Do sexual minority women have higher substance use rates than heterosexual women?
Studies consistently find that sexual minority women, including lesbian, bisexual, and other non-heterosexual women, experience higher rates of substance use and substance use disorders compared to heterosexual women. This disparity is linked to specific stressors and life experiences unique to this population.
What the research says
A review of epidemiological data indicates that sexual minority women show elevated prevalence of alcohol, tobacco, cannabis, and polysubstance use compared with heterosexual women 14. Bisexual women are frequently identified as the highest-risk subgroup within this population 14.
The reasons for these higher rates include minority stress-related processes, internalized stigma, discrimination, victimization, and adverse childhood experiences 14. Research also shows that sexual minority women report higher rates of childhood sexual abuse than heterosexual women, which may contribute to negative mental health and substance use outcomes 5. Additionally, experiences of violent victimization and polyvictimization are higher among sexual minority women and are associated with greater substance use 6.
Intersectional disadvantage, such as racial or ethnic minority status and socioeconomic marginalization, can further amplify vulnerability to substance use in this group 14.
What to ask your doctor
- How do my personal experiences with stigma or discrimination affect my risk for substance use?
- Are there LGBTQ+-affirming treatment options available for substance use disorders?
- How can we address past trauma or childhood abuse in my treatment plan?
- What resources exist for sexual minority women facing intersectional challenges like racism or poverty?
This question is drawn from common patient questions about Primary Care & Family Medicine and answered using cited medical research. We do not provide individualized advice.