Trans people experience a high rate of substance abuse and dependence, which includes alcohol, tobacco, marijuana, other illicit drugs, and nonmedical prescription drug misuse. It is difficult to know the exact prevalence of substance use among trans people, as much of the data gathered from LGBTQ populations do not effectively separate out trans people. It is clear, however, that trans people experience very high rates of substance abuse and dependence—two to three times the rate of cisgender (cis) people. Disparities in substance use by gender identity are found as early as adolescence and across racial and ethnic groups.