Higher rates of binge drinking by lesbian and gay teens may be due to chronic stress

Higher rates of binge drinking by lesbian and gay adolescents compared to their heterosexual peers may be due to chronic stress caused by difficult social situations, according to a study to be presented Saturday, May 3, at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

Research has shown that lesbian and gay people experience higher rates of physical and mental health problems. One explanation for these disparities is minority stress. According to this theory, chronic stress due to discrimination, rejection, harassment, concealment of sexual orientation, internalized homophobia (negative attitudes toward homosexuality) and other negative experiences leads to poor health.

The authors of this study sought to determine if minority stress theory could explain why gay and lesbian adolescents engage in binge drinking more than heterosexual youths. To do this, they analyzed responses from 1,232 youths ages 12-18 years who took part in an online survey conducted by OutProud: The National Coalition for Gay, Lesbian, Bisexual and Transgender Youth. Sixteen percent of youths identified themselves as lesbian females and 84 percent as gay males.

The survey asked questions about sexual minority experiences and included more than 260 variables. It represents the only known research to explore the relationship between binge drinking and a variety of minority stress experiences, such as homophobia and gay-related victimization, in a large national sample of lesbian and gay adolescents.

"Although other studies of adolescents commonly report on sexuality or sexual identity, these general population studies do not typically assess nuanced experiences of stress among sexual minority adolescents," said lead author Sheree M. Schrager, PhD, MS, director of research in the Division of Hospital Medicine at the Saban Research Institute of Children's Hospital Los Angeles.

Consistent with minority stress theory, participants reported greater psychological distress when they experienced violence or victimization, if they had internalized homophobia, and if they had made their sexual orientation known.

Internalized homophobia was a significant predictor of binge drinking, while experiencing violence or victimization was marginally associated with drinking large amounts of alcohol in a short period of time. Those living with their parents were less likely to report binge drinking.

Feeling connected to the gay community was both positively and negatively associated with binge drinking. Those who felt connected were more likely to report binge drinking. However, community connectedness protected against internalized homophobia, thereby indirectly protecting against heavy episodic drinking.

"Given that interventions are more effective when they are developed to match the cultural experiences of participants, theoretically grounded studies like this one can potentially lead to tailored treatment approaches based on the unique experiences of lesbian and gay adolescents," Dr. Schrager said.