Polyvictimization and Substance Use Among Sexual Minority Cisgender Women.

BACKGROUND: Violent victimization and substance use are higher among sexual minority cisgender women (SMCW) than heterosexual cisgender women. Unknown, however, is how polyvictimization-experiencing multiple types of violent victimization-affects substance use among SMCW. Purpose/Objectives: This study explores the relationship between polyvictimization and substance use among a small sample of SMCW. Methods: An exploratory secondary data analysis was conducted on data from a convenience sample of 115 SMCW currently in relationships (70.4% lesbian, 73.9% non-Hispanic white) via a cross-sectional survey. Lifetime physical, sexual, and crime-related violent victimization were measured via the Trauma History Questionnaire. Past-year substance use was measured via the Drug Abuse Screening Test (DAST-10). Mann-Whitney U testing and linear regression modeling were used to examine differences in substance use by victimization status (victimized/non-victimized) and the association between polyvictimization and substance use. Results: Lifetime prevalence of violent victimization was high with 60.9% of the sample reporting at least one type of victimization: 10.4% experienced physical, 22.6% experienced sexual, and 22.6% experienced crime-related violent victimization. Substance use was significantly greater for victimized participants than non-victimized participants. Modeling showed that as violent victimization increased by one unit, substance use scores increased by .30 units. Conclusion/Importance: Preliminary evidence suggests that increase in violent victimization was associated with increased substance use among SMCW. Findings indicate a need for additional confirmatory research with more representative samples and longitudinal data. Behavioral health practitioners are urged to consider the implications of these findings and assess for past cumulative violence and current risk of substance use disorder, to appropriately facilitate treatment planning.

Trans* Community Connection, Health, and Wellbeing: A Systematic Review.

Purpose: Transgender and nonbinary (trans*) people are affected disproportionately by discrimination and violence, contributing to gender minority stress and negative health effects. Transgender community connection (TCC), defined as (i) emotional connectedness (internal sense of belonging) to the trans* community and/or (ii) behavioral participation in the trans* community (observable interaction with other trans* people, in person, online, or through media) may moderate these negative effects on health. This systematic review synthesizes research on links between TCC and health and wellbeing for trans* people. Methods: Twenty research articles (3 quantitative, 3 mixed methods, and 14 qualitative) linking TCC to health and wellbeing were identified from systematic searches of PubMed, CINAHL, and PsycINFO. Data regarding TCC were extracted, synthesized, and grouped by (i) gender transitioning, (ii) mental health, (iii) sexual health, and (iv) access to care to illustrate the findings. Results: TCC was linked to several positive outcomes, including improved mental health, increased connection to care, supported exploration of sexual and gender identities, and informed gender transition. For transgender women, especially, TCC was also linked to increased engagement in sex work (as a worker, not a client) and, in some cases, deterred them from getting sexual health testing and treatment due to fear of being observed at specialized clinics and subsequent loss of confidentiality among peers. Conclusion: These findings highlight the overall protective nature of TCC and a need to consider best practices to ensure confidentiality for community members. The findings can be used to inform the development and adaptation of health care interventions aimed at decreasing the harmful effects of gender minority stress for trans* people.