Addressing gaps on risk and resilience factors for alcohol use outcomes in sexual and gender minority populations

Abstract

Issues In 2011, the Institute of Medicine (IOM) released a report that constituted the first comprehensive effort by a federal body to understand the current state of science pertinent to the health needs of sexual and gender minority populations. This mini-review summarises recent empirical, methodological and theoretical advances in alcohol-related research among to lesbian, gay, bisexual and transgender populations and highlights progress toward addressing gaps, with a particular interest in those identified by the IOM report. Approach Articles published since 2011 were identified from PsycINFO and PubMed database searches, using various combinations of keyword identifiers (alcohol, alcohol abuse, substance abuse, LGBT, lesbian, gay, bisexual, transgender). Reference sections of included articles were also examined for additional citations. Key Findings Recent empirical work has contributed to a greater understanding of sub-group differences within this diverse population. Evidence has supported theorised influences that can account for alcohol-related disparities, yet important gaps remain. Studies that examine the role of gender identity and its intersection with sexual identity within transgender and gender non-conforming sub-populations are lacking. Methodological advances in this literature have begun to allow for examinations of how minority-specific and general risk factors of alcohol misuse may contribute to patterns of alcohol involvement over time and within social-relational contexts. Conclusions The recommendations made in the current mini-review are meant to facilitate future collaborative efforts, scale development, thoughtful methodological design and analysis, and theoretically-driven nuanced hypotheses to better understand, and ultimately address, alcohol-related disparities among sexual and gender minority populations.

Victimization as a mediator of alcohol use disparities between sexual minority subgroups and sexual majority youth using the 2015 National Youth Risk Behavior Survey

“…Nearly all were found among bisexual-identified youth and students with both male and female sexual partners; these sexual minority individuals had up to twice the odds of engaging in alcohol use behaviors when compared with sexual majority students. This is consistent with numerous prior studies that have found that bisexual individuals are disproportionately likely to use drugs and alcohol, even in comparison with gay and lesbian individuals (Drabble et al, 2013; Green and Feinstein, 2012; Hughes et al, 2010; Hughes et al, 2014; Talley et al, 2016). …”

“…Similar results have been found between sexual minority men and women (Chow et al, 2013), but they have not been fully consistent (Bariola et al, 2016). Among sexual minority adolescents, 2005 and 2007 YRBS data found that females were heavier alcohol users than males (Talley et al, 2016). As the contradictory data from some of these studies are nearly a decade old, perhaps this reflects changing dynamics in alcohol initiation and usage among youths.…”

Are alcohol‐related disparities between sexual minority and heterosexual youth decreasing?

“…Also similar to previous studies and meta-analyses [11,12,35], sexual minority girls demonstrated a greater number of disparities in alcohol use behavior across the 15-year time span than were observed in the comparisons between heterosexual and sexual minority boys. Furthermore, as with previous research, bisexual and mostly heterosexual youth in our study displayed greater risk for alcohol use behaviors across years when compared to their heterosexual peers, especially among females, while gay/lesbian youth did not differ from heterosexual youth in 23 of the 32 comparisons.…”

“…Sexual minority (i.e. lesbian/gay and bisexual [LGB]) youth represent an at-risk group for alcohol use and misuse during adolescence [11][12][13]. More than a decade of research demonstrates disproportionately high rates of alcohol use among LGB compared to heterosexual youth across multiple indicators of risk including: life-time alcohol use [14], early initiation [14,15], frequency of use [16,17], the participation in and frequency of heavy episodic drinking (HED) [14,18] and problems related to drinking [19].…”

Effects of sexual assault on alcohol use and consequences among young adult sexual minority women.

“…The minority stress model, where stress mediates relationships between a stigmatized sexual identity and, in this case, alcohol use and consequences (Meyer, 2003; Talley et al, 2016), has some limitations in that it does not incorporate potential psychological mediators between stress and health outcomes (Hatzenbeuhler, 2009). It also fails to incorporate moderators such as gender.…”