Why non-heterosexual women are more likely to abuse alcohol

If Caitlyn Jenner has taught us anything this week, it’s that being one’s true self is key to mental and emotional health—particularly when it comes to gender and sexual orientation. But if the message wasn’t already coming through loud and clear, a new study drives home the point, revealing that the stress of feeling stuck between who you want to be and who you’re allowed to be can lead to self-destructive coping mechanisms.

The research, published in the Journal of Health and Social Behavior, found that women of sexual minorities—in other words, lesbian and bisexual women—who aren’t open about their orientation are more likely to abuse alcohol.

The Study

Researchers from Texas Tech University, University of Illinois at Chicago, and University of Utah examined data collected from hundreds of self-identified sexual minority women spanning 10 years over three different waves.

They collected the data from the Chicago Health and Life Experiences of Women (CHLEW) from 2000 to 2010 to find out if and why these women are more likely to engage in risky alcoholic behavior.

At each wave in the study women were asked, “How do you define your sexual identity?” with answer options being (1) only homosexual/lesbian, (2) mostly homosexual/lesbian/gay, (3) bisexual, (4) mostly heterosexual, (5) only heterosexual.

They were also asked, “Which of the following best describes who you could be sexually attracted to?” and “In the past five years, has your partner(s) in your sexual relationship(s) been …” With answer options being  (1) only women, (2) mostly women, (3) equally men and women, (4) mostly men, (5) only men.

The researchers hypothesized that women whose sexual identity didn’t fully match their attraction and behavior were more likely to engage in hazardous drinking. In other words, a woman who tends to only be attracted to women but has had romantic relationships with men anyway might be more likely to use alcohol in a negative way.

The hypothesis arose from a concept in psychology called cognitive dissonance theory—the idea that holding two contradicting beliefs at the same can lead to mental stress or discomfort. Alcohol would offer a way to cope with that discomfort.

“We thought people would be more likely to report hazardous drinking, that is, drinking to intoxication, binge drinking and other negative consequences associated with drinking,” said Amelia E. Talley, an assistant professor at Texas Tech University and co-author of the study, in a press release. All as a way to “alleviate self-focus and take away negative affectivity by distracting themselves from these inconsistencies,” she explained.

After analyzing the data the researchers found that their hypothesis proved true.

“Results indicated that sexual minority women who reported more opposite-sex sexual behavior, relative to their sexual identity, at a given assessment were likely to report higher levels of hazardous drinking at subsequent waves,” they wrote in the study.

Why sexual minority women are at risk

Many gay and bisexual women find themselves caught between how they identify in public and how they behave (or want to behave) in private, experiencing a psychological and emotional disconnect—which may cause them to turn to hazardous behaviors such as drinking to cope.

The researchers found this to be especially true of older lesbian women (who can no longer pull the “I’m experimenting” card).

“There was evidence that it could be more detrimental to acknowledge or report these discrepancies as you get older,” Talley said. “People see you in a different light; you have to answer to friends and family or larger society about the changes you are exploring with regard to your sexual identity. It’s difficult when you get older because of people’s expectations that you should have your sexual orientation figured out. Younger women are afforded more wiggle room in regard to exploring their sexuality.”

The authors point out that more research on the connection between cognitive dissonance theory and alcohol abuse among sexual minority women—but they advise medical professionals to be aware of the mental stressors placed on women whose sexuality may be more fluid.

“The take-home point is the ambiguity appears to be what’s driving the higher rates of hazardous drinking. It would be great to have more open-mindedness within the larger society and get away from just assuming that identifying as a non-heterosexual puts you at higher risk to drink,” said Talley. “I want to understand the mechanism: What is it about identifying as non-heterosexual that puts you at risk?”

Taryn Hillin is Fusion’s love and sex writer, with a large focus on the science of relationships. She also loves dogs, Bourbon barrel-aged beers and popcorn — not necessarily in that order.