An Ecological-Momentary-Assessment Investigation of the Gender-Minority Stress-and-Resilience Model to Explain Alcohol Outcomes in Transgender and Gender-Diverse Adults

Transgender and gender-diverse (TGD) adults may drink to cope with gender-minority stressors, increasing risk for alcohol-related harms. Using 21 days of ecological momentary assessments from 99 TGD adults residing in Canada, associations between gender-minority stressors and resilience factors with alcohol use and harms and risk processes were examined. Gender-minority stressors were positively associated within persons with daily and momentary negative affect, daily psychological distress, daily and momentary alcohol craving, and daily drinking to cope but not with daily alcohol use or harms. Mediation analyses supported positive indirect within-persons same-day associations between minority stressors and alcohol use via craving and drinking to cope and with alcohol harms via distress, negative affect, and social-drinking motives. Resilience was negatively associated within persons to daily and momentary negative affect, daily distress, and daily coping motives but positively associated with daily social and conformity motives and alcohol use.