidence
Large well-established cohort study (ABCD) with appropriate statistical methods, though cross-sectional analysis and rare outcome limit conclusions.
When this study was published
2024 study
The bigger picture
This study moves beyond a binary transgender/cisgender framework to examine multiple dimensions of gender diversity. The finding that different dimensions predict different substance use behaviors suggests that "gender-diverse youth" is not a monolithic group when it comes to health risk.
Questions still open
- Do the associations between gender diversity and substance experimentation change as these adolescents age? Are minority stress mechanisms driving the association, or are there other pathways? Would gender-affirming interventions reduce substance experimentation in this group?
Common questions
Are gender-diverse teens more likely to try cannabis?
Which dimension of gender diversity was most consistently linked to substance use?
Read the original research
Association between gender diversity and substance use experimentation in early adolescents.
Drug and alcohol dependence, 265, 112473
Citation
Shao, Iris Y; Low, Patrick; Sui, Shirley; Otmar, Christopher D; Ganson, Kyle T; Testa, Alexander; Santos, Glenn-Milo; He, Jinbo; Baker, Fiona C; Nagata, Jason M. (2024). Association between gender diversity and substance use experimentation in early adolescents.. Drug and alcohol dependence, 265, 112473. https://doi.org/10.1016/j.drugalcdep.2024.112473
Explore the wider topic
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