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This study examines the mediating role of posttraumatic stress symptoms (PTSS) in the associations among SA severity, drinking to cope with anxiety, and average weekly drinks while considering the moderating roles of gender identity and sexual orientation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 2160 college students who were diverse in gender (cisgender women, 64.4%; cisgender men, 30.6%, and transgender and gender diverse [TGD] individuals\u2009=\u20094.9%) and sexual orientation (heterosexual\u2009=\u200968.0%, LGBQ+\u2009=\u200932.0%) completed measures of SA severity, PTSS, drinking to cope with anxiety motives, and average weekly drinks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mediation model for the full sample indicated significant indirect effects of SA severity on drinking to cope with anxiety through PTSS, but not on average weekly drinks. Moderation analyses revealed differential relationships between the variables based on both gender identity and sexual orientation. For instance, the association between SA severity and PTSS was stronger for cisgender women and TGD individuals than cisgender men, and for LGBQ+ individuals than heterosexual individuals. While the association between PTSS and average weekly drinks was only significant for cisgender men, the association between PTSS and drinking to cope with anxiety was significant for both cisgender men and women but not TGD individuals. Furthermore, the association between SA severity and drinking to cope with anxiety was stronger for cisgender women than cisgender men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings from this study demonstrate sexual orientation and gender identity differences and similarities in the associations of SA severity, PTSS, drinking to cope with anxiety, and alcohol use. Results are discussed in relation to the self\u2010medication hypothesis and tailoring interventions for diverse groups.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.15194","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T01:59:17Z","timestamp":1695088757000},"page":"2169-2183","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Associations among sexual assault, posttraumatic stress, drinking to cope with anxiety, and alcohol use based on gender identity and sexual orientation"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9346-7544","authenticated-orcid":false,"given":"Chelsea D.","family":"Kilimnik","sequence":"first","affiliation":[{"name":"Department of Psychology &amp; Neuroscience and the Ren\u00e9e Crown Wellness Institute University of Colorado Boulder  Colorado Boulder USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grisel","family":"Garc\u00eda\u2010Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Department of Health Policy &amp; Behavioral Sciences, School of Public Health Georgia State University  Georgia Atlanta USA"},{"name":"The National Center for Sexual Violence Prevention, Mark Chaffin Center for Healthy Development Georgia State University  Georgia Atlanta USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nashalys K.","family":"Salamanca","sequence":"additional","affiliation":[{"name":"The National Center for Sexual Violence Prevention, Mark Chaffin Center for Healthy Development Georgia State University  Georgia Atlanta USA"},{"name":"Department of Psychology Georgia State University  Georgia Atlanta USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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