A Whole New Level: The effect of Different Levels of Sexual and Gender Minority stress on Alcohol and Cannabis Use

Research shows that people with minoritized sexual orientations and gender identities (SGM individuals) have higher rates of alcohol and cannabis use and experience more negative consequences due to use compared to cisgender straight peers (Dunbar et al., 2022; Fish & Exten, 2020; Meads et al., 2023; Sarah et al., 2022; Wheldon et al., 2023). Minority stress theory posits that these disparities can be explained by the fact that SGM individuals experience additional stressors at the societal, community, interpersonal, and individual levels. Although meta-analytic research has found that sexual and gender minority stressors are related to alcohol and substance use (Bresin et al., 2023), there are two major limitations to the current literature. First, although sexual and gender minority stressors exist at multiple levels (i.e., society, community, interpersonal, and individual), most studies have focused only on one level (e.g., State Policy; Todd et al., 2024; Individual; Mereish et al., 2023). Second, most of the research linking minority stress to alcohol and cannabis use has been cross-sectional (Bresin et al., 2023). Thus, there are currently no studies linking societal, community, and interpersonal minority stressors to future alcohol and/or cannabis use. The goal of this study is to examine the direct and interactive effects of societal sexual and gender minority stressors, as indicated by state policies (i.e., Movement Advancement Project, 2024), community sexual and gender minority stressors, as indicated by municipal policies (i.e., Human Rights Campaign’s Municipality Equality Index), and interpersonal sexual and gender minority stressors, as indicated by self-report in a 28-day daily diary study, on alcohol and cannabis use.