Transgender college students engage in more high-risk drinking than cisgender peers
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* Julia Haskins

First-year transgender college students are more likely than their cisgender peers to engage in high-risk drinking patterns and experience negative alcohol-related consequences, a new study finds.

Transgender college students face unique pressures related to their identities and other challenges as they transition to adulthood, according to the study published March 21 in *Alcoholism: Clinical and Experimental Research*. Further, transgender people are regularly harassed, discriminated against and socially excluded, the study said.

To cope with such hardships, transgender students may engage in high-risk drinking, leading to negative alcohol-related consequences, such as risky sexual practices and physical and mental health problems, as well as alcohol-related blackouts.

High-risk drinking among college students is a serious public health issue for students of all gender identities, lead study author Larry Tupler, PhD, associate professor in psychiatry and behavioral sciences at Duke University School of Medicine, said. However, transgender students generally have different motivations for drinking than their cisgender peers, as the study found.

Researchers used an online survey to determine the frequency of high-risk drinking behaviors as well as the amount of alcohol students consumed and their motivations for drinking. Male and female transgender students were compared with their male and female cisgender peers on alcohol-related consequences. Among the 422,906 students at 370 colleges and universities who participated in the survey, 989, or 0.2 percent, identified as transgender.

Students reported their drinking experiences over a 14-day period, including the number of days they drank alcohol, how many drinks they consumed in total and the maximum number of drinks they consumed on any given day. Alcohol-related consequences, alcohol-related blackouts and drinking motivations were measured on a 7-point scale.

The survey found that transgender students had a greater likelihood of consuming alcohol on more days, consuming more drinks in total and consuming a greater number of maximum drinks on any given day than their cisgender peers. In addition, transgender students reported higher rates of alcohol-related blackouts, at 36 percent, compared with their cisgender counterparts, at 25 percent. Transgender students were significantly more likely to report academic, confrontational, social and sexual alcohol-related consequences than cisgender students. They were only slightly more likely than cisgender students to experience physical alcohol-related consequences, such as a stomachache.

Among their drinking motivations, transgender students more frequently cited issues related to stress; social anxiety; self-esteem; and the properties of alcohol itself, such as its ability to get consumers drunk, allow them to experiment and make them feel happy. Cisgender students, meanwhile, were more likely to report positive social motivations for drinking, such as celebrating or enjoying time with friends.

Male-to-female transgender students were more likely than female-to-male transgender students to experience negative alcohol-related consequences, which may be attributed to biological or sociocultural factors, Tupler said.

The study called for institution-wide efforts to address the needs of transgender students, thereby reducing negative alcohol-related consequences.

“Transgender students tend to drink for reasons of self-esteem or anxiety, so if colleges maybe focus on the reasons for drinking and are able to give a message such as, ‘You’re OK, you’re a valued person’…(that would) make them feel more accepted,” Tupler told The Nation’s Health. “A lot more research and understanding needs to be put forward to make for a better society to increase acceptance of people and to reduce the reasons why transgender students drink.”

For more information, visit [http://onlinelibrary.wiley.com/doi/10.1111/acer.13358/full](http://onlinelibrary.wiley.com/doi/10.1111/acer.13358/full).

*   Copyright The Nation’s Health, American Public Health Association