A Qualitative Analysis of Transgender and Gender Nonconforming College Students' Experiences of Gender-Based Discrimination and Intersections With Alcohol Use

Objective: Transgender and gender-nonconforming (TGNC) emerging adults (EAs) are a vulnerable population at risk for negative mental health and alcohol use outcomes often attributed to unique experiences of discrimination and transphobia, including in colleges/universities through institutionalized transphobia. There are no extant psychosocial interventions that focus on the experiences of EA TGNC undergraduate students. Method: The current study utilized a Community-Based Participatory Research framework and exploratory qualitative approach to better understand the unique experiences of this population (N = 16). Data are presented from an inductive thematic analysis of focus groups and interview transcripts that highlight TGNC experiences of gender-based stressors and substance use and provide feedback on a brief psychosocial intervention to prevent high-risk alcohol use among TGNC. Results: Main themes were TGNC-specific experiences (e.g., pronoun misuse, invalidating interactions with faculty and staff), coping with gender-based discrimination and stressors (e.g., use of alcohol and other drugs), and resources and programs (e.g., lack of TGNC representation in leadership roles). Notable subthemes included the impact of intersecting gender, race, and class divisions, medical and mental health-care concerns, and qualities of interventions perceived as effective versus ineffective. Conclusions: This is one of the first studies to gather information related to the desires of EA TGNC undergraduate students on addressing high-risk alcohol use. Data provide considerations for developing psychosocial interventions to address negative mental health outcomes and risks associated with alcohol and other drug use among EA TGNC undergraduate students, such as creating safe interventions and utilizing a strengths-based approach to teaching coping skills. Public Health Significance Statement This study elevates the voices of emerging adult trans and gender-nonconforming college students and describes their experiences with alcohol and other drugs as well as common challenges they face and forms of resilience. The study also offers considerations for developing and implementing trans-affirmative brief alcohol interventions.