Sexual Orientation-Based Discrimination, Excessive Alcohol Use, and Substance Use Disorders Among Sexual Minority Adults

Slater, Megan E.; Godette, Dionne C.; Huang, Boji; Ruan, W. June; Kerridge, Bradley T.

doi:10.1089/lgbt.2016.0117

Cited by 117 publications

(98 citation statements)

References 33 publications

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“…In this national US study of reported discrimination among LGBTQ adults, four key findings emerge. First, study results extend prior findings that LGBTQ adults in the United States experience pervasive discrimination across many areas of life . In particular, we found widespread interpersonal manifestations, including slurs, harassment, and violence.…”

Section: Discussionsupporting

confidence: 84%

Discrimination in the United States: Experiences of lesbian, gay, bisexual, transgender, and queer Americans

Casey

Reisner

Findling

et al. 2019

Health Services Research

288

148

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Objective To examine reported experiences of discrimination against lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults in the United States, which broadly contribute to poor health outcomes. Data Source and Study Design Data came from a national, probability‐based telephone survey of US adults, including 489 LGBTQ adults (282 non‐Hispanic whites and 201 racial/ethnic minorities), conducted January‐April 2017. Methods We calculated the percentages of LGBTQ adults reporting experiences of discrimination in health care and several other domains related to their sexual orientation and, for transgender adults, gender identity. We report these results overall, by race/ethnicity, and among transgender adults only. We used multivariable models to estimate adjusted odds of discrimination between racial/ethnic minority and white LGBTQ respondents. Principal Findings Experiences of interpersonal discrimination were common for LGBTQ adults, including slurs (57 percent), microaggressions (53 percent), sexual harassment (51 percent), violence (51 percent), and harassment regarding bathroom use (34 percent). More than one in six LGBTQ adults also reported avoiding health care due to anticipated discrimination (18 percent), including 22 percent of transgender adults, while 16 percent of LGBTQ adults reported discrimination in health care encounters. LGBTQ racial/ethnic minorities had statistically significantly higher odds than whites in reporting discrimination based on their LGBTQ identity when applying for jobs, when trying to vote or participate in politics, and interacting with the legal system Conclusions Discrimination is widely experienced by LGBTQ adults across health care and other domains, especially among racial/ethnic minorities. Policy and programmatic efforts are needed to reduce these negative experiences and their health impact on sexual and/or gender minority adults, particularly those who experience compounded forms of discrimination.

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Section: Discussionsupporting

confidence: 84%

Discrimination in the United States: Experiences of lesbian, gay, bisexual, transgender, and queer Americans

Casey

Reisner

Findling

et al. 2019

Health Services Research

288

148

View full text Add to dashboard Cite

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“…This chronic minority stress arises from a range of experiences, such as discrimination, victimization, and interpersonal rejection based on one’s sexual orientation (Meyer, 2003). Minority stress has been identified as a major mechanism underlying the substantial sexual orientation-related disparities observed in mental health (Bränström, Hatzenbuehler, & Pachankis, 2016; Eaton, 2014; Hatzenbuehler, McLaughlin, Keyes, & Hasin, 2010) and substance use (Lehavot & Simoni, 2011; McCabe, Bostwick, Hughes, West, & Boyd, 2010; Slater, Godette, Huang, Ruan, & Kerridge, 2017). …”

Section: Introductionmentioning

confidence: 99%

Physical Health Disparities Across Dimensions of Sexual Orientation, Race/Ethnicity, and Sex: Evidence for Increased Risk Among Bisexual Adults

et al. 2018

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Accumulating evidence suggests that sexual minority individuals are at increased risk for physical health conditions compared to heterosexual individuals. However, we know little about physical health disparities affecting bisexual individuals, a population at increased risk for psychiatric and substance use conditions compared to both heterosexual and lesbian/gay populations. Using a large, nationally representative sample, we examined physical health disparities for bisexual individuals. To advance research on sexual minority health disparities, we further: (1) compared prevalence rates of physical health conditions across three dimensions of sexual orientation (i.e., identity, attractions, behavior) and (2) examined whether disparities differed by sex and race/ethnicity. Results indicated that sexual minority individuals were at increased risk for many physical health conditions. Notably, individuals with bisexual identity, attractions, and/or behavior were at increased risk for more physical health conditions than other sexual minority groups. The number and types of physical health disparities affecting bisexually identified individuals and individuals with same- and opposite-sex attractions and/or sexual partners varied across sex and race/ethnicity, with the most consistent disparities emerging for individuals who reported same- and opposite-sex sexual partners. Our findings highlight the substantial physical health disparities affecting sexual minorities and the heightened risk conferred by all facets of bisexuality.

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“…SM‐related discrimination has been found to be associated with increased tobacco, alcohol and drug use in SM populations , although differentially associated with substance use across SM identities . We found that while SM‐related discrimination was significantly higher among SM, discrimination was not significantly associated with SUD among SM‐identifying individuals.…”

Section: Discussionmentioning

confidence: 49%

“…Effective strategies to incorporate social support may require assessing the functional support received and tailoring interventions based on social networks. SM-related discrimination has been found to be associated with increased tobacco, alcohol and drug use in SM populations [13,17,62,63], although differentially associated with substance use across SM identities [8,13,64]. We found that while SM-related discrimination was significantly higher among SM, discrimination was not significantly associated with SUD among SM-identifying individuals.…”

Section: Discussionmentioning

confidence: 50%

Functional and structural social support, substance use and sexual orientation from a nationally representative sample of US adults

et al. 2019

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Background and Aims Sexual minority (SM) populations experience higher rates of substance use disorder (SUD) associated with increased sexual orientation‐related stress. Social support may moderate the impact of stress on SUD among SM adults. This study assessed associations between social support and DSM‐5 SUD by sex and sexual minority identity. Design Cross‐sectional study using data from the 2012–13 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC‐III). Setting and participants A nationally representative cross‐sectional sample of adults (n = 36 309) in the United States. Measurements SUD were defined based on the DSM‐5 criteria for alcohol use (AUD), tobacco use (TUD) and drug use (DUD) disorders. Structural social support was measured as the type and frequency of kin and non‐kin contact, and functional social support was measured by the Social Provision Scale. Findings SM adults had higher odds of all SUD compared to heterosexual adults [AUD = 1.535, 95% confidence interval (CI) = 1.782–1.844; TUD = 1.512, 95% CI = 1.234–1.854; DUD = 1.520, 95% CI = 1.139–2.028]; SM women experienced the highest proportion of all SUD (AUD = 27.1%, TUD = 29.1%, DUD = 10.9%). Type of social support was differentially associated with SUD by sex and sexual identity status. Higher social provision was associated with lower rates of AUD [adjusted odds ratio (aOR) = 0.771, 95% CI = 0.705–0.844], TUD (aOR = 0.747, 95% CI = 0.694–0.804] and DUD (aOR = 0.558, 95% CI = 0.490–0.636). Marriage was associated with lower SUD among heterosexual men (AUD, aOR = 0.500, 95% CI = 0.432–0.579; TUD, aOR = 0.603, 95% CI = 0.521–0.699; DUD, aOR = 0.504, 95% CI = 0.369–0.689) and women (AUD, aOR = 0.637, 95% CI = 0.529–0.767; TUD = 0.0.584, 95% CI = 0.507–0.671; DUD, aOR = 0.515, 95% CI = 0.372–0.712). Compared to heterosexual adults, SM women with at least one child under the age of 18 years had higher odds of TUD (aOR = 1.990, 95% CI = 1.325–2.988). SM‐related discrimination was not associated with SUD among some SM subgroups, but discrimination among male heterosexually identifying individuals reporting same‐sex attraction or behavior was associated AUD (aOR = 4.608, 95% CI = 1.615–13.14). Conclusions In the United States there are significant associations between functional support (quality or provision of support) and structural support (type and frequency of social networks) and substance use disorder (SUD) which differ by sex and sexual identity status.

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Sexual Orientation-Based Discrimination, Excessive Alcohol Use, and Substance Use Disorders Among Sexual Minority Adults

Abstract: Sexual orientation-based discrimination was associated with select substance use outcomes, especially among bisexuals, Hispanics, and less educated sexual minority adults, highlighting potential disparities associated with experiencing discrimination.

Cited by 117 publications

References 33 publications

Discrimination in the United States: Experiences of lesbian, gay, bisexual, transgender, and queer Americans

Discrimination in the United States: Experiences of lesbian, gay, bisexual, transgender, and queer Americans

Physical Health Disparities Across Dimensions of Sexual Orientation, Race/Ethnicity, and Sex: Evidence for Increased Risk Among Bisexual Adults

Functional and structural social support, substance use and sexual orientation from a nationally representative sample of US adults

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