title: Dyadic effects of gender minority stressors in substance use behaviors among transgender women and their non-transgender male partners.
abstract: BACKGROUND
  Despite evidence that interpersonal processes shape health behaviors, research concerning the dyadic effects of gender minority stressors on substance use behaviors of transgender people is scarce. The objective of this study was to use dyadic analysis to examine whether transgender discrimination was associated with substance use among transgender women and their male partners.
  
  
  METHODS
  Transgender women and their male partners (N=191 couples;N=382 individuals) completed questionnaires. Participants' mean age was 37.1; 79.1% were racial/ethnic minority; 61.3% earned <$500 per-month. The mean relationship duration was 37.9 months. Actor-Partner Interdependence Models were used to examine the associations between transgender-related discrimination and past 30-day non-marijuana illicit drug use adjusting for age, relationship length, financial hardship, and depressive distress among partners in these dyads.
  
  
  RESULTS
  Illicit drug use was reported by 31.4% of transgender women and 25.1% of their male partners. Perceived transgender discrimination was independently associated with increased odds of illicit drug use for transgender women (actor effect) but not for their male partners. Financial hardship statistically predicted drug use for both partners (actor effects). There were no partner effects for financial hardship on drug use. Overall, 34.5% of dyads had discrepant substance use. Discrimination scores of male partners differentiated dyads who reported discrepant substance use.
  
  
  CONCLUSIONS
  Gender minority stressors are critical to understanding substance use among transgender women and their male partners. Integrating socioeconomic status into gender minority stress frameworks is essential. Results have implications for substance use prevention and treatment, including the need to incorporate gender minority stressors into interventions.
authors: Department of Epidemiology, Harvard School of Public Health, Boston, MA ; The Fenway Institute, Fenway Health, Boston, MA.
authors: Sari L
authors: SL
authors: Reisner
authors: Basic & Applied Social Psychology, Graduate Center at the City University of New York, New York City, NY.
authors: Kristi E
authors: KE
authors: Gamarel
authors: Public Health Institute, Oakland, CA.
authors: Tooru
authors: T
authors: Nemoto
authors: Brown University, Providence, RI.
authors: Don
authors: D
authors: Operario
keywords: couples; discrimination; financial hardship; substance use; transgender women
references: Psychiatr Clin North Am. 2003 Dec;26(4):991-1010
references: 14711132
references: J Consult Clin Psychol. 2001 Feb;69(1):130-4
references: 11302271
references: Am J Epidemiol. 1986 Sep;124(3):372-88
references: 3740038
references: J Fam Psychol. 2005 Mar;19(1):86-97
references: 15796655
references: Behav Ther. 2012 Mar;43(1):88-98
references: 22304881
references: Soc Sci Med. 1992 Apr;34(8):907-17
references: 1604380
references: J Assoc Nurses AIDS Care. 2009 Sep-Oct;20(5):362-72
references: 19732695
references: Br J Psychiatry. 1997 Jun;170:541-8
references: 9330021
references: J Health Psychol. 1997 Jul;2(3):335-51
references: 22013026
references: J Aging Health. 2010 Dec;22(8):1132-57
references: 20682949
references: Am J Psychiatry. 2005 Aug;162(8):1452-60
references: 16055766
references: Pers Soc Psychol Bull. 2006 Aug;32(8):1085-99
references: 16861312
references: J Marriage Fam. 2010 Jun;72(3):685-704
references: 20676350
references: J Sex Res. 2010 Jan;47(1):12-23
references: 19568976
references: Sex Roles. 2013 Jun 1;68(11-12):675-689
references: 23729971
references: Behav Modif. 2006 Sep;30(5):571-97
references: 16894231
references: Dev Psychol. 2002 Mar;38(2):179-93
references: 11881755
references: Sci Pract Perspect. 2004 Aug;2(2):30-41
references: 18552731
references: J Fam Psychol. 2010 Oct;24(5):551-9
references: 20954765
references: Am J Public Health. 2013 May;103(5):943-51
references: 23488522
references: J Pers Soc Psychol. 2009 Sep;97(3):435-50
references: 19686000
references: Annu Rev Psychol. 2003;54:579-616
references: 12499517
references: AIDS Behav. 2011 Apr;15(3):674-82
references: 20740376
references: Soc Sci Med. 2012 Sep;75(6):1114-21
references: 22703888
references: Psychol Bull. 2003 Sep;129(5):674-97
references: 12956539
references: Am J Public Health. 2001 Jun;91(6):915-21
references: 11392934
references: Drug Alcohol Rev. 2005 Jul;24(4):369-85
references: 16234133
references: AIDS Educ Prev. 2009 Apr;21(2):113-27
references: 19397434
references: AIDS Behav. 2008 Jan;12(1):18-26
references: 17705095
references: AIDS Behav. 2006 Mar;10(2):217-25
references: 16362237
references: Psychol Bull. 2001 Jul;127(4):472-503
references: 11439708
references: J Subst Abuse Treat. 2009 Dec;37(4):379-87
references: 19553063
references: Soc Sci Med. 2006 Mar;62(6):1369-80
references: 16146666
references: J Homosex. 2006;51(3):53-69
references: 17135115
references: Fam Relat. 2012 Apr 1;61(2):297-312
references: 22577243
references: Am J Public Health. 2013 Oct;103(10):1820-9
references: 23153142
references: Soc Sci Med. 2013 May;84:22-9
references: 23517700
references: Soc Sci Med. 2012 Jun;74(11):1783-90
references: 22227238
references: J Consult Clin Psychol. 2002 Aug;70(4):967-75
references: 12182280
references: J Couns Psychol. 2011 Jan;58(1):139-50
references: 21171740
references: J Adolesc Health. 2006 Mar;38(3):230-6
references: 16488820
references: Am J Public Health. 2004 Jul;94(7):1193-9
references: 15226142
references: Psychol Bull. 2009 Jul;135(4):531-54
references: 19586161
references: J Stud Alcohol Drugs. 2008 May;69(3):352-61
references: 18432377
references: J LGBT Health Res. 2007;3(2):37-47
references: 19835040
references: Psychol Bull. 2009 Sep;135(5):707-30
references: 19702379
references: J Pers Soc Psychol. 1999 Jan;76(1):54-71
references: 9972553
references: BMC Public Health. 2012 Aug 15;12:663
references: 22894701
references: Psychol Bull. 1997 Sep;122(2):170-91
references: 9283299
references: AIDS Behav. 2008 Jan;12(1):1-17
references: 17694429
references: Int J Epidemiol. 2006 Aug;35(4):888-901
references: 16585055
references: J Fam Psychol. 2014 Aug;28(4):437-47
references: 24932942
references: J Couns Psychol. 2009 Jan;56(1):97-109
references: 20047016