# Substance Use and Gender-Affirming Care in Oregon's Medicaid Program

> **NIH NIH K01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2021 · $185,425

## Abstract

PROJECT SUMMARY/ABSTRACT
 The proposed K01 award provides Dr. Downing, a new Assistant Professor in the Oregon Health &
Science University/Portland State University School of Public Health, with the training and skills needed to
achieve their long-term goal of becoming an independent investigator focused on the prevention and treatment
of substance use disorders (SUD) among transgender and gender non-conforming (trans) people. Trans
people face unique challenges related to SUD prevention and treatment, including lower healthcare access
resulting from the failure of healthcare payers to cover medically necessary, trans-specific care. Dr. Downing’s
background in health policy, gender and sexual minority population health, and quantitative methods in
addition to their lived experience as a gender minority person makes them uniquely qualified to make
significant contributions to this field. There are three areas where additional training will improve their ability to
achieve their long-term career goals: 1) the financing and care delivery of state Medicaid programs, 2) the
epidemiology and treatment of SUD, and 4) qualitative and mixed methods research.
 Dr. Downing’s training goals will be achieved through coursework, directed readings, one-on-one
meetings with mentors, and mentored research activities. The K01 mentored research mixed-methods study
will identify risk factors for SUD and facilitators of treatment among trans people in Oregon’s Medicaid
program. The first aim of this proposal is to identify predictors of SUDs and overdose among trans people. The
second aim is to identify predictors of substance use treatment among trans people with a history of a
substance use disorder. The third aim proposes to understand mechanisms by which screening and treatment
for SUD among trans people occur by conducting interviews with trans people and providers who serve this
patient population. This proposal is highly innovative because it: 1) provides the first representative estimates
of SUD and treatment among trans people enrolled in Medicaid, 2) employs a quasi-experimental approach to
evaluate the impact of insurance coverage of gender-affirming care on SUD; and 3) uses a mixed methods
approach to provide context for findings. This training will expand the candidate’s ability to conduct research
that specifically meets three NIDA key goals: identifying the behavioral and social causes of drug use and
addiction, developing new and improved interventions to prevent drug use and its consequences, and
assessing the impact of polices on SUD.

## Key facts

- **NIH application ID:** 10300945
- **Project number:** 1K01DA050775-01A1
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Jae Downing
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $185,425
- **Award type:** 1
- **Project period:** 2021-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10300945

## Citation

> US National Institutes of Health, RePORTER application 10300945, Substance Use and Gender-Affirming Care in Oregon's Medicaid Program (1K01DA050775-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10300945. Licensed CC0.

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