PACT Research Studies
At least 1 in 300 Canadian aged 15+ identify as transgender; however, the trans community has been underrepresented and underserved in research and health care systems [1-2]. Most population-based Canadian surveys do not assess gender identity [3], so we know very little about population-level drinking patterns and outcomes. Addressing drinking in trans individuals is further complicated by the fact that harmful drinking is typically assessed using measures that have been developed with cisgender individuals in mind, and utilize sex- or gender-based cut-offs.
Existing research suggests that trans adults report problematic drinking at concerning rates. However, few studies have evaluated reasons for heavy drinking and related harms [4]. Data is similarly scarce for day-to-day and lifetime use. In a 2018 literature review among US samples trans adults were found to exhibit hazardous drinking [5-6], past-year alcohol use disorder [7-8], and alcohol-related harms (e.g., being victimized while intoxicated) [9]. In a separate study comparing the experiences of trans and cisgender participants, trans individuals had significantly elevated rates of alcohol use disorder [10].
In a previous study conducted by Dr. Dermody, researchers found that trans men, women, and non-binary individuals exhibited inequities (when compared to cisgender women) with increased accounts of non-consensual sex and mental health symptoms when drinking [11]. Findings from this study further suggested that when compared to cisgender women, trans individuals may also experience more alcohol-related harms at lower levels of drinking.
PACT Background
In 2021, the CARE Lab launched a pilot study for the Predictors of Alcohol use and Consequences in Transgender (PACT) Adults Pilot Study. A total of 25 participants across Canada (aged 19+) were recruited. Main findings from this preliminary study have been published.
In 2022, the CARE Lab launched the PACT Youth Pilot Study. A total of 40 participants across Canada (aged 16-29) were recruited. Of this group, 19 participated in a one-on-one interview with a peer researcher. Main findings from this study are currently in the publication process. Additional data analysis is ongoing.
In 2023, the CARE Lab launched the PACT Adult Study. A total of 100 participants across Canada (aged 19+) were recruited. Of this group, 40 are expected to participate in a one-on-one interview with a peer researcher. Recruitment targets were met exceptionally early, so a longitudinal portion to the study has recently been added! Data collection for this project is ongoing, and preliminary analysis is underway. Some preliminary findings have been published at conferences.
Two out of three PACT studies to date have received funding form the Canadian Institutes of Health Research (CIHR).
References
1. Statistics Canada. (2022, April 27). Canada is the first country to provide census data on transgender and non-binary people. https://www150.statcan.gc.ca/n1/daily-quotidien/220427/dq220427b-eng.htm
2. Giblon, R. & Bauer, G. R. (2017). Health care availability, quality, and unmet need: a comparison of transgender and cisgender residents of Ontario, Canada. BMC Health Services Research, 17. https://doi.org/10.1186/s12913-017-2226-z
3. Waite, S., & Denier, N. (2019). A research note on Canada’s LGBT data landscape: Where we are and what the future holds. Canadian Review of Sociology/Revue canadienne de sociologie, 56, 93-117. https://doi-org.ezproxy.lib.torontomu.ca/10.1111/cars.12232
4. Gilbert, P.A., Pass, L.E., Keuroghlian, A.S., Greenfield, T.K., & Reisner, S.L. (2018). Alcohol research with transgender populations: A systematic review and reccommendations to strengthen future studies. Drug and Alcohol Dependence, 186, 138-146. https://doi.org/10.1016/j.drugalcdep.2018.01.016
5. Kerr-Corrêa, F., Pinheiro, F. M. L., Júnior, Martins, T. A., Costa, D. L. da C., Macena, R. H. M., Mota, R. M. S., Yaegaschi, M. Y., Carneiro, K. L. L., Kendall, C., & Kerr, L. R. F. S. (2017). Hazardous alcohol use among transwomen in a Brazilian city. Cadernos de Saude Publica, 33(3), e00008815. https://doi.org/10.1590/0102-311X00008815
6. Herrera, M. C., Konda, K. A., Leon, S. R., Deiss, R., Brown, B., Calvo, G. M., Salvatierra, H. J., Caceres, C. F., & Klausner, J. D. (2016). Impact of alcohol use on sexual behavior among men who have sex with men and transgender women in Lima, Peru. Drug and Alcohol Dependence, 161, 147–154. https://linkinghub.elsevier.com/retrieve/pii/S0376871616000600
7. Blosnich, J.R., Marsiglio, M.C., Dichter, M.E., Goa, S., Gordon, A.J., Shipherd, J.C., Kauth, M.R., Brown, G.R., & Fine, M.J. (2017). Impact of social determinants of health on medical conditions among transgender veterans. American Journal of Preventative Medicine, 52(4), 491-498. https://doi.org/10.1016/j.amepre.2016.12.019
8. Reisner, S. L., Deutsch, M. B., Bhasin, S., Bockting, W., Brown, G. R., Feldman, J., Garofalo, R., Kreukels, B., Radix, A., Safer, J. D., Tangpricha, V., TʼSjoen, G., & Goodman, M. (2016). Advancing methods for US transgender health research. Current Opinion in Endocrinology, Diabetes, and Obesity, 23(2), 198–207. https://journals.lww.com/01266029-201604000-00018
9. Coulter, R.W.S., Blosnich, J.R., Bukowsky, L.A., Herrick, A.L., Siconolfi, D.E., & Stall, R.D. (2015). Differences in alcohol use and alcohol-related problems between transgender- and nontransgender-identified young adults. Drug and Alcohol Dependence, 154, 251-259. 10.1016/j.drugalcdep.2015.07.006
10. Hughto, J. M. W., Quinn, E. K., Dunbar, M. S., Rose, A. J., Shireman, T. I., & Jasuja, G. K. (2021). Prevalence and co-occurrence of alcohol, nicotine, and other substance use disorder diagnoses among US transgender and cisgender adults. JAMA Network Open, 4(2), e2036512. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775924
11. Dermody, S. S., Lamb, K. M., & Kerr, D. C. R. (2021). Heavy drinking and drinking harms for cisgender and transgender college students. Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors, 36(5), 1-11. https://doi.org/10.1037/adb0000778