Primary Submission Category: LGBTQ+
Patterns of Sexual Minority Substance Abuse & Mental Health: An Exploration of the Impacts of Internalized Homophobia
Authors: Caleb Cooley
Presenting Author: Caleb Cooley*
Efforts to address the lack of knowledge of sexual minority health disparities, including mental health and substance abuse, have grown substantially in the past decade. Minority stress theory, particularly Meyer’s model of minority stress, is a promising approach to understanding the disparate levels of substance abuse experienced by sexual minorities. It is also important to contextualize how identity formation plays a role in shaping experiences highlighted in the minority stress model. Previous research often analyzed sexual minorities in the aggregate without attention to the differences within this heterogeneous population. Recent work has begun to disaggregate lesbian, gay, and bisexual individuals to understand how each identity has specific contexts and distinct behavioral outcomes. For example, bisexual individuals experience higher rates of discrimination and substance abuse than those who have a primary attraction only to one sex, but little work has been done to understand the underlying factors and mechanisms that lead to diverging outcomes experienced within sexual minority populations, particularly the higher rates of substance abuse and mental disability among bisexual individuals.
This paper utilizes data from the Generations Study, a nationally representative longitudinal, five-year study that examines the health and well-being across three generations of lesbians, gay men, and bisexuals. I utilize this data to investigate the impact of both proximal and distal stressors in predicting patterns of poor mental health and substance abuse disparities among sexual minority adults, with a focus on the role of internalized homophobia. This novel data allows for the investigation of previously understudied contextual factors which shape the lives of sexual minorities. In this paper I analyze data from the first wave of the survey, which has a sample size of just over 1,500 adult sexual minorities.
The first outcome of interest is substance abuse, which is assessed using the Drug Use Disorders Identification Test (DUDIT). I also investigate patterns of mental disability utilizing the Kessler 6, which is a tool for measuring psychological distress. I investigate the potential moderating role of internalized homophobia, or the internalization of negative attitudes of sexual minority identity into one’s self-image, in shaping patterns of substance abuse and mental disability. The analysis considers sexual orientation as an independent variable, categorizing respondents reporting a sexual minority identity into 1 of 3 categories: lesbian/gay, bisexual, or another sexual minority identity.
This research seeks to address the following questions: Does internalization of stigma into one’s self-perception or identity predict higher prevalence of substance abuse and mental disability among sexual minorities? Further, does internalized stigma predict different rates of substance use and mental disability for lesbian, gay, and bisexual respondents? By analyzing sexual minority identities relative to one another rather than an aggregated sexual minority variable relative to heterosexuals, this research provides a more nuanced analysis to understand the variation between lesbians, gays, bisexuals, and other sexual orientations in terms of substance abuse and mental disability.