Purpose: Existing studies have identified sexual minorities as being at enhanced risk for reporting synthetic cannabinoid (SC) use. It is unclear whether this association is the result of those that identify as a minority due to sexual orientation being more likely to use SCs, due to those that identify as transgender using SCs more, or both. Deconstructing this relationship will allow for targeted clinical advice and public health campaigns. Methods: Data from the 2015 and 2017 Youth Risk Behavior Study are utilized. In total, 31,279 youth were asked about their gender identity, sexual orientation, and SC use history. Bivariate analyses and logistic regression models were completed to explore relevant associations. Results: Identifying as lesbian, gay, bisexual, or questioning was linked to SC use and continuing SC use. Similarly, identifying as transgender was linked to SC use and continuing use. Regression analyses showed no significant interactive effect; identifying as both LGBQ and transgender does not have a compounding effect on use likelihood. Conclusions: Both sexual orientation and gender identity contribute to the relationship between sexual minority status and SC use noted in extant literature. This relationship is hypothesized to be tied to increased exposure to discrimination, victimization, and social isolation. Thus, efforts to directly counsel LGBTQ patients about the dangers associated with SC use are warranted as well as social policy reforms to better protect and support members of the LGBTQ community.
Keywords: K2; LGBTQ; Synthetic cannabinoids; spice; transgender.