Beth Counselman Carpenter smiles for the camera, wearing a black dress with a red pattern, along with a pendant.
Beth Counselman Carpenter, PhD '14, is an associate professor in the School of Social Work whose research includes a focus on issues facing the LGBTQ+ community and other marginalized populations.

Different subsets of the transgender population have different rates of marijuana use when medically transitioning, new research finds

Transgender and gender-expansive individuals experience significant health disparities in multiple areas, including poor outcomes, barriers to access and lack of culturally informed care. “For trans*identified and nonbinary folx, who have a history of being pathologized in terms of diagnosis and treatment, it can be frightening—and even downright traumatizing—to reach out for any kind of healthcare,” said Beth Counselman Carpenter, PhD ’14, associate professor in the School of Social Work.

Her most recent project, undertaken with colleagues Alex Redcay, PhD, of Millersville University and Kevin Lally, DSW, of Bloomsburg University, strives to help behavioral health clinicians to develop more inclusive therapeutic strategies for non-cisgender clients. “The Impact of Gender Identity, Medical Transition, and Other Substances on Marijuana Use for Transgender Adults¹ ” (Journal of Social, Behavioral, and Health Sciences, 2022) explores the interplay of gender identity, age, medical transition and the use of marijuana within the transgender community. ¹ As the authors write, “A deeper understanding of the relationship of these variables will … [allow] for more thorough and accurate assessment protocols for individuals seeking medical transition.”

Most prior studies on the subject have treated the transgender community as a monolith, so Dr. Counselman Carpenter and her colleagues knew they had to proceed with far more care. They asked participants to self-report as one of four possible gender identities—transgender woman, transgender man, genderqueer/ nonbinary assigned male at birth or genderqueer/nonbinary assigned female at birth—and to note if they had transitioned medically (through hormones) or surgically.

This approach yielded some novel results. “We saw that medical transition moderated marijuana use, but we were surprised to find that taking hormones and having had surgical transition was a factor in reported rates of heavier use,” she noted. “We were also surprised by both the intersection of identities and the age group (30 to 40) that presented with higher use, as this was a unique finding when compared to other studies.” Based on these findings, clinicians should be able to apply far more specificity in their assessment and treatment, particularly when evaluating how a client may be using substances before, during and after their transition.

Going forward, Dr. Counselman Carpenter hopes to see more research like hers: dedicated to filling gaps in education, attuned to variations in gender identity, and sensitive to the difficult reality of accessing lifesaving services. “There are so many roadblocks for folx, particularly with marginalized identities, in receiving quality behavioral healthcare, but we need affirmative and effective care now more than ever,” she said.

¹ Counselman Carpenter, Elizabeth, et al. “The Impact of Gender Identity, Medical Transition, and Other Substances on Marijuana Use for Transgender Adults.” Journal of Social, Behavioral, and Health Sciences, vol. 16, iss. 1, pp. 252–264, 2022.

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