Table 4.

Associations between gender diversity and substance use (new experimentation) in Year 3 of the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,092).

	Alcohol	Nicotine	Cannabis	Any substance
Gender Diversity Measure	AOR (95 % CI)	AOR (95 % CI)	AOR (95 % CI)	AOR (95 % CI)
Felt gender group^a
Cisgender/SCFG (reference)
1-STEP	2.28 (1.47, 3.54)	1.03 (0.47, 2.23)	1.01 (0.28, 3.62)	1.87 (1.24, 2.80)
2-STEP	2.12 (1.22, 3.70)	0.99 (0.38, 2.58)	2.06 (0.69, 6.18)	1.95 (1.17, 3.23)
Minority group	1.26 (0.72, 2.21)	1.30 (0.63, 2.69)	2.30 (0.93, 5.70)	1.29 (0.81, 2.05)
Are you transgender?^a
No (reference)
Maybe	0.99 (0.32, 3.12)	(−)	(−)	0.56 (0.17, 1.81)
Yes	0.83 (0.18, 3.79)	3.37 (1.04, 10.92)	5.85 (1.40, 24.36)	1.37 (0.52, 3.59)
Felt gender (mean score)^b	1.25 (1.03, 1.51)	1.17 (0.85, 1.61)	1.59 (1.15, 2.22)	1.22 (1.03, 1.45)
Gender non-contentedness^b	1.06 (0.86, 1.31)	1.30 (1.02, 1.66)	1.55 (1.17, 2.04)	1.18 (1.00, 1.40)
Gender expression^b	1.27 (1.08, 1.50)	1.21 (0.95, 1.55)	1.91 (1.45, 2.53)	1.34 (1.15, 1.55)
Gender spectrum (mean score)^c	1.23 (1.04, 1.46)	0.98 (0.75, 1.28)	0.83 (0.54, 1.26)	1.07 (0.91, 1.27)

ABCD Study sampling weights were applied based on the American Community Survey from the US Census; bold indicates p < 0.05; (−) indicates insufficient data for the subgroup

Categories represent increasing gender diverse identities based on questions of adolescents’ felt gender. In increasing order, categories are cisgender, 1-STEP, 2-STEP, and minority group. SCFG = sex congruent felt gender (Potter et al., 2021). AOR > 1 indicates higher odds of substance use outcomes.

Scores rated on a scale from 1 (most gender conforming) to 5 (most gender diverse); AOR > 1 indicates higher odds of substance use outcomes in gender diverse individuals.

Scores rated on a scale from 1 (most gender conforming) to 7 (most gender diverse); AOR > 1 indicates higher odds of substance use outcomes in gender diverse individuals.