UCSF

Purpose: Minority stress is related to short-term increases in substance use. This study identified patterns of cannabis use over four years among sexual and gender minority (SGM) people. We examined if cannabis use trajectories related to baseline minority stressors, and if differences by gender persisted after accounting for minority stress. Procedures: Participants were 11,813 SGM people within The PRIDE Study who provided information about risk for cannabis use disorder via the National Institute on Drug Abuse Modified Alcohol, Smoking, and Substance Involvement Screening Test annually for up to four years. Latent class growth curve mixture models identified five cannabis use trajectories: ‘low or no risk’, ‘low moderate risk’, ‘high moderate risk’, ‘steep risk increase’, and ‘highest risk’. Results: Participants (n = 5,673) who reported past-year discrimination and/or victimization at baseline had greater odds of membership in any cannabis risk category compared to the ‘low risk’ category (odds ratios [OR] 1.17-1.33). Internalized stigma was related to ‘high moderate’ and ‘highest risk’ cannabis use over time (ORs 1.27-1.38). After accounting for minority stress, gender expansive people and transgender men had higher odds than cisgender men to have ‘low moderate risk’ (ORs 1.61, 1.67) or ‘high moderate risk’ (ORs 2.09, 1.99). Transgender men had higher odds of having ‘highest risk’ (OR 2.36) cannabis use compared to the ‘low or no risk’ category. Conclusions: Minority stress at baseline is related to prospective cannabis use risk trajectories, and gender expansive people and transgender men have greater cannabis use risk even after accounting for minority stress.