Intersecting marginalized identities, multiple discrimination, depressive symptoms, and cannabis use among U.S. young adults, 2021-2024.

Abstract

This study examined intersecting marginalized identities (based on race/ethnicity, gender, and sexual orientation), type-specific and multiple perceived discrimination (PD) prevalence, and associations with depressive symptoms and cannabis use among young adults. Data were from 3,888 U.S. respondents aged 19-30 in the Monitoring the Future (MTF) Panel study collected in 2021-2024. We estimated 12-month type-specific PD (gender, race/ethnicity, sexual orientation) prevalence, and multiple discrimination (2+ PD types) prevalence. We estimated associations between intersecting marginalized identities (2+ marginalized identities), multiple discrimination, depressive symptoms, and 30-day cannabis use, controlling for education and employment status, age, and year. In descending order, 44.5% of young adults reported perceived gender discrimination; 37.0% racial/ethnic discrimination; and 19.6% sexual orientation discrimination; 32.9% reported multiple discrimination. Overall, 40.2% respondents reported a single marginalized identity; 35.6% reported intersecting marginalized identities. Those with intersecting marginalized identities were more likely to report multiple discrimination. Intersecting marginalized identities and multiple discrimination were associated with higher depressive symptoms; multiple discrimination (but not intersecting marginalized identities) was associated with higher odds of 30-day cannabis use before and after controlling for depressive symptoms. Multiple discrimination and 30-day cannabis use associations were stronger among those identifying as non-Hispanic Black and non-Hispanic Asian American or Pacific Islander versus non-Hispanic White. Young adults with intersecting marginalized identities were more likely to report multiple discrimination, which was a risk factor for depressive symptoms and cannabis use. Understanding how multiple discrimination relates to depressive symptoms and cannabis use behaviors may strengthen prevention and intervention efforts.