# Prejudice, Mental Health, and Substance Use Among Gender Minority Emerging Adults with Binary and Nonbinary Gender Identities

> **NIH NIH R01** · BOSTON CHILDREN'S HOSPITAL · 2022 · $452,985

## Abstract

PROJECT SUMMARY/ABSTRACT
Gender minority (GM) individuals have a different gender than their sex assigned at birth, including individuals
with binary gender identities (e.g., transgender man, transgender woman) and nonbinary gender identities.
Nonbinary GM individuals identify outside of the gender binary, the societal belief in two discrete genders:
woman and man. Compared to binary GM individuals, nonbinary GM individuals may be at increased risk for
substance use and adverse mental health due to exposure to stigma associated with being nonbinary.
Although some research has examined mental health among nonbinary GM adults, no research has examined
mental health and substance use among binary vs. nonbinary GM emerging adults with intersecting minority
identities. The proposed research integrates Minority Stress Theory and Intersectionality Theory to propose
that nonbinary GM individuals, particularly those with other minority identities (e.g., racial/ethnic or sexual
minority), may experience prejudice events (discrimination, violence) across different settings, which may
adversely affect their health. Examining associations between prejudice events and health among binary and
nonbinary GM emerging adults is critical to identifying protective factors that buffer the adverse effects of
prejudice events on substance use and mental health. These associations will be examined via analysis of
existing data from binary and nonbinary GM emerging adults, ages 18-25 years, from the 2015 U.S.
Transgender Survey (N=12,958). The proposed research aims to: 1) Compare the prevalence of prejudice
events in multiple settings, substance use, and mental health outcomes between binary and nonbinary GM
emerging adults by sex assigned at birth, race/ethnicity, and sexual orientation. We anticipate that nonbinary
GM individuals will report more prejudice events, substance use, and adverse mental health than binary GM
individuals (H1), and that GM individuals who hold other minority statuses will report more prejudice events,
substance use, and adverse mental health than GM individuals who do not hold other minority statuses (H2).
2) Investigate the impact of prejudice events on substance use and mental health outcomes among binary and
nonbinary GM emerging adults. We predict that prejudice events will be associated with increased substance
use and adverse mental health (H3), and that these associations will be stronger among nonbinary GM
individuals than binary GM individuals (H4), and among GM individuals who hold other minority statuses than
GM individuals who do not hold other minority statuses (H5). 3) Examine protective factors as moderators of
associations between prejudice events and substance use and mental health among binary and nonbinary GM
emerging adults. We expect that protective factors will moderate the adverse effects of prejudice events on
substance use and mental health among both binary and nonbinary GM individuals (H6). Findings from this
study w...

## Key facts

- **NIH application ID:** 10445229
- **Project number:** 5R01MD015031-02
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Sabra L. Katz-Wise
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $452,985
- **Award type:** 5
- **Project period:** 2021-07-06 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10445229

## Citation

> US National Institutes of Health, RePORTER application 10445229, Prejudice, Mental Health, and Substance Use Among Gender Minority Emerging Adults with Binary and Nonbinary Gender Identities (5R01MD015031-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10445229. Licensed CC0.

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