Social Relationships and Gender-Diverse Young People's Capacities to Manage Problematic Substance Use

Trans and gender-diverse young people seek help from alcohol and drug services at higher rates than their cisgender peers. However, little is known about the factors that influence their capacities to manage problematic substance use. The aim of this study was to explore social relationships as a potential factor shaping these capacities. In the qualitative study reported here, 12 interviews were conducted with five young people aged 19 to 21 years who identified as trans, nonbinary, or both. Interviews were conducted during and following participants' engagement with alcohol and drug treatment programmes across two Australian states. We found that participants' social relationships influenced their self-reported capacities to manage their substance use in both supportive and detrimental ways. Experiences of gender-based discrimination and the alcohol and drug practices of those in participants' social networks were identified as highly influential. Social relationships facilitated access to resources and shaped motivation to reduce substance use. These insights resonated with the experiences of cisgender young people, with some key points of differentiation. Findings suggest the need for alcohol and drug services to provide more responsive support for trans and gender-diverse young people within and beyond their direct engagements with services. IMPLICATIONS Understanding the experiences of trans and gender-diverse young people and how these shape their capacities to manage problematic substance use will enable services to deliver more culturally responsive support. Recognising the influence of social relationships in trans and gender-diverse young people's capacities to manage substance use will assist services in addressing the broader social contexts shaping their substance use. Clarifying how social relationships can both support and undermine trans and gender-diverse young people's capacities to manage substance use will assist staff to build more supportive relationships with people who use services.