Abstract
Results from community-based research studies have shown that male-to-female transgender (MTF) persons have high rates of substance abuse. Multiple and unique psychological, economic, and societal factors contribute to this elevated rate of drug use. Cofactors, such as substance abuse and multiple environmental risk factors (e.g., discrimination, unemployment, homelessness), may contribute to the poor health outcomes observed in the MTF transgender community. In this article the authors review existing alcohol and other drug use (AOD) research and examine risk factors for AOD use in MTF transgender persons. Implications for counselors working with members of the MTF transgender community are explored and recommendations for future research are presented.