Volume 44, Issue 5 pp. 1374-1383

ORIGINAL PAPER

Alcohol Use Disparities Among Transgender and Nonbinary Adults: An Intersectional Investigation

Ryan C. Shorey,

Corresponding Author

Ryan C. Shorey

[email protected]

orcid.org/0000-0002-0927-3959

Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA

Correspondence:

Ryan C. Shorey ([email protected])

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D. A. Briley,

D. A. Briley

Department of Psychology, University of Illinois, Champaign-Urbana, Illinois, USA

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Jane Hereth,

Jane Hereth

Department of Social Work, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA

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michael munson,

michael munson

FORGE, Milwaukee, Wisconsin, USA

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Jaclyn S. Fishbach,

Jaclyn S. Fishbach

Department of Psychology, University of Illinois, Champaign-Urbana, Illinois, USA

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Joseph R. Cohen,

Joseph R. Cohen

Department of Psychology, University of Illinois, Champaign-Urbana, Illinois, USA

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Ryan C. Shorey,

Corresponding Author

Ryan C. Shorey

[email protected]

orcid.org/0000-0002-0927-3959

Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA

Correspondence:

Ryan C. Shorey ([email protected])

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D. A. Briley,

D. A. Briley

Department of Psychology, University of Illinois, Champaign-Urbana, Illinois, USA

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Jane Hereth,

Jane Hereth

Department of Social Work, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA

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michael munson,

michael munson

FORGE, Milwaukee, Wisconsin, USA

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Jaclyn S. Fishbach,

Jaclyn S. Fishbach

Department of Psychology, University of Illinois, Champaign-Urbana, Illinois, USA

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Joseph R. Cohen,

Joseph R. Cohen

Department of Psychology, University of Illinois, Champaign-Urbana, Illinois, USA

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First published: 13 May 2025

https://doi.org/10.1111/dar.14077

Funding: This work was supported by National Institute on Alcohol Abuse and Alcoholism (R21AA030350).

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ABSTRACT

Introduction

This study examined an intersectional perspective on alcohol use disparities within transgender and nonbinary (TGNB) adults.

Methods

We examined the data from the 2015 U.S. Transgender Survey (N = 27,715), a cross-sectional, nationwide survey of TGNB adults. The number of drinking days and the number of binge-drinking days were primary outcomes. Analyses followed a multilevel analysis of individual heterogeneity and discriminatory accuracy approach to examine alcohol disparities across gender identities (transgender, nonbinary and crossdresser) and intersections with race/ethnicity, age, sex assigned at birth and dis/ability status.

Results

Significant identity-related differences existed within TGNB communities across all facets of identity. Relative to the sample average, individuals at the intersection of White and crossdressers reported elevated levels of alcohol use. Further, effects were most pronounced across combinations of transgender, nonbinary, White and Black participants to accurately describe alcohol risk in subpopulations relative to examining risk associated with each one of these identities independently.

Discussion and Conclusions

Disparities in alcohol use among TGNB adults are best understood from an intersectional perspective. Affirming public health initiatives for alcohol use should consider identity-related differences across TGNB communities.

Scientific Significance

Results provide the first evidence that alcohol use disparities exist across gender and intersecting identities in a large sample of TGNB adults. Findings lay the groundwork for future research examining mechanisms responsible for these disparities.

Conflicts of Interest

The authors declare no conflicts of interest.

Open Research

Data Availability Statement

The data that support the findings of this study are openly available in ICPSR at https://www.icpsr.umich.edu/web/RCMD/studies/37229, reference number ICPSR 37229.

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Volume44, Issue5

July 2025

Pages 1374-1383

Alcohol Use Disparities Among Transgender and Nonbinary Adults: An Intersectional Investigation

ABSTRACT

Introduction

Methods

Results

Discussion and Conclusions

Scientific Significance

Conflicts of Interest

Open Research

Data Availability Statement

References

References

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Alcohol Use Disparities Among Transgender and Nonbinary Adults: An Intersectional Investigation

ABSTRACT

Introduction

Methods

Results

Discussion and Conclusions

Scientific Significance

Conflicts of Interest

Open Research

Data Availability Statement

References

References

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