title: Substance Use Among Transgender Students in California Public Middle and High Schools.
abstract: Transgender adolescents face tremendous social stress in families and schools, which often leads to behavioral health disparities. This study assessed whether rates of substance use were higher among transgender adolescents when compared to nontransgender adolescents.
  
  
  
  This study is a secondary data analysis of the 2013-2015 California Healthy Kids Survey (CHKS) that examines whether rates of substance use are higher among transgender youth when compared to nontransgender youth. Participants included 4778 transgender and 630,200 nontransgender students in middle and high schools in nearly all school districts in California. The study outcomes were lifetime, recent, and in-school use of cigarettes, tobacco, alcohol, marijuana, cocaine, and ecstasy as well as nonmedical use of prescription painkillers, diet pills, Ritalin or Adderall, and cold medicine.
  
  
  
  Transgender students were about 2-1/2 times more likely as nontransgender students to use cocaine/methamphetamine in their lifetime (odds ratio [OR] = 2.53; 95% confidence interval [CI] = 2.18-2.95) and about 2.8 times as likely to report past 30-day inhalant use (OR = 2.80; 95% CI = 2.41-3.26). Transgender students were more than twice as likely to report past 30-day prescription pain medication use (OR = 2.19; 95% CI = 1.90-2.53) and more than 3 times as likely to use cigarettes in school (OR = 3.37; 95% CI = 2.84-3.99).
  
  
  
  The study's findings indicate a need for community- and school-based interventions that reduce substance use among transgender youth.
authors.affiliation: College of Educational Studies, Chapman University, One University Drive, Orange, CA 92866.
authors.forename: Kris Tunac
authors.initials: KT
authors.lastname: De Pedro
authors.affiliation: Transdisciplinary Center for Health Equity Research, College of Education and Human Development, Texas A&M University, 801 Harrington Tower, College Station, TX, 77843-4222.
authors.forename: Tamika D
authors.initials: TD
authors.lastname: Gilreath
authors.affiliation: College of Educational Studies, Chapman University, One University Drive, Orange, CA 92866.
authors.forename: Christopher
authors.initials: C
authors.lastname: Jackson
authors.affiliation: Darden College of Education, Old Dominion University, 120 Education Building, Norfolk, VA 23529.
authors.forename: Monica Christina
authors.initials: MC
authors.lastname: Esqueda
mesh_terms: D000293:Adolescent; D002140:California / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data*; D012307:Risk Factors; D012309:Risk-Taking; D012574:Schools; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D063106:Transgender Persons / Q000523:psychology / Q000706:statistics & numerical data*
keywords: alcohol use; cigarette use; cocaine use; illicit drug use; prescription pain medication; substance use; transgender youth