Are Outness and Community Involvement Risk or Protective Factors for Alcohol and Drug Abuse Among Sexual Minority Women?

Abstract

Sexual minority women (SMW) are at increased risk for substance abuse compared to heterosexual women. Two psychosocial factors that have been implicated in SMW's substance abuse are outness and LGBT community involvement, but findings have been mixed as to whether these are risk or protective factors. One possible explanation is that they may have different consequences for subgroups of SMW (lesbians, bisexual women, and queer women). While being open about one's sexual orientation and involved in the community may be protective for lesbians, discrimination against bisexual women may lead these same factors to contribute to substance abuse for bisexual women. It is unclear how these associations will operate for queer women, given limited research on this subpopulation. The current study examined whether sexual identity moderated the associations between outness and community involvement with alcohol and drug abuse. We also examined whether perceived discrimination would help explain why these associations may be different for subgroups of SMW. A sample of 288 self-identified SMW (113 lesbians, 106 bisexual women, and 69 queer women) completed an online survey. Higher outness was associated with higher alcohol and drug abuse for bisexual women, but not for lesbians or queer women. Similarly, higher community involvement was associated with higher drug abuse for bisexual women, but not for lesbians or queer women. Among bisexual women, the association between community involvement and drug abuse was mediated by perceived discrimination. Further, the association between outness and drug abuse was mediated by both community involvement and perceived discrimination. Findings demonstrate that outness and community involvement function as risk factors for substance abuse for bisexual women, in part due to their associations with discrimination.

Minority Stressors, Rumination, and Psychological Distress in Lesbian, Gay, and Bisexual Individuals

“…These studies' results may have differed from each other as their participants experienced differing amounts of increases in prejudice events and decreases in proximal stressors, possibly due to specific characteristics of the sample. Indeed, the present results have suggested that bisexuality may be one fact that affects changes in these variables after coming out (Hypotheses 7 and 8), and previous research has found that outness and health outcomes are differentially associated for bisexual individuals (Feinstein et al, 2017) and for men and women, depending on recency of coming out (Pachankis, Cochran, & Mays, 2015). Future research should conceive of prejudice events and proximal stressors as potential mediators between outness and distress, attempt to verify the direction of these relationships, and further examine the subgroups and circumstances that modulate the benefits and risks of coming out.…”

“…Indeed, as bisexual individuals report experiencing prejudice events from both heterosexual and lesbian/ gay individuals (Brewster & Moradi, 2010;Dyar et al, 2014) and it has been theorized that bisexual individuals who are not out may have an easier time blending into the general population than lesbian/gay individuals (Chung, 2001), there may simply be fewer benefits and more costs to being out as bisexual. Indeed, research has found that higher outness is associated with higher alcohol and drug abuse for bisexual women, but not for lesbians or queer women, corroborating this idea and offering a potential explanation for inconsistent findings about outness (Feinstein, Dyar, & London, 2017). In conclusion, sexual minority subgroup (being bisexual, gay, or another sexual minority) effects on the strength of the relationships between outness and other minority stressors should be assessed before bisexual individuals are encouraged to come out to alleviate their distress, and sexual minority subgroup should be conceptualized as a potential moderating factor in Hatzenbuehler's (2009) framework, alongside sex and race.…”

Research on alcohol and other drug (AOD) use among sexual minority women: A global scoping review

“…The small number of studies that examined the association between sexual orientation disclosure and AOD use reported mixed findings. Feinstein, Dyer, and London [104] analyzed data from SMW recruited online and found that higher levels of sexual orientation disclosure were associated with greater numbers of AOD-use related consequences among bisexual women, but not among lesbian-or queer-identified women. In a sample of lesbian women in New Zealand, Saphira, and Glover [105] found no association between level of disclosure and alcohol use; however, women who reported marijuana use reported higher levels of disclosure.…”

Young sexual minority women's definition of community: Toward addressing health disparities in the LGBTQQ community

“…The status quo in conducting studies with and about lesbian, bisexual, and queer women's health issues involves grouping these distinct subgroups of women under the monolithic LGBTQQ community, which fails to account for intragroup distinctions (Feinstein, Dyar, & London, 2016). A recent surge in publications that explore sexual minority women's conception of community indicates a belated recognition for the need for targeted health studies among this population (see Eliason, 2015;Harris, Battle, Pastrana, & Daniels, 2015;Rothblum, 2010).…”