Evidence map›Paper›PMID 40911999›Full record

ArticleDrug and alcohol dependence2025

Medical gender affirmation appears protective against problematic substance use among transgender women and transfeminine adults: Findings from The LITE Study.

Jack Andrzejewski, Heather L Corliss, Heather A Pines, Ravi Goyal, Eileen V Pitpitan, Britt Skaathun, Andrea L Wirtz, Sari L Reisner, American Cohort to Study HIV Acquisition among Transgender Women (LITE) Study Group

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In one paragraph

Article in Drug and alcohol dependence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jack AndrzejewskiUniversity of California, San Diego-San Diego State University, Joint Doctoral Program in Public Health, Health Behavior Track, San Diego, CA, USA; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA. Electronic address: jdandrzejewski@g.ucla.edu.
Heather L CorlissInstitute for Behavioral and Community Health, San Diego State University, San Diego, CA, USA; School of Public Health, San Diego State University, San Diego, CA, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA.
Heather A PinesSchool of Public Health, San Diego State University, San Diego, CA, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA.
Ravi GoyalDivision of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA.
Eileen V PitpitanSchool of Social Work, San Diego State University, San Diego, CA, USA.
Britt SkaathunDivision of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA.
Andrea L WirtzDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. Electronic address: awirtz1@jhu.edu.
Sari L ReisnerDepartment of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
American Cohort to Study HIV Acquisition among Transgender Women (LITE) Study Group

Funding

The impact of HIV viral diversity and cellular immunity on HIV pathogenesisP30AI060354 · NIAID · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI ARTHUR Y KIM · 2004 to 2026
$94.4M
VirologyP30AI036214 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SUSAN JANET LITTLE · 1994 to 2026
$78.4M
Virology and Molecular Biomarkers CoreP30AI050409 · NIAID · EMORY UNIVERSITY · PI Ann M Chahroudi, Colleen F Kelley · 2002 to 2026
$74.0M
Vaccine Response and Immunotherapeutics SWGP30AI094189 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Anna Palmer Durbin · 2012 to 2026
$67.0M
University of Miami Developmental Center for AIDS Research (D-CFAR)P30AI073961 · NIAID · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI Savita Pahwa · 2007 to 2026
$33.8M
SWG 2: Cure Research Scientific Working GroupP30AI117970 · NIAID · GEORGE WASHINGTON UNIVERSITY · PI Italo Mocchetti · 2015 to 2026
$29.6M
Training Program in Substance Use, HIV and Related InfectionsT32DA023356 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Natasha Martin, Steffanie A Strathdee · 2007 to 2026
$7.8M
LITE CONNECT: Addressing testing gaps and epidemiologic disparities of COVID-19 amongtransgender people in the United StatesUH3AI133669 · NIAID · JOHNS HOPKINS UNIVERSITY · PI REISNER, SARI, WIRTZ, ANDREA L · 2019 to 2022
$6.9M
American Cohort to Study HIV Acquisition among Transgender Women in High Risk AreasUG3AI133669 · NIAID · JOHNS HOPKINS UNIVERSITY · PI REISNER, SARI, WIRTZ, ANDREA L · 2017 to 2018
$3.5M
NIAID NIH HHS P30 AI036214NIAID NIH HHS P30 AI050409NIAID NIH HHS P30 AI060354NIAID NIH HHS P30 AI073961NIAID NIH HHS P30 AI094189NIAID NIH HHS P30 AI117970NIAID NIH HHS UG3 AI133669NIAID NIH HHS UH3 AI133669NIDA NIH HHS T32 DA023356
6 · The paper itself

Abstract

objectiveTo estimate the association between medical and legal gender affirmation with problematic substance use among transfeminine adults.

methodsData from a longitudinal cohort (The LITE Study) were analyzed (n = 1186). Participants were enrolled between March 2018 and August 2020 and followed for 2 years. We tested the association between baseline medical and legal gender affirmation with problematic drug use (DAST-10 ≥3) and problematic alcohol use (AUDIT-C≥4) at 12-months. We used Poisson regression to estimate adjusted prevalence ratios (aPR) and 95 % confidence intervals (CI).

resultsMean age was 31.0 years (standard deviation=11.2). For race and ethnicity, 55.8 % were non-Latinx, white, 13.0 % were non-Latinx Black/African American, 17.1 % were Latinx, and 14.1 % were Asian, American Indiana/Alaskan Native, Native Hawaiian/Pacific Islander, or multiracial. For exposures, 75.1 % had met need for medical gender affirmation, 16.4 % did not seek medical gender affirmation, 8.5 % had unmet need for medical gender affirmation, and 19.5 % had all IDs match their chosen name/gender. At follow-up, 24.1 % had problematic drug use, and 27.6 % had problematic alcohol use. Participants with met need for medical gender affirmation were less likely to have problematic drug use at follow-up (aPR=0.70, 95 %CI=0.49-0.99) compared to those with unmet need. Compared to those who did not seek medical gender affirmation, those with met need (aPR=0.72, 95 %CI=0.57-0.91) and unmet need (aPR=0.68, 95 %CI=0.47-0.97) were less likely to have problematic alcohol use.

conclusionMedical gender affirmation appears protective against problematic substance use. Increasing access to medical gender affirmation may improve substance use outcomes among transfeminine adults who desire such services.

Indexed as

Legal gender affirmationMedical gender affirmationProblematic alcohol useProblematic drug useTransgender

Identifiers

PMID40911999
PMCPMC12450586

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.