Longitudinal associations between minority stressors and substance use among sexual and gender minority individuals

Background: Sexual and gender minority individuals (SGM) are at increased risk for substance use and substance use problems compared to heterosexual individuals. A growing cross-sectional literature has demonstrated that minority stressors are associated with higher risk for substance use among SGM individuals. However, longitudinal research in this area is limited and existing longitudinal studies have focused almost exclusively on one type of substance use (alcohol) and one minority stressor (SGM victimization).

Methods: To extend the longitudinal body of research on associations between minority stressors and substance use, we utilized seven waves of data from a longitudinal cohort study of 1091 SGM individuals assigned male at birth to examine associations between three minority stressors, general stress, and marijuana and alcohol use.

Results: At the within-person level, results indicated that when individuals experienced more internalized stigma, microaggressions, victimization, or general stress than usual, they reported more concurrent alcohol problems. Further, when individuals experienced more microaggressions or general stress than usual, they also experienced more concurrent marijuana use problems. However, stressors were not prospectively associated with higher rates of alcohol or marijuana problems six months later.

Conclusions: Findings indicate that minority stressors are consistently associated with more concurrent alcohol problems, while these associations may be less consistent for marijuana problems. The lack of prospective effects of minority stress on substance use points to the need for innovative methods for examining these effects, such as daily or weekly diary studies.