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Abstract

Objective:

The authors qualitatively examined how lesbian, gay, bisexual, transgender, and queer (LGBTQ) young adults with probable substance use disorders conceptualized their substance use vis-à-vis their LGBTQ identities.

Methods:

Individual, in-depth, semistructured interviews were conducted with 59 LGBTQ young adults (ages 21–34) who were participants in a larger longitudinal cohort study and who met criteria for a probable substance use disorder. Data were analyzed via iterative, thematic analytic processes.

Results:

Participants’ narratives highlighted processes related to minority stress that shape substance use, including proximal LGBTQ stressors (e.g., self-stigma and expectations of rejection) and distal LGBTQ stressors (e.g., interpersonal and structural discrimination) and associated coping. Participants also described sociocultural influences, including the ubiquitous availability of substances within LGBTQ social settings, as salient contributors to their substance use and development of substance use disorders. Participants who considered themselves transgender or other gender minorities, all of whom identified as sexual minorities, described unique stressors and coping at the intersection of their minority identities (e.g., coping with two identity development and disclosure periods), which shaped their substance use over time.

Conclusions:

Multilevel minority stressors and associated coping via substance use in adolescence and young adulthood, coupled with LGBTQ-specific sociocultural influences, contribute to the development of substance use disorders among some LGBTQ young adults. Treatment providers should address clients’ substance use vis-à-vis their LGBTQ identities and experiences with related stressors and sociocultural contexts and adopt culturally humble and LGBTQ-affirming treatment approaches. Efforts to support LGBTQ youths and young adults should focus on identifying ways of socializing outside of substance-saturated environments.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 112 - 120
PubMed: 31640522

History

Received: 15 January 2019
Revision received: 23 July 2019
Accepted: 8 August 2019
Published online: 23 October 2019
Published in print: February 01, 2020

Keywords

  1. Alcohol and drug abuse
  2. LGBTQ community
  3. Sexual and gender minorities
  4. Young adults
  5. Substance use disorders
  6. Minority stress

Authors

Details

Jennifer K. Felner, M.P.H., Ph.D.
School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska).
Jennifer P. Wisdom, Ph.D., M.P.H.
School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska).
Tenneill Williams, M.S.
School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska).
Laura Katuska, M.P.H.
School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska).
Sean J. Haley, M.P.H., Ph.D.
School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska).
Hee-Jin Jun, Sc.D., M.P.H.
School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska).
Heather L. Corliss, M.P.H., Ph.D. [email protected]
School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska).

Notes

Send correspondence to Dr. Corliss ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

National Institute on Drug Abusehttp://dx.doi.org/10.13039/100000026: K01DA023610, R01DA033974, TADA023356
California Tobacco-Related Disease Research Program: T29FT0265
Research reported in this article was supported by awards K01DA023610 and R01DA033974 (principal investigator, Dr. Corliss) from the National Institute on Drug Abuse (NIDA). Dr. Felner is supported by training grants under award TADA023356 (principal investigator, Steffanie Strathdee, Ph.D.) from NIDA and award T29FT0265 from the California Tobacco-Related Disease Research Program (TRDRP) (principal investigator, Dr. Felner).

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