The purpose of this review was to examine socioecological risk factors for substance use among sexually and gender diverse (SGD) Latine youth and young adults (YYA).
Methods:
We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided search in PubMed, PsycInfo, Web of Science, and MEDLINE on July 16, 2025. Inclusion criteria were the following: (1) peer-reviewed journal article published on or after January 2014; (2) sample aged between 10 and 29 years old; (3) intersectional analysis of Latine and SGD subsample; (4) analysis for associative or predictive properties of individual-level, interpersonal-level, and/or structural-level risk factors with substance use. Studies that failed to meet all criteria were excluded. The quality of articles was assessed using the Appraisal tool for Cross-Sectional Studies and the Quality of Reporting of Observational Longitudinal Research tool.
Results:
Twelve studies were included in the final synthesis, the majority being cross-sectional studies (9, 75%) with youth/adolescent samples (8, 67%). Outcomes from reviewed studies indicated that depression and psychological distress were associated with substance use among SGD Latine YYA. In addition, victimization, discrimination, and absence of social support contributed to substance use among SGD Latine YYA.
Conclusions:
Outcomes from reviewed studies prompt targeted consideration of individual-level mental health and interpersonal-level discrimination and support as it relates to substance use prevention and intervention among SGD Latine YYA. Future research should explore the intersecting cultural influences of being Latine and SGD on substance use and access to mental health and social support resources among SGD Latine YYA.
Substance Abuse and Mental Health Service Administration. 2023 National Survey on Drug Use and Health: Among the Hispanic or Latino Population Aged 12 or Older. U.S. Department of Health and Human Services, Center for Behavioral Health Statistics and Quality: Rockville, MD; 2025. Available from: https://www.samhsa.gov/data/sites/default/files/reports/rpt53159/2023-nsduh-pop-slides-hispanic.pdf [Last accessed: April11, 2025].
2.
Substance Abuse and Mental Health Services Administration. 2023 National Survey on Drug Use and Health: Among the Lesbian, Gay, Bisexual, or Some Other Term (LGB+) Population Aged 12 or Older. U.S. Department of Health and Human Services, Center for Behavioral Health Statistics and Quality: Rockville, MD;. 2025. Available from: https://www.samhsa.gov/data/sites/default/files/reports/rpt53159/2023-nsduh-pop-slides-lbgplus.pdf [Last accessed: April11, 2025].
3.
AhmadFB, CisewskiJA, RossenLM, et al.Provisional Drug Overdose Death Counts. National Center for Health Statistics: Hyattsville, MD; 2025; doi: 10.15620/cdc/20250305008 [Last accessed: April 11, 2025]
4.
SiddiquiN, UrmanRD. Opioid use disorder and racial/ethnic health disparities: Prevention and management. Curr Pain Headache Rep, 2022; 26(2):129–137; doi: 10.1007/s11916-022-01010-4
5.
MorenoO, AvilaM, Garcia-RodriguezI, et al.Culturally enhancing a group-based motivational interviewing substance use prevention program for Latine youth. Contemp Clin Trials Commun, 2022; 30:100991; doi: 10.1016/j.conctc.2022.100991
6.
MargolisKA, ThakurSK, ZarndtAN, et al.E-cigarette susceptibility among US middle and high school students: National Youth Tobacco Survey data trend analysis, 2014–2018. Prev Med, 2021; 143:106347; doi: 10.1016/j.ypmed.2020.106347
7.
BronfenbrennerU. Toward an experimental ecology of human development. Am Psychol, 1977; 32(7):513–531; doi: 10.1037/0003-066X.32.7.513
8.
BronfenbrennerU. Ecological models of human development. In: International Encyclopedia of Education, Vol. 3, 2nd. Ed. Elsevier: Oxford, UK; 1994; pp. 1643–1647.
9.
KilanowskiJF. Breadth of the socio-ecological model. J Agromedicine, 2017; 22(4):295–297; doi: 10.1080/1059924X.2017.1358971
White HughtoJM, ReisnerSL, PachankisJE. Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions. Soc Sci Med, 2015; 147:222–231; doi: 10.1016/j.socscimed.2015.11.010
12.
MainaG, MarshallK, SherstobitofJ. Untangling the complexities of substance use initiation and recovery: Client reflections on opioid use prevention and recovery from a social-ecological perspective. Subst Abuse, 2021; 15:11782218211050372; doi: 10.1177/11782218211050372
13.
NydeggerLA, ClabornKR. Exploring patterns of substance use among highly vulnerable Black women at-risk for HIV through a syndemics framework: A qualitative study. PLoS One, 2020; 15(7):e0236247; doi: 10.1371/journal.pone.0236247
14.
SantacroseDE, Kia-KeatingM, LucioD. A systematic review of socioecological factors, community violence exposure, and disparities for Latinx youth. J Trauma Stress, 2021; 34(5):1027–1044; doi: 10.1002/jts.22733
15.
MeyerIH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychol Bull, 2003; 129(5):674–697; doi: 10.1037/0033-2909.129.5.674
16.
Rivas-KoehlM, Rivas-KoehlD, SmithM. S. The temporal intersectional minority stress model: Reimagining minority stress theory. J Fam Theory Rev, 2023; 15(4):706–726; doi: 10.1111/jftr.12529
17.
GriebSM, PlattR, VazquezMG, et al.Mental health stigma among spanish-speaking Latinos in Baltimore, MD. J Immigr Minor Health, 2023; 25(5):999–1007; doi: 10.1007/s10903-023-01488-z
18.
SchmitzRM, SanchezJ, LopezB. LGBTQ+ Latinx young adults’ health autonomy in resisting cultural stigma. Cult Health Sex, 2019; 21(1):16–30; doi: 10.1080/13691058.2018.1441443
19.
JohnsMM, GordonAR, AndrzejewskiJ, et al.Differences in health care experiences among transgender and gender diverse youth by gender identity and race/ethnicity. Prev Sci, 2023; 24(6):1128–1141; doi: 10.1007/s11121-023-01521-5
20.
LettE, AsaborEN, BeltránS, et al.Characterizing health inequities for the US transgender Hispanic population using the Behavioral Risk Factor Surveillance System. Transgend Health, 2021; 6(5):275–283; doi: 10.1089/trgh.2020.0095
21.
MacapagalK, BhatiaR, GreeneGJ. Differences in healthcare access, use, and experiences within a community sample of racially diverse lesbian, gay, bisexual, transgender, and questioning emerging adults. LGBT Health, 2016; 3(6):434–442; doi: 10.1089/lgbt.2015.0124
22.
WellsKJ, GordonJR, CarrizosaCM, et al.Interpersonal and community-level influences across the PrEP cascade among young adult Latinx men who have sex with men living in a US-Mexico border region: A qualitative study. AIDS Behav, 2024; 28(3):759–773; doi: 10.1007/s10461-023-04185-y
23.
MooreKL, LopezL, CamachoD, et al.A qualitative investigation of engagement in mental health services among Black and Hispanic LGB young adults. Psychiatr Serv, 2020; 71(6):555–561; doi: 10.1176/appi.ps.201900399
24.
MazonC, Jimenez-MaldonadoJ, WaltersFP. Intersectionality and adolescent medicine: An overview. Curr Opin Pediatr, 2023; 35(4):401–407; doi: 10.1097/MOP.0000000000001251
25.
PagliaccioD. Mental health disparities among sexual and gender minority students in higher education. J Am Coll Health, 2025; 73(5):1951–1962; doi: 10.1080/07448481.2024.2404944
26.
FaheyKML, KovacekK, AbramovichA, et al.Substance use prevalence, patterns, and correlates in transgender and gender diverse youth: A scoping review. Drug Alcohol Depend, 2023; 250:110880; doi: 10.1016/j.drugalcdep.2023.110880
27.
ChienYS, SchwartzG, HuangL, et al.State LGBTQ policies and binge drinking among sexual minority youth in the US: A multilevel analysis. Soc Psychiatry Psychiatr Epidemiol, 2022; 57(1):183–194; doi: 10.1007/s00127-021-02119-4
28.
EisenbergME, EricksonDJ, GowerAL, et al.Supportive community resources are associated with lower risk of substance use among lesbian gay bisexual and questioning adolescents in Minnesota. J Youth Adolesc, 2020; 49(4):836–848; doi: 10.1007/s10964-019-01100-4
29.
Fallin-BennettA, GoodinA. Substance use and school characteristics in lesbian, gay, bisexual, and heterosexual high school students. J Sch Health, 2019; 89(3):219–225; doi: 10.1111/josh.12731
30.
HatchelT, MarxR. Understanding intersectionality and resiliency among transgender adolescents: Exploring pathways among peer victimization, school belonging, and drug use. Int J Environ Res Public Health, 2018; 15(6):1289; doi: 10.3390/ijerph15061289
31.
KiddJD, JackmanKB, WolffM, et al.Risk and protective factors for substance use among sexual and gender minority youth: A scoping review. Curr Addict Rep, 2018; 5(2):158–173; doi: 10.1007/s40429-018-0196-9
32.
SmithBC, ArmelieAP, BoartsJM, et al.PTSD, depression, and substance use in relation to suicidality risk among traumatized minority lesbian gay and bisexual youth. Arch Suicide Res, 2016; 20(1):80–93; doi: 10.1080/13811118.2015.1004484
33.
ReisnerSL, GreytakEA, ParsonsJT, et al.Gender minority social stress in adolescence: Disparities in adolescent bullying and substance use by gender identity. J Sex Res, 2015; 52(3):243–256; doi: 10.1080/00224499.2014.886321
34.
CorreaKA, DelfelEL, WallaceAL, et al.Hispanic/Latinx ethnic differences in the relationships between behavioral inhibition, anxiety, and substance use in youth from the ABCD cohort. Front Psychiatry, 2023; 14:1251032; doi: 10.3389/fpsyt.2023.1251032
35.
Montero-ZamoraP, VosSR, UngerJB, et al.Perceived negative political climate among Hispanic/Latino adolescents before and after the 2020 U.S. presidential election: Associations with internalizing symptoms and substance use. Int J Intercult Relat, 2023; 94:101790; doi: 10.1016/j.ijintrel.2023.101790
36.
JacobsW, BarryAE, MerianosAL, et al.Gender differences in socio-ecological determinants of alcohol use among Hispanic adolescents. J Sch Health, 2020; 90(2):99–106; doi: 10.1111/josh.12860
37.
MereishEH, Treloar PadovanoH, ParletteB, et al.Momentary associations among minority stress, craving, affect, and nicotine use among sexual minority youth. J Clin Child Adolesc Psychol, 2022; 51(6):877–891; doi: 10.1080/15374416.2022.2093208
38.
RestarAJ, JinH, OgunbajoA, et al.Prevalence and risk factors of nonmedical prescription opioid use among transgender girls and young women. JAMA Netw Open, 2020; 3(3):e201015; doi: 10.1001/jamanetworkopen.2020.1015
39.
VanceSRJr, ChenD, GarofaloR, et al.Mental health and gender affirmation of Black and Latine transgender/nonbinary youth compared to White peers prior to hormone initiation. J Adolesc Health, 2023; 73(5):880–886; doi: 10.1016/j.jadohealth.2023.06.022
40.
RusowJA, SrivastavaA, BrayBC, et al.Intimate partner violence types are differentially associated with substance use among young urban sexual minority men of color. PLoS One, 2024; 19(9):e0309958; doi: 10.1371/journal.pone.0309958
41.
PageMJ, McKenzieJE, BossuytPM, et al.The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 2021; 372:n71; doi: 10.1136/bmj.n71
42.
SawyerSM, AzzopardiPS, WickremarathneD, et al.The age of adolescence. Lancet Child Adolesc Health, 2018; 2(3):223–228; doi: 10.1016/S2352-4642(18)30022-1
43.
LangMJ, DavidV, Giese-DavisJ. The age conundrum: A scoping review of younger age or adolescent and young adult as a risk factor for clinical distress, depression, or anxiety in cancer. J Adolesc Young Adult Oncol, 2015; 4(4):157–173; doi: 10.1089/jayao.2015.0005
44.
ArnettJJ. Emerging Adulthood: The Winding Road from the Late Teens Through the Twenties. 2nd ed. Oxford University Press: New York, NY; 2015.
45.
OuzzaniM, HammadyH, FedorowiczZ, et al.Rayyan—a web and mobile app for systematic reviews. Syst Rev, 2016; 5(1):210; doi: 10.1186/s13643-016-0384-4
46.
CurryCW, BeachLB, WangX, et al.At-school victimization and alcohol use among minoritized U.S. youth, 2009–2017. Am J Prev Med, 2022; 63(5):772–782; doi: 10.1016/j.amepre.2022.06.003
47.
RosalesR, SellersCM, LeeCS, et al.Examining racial/ethnic differences in the association of victimization and suicidal thoughts and behaviors with alcohol use among sexual minority youth. LGBT Health, 2023; 10(2):109–120; doi: 10.1089/lgbt.2021.0267
48.
PollittAM, MalloryAB, FishJN. Homophobic bullying and sexual minority youth alcohol use: Do sex and race/ethnicity matter? LGBT Health, 2018; 5(7):412–420; doi: 10.1089/lgbt.2018.0031
49.
WatsonRJ, FishJN, PoteatVP, et al.Teacher support, victimization, and alcohol use among sexual and gender minority youth: Considering ethnoracial identity. Prev Sci, 2021; 22(5):590–601; doi: 10.1089/lgbt.2018.0229
50.
DyarC, FeinsteinBA, MalloryAB, et al.Intersectional effects of sexual orientation and racial/ethnic discrimination on substance use among young adult sexual minority cisgender women and nonbinary people of color: Testing additive, prominence, and multiplicative hypotheses. Psychol Sex Orientat Gend Divers, 2025; 12(2):321–336; doi: 10.1037/sgd0000680
51.
LeeJS, SafrenSA, BainterSA, et al.Examining a syndemics network among young Latino men who have sex with men. Int J Behav Med, 2020; 27(1):39–51; doi: 10.1007/s12529-019-09831-1
52.
HalkitisPN, SiconolfiDE, StultsCB, et al.Modeling substance use in emerging adult gay, bisexual, and other YMSM across time: The P18 cohort study. Drug Alcohol Depend, 2014; 145:209–216; doi: 10.1016/j.drugalcdep.2014.10.016
53.
RistucciaA, LoSchiavoC, KapadiaF, et al.Motivations for alcohol use to intoxication among young adult gay, bisexual, and other MSM in New York City: The P18 cohort study. Addict Behav, 2019; 89:44–50; doi: 10.1016/j.addbeh.2018.09.014
54.
AbreuRL, SkidmoreSJ, BarritaAM, et al.Substance use, parental and teacher support, and mental health outcomes among Latinx sexual and gender minority youth. J Homosex, 2025:1–22; doi: 10.1080/00918369.2025.2496200
55.
KuhlemeierA, WillgingCE. A multigroup structural equation modeling approach for analyzing differences among sexually diverse youth. J Homosex, 2025; 72(9):1726–1750; doi: 10.1080/00918369.2024.2389903
56.
LozanoA, ScottD, Soto SugarSE, et al.Intersecting identities among Hispanic sexual minority youth and their relationship with substance use and depressive symptoms. J Adolesc Health, 2025; 77(2):292–299; doi: 10.1016/j.jadohealth.2025.04.021
57.
BarritaAM, AbreuRL, ParmenterJG, et al.Protective effects of online safety and parental acceptance for sexual and gender minority Latinx youth: A quantitative analysis of cyberbullying, psychological distress, and coping with alcohol. LGBT Health, 2025; 12(7):490–498; doi: 10.1089/lgbt.2024.0396
58.
DownesMJ, BrennanML, WilliamsHC, et al.Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open, 2016; 6(12):e011458; doi: 10.1136/bmjopen-2016-011458
59.
ToothL, WareR, BainC, et al.Quality of reporting of observational longitudinal research. Am J Epidemiol, 2005; 161(3):280–288; doi: 10.1093/aje/kwi042
60.
CruzTH, Ross-ReedDE, FitzGeraldCA, et al.Effects of school policies and programs on violence among all high school students and sexual and gender minority students. J Sch Health, 2023; 93(8):679–689; doi: 10.1111/josh.13297
61.
GreenAE, WillgingCE, RamosMM, et al.Factors impacting implementation of evidence-based strategies to create safe and supportive schools for sexual and gender minority students. J Adolesc Health, 2018; 63(5):643–648; doi: 10.1016/j.jadohealth.2018.06.004
62.
McDermottE, KaleyA, KanerE, et al.Understanding how school-based interventions can tackle LGBTQ+ youth mental health inequality: A realist approach. Int J Environ Res Public Health, 2023; 20(5):4274; doi: 10.3390/ijerph20054274
63.
RogersBG, TomaE, HarknessA, et al.“Why not just go on PrEP?”: A study to inform implementation of an HIV prevention intervention among Hispanic/Latino men who have sex with men in the northeastern United States. J Acquir Immune Defic Syndr, 2024; 97(1):26–39; doi: 10.1097/QAI.0000000000003461
64.
AbreuRL, HernandezM, RamosI, et al.Latinx bi+/plurisexual individuals’ disclosure of sexual orientation to family and the role of Latinx cultural values, beliefs, and traditions. J Bisexuality, 2023; 23(1):1–26; doi: 10.1080/15299716.2022.2116516
65.
Toro-MornMI, LoueS, SajatovicM. Familismo. In: Encyclopedia of Immigrant Health. Springer: New York, NY; 2012; pp. 545–547.
66.
DiBelloAM, GonzalesR, YoungCM, et al.Blood is thicker than booze: Examining the role of familism and gender in alcohol use and related consequences among Hispanic college students. J Ethn Subst Abuse, 2016; 15(3):310–324; doi: 10.1080/15332640.2015.1044684
67.
RyanC, RussellST, HuebnerD, et al.Family acceptance in adolescence and the health of LGBT young adults. J Child Adolesc Psychiatr Nurs, 2010; 23(4):205–213; doi: 10.1111/j.1744-6171.2010.00246.x
68.
PradoG, PantinH, BrionesE, et al.A randomized controlled trial of a parent-centered intervention in preventing substance use and HIV risk behaviors in Hispanic adolescents. J Consult Clin Psychol, 2007; 75(6):914–926; doi: 10.1037/0022-006X.75.6.914
69.
PantinH, CoatsworthJD, FeasterDJ, et al.Familias Unidas: The efficacy of an intervention to promote parental investment in Hispanic immigrant families. Prev Sci, 2003; 4(3):189–201; doi: 10.1023/a:1024601906942
70.
RaffulC, OrozcoR, PeraltaD, et al.Feasibility, acceptability, and perceived usefulness of a community-evidence-based harm reduction intervention for sexualized stimulant use among Mexican gay, bisexual, and other men who have sex with men. Harm Reduct J, 2024; 21(1):95; doi: 10.1186/s12954-024-01020-y
71.
VegaGP, McGillCM, DuranA, et al.Familismo, religiosidad, and marianismo: College Latina lesbians navigating cultural values and roles. Jle, 2022; 22(5):1939–1952.
72.
WeinickRM, JacobsEA, StoneLC, et al.Hispanic healthcare disparities: Challenging the myth of a monolithic Hispanic population. Med Care, 2004; 42(4):313–320; doi: 10.1097/01.mlr.0000118705.27241.7c
73.
SmithMK, PlanalpC, BennisSL, et al.Widening racial disparities in the US overdose epidemic. Am J Prev Med, 2025; 68(4):e1–e8; doi: 10.1016/j.amepre.2024.12.020
