Alcohol intoxication, condom use rationale, and men's coercive condom use resistance: The role of past unintended partner pregnancy.

OBJECTIVE: Cisgender men's condom use resistance (CUR), deliberate attempts to avoid using a condom with a partner who wishes to use one, may include coercive strategies, such as deception and force, and places their partners at risk for unintended pregnancy and sexually transitted infections (STIs). This investigation used an alcohol administration design to examine one distal (history of unintended partner pregnancy) and two proximal (acute alcohol intoxication, condom use rationale) contributors to men's intentions to engage in coercive CUR. METHOD: Nonproblem drinking, cisgender men (N = 313) completed questionnaires, then were randomized to a beverage condition (control, placebo, low dose [.04%gm], and high dose [.08%gm]). Participants completed a sexual risk analog and reported their coercive CUR intentions after a hypothetical, female partner provided a condom use rationale (STI avoidance or pregnancy avoidance). RESULTS: Men who received the pregnancy condom use rationale reported higher intentions to engage in coercive CUR when they received a high alcohol dose relative to sober men. For men who had a history of unintended partner pregnancy, receiving a pregnancy condom use rationale was associated with greater intentions to have forced, condomless sex if they received a high alcohol dose relative to sober men. CONCLUSIONS: Intoxicated men may be more likely to engage in coercive CUR; this may indicate that when intoxicated, pregnancy risks are less salient relative to STI-related outcomes. As reproductive rights are being decimated, effective interventions targeting CUR, particularly when intoxicated, are needed in tandem with policies that affirm one's ability to prevent and terminate pregnancy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Alcohol-involved rape: Limitations of the "rape exception" for abortion access.

OBJECTIVE: In June 2022, the U.S. Supreme Court removed federal abortion protections, giving individual states the authority to enact abortion regulations. Since that ruling, many states have enacted abortion bans; however, several of these states allow "rape exceptions," theoretically providing rape victims who become pregnant access to abortion services. Notably, alcohol use by the rape victim and perpetrator is common. In this brief report, we describe findings from research on alcohol-involved rape that have the potential to impact the utility of rape exceptions. METHOD: In this synthesis of the research literature pertaining to alcohol-involved rape victimization and perpetration, we focus on key concepts detailed in extant research likely relevant to accessing abortion services through rape exceptions. RESULTS: Victim alcohol intoxication may limit the use of rape exceptions to abortion bans by delaying rape acknowledgment, increasing victim blame, undermining victim credibility, and deterring rape reporting. Commensurately, perpetrator alcohol intoxication may increase the need for victims to access abortion services by reducing perpetrator condom use during rape and increasing other sexually aggressive acts such as nonconsensual condom removal. CONCLUSIONS: Research evidence suggests that alcohol-involved rape incidents present critical obstacles to utilizing statutory rape exceptions to banned abortion services beyond challenges that non-alcohol-involved rape survivors are also likely to experience. Rape survivors from oppressed communities (e.g., people of color, gender minorities, and/or sexual minorities) may be disproportionately impacted. Empirical investigations specifically examining how substance use during rape impacts reproductive health care accessibility are paramount for informing health care providers, law enforcement, legal practitioners, and policymakers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Hey ChatGPT, Let's Talk About Sexual Consent.

Access to sexual health education, such as education on sexual consent, is limited in the US. Artificial intelligence (AI), such as ChatGPT, provides a potential opportunity to increase access to sexual consent information and education. However, what ChatGPT knows about sexual consent and if this aligns with the current evidence-based literature on sexual consent is unclear. The goal of this research commentary was to explore what ChatGPT knows about sexual consent with a focus on: 1) the definition of consent, 2) how consent could be communicated, and 3) the impact that substances have on consent. We also examined the reliability of ChatGPT's responses by having three different researchers ask ChatGPT the same set of questions. Across our questions, ChatGPT provided similar and comprehensive responses that discussed key features of consent - that consent is freely given or reversible. ChatGPT provided examples of different verbal and nonverbal cues people can use to communicate and interpret consent and discussed the ways that substances can impact consent communication. Overall, ChatGPT could be a potential resource for educators and young people who seek information about sexual consent; however, we should proceed with caution. ChatGPT is not a replacement for an educator but rather a way to increase access to education.

A Proposed Model for the Role of Fear of Intimacy and Social Support in Behavioral Activation: A Cross-Sectional Analysis.

Behavioral theories of depression posit that depression results from the environment not adequately reinforcing non-depressive behaviors. One commonly used treatment based on the behavioral model of depression is Behavioral Activation. While many implementations of Behavioral Activation emphasize social interactions, there is limited empirical investigation into the contribution of specific facets of social engagement in the behavioral model of depression. Fear of intimacy, an indicator of willingness to engage in specific types of social interactions, may play an important role in understanding at a functional level what aspects of social engagement are important in behavioral activation. The current study (N = 353) proposes a model, anchored in functional outcomes of behavioral interactions, to explain the development and utilization of social support as environmental enrichment. The proposed model accounted for 55% of the variance of depressive symptoms. Findings were consistent with a model where fear of intimacy was directly and indirectly associated with depression via activation, social support, and environmental enrichment. Notably, social support was not directly associated with depression. Findings suggest the importance of incorporating vulnerable self-disclosure in behavioral activation treatments to foster environmental enrichment.

Associations Between Pornography Consumption Patterns, Pornography Consumption Motives, and Social Wellbeing among U.S. College Students: A Latent Profile Analysis with a Primarily Female Sample.

This study identified profiles of pornography motivations and outcomes and assessed differences between profiles on three measures of social well-being: social support, fear of intimacy, and loneliness. Latent profile analysis and group comparisons were conducted using cross-sectional data from college students (N = 389). Results indicated four profiles: low motivation/average distress, porn for enjoyment, high motivation/average guilt, low motivation/high distress. Those in the high motivation/average guilt profile reported more social well-being difficulties relative to the other profiles and non-pornography consumers. Results suggest that individuals who report varying pornography use motivations and negative outcomes may report difficulties with social well-being, with implications for intimate relationships.

Power-Related Emotions, Alcohol Intoxication, and Nonconsensual Sex Intentions: The Role of Fear of Intimacy.

The problem of alcohol-involved sexual assault against women highlights the need to identify how the presence of alcohol interacts with risk factors associated with sexual assault perpetration. One risk factor for sexual assault perpetration is fear of intimacy, the inhibited capacity to exchange vulnerable thoughts and emotions with a valued individual. Men who have perpetrated sexual violence report higher fear of intimacy and alcohol use than those who have not. However, little research has investigated how fear of intimacy may contribute to sexual assault perpetration in the context of alcohol intoxication. This study examined alcohol intoxication, fear of intimacy, proximal power-related emotions, and nonconsensual sex intentions. Non-monogamous, male social drinkers (N = 94) completed measures and were randomly assigned to an alcohol condition (alcohol [BrAC = .10%] versus control). Participants then read a sexual assault analogue scenario depicting sexual assault against a hypothetical woman and reported power-related emotions and nonconsensual sex intentions. Self-reported fear of intimacy differed across types of past perpetration. Results found that for intoxicated men only, fear of intimacy was positively associated with power-related emotions, and power-related emotions were positively associated with nonconsensual sex intentions. These associations were not observed for men in the control condition who did not consume alcohol. Future research should examine intimacy-related interventions for sexual assault prevention programming.

Emotion Regulation and Intimate Partner Violence Perpetration in Undergraduate Samples: A Review of the Literature.

Intimate partner violence (IPV) perpetration increases throughout young adulthood and is particularly widespread among college students, resulting in mental health and academic consequences. Deficits in emotion regulation (ER) are an important factor associated with IPV perpetration; the developmental tasks and challenges associated with college, including relationship stressors and hazardous alcohol use, implicate ER as a particularly relevant risk factor for IPV perpetration. Thus, college presents an important opportunity for intervention in order to change the trajectories of IPV perpetration across young adulthood. The purpose of this review was to synthesize findings regarding ER and psychological, physical, and sexual IPV perpetration among college students. Twenty-one articles met inclusion criteria. Studies were organized into five categories: (a) direct associations of ER with IPV perpetration, (b) qualitative assessment of ER and IPV, (c) ER in indirect effects models, (d) ER in moderation models, and (e) experiments with ER instructional sets. Overall, ER emerged as an important inhibiting factor for IPV perpetration, particularly impulse control and access to ER strategies. ER deficits in the context of impelling (e.g., negative affect, trauma history) and instigating (e.g., provocation) factors emerged as consistent predictors of psychological and physical IPV perpetration for both male and female students. Deficits in ER were associated with sexual IPV perpetration among men; however, very few studies examined sexual IPV. Experimental paradigms suggest cognitive reappraisal may reduce IPV perpetration, while suppression may, in some contexts, increase perpetration. Methodological strengths and weaknesses and implications for IPV prevention and interventions programming for college students are discussed.

The Effects of Childhood Sexual Abuse, Mental Health, and Motives for Sex on Sexual Risk-Taking Among United States Men Who Have Sex with Women.

This study assessed the role of mental health symptoms and motives for sex in the association between childhood sexual abuse (CSA) and sexual risk-taking among men who have sex with women (MSW). The sample consisted of young adult (ages 21 to 30), non-monogamous MSW (N = 532) who reported having condomless sex at least once in the past year. Due to alcohol-related aims from two larger studies from which the data were analyzed, participation was excluded to men who regularly consumed alcohol (3 to 35 weekly drinks) and reported no symptoms of alcohol use disorder. Participants answered background questionnaires in lab and then completed a six-week, follow-up survey assessing the number of sex partners and condom use during the prior six weeks. CSA survivors reported greater mental health symptoms and sex motives related to coping, self-affirmation, and partner approval relative to non-survivors. CSA, sex for partner approval, and sex to enhance motives were positively associated with the number of sex partners. Participants endorsing self-affirmation sex motives reported higher condom use than those who did not. CSA contributes to long-term mental and sexual health outcomes among MSW. Identifying and treating depressive and anxiety symptoms and motives for sex may improve sexual health among CSA survivors.

Acute Alcohol Intoxication, State Anger, and Sexual Assault Perpetration: The Role of State Emotion Regulation.

Objective: Alcohol-involved sexual assault remains a pervasive problem, with extensive individual- and societal-level costs. Emotion regulation (ER), the process through which an individual modulates emotional states, remains an understudied predictor of sexual assault perpetration, with past research focusing on general ER tendencies (e.g., trait ER) as predictors of sexual assault perpetration. This study sought to examine the associations between state ER on sexual assault perpetration in the context of state anger and acute alcohol intoxication. Method: Single, male social drinkers aged 21-30 with a history of sexual risk-taking (N = 92) participated in an alcohol administration paradigm and were randomly assigned to an alcohol condition [sober control vs. intoxicated (BrAC = .10%)]. Intoxicated and sober participants completed a sexual assault analogue that assessed state anger, state ER, and sexual assault perpetration intentions against a hypothetical female partner. Results: Path analysis demonstrated interactive effects of state ER and state anger on sexual assault perpetration intentions. Relative to men with low and moderate levels of anger, state ER was associated with lower intentions to perpetrate sexual assault for men with high levels of anger. Alcohol intoxication did not directly predict state ER, state anger, or sexual assault perpetration intentions. Conclusions: The results suggested that state ER may be protective against sexual assault perpetration for men who experience anger in response to a partner's expression of non-consent. Because replication is necessary, the results carry tentative implications for state ER as an intervention target for sexual assault prevention programming.

Alcohol intoxication and sexual risk intentions: Exploring cultural factors among heavy drinking women.

INTRODUCTION: Sexually Transmitted Infections (STI) rates are the highest of the last 20 years, with people of color and women particularly affected. Ongoing research has identified risk factors (e.g., alcohol intoxication) and protective factors (e.g., risk perception) for sexual risk behaviors, such as inconsistent condom use. Depending on behavioral norms within a group, ethnic identity (EI) - the exploration and sense of belonging to one's ethnicity - may be a risk or protective factor. This study examined the relations between EI, alcohol intoxication, and STI risk perception on sexual risk intentions among women of color (WOC) and white women (WW). METHODS: Cisgender women (N = 390; 35% WOC; 65% WW) completed measures and were randomly assigned to an alcohol condition (0.10% BrAC vs control). They projected themselves into an eroticized scenario and self-reported two aspects of STI risk perception (personal, partner) and two sexual risk behaviors (condomless sex intentions, condom decision abdication intentions). RESULTS: Path analysis indicated that intoxicated women endorsed higher sexual risk intentions compared to women in the control group. Personal STI risk perception was negatively associated with sexual risk intentions. Indirect effects indicated that race was indirectly associated with both indicators of sexual risk, such that WOC reported higher perceived personal STI risk and subsequently endorsed lower sexual risk intentions compared to WW. Surprisingly, EI was associated with higher perceived partner risk for WW only. CONCLUSIONS: Prevention initiatives that address STI risk perception, condom assertion behaviors, and alcohol may be effective for mitigating women's sexual risk behaviors.

The Interplay of Sexual Arousal and Power-Related Emotions in Men's Alcohol-Involved Sexual Aggression Intentions.

Research has identified power/dominance and sexual arousal as key motivators of men's sexual aggression; however, little research has examined the interplay of these two factors in alcohol-involved sexual aggression. Two alcohol administration experiments investigated the roles of power-related sex motives and power- and sexual arousal-related emotions on men's sexual aggression intentions. In Study 1, participants (N = 96) read a sexual aggression scenario after random assignment to consume either an alcoholic (target peak BrAC = .10%) or nonalcoholic beverage. Results indicated that power-related sex motives indirectly predicted stronger sexual aggression intentions through greater in-the-moment power-related emotions but not through sexual arousal-related emotions. Intoxicated men with more severe perpetration histories reported stronger sexual aggression intentions. In Study 2, participants (N = 203) completed similar measures after random assignment to receive either a brief emotion regulation-focused intervention (cognitive restructuring or mindfulness) or a control, followed by either alcohol (target peak BrAC = .08%) or nonalcoholic beverage consumption. Results demonstrated that greater power-related sex motives indirectly predicted stronger sexual aggression intentions through greater feelings of power and sexual arousal. Additionally, findings suggest that cognitive restructuring approaches may mitigate these relationships in sober men, while mindfulness approaches may exacerbate these relationships in intoxicated men.

Alcohol-involved sexual aggression: Emotion regulation as a mechanism of behavior change.

OBJECTIVE: Sexual aggression remains a significant public health problem, with the majority of sexual assaults involving alcohol. Founded upon an experimental medicine approach to behavior change, the current study used a proximal change experiment to target and test emotion regulation (ER) as a mechanism underlying alcohol-involved sexual aggression. METHOD: Heavy episodic drinking men aged 21-30 with a sexual assault perpetration history (N = 209) were randomly assigned to a brief, online, ER-focused cognitive restructuring or mindfulness intervention or to control. Intervention effects were evaluated during sober and intoxicated states through laboratory-based alcohol administration (target BrAC = .08%). Intoxicated and sober participants completed a proximal change protocol that included implementing ER skills during a sexual aggression analogue that assessed relevant emotions and intentions. RESULTS: Path analysis demonstrated that relative to control, the cognitive restructuring intervention improved emotional modulation and emotional clarity, resulting in lower sexual arousal and anger, respectively, followed by decreased sexual coercion intentions. The mindfulness intervention yielded mixed results, predicting decreased sexual aggression intentions compared to control but also predicting stronger coercive tactic intentions in intoxicated men with more severe sexual aggression histories. Both interventions improved emotional acceptance relative to control, but only for sober men. CONCLUSIONS: Overall, the current study demonstrated that ER-focused interventions improved proximal ER skills associated with reduced sexual aggression intentions, signifying ER as an important mechanism for changing sexually aggressive behavior. Because intervention efficacy varied by intoxication state, further research is needed to assess the effectiveness of ER interventions targeting real-world alcohol-involved sexual aggression. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychological Effects of Abuse, Partner Pressure, and Alcohol: The Roles of in-the-Moment Condom Negotiation Efficacy and Condom-Decision Abdication on Women's Intentions to Engage in Condomless Sex.

Women's experiences of intimate partner violence (IPV) from their male partners can include psychological, physical, and sexual control and abuse. The psychological effects of abuse (PEA) include terror, shame, and loss of power and control in relationships. While women's experiences of IPV are associated with decreased condom use, limited research has examined the impact of PEA on women's condom use. Intoxicated (breath alcohol content [BrAC] = .10%) versus sober women were evaluated to test the hypothesis that PEA would interact with intoxication and scenario-context partner pressure to forgo condom use and be associated with intentions to engage in condomless sex. After beverage administration, community women (N = 405) projected themselves into a computerized scenario depicting a male partner exerting high or low pressure for condomless sex. In-the-moment condom negotiation self-efficacy and condom-decision abdication-letting the man decide on condom use-were assessed. Path analysis examined the direct and indirect effects of PEA, alcohol, and partner pressure conditions on condomless sex intentions. PEA increased condomless sex intentions indirectly through decreased condom negotiation self-efficacy. Intoxication increased condomless sex intentions indirectly through decreased condom negotiation self-efficacy and increased condom-decision abdication. Intoxicated women in the low pressure condition were more likely to abdicate the condom decision than women in the high pressure condition. Women who have experienced greater PEA may benefit from interventions focusing on how condom negotiation self-efficacy, condom-decision abdication, and intoxication influence sexual decision-making.

Effects of Alcohol, Condom Request Style, and State Anger on Men's Condom Use Resistance.

OBJECTIVE: The purpose of this study was to examine the distal predictors (alcohol expectancies, adversarial heterosexual beliefs) and proximal predictors (alcohol intoxication, partner's condom use request style, state anger) of young men's condom use resistance (CUR). METHOD: Young, male, non-problem drinking, inconsistent condom users (N = 297) completed an alcohol administration experiment. After completing background measures, participants were randomly assigned to receive a control or alcoholic beverage (target peak breath alcohol concentration = .08%). They then read a randomly assigned hypothetical sexual scenario in which their female partner requested to use a condom either indirectly, directly, or insistently. Participants' desire to have condomless sex, state anger, and both coercive and noncoercive CUR intentions were assessed. RESULTS: Path analyses demonstrated that alcohol intoxication directly predicted noncoercive CUR intentions. In addition, a moderated mediation pathway was found such that, relative to sober participants, intoxicated men's sexual aggression-related alcohol expectancies were positively associated with their state anger in response to the partner's condom use request. This increased anger was related to stronger noncoercive CUR intentions. Adversarial heterosexual beliefs both directly and indirectly predicted coercive and noncoercive CUR intentions. CONCLUSIONS: Path analysis demonstrated that alcohol intoxication increased intentions to resist condom use through noncoercive tactics. In addition, men's misogynistic attitudes and alcohol intoxication were associated with greater feelings of anger, which predicted stronger coercive and noncoercive CUR intentions.

Disrupting the path to craving: Acting without awareness mediates the link between negative affect and craving.

Low treatment utilization, relapse, and chronicity are characteristic of substance use disorders (SUDs). Craving is an important predictor of relapse. Individuals with an SUD report using various coping strategies in response to negative affect, two of which are investigated in the current study: suppression and acting with awareness. Suppression is typically understood to be avoidance of unwanted experience through turning attention away from unwanted stimuli. Acting with awareness (AWA) is a facet of mindfulness, which includes turning toward experience with kindness and curiosity, even when the experience is unwanted. Evidence suggests mindfulness may reduce craving, while suppression has been associated with increased craving. In the current study, participants (N = 210) had recently completed inpatient or intensive outpatient SUD treatment followed by a randomized controlled trial of aftercare. Participants completed measures within 2 weeks following the completion of the aftercare intervention. Negative affect and severity of dependence were both positively associated with craving. Structural equation modeling evaluated AWA and suppression as partial mediators of the link between negative affect and craving. Suppression was positively associated and AWA was negatively associated with craving. Mediation analyses revealed the indirect effect of negative affect on craving through AWA was significant, but the path through suppression was not. These findings suggest that AWA may inhibit the development of craving from negative affect, but further research is needed. Future research should investigate the path from negative affect to craving with greater temporal resolution to evaluate how these phenomena function with increased ecological validity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Sexual Victimization and Sex-Related Drinking Motives: How Protective is Emotion Regulation?

One in five college women experience sexual victimization (SV), and SV severity is associated with subsequent psychological distress, including sex-related distress. SV severity may also be associated with drinking motives to cope with sex-related distress and to enhance sex (sex-related drinking motives [SRDMs]), particularly if individuals suffer from emotion regulation (ER) difficulties. College women (N = 151) completed a survey assessment of ER, SV history, childhood sexual abuse (CSA), and SRDMs. Twelve regression models assessed six facets of ER as moderators between SV severity and SRDMs. Among women with no or low levels of prior SV severity, women with greater access to ER strategies were less likely to endorse drinking to cope SRDMs. At higher levels of SV severity, women at all levels of access to ER strategies were equally likely to endorse drinking to cope SRDMs, suggesting that access to ER strategies did not mitigate motivations to drink to cope with sex-related distress for these women. Women with severe SV histories may benefit from interventions that build on existing ER strengths or address other factors. However, greater access to ER strategies may serve as a protective factor against SRDMs when SV severity is low.

Men's Coercive Condom Use Resistance: The Roles of Sexual Aggression History, Alcohol Intoxication, and Partner Condom Negotiation.

Condom use resistance (CUR) through coercive tactics is a significant public health concern. The present study investigated CUR risk factors through an alcohol administration experiment using a sexual risk analog with a community sample of male nonproblem drinkers ( N = 321). Utilizing a path analysis framework, results demonstrated that men with more severe sexual aggression histories displayed stronger in-the-moment power and control responses, which was associated with greater coercive CUR and unprotected sex intentions. A significant interaction between sexual aggression history, risk rationale, and alcohol condition also predicted coercive CUR intentions. These findings emphasize the relationship between sexual aggression and sexual risk behaviors and highlight the importance of targeting these constructs in intervention and prevention efforts.

The Role of Distal Minority Stress and Internalized Transnegativity in Suicidal Ideation and Nonsuicidal Self-Injury Among Transgender Adults.

Transgender people are at elevated risk for nonsuicidal self-injury (NSSI) and suicidal ideation compared to the general population. Transgender (trans) refers to a diverse group of people who experience incongruence between their gender identity and sex assigned at birth. The present study is guided by the minority stress model and the psychological mediation framework, which postulate that sexual minority groups experience elevated stress as a result of anti-minority prejudice, contributing to negative mental health outcomes. This study utilized these theories to investigate the role of internalized transnegativity-internalization of negative societal attitudes about one's trans identity-in the relationships of distal trans stress to suicidal ideation and NSSI. A U.S. national sample of trans adults (N = 237) completed a battery of online measures. Structural equation modeling (SEM) was used to compare models with mediation and moderation effects. Results suggested that internalized transnegativity acts as both a mediator and a moderator in the relationship between distal trans stress and suicidal ideation. Log likelihood comparisons suggested moderation models had the superior fit for these data. Results suggest that clinical interventions should directly target individuals' internalized transnegativity as well as societal-level transnegativity.

Understanding sexual assault risk perception in college: Associations among sexual assault history, drinking to cope, and alcohol use.

INTRODUCTION: Sexual assault history and alcohol use are associated with higher likelihood of subsequent sexual assault. Alcohol use and drinking to cope are associated with re-assault, but it is unclear whether these factors are associated with malleable constructs like sexual assault risk perception. This study examined typical weekly drinking and drinking to cope motive as factors underlying the association between sexual assault history and risk perception. METHODS: Both perceived likelihood of experiencing incapacitated sexual assault and when to leaving a hypothetical sexual assault scenario were assessed as indicators of sexual assault risk perception. 660 female college students recruited from psychology courses completed questionnaires online. RESULTS: Results revealed that sexual assault history severity was positively associated with perceived incapacitated sexual assault likelihood and when to leave a risky scenario. Drinking to cope with anxiety was positively associated with perceived incapacitated sexual assault likelihood. Among women who reported regular drinking, typical weekly drinking was positively associated with when to leave a risky scenario, such that women who reported more weekly drinks stayed in a potentially risky scenario longer than women who reported fewer weekly drinks. CONCLUSIONS: These findings suggest that alcohol use and drinking to cope with anxiety are associated with risk perception. Sexual assault history was associated with both perceived incapacitated sexual assault likelihood and when to leave a hypothetical scenario. Alcohol use and drinking to cope are two potential points of intervention for sexual assault risk reduction programs, but further examination is needed.

A descriptive analysis of alcohol behaviors across gender subgroups within a sample of transgender adults.

OBJECTIVE: Transgender (trans) adults are identified as an at-risk group for problem alcohol use. Descriptive empirical data examining alcohol behaviors among trans adults is limited. The present study investigates alcohol behaviors - quantity, frequency, alcohol-related problems, and drinking to cope motives - across sex assigned at birth, gender expression, and gender identity subgroups within a sample of trans adults. METHOD: A total of 317 trans participants were recruited to complete a cross-sectional battery of online measures assessing alcohol use behaviors, alcohol-related problems, and drinking to cope. Gender identity was assessed through two methods: (1) an open-ended question in which participants wrote-in their primary gender identity; and (2) participants rated the extent to which they identified with 14 gender identity categories. RESULTS: This sample had high rates of alcohol use, alcohol-related problems, and drinking to cope motives relative to the general population. Significant and meaningful differences in drinking frequency, alcohol-related problems and drinking motives were found according to gender expression, but not sex assigned at birth or gender identity. CONCLUSIONS: Future work should examine alcohol behaviors among trans individuals, including investigation of predictors and causal pathways, to inform prevention and intervention work aimed at reducing trans people's risk for alcohol-related problems.