Associations Between Discrimination and Substance Use Among Transgender Women of Color in New York City

The TURNNT Cohort Study

Bibliographic Data

ID19578488
AuthorsJenesis Merriman (0009-0008-7950-5701, Columbia University), Su Hyun Park (0000-0002-5527-7520, National University of Singapore), Musa Omar Suleiman (Primary HealthCare), Adam Whalen (0000-0003-0235-1341, Columbia University), Adam M Whalen, Adana A M Llanos (0000-0001-9954-9121, Columbia University), Jeremy D Kidd (0000-0002-9502-1669, Columbia University Irving Medical Center), Jeremy Kidd, Sahnah Lim (0000-0001-7406-5235, New York University), Alexander Furuya (0009-0008-4596-9014, Columbia University), Chau Trinh-Shevrin, Chau Trinh‐Shevrin (0000-0001-9635-0512, New York University), Denton Callander (0000-0002-4116-4250, UNSW Sydney), Asa Radix (0000-0001-9611-4181, Community Health Center), Kim Watson (CK Life, New York, New York, USA), Dustin T Duncan (0000-0001-8586-8711, Columbia University, corresponding author)
Year2025
Volume9
Issue1
Publication date2025-08-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Equity (JOURNAL)
Journal identifiersISSN: 2473-1242 • E-ISSN: 2473-1242
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/24731242251398305
OpenAlexW7117565414
LanguageEN
References cited29

Introduction: Transgender women of color (TWOC) face elevated rates of substance use, driven in part by intersecting systems of discrimination and structural inequities. Previous research has highlighted the connection between discrimination and substance use, but few studies have explored this relationship among TWOC. This study examines cross-sectional and longitudinal associations between perceived discrimination and substance use among TWOC in New York City. Methods: Data were drawn from the Trying to Understand Neighborhoods and Networks Among Transgender Women of Color Cohort Study, a prospective study of TWOC followed over 1 year (August 2020 to November 2022; analytic N = 293). Discrimination was measured using a modified Everyday Discrimination Scale and categorized as low, moderate, or high. Substance use outcomes, including recreational substance use and frequent alcohol use, were measured at baseline, 6 months, and 12 months. Associations were assessed using multivariable modified Poisson regression and generalized estimating equations, adjusting for covariates. Results: At baseline, 38.2% of participants reported moderate discrimination, and 25.3% reported high discrimination. Recreational substance use was reported by 34.8% at baseline, 19.1% at 6 months, and 22.6% at 12 months. Moderate and high discrimination were significantly associated with substance use at baseline (adjusted prevalence ratios [aPRs] = 1.75 and 1.77, respectively) and 12 months (aPRs = 3.14 and 3.06, respectively). In adjusted longitudinal models, both moderate (adjusted odds ratio [aOR] = 2.97) and high (aOR = 2.39) discrimination were associated with increased recreational substance use over time. No significant associations were observed with frequent alcohol use. Conclusion: Discrimination is associated with increased substance use among TWOC. Interventions are needed to address discrimination and its effects as a determinant of individual and public health

Cohort study · Longitudinal study · Odds · Poisson regression · Recreation · Recreational drug use · Substance use · Transgender · LGBTQ Health, Identity, and Policy · Names, Identity, and Discrimination Research · Racial and Ethnic Identity Research

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