We conducted an analysis of the prevalence of substance and behavioral addictions across different transgender and gender diverse (TGD) subgroups. We performed a scoping review using MEDLINE and Google Scholar databases and examined 12 addictions, including alcohol, nicotine, cannabis, illicit drugs, gambling, eating/food, internet, sex, love, exercise, work, and shopping. We presented prevalence rates for each addiction as a function of an individual’s gender identity (stratified into transgender females, transgender males, and gender nonconforming), and used cisgender women and men as reference groups. We included 55 studies in our final analysis, the majority of which investigated substance use disorders among TGD subgroups. Overall findings indicated that substantial differences in substance use exist among US TGD subgroups. There were far fewer publications that examined the prevalence of behavioral addictions across TGD subgroups. However, despite limited research in this area, findings still suggest that notable differences in behavioral addictions may exist between individual TGD subgroups. The conclusions of our review may provide clinicians with a better ability to screen for and treat at-risk individuals within the TGD community.

The purpose of this study is to present current data on the prevalence and co-occurrence of 12 substance and behavioral addictions among adult cisgender sexual minorities (SM). We utilized MEDLINE, PsycINFO, and Google Scholar databases to systematically review the literature on alcohol, nicotine, cannabis, illicit drugs, gambling, eating/food, Internet, sex, love, exercise, work, and shopping within the SM community. Peer reviewed empirical articles in English from 2000 to 2019 were included. When possible, we compared prevalence and co-occurrence statistics between four SM subgroups (stratified into lesbian women, bisexual women, gay men, and bisexual men), and used heterosexual women and men as reference groups. Studies were scant within each area of addiction with the most studies focusing on addictions acknowledged within the DSM-V (alcohol, nicotine, cannabis, illicit drugs, gambling). Significantly fewer studies addressed the prevalence and co-occurrence of behavioral addictions across SM subgroups. Most studies assessing addiction among SM populations either categorize SMs into a single group or only stratify by gender. However, even with limited research, the findings from this review suggest that significant differences in addictive behaviors exist when comparing one SM subgroup to another. There is a strong need for more research that quantifies these disparities through prevalence and co-occurrence statistics.

Pediatric presentations of factitious disorder (Munchausen syndrome) remain underdiagnosed and poorly understood compared to adult cases. The purpose of this study is to review the current literature on child and adolescent factitious disorder in order to better understand the differences between pediatric and adult presentations of this disorder. We also present the case of an adolescent girl with factitious disorder; her hospital course draws attention to the excessive healthcare expenditures and risk of iatrogenic complications associated with this diagnosis. We utilized MEDLINE and Google Scholar databases to conduct our review. Despite the limited number of high-quality studies analyzing pediatric presentations of factitious disorder, our review yielded several important findings. Studies suggest that the general acceptance of somatization as a common way for young people to manifest emotional stress may explain the under-diagnosis of this disorder in pediatric populations. Studies also highlighted differences in the clinical characteristics of factitious disorder when patients are stratified by age; most notably, younger patients are more willing to admit intentional falsifications when confronted and more likely to accept treatment, making them a potentially more effective target for intervention.

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