Importance Nonmedical prescription opioid use is a pressing public health issue in the
United States. Transgender youth, including adolescent girls and young women who were
assigned male at birth and currently identify as women, female, transgender women, or
another diverse gender identity along the transfeminine gender spectrum, are more likely
than their cisgender peers to report illicit substance use and meet diagnostic criteria for
substance use disorders. However, relatively little is known about the experiences of these …