Comparing Cisgender and Trans-spectrum Postsecondary Student Alcohol and Substance Use: Results From the Arkansas Collegiate Substance Use Assessment.

Purpose: Examine self-reported substance use of cisgender and trans-spectrum students.

Design: Observational Study, cross-sectional design.

Setting: Arkansas post-secondary institutions.

Subjects: Active students enrolled in 2021, sample responses n = 3659.

Measures: 9 Demographics, 13 recent substance use outcomes, 1 weekly alcohol use outcome, and 1 COVID-related substance use outcome.

Analysis: Demographic and geospatial descriptives; t test/Cohen's d effect size; X2 Test for Independence/Cramer's V effect size; OLS Regression/Standardized Beta coefficients/Adjusted R2 effect sizes; level of significance = .05.

Results: Trans-spectrum students are 1.8% of the sampled responses (n = 3315) with geographical variation. Weekly alcohol consumption is greater with trans-spectrum (MD = 0.74, d = .102), along with frequency of recent use of marijuana (V = .113), cocaine (V = .097), sedatives (V = .098), hallucinogens (V = .127), designer drugs (V = .087), and meth (V = .151). Suicidal thoughts (V = .112) and attempted suicide (V = .118) are greater and COVID increased use of substances (29.3% for trans-spectrum v 13.7% for cisgender, V = .073). Gender (B = .099), family history (B = .092), and campus policies (B = .084) impact weekly alcohol consumption (P < .001, R2 = .024).

Discussion/conclusions: Trans-spectrum students report higher usage rates, suicidal thoughts, and COVID impacts on usage. Family history and campus policies also show impact on weekly alcohol use. Future postsecondary substance use assessments should include trans-spectrum demographic categories.