Alcohol use at the intersection of sexual orientation and gender identity in a representative sample of youth in Colorado.

Background And Objectives: Lesbian, gay, bisexual, and questioning (LGBQ) youth are at greater risk of problematic alcohol use than their heterosexual peers, yet there is a dearth of research examining variability in alcohol use among youth that simultaneously accounts for sexual orientation and gender identity. This paper examines the relationship between alcohol use and intersecting identities of sexual orientation and gender while accounting for this population's disproportionate experiences of depression and dating and sexual violence.

Methods: The study used a representative sample (n = 27,621) of high school students. Logistic regressions were used to determine if earlier age at first drink, 30-day alcohol use, and binge drinking were significantly related to intersectional sexual orientation and gender identity. Secondary models added depression, dating violence, and sexual violence to analyses to determine if they explained any of the variance in alcohol use variables in LGBQ and transgender youth.

Results: Transgender youth who identified as heterosexual or questioning their sexual orientation were at greatest risk for early initiation of alcohol use and binge drinking. These relationships between intersectional identity and alcohol use became nonsignificant when depression, dating violence, and sexual violence were added to the models.

Conclusions And Scientific Significance: This is the first study to examine relationships between intersecting identities of sexual orientation and gender identity and alcohol use among youth. Risky alcohol use among transgender youth may be attributed to experiences of depression, dating violence, and sexual violence impacting these populations. Interventions should focus on reducing transgender youth exposure to violence.