The impact of civil union legislation on minority stress, depression, and hazardous drinking in a diverse sample of sexual-minority women: A quasi-natural experiment

Abstract

Rationale A small but growing body of research documents associations between structural forms of stigma (e.g., same-sex marriage bans) and sexual minority health. These studies, however, have focused on a limited number of outcomes and have not examined whether sociodemographic characteristics, such as race/ethnicity and education, influence the relationship between policy change and health among sexual minorities. Objective To determine the effect of civil union legalization on sexual minority women’s perceived discrimination, stigma consciousness, depressive symptoms, and four indicators of hazardous drinking (heavy episodic drinking, intoxication, alcohol dependence symptoms, adverse drinking consequences) and to evaluate whether such effects are moderated by race/ethnicity or education. Methods During the third wave of data collection in the Chicago Health and Life Experiences of Women study (N=517), Illinois passed the Religious Freedom Protection and Civil Union Act, legalizing civil unions in Illinois and resulting in a quasi-natural experiment wherein some participants were interviewed before and some after the new legislation. Generalized linear models and interactions were used to test the effects of the new legislation on stigma consciousness, perceived discrimination, depression, and hazardous drinking indicators. Interactions were used to assess whether the effects of policy change were moderated by race/ethnicity or education. Results Civil union legislation was associated with lower levels of stigma consciousness, perceived discrimination, depressive symptoms, and one indicator of hazardous drinking (adverse drinking consequences) for all sexual minority women. For several other outcomes, the benefits of this supportive social policy were largely concentrated among racial/ethnic minority women and women with lower levels of education. Conclusions Results suggest that policies supportive of the civil rights of sexual minorities improve the health of all sexual minority women, and may be most beneficial for women with multiply marginalized statuses.

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

“…Discrimination explained some, but not all, of the variance in alcohol dependence. In a rare quasi-experimental study, Everett, Hatzenbuehler, and Hughes [93] examined the impact of new civil union legislation in Illinois (a mid-Western state in the US) on minority stress, depression, and hazardous drinking in wave 3 of the CHLEW. Legislation was associated with reductions in stigma consciousness, perceived discrimination, depressive symptoms, and adverse drinking consequences in the full sample.…”

“…In addition, little attention has been paid to structural stigma. In one study [93] using a quasi or natural experimental design investigators compared SMW interviewed before a state policy (structural) change related to legal recognition of same-sex relationships with those interviewed after the change. Women interviewed after the change showed better alcohol use and mental health outcomes than those interviewed before the change.…”

Alcohol Use, Age, and Self-Rated Mental and Physical Health in a Community Sample of Lesbian and Bisexual Women

“…36,37 To date, CHLEW researchers have collected three waves of data from women recruited in the greater Chicago metropolitan area. 19,38 The CHLEW includes a broad range of questions about drinking and drinking-related problems, mental and physical health, and life experiences. The current study was approved by the Institutional Review Board at the Principal Investigator's (PI's; T.L.H.)…”

Eating disorders symptoms in sexual minority women: A systematic review

“…Over the last decade, researchers have shown an increased interest for the physical and mental health of sexual minorities (SMs), that is, individuals who identify themselves as gay, lesbian, bisexual, or have engaged in same-sex sexual behaviour (Everett, Hatzenbuehler, & Hughes, 2016;Kerridge et al, 2017;Upchurch, Krueger, & Wight, 2016). Although there are few studies, the results showed substantial health disparities between SM individuals and heterosexual peers, with a greater number of physical health symptoms and conditions (e.g., pain, dermatitis, and asthmas) and a higher risk of mental problems (e.g., depressive symptoms, suicide risk, and substance use or abuse) in SM subjects (Marshal et al, 2011;Operario et al, 2015;Strutz, Herring, & Halpern, 2015).…”