Alcohol use among sexual minority adolescents is linked to discrimination and stigmatization

Sexual minority adolescents – lesbian, gay, or bisexual youth – are at an increased risk for substance use, including alcohol. A new study finds that discriminatory and stigmatizing experiences may be to blame. These results and others will be shared at the 44th annual scientific meeting of the Research Society on Alcoholism (RSA), which due to the COVID-19 pandemic will be held virtually this year from the 19th – 23rd of June 2021.

“About 20 years of research show that sexual minority adolescents are more likely – and in some studies, twice as likely – to initiate alcohol and other substance use earlier than their peers, and that their use tends to escalate more quickly,” said Jeremy T. Goldbach, associate professor and director of the Center for LGBTQ Health Equity at the University of Southern California. “What is less clear is ‘why’ this occurs.” Goldbach will discuss his findings at the virtual RSA meeting on 21June 2021.

Goldbach explained that prior studies have suggested that a variety of stigmatizing minority stressors – including bullying at school, family rejection, and a lack of safe and supportive spaces – may lead to later substance use. “Generally speaking,” he said, “when people experience chronic stress over time, this lessens their capacity to cope and results in poorer health. We wanted to look at how discrimination experienced by sexual minorities, including violence and victimization as they navigate the world, may be internalized by an individual and affect his or her concept of self as well as their choices.”

The current study surveyed 2,567 sexual minority adolescents across the U.S., ages 14-17 years old, as part of the five-year Adolescent Stress Experiences over Time Study (ASETS). The youth were recruited through a hybrid social media and respondent-driven sampling. Questions addressed sexual minority stress, discrimination, and mental-health symptoms, examined associations between 10 domains of minority stress and self-reported alcohol use during the previous 30 days, and explored which sources of minority stress were more likely to predict alcohol use.

“We found that sexual minority adolescents who reported using alcohol during the previous 30 days reported more minority stressors across all 10 domains than those who did not use alcohol during the same time period,” said Goldbach. “In other words, sexual minority adolescents are placed at higher risk because of discriminatory and stigmatizing experiences. It is important to note that many sexual minority adolescents who reported lower levels of stress had alcohol-use patterns similar to their peers.”

Goldbach emphasized that minority stressors can be moderated by addressing the social climate that sexual minority adolescents live within, such as schools, and helping them learn how to cope when they experience stressors. “If an unsafe world leads to poor outcomes, then we must address that world. Meaning, interventions should simultaneously address the community-level climate through protective school policies to reduce these experiences from happening, while also helping sexual minority adolescents build resilience through individual/group level interventions,” he said.