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

Objective To determine the prevalence of food insecurity and substance use among U.S. transgender and gender diverse (TGD) college students in comparison with cisgender counterparts.Participants Secondary data from 102,802 undergraduates responding to the Fall 2020 and Spring 2021 American College Health Association’s National College Health Assessments was used.Methods The five most commonly used substances on college campuses including alcohol, cannabis, cocaine, hallucinogens, and prescription stimulants were selected for the analyses of substance use. Logistic regression analysis was performed to examine the relationship between substance use and food insecurity, and gender identification.Results After controlling for confounding factors, TGD students had significantly higher odds of using hallucinogens, cannabis, prescription stimulants, and cocaine (OR = 1.87, 1.58, 1.32, and 1.24, respectively) compared to cisgender peers, and a significantly higher proportion of cannabis, cocaine, and hallucinogen users in TGD students reported consequent problems caused by their substance use (p < .001). Lastly, a significantly higher prevalence of food insecurity was found in TGD students after controlling for the covariates (p < .05).Conclusion Our findings suggest the need for effective prevention programs and treatment strategies that are specific to TGD college students for addressing the disparities in substance use and food insecurity.