Lesbian, Bisexual Women Face Greater Barriers to Alcohol Use Disorder Treatment

About 43% of sexual minority women report heavy episodes of drinking, with 10% meeting the criteria for alcohol dependence. In this Verywell Mind article, Mindpath Health’s Kiana Shelton, LCSW, Taish Malone, PhD, LPC-S, and Brandi Garza, LPC, discuss possible barriers to treatment.

A recent study found that sexual minority women—lesbian and bisexual— (SMW) face significant barriers when it comes to addressing problematic alcohol use.

Researchers found that 43% of sexual minority women reported heavy episodes of drinking in the past year, while 10% met the criteria for alcohol dependence, and 22% reported that they recently wanted to reduce their drinking.

Negative coping skill for stress

Deidra Thompson, DNP, FNP-C, PMHNP-BC, says, “Sexual minority women (SMW), particularly women of color, young age and low income, face significant barriers to alcohol use disorder (AUD) treatment and are often dissatisfied with treatment when they seek help.”

Thompson explains, “Lesbian and bisexual women are at greater risk for AUD, and more research is needed to determine the factors that directly influence the increased risk for this population. It would also prove beneficial to develop interventions that will enhance the engagement of SMW in AUD treatment and improve outcomes.”

There are other factors that can increase the risk for AUD, as Thompson notes family history, social influences and psychological factors such as a mental illness or past trauma. “Alcohol is also sometimes used as a negative coping skill for stress,” she says.

Intersectional understandings are needed

A social worker with Mindpath Health, Kiana Shelton, LCSW, highlights how this publication fits with the need for intersectionality as it relates to the LGBTQIA+ community, as sexual minority women who were Black experienced greater challenges. “There still needs to be more LGBTQIA+ focused studies to better understand the ways in which we can serve this minority community,” she says.

Race, sexual orientation, gender identity/expression and socioeconomic status were just a few examples that Shelton highlights to demonstrate how they may impact how one accesses treatment, the quality of that care, and their decision to remain in treatment.

As an LGBTQIA+ affirming therapist, Shelton notes how crucial it is to hold awareness of your work environment and language. “As providers, we can say a lot about who we are before we even say a word, and this can hold a great impact on one’s continual treatment for care,” she says.

Equitable care access is uncertain

The “us” and “them” mentality that has plagued America’s underbelly has become more noticeable, causing many to question rights, justice, and equity, according to Taish Malone, PhD, LPC-S, a psychotherapist with Mindpath Health. “This article must be used to understand that the standard of expecting equitable care is now an uncertainty,” she says.

The LGBTQIA+ population has significantly high rates of behavioral health issues, as Malone notes the impact of minority stress on the LGBTQIA+ population. “The normalized disparagement of these subpopulations leaves them vulnerable to excessive stress and therefore more susceptible to both mental and physical manifestations,” she says.

Malone explains that such research highlights the need for more diverse offerings regarding treatment. “No one should be ostracized or refused the best level of care that should be afforded to all inhabitants of our country so that it can undoubtedly meet its claim to be great,” she says.

Lived experience of queerness helps

Therapist with Mindpath Health, Brandi Garza, LPC, says, “This article uses data from 2010-2012. The Supreme Court ruling on marriage equality wasn’t until 2015, and since then there have been massive shifts in the visual acceptance of the LGBTQIA+ and would include the sexual minority women subgroup that is the focus [of]…the…study.”

One of the most critical aspects of the therapeutic relationship is self-disclosure, according to Garza. “It is important for companies to not only hire therapists and counselors and tech assistants and doctors who are on the spectrum of sexuality and gender, but we must also encourage them to live openly in the manner they feel is appropriate,” she says.

Garza explains that there can be vast differences in power differentials when working with marginalized populations, as she advocates for more inclusive treatment facilities that offer financial aid and higher diversity of staff that reflect the population they serve.

Read the full Verywell Mind article with sources.