Gender-targeted Substance Use Interventions for Young Cisgender Women and Transgender Women – A Scoping Review

Polysubstance use among young people has recently become the focus of popular media, public health interventions, and research due to alarming increases in polysubstance use-related morbidity and mortality in younger age groups. Data in Canada and the U.S. indicates that morbidity and mortality due to polysubstance use among youth is increasing. Researchers have shown that adult-focused interventions for polysubstance use cannot simply be ‘mapped onto’ youth, as young people occupy lifeworlds distinct from those of older adults. Adult-focused interventions may be irrelevant and not efficacious for youth. Further, some researchers have argued there need to more gender-targeted interventions to attenuate the impact(s) of polysubstance use arguing that interventions for substance use will be more efficacious if they are gender-targeted. It has been argued that young females/women and young trans women experience and occupy unique lifeworlds that necessitates the development of targeted polysubstance use intervention(s). Our cursory review of the literature on youth/gender-targeted interventions for polysubstance use revealed there have been no systematic (scoping) reviews of the gender-targeted interventions for polysubstance use among young women/females and/or young trans women. The literature we have identified focuses on adult women/females and has highlighted accessibility barriers for adult women seeking substance use services (e.g., a lack of childcare, stigma, concerns about children being taken away, long wait times, etc.) (Elms et al., 2018; Najavits et al., 2018). Several examples of interventions for adult women we have identified include A Woman’s Path to Recovery (female veterans), Helping Women Recover and Beyond Trauma , Breaking the Cycle , female-specific cognitive behavioral therapy, Moment by Moment in women’s recovery. The interventions address pregnant women’s needs, domestic violence needs, and working mothers’ needs (Johnstone et al., 2023). A recently published systematic review of substance use interventions for adult women (Johnstone et al., 2023) indicated several of the interventions they found were efficacious for the treatment of substance use but they noted there were several gaps in the current landscape of female/women-specific substance use interventions including, programs for women with a dual diagnosis (mental health conditions and substance use), integrated treatment for women who experience trauma, programs for homeless women, previously or currently incarcerated women, and institutionalized women. Due to the lack of reviews concerning the landscape of interventions/treatments for young women/females and trans women, this paper will 1) Identify young women/female and trans women-targeted interventions 2) Characterize the nature of the interventions to understand where they have been developed, the rationale for their development and implementation, and the mechanisms through which they impact substance use behaviors, and 3) To identify potential gaps in interventions and areas for improvement. We are undertaking a scoping review of the literature that will map and characterize the young female/women and trans women-targeted interventions for substance use (e.g., opioids, cocaine, alcohol, etc.). Our review follows the protocol for scoping reviews as outlined in the JBI Manual for Evidence Synthesis (2020). The inclusion criteria for this review are, I) Studies including young women/females/trans women (ages 15-25), II) Assessing any treatment or intervention for polysubstance use, and III) Measuring any outcome on substance use. Descriptive statistics will be developed regarding geographic location(s) of the studies, intervention type(s), and substances use outcomes. We will perform a content analysis of the included studies which will summarize the rationale(s) for a female/women/trans woman-targeted approaches, characteristics of the interventions (e.g., inpatient, etc.), and identify what might be ‘missing’ from the interventions or treatments. We are in the process of completing this review and have not yet identified our main argument(s). We anticipate this review will help researchers, policymakers, and professionals working with young women/females and trans women understand which interventions are efficacious and the mechanisms through which they are efficacious. We also anticipate this review will provide an in-depth understanding of the rationale and justifications for gender-targeted/gender diverse intervention(s) and will identify gaps or ‘missing’ considerations in the studies we identify. Despite the fact we are currently in the process of completing this review, our topical focus is aligned with thematic focus of the CSA conference. The results of this review will highlight and emphasize the possibilities of and for gender diverse polysubstance use interventions and highlight the gender-specific needs, desires, and experiences of young people that can be integrated in substance use interventions to attenuate the impacts of the North American polysubstance use health crisis among youth.

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