Cannabis use within broader mental health strategies: insights from sexual and gender diverse youth

Mental health and cannabis-related inequities persist between sexual and gender diverse (SGD) youth and their non-SGD counterparts. SGD youth are at heightened risk of cannabis-related harms, which may further exacerbate existing mental health inequities. To date, research has largely adopted a deficit-based perspective, emphasizing risks and vulnerabilities. Yet, these perspectives do not capture the full range of SGD youth mental health and their experiences with cannabis use. Little is known about the efforts of SGD youth to improve or maintain a positive mental health. The present qualitative descriptive study explored the strategies that SGD youth who use cannabis undertake to promote their mental health and examined how cannabis features within these efforts. A peer researcher conducted semi-structured individual interviews with 15 SGD youth who used cannabis and self-reported mental health issues. Data underwent collaborative inductive thematic analysis. Participants promoted their mental health by (1) seeking a safe space to foster introspection and confront emotions; (2) constructing identities and accepting one’s authentic self; and (3) managing stress and cultivating positive experiences. To achieve these goals, participants engaged, in addition to cannabis use, with interpersonal relationships, support systems, and physical and mental breaks. Participants also identified negative experiences with cannabis, including over-reliance, decreased focus, fuzzy thinking, and anxiety, pointing to therapeutic relationships, social support, and other mechanisms as longer-term pathways to mental well-being. SGD youth who use cannabis do not rely solely on cannabis to manage their mental health. Rather, cannabis is integrated into a broader array of strategies aimed at achieving mental health goals. This study provides a valuable perspective on the mental health of SGD youth from a positive, strengths-based perspective. Our findings reflect the complexity of cannabis use in this population; although cannabis use may be used to cope with mental health struggles, it may simultaneously coexist with broader health-promoting strategies. This complexity underscores the need for nuanced, non-stigmatizing approaches to cannabis use in this population. These findings have the potential to inform SGD-tailored harm reduction initiatives and mental health interventions that recognize the multifaceted role cannabis can play in SGD youth’s lives.