Disparities in substance abuse in lesbian, gay, bisexual and transgender individuals: is homophobia the driving force?

It has been suggested that members of the lesbian, gay, bisexual, and transgender (LGBT) population are at an increased risk for alcohol and/or substance abuse problems compared to their heterosexual counterparts. Alcohol and substance abuse is a significant public health problem and has been linked to various adverse health outcomes including liver and other cancers, cirrhosis, cardiovascular disease, brain damage, high blood pressure, and depression. Homophobia and its negative effects on LGBT individuals is a suggested reason for this health disparity and is a relevant public health issue. Internalizing homophobia has been linked to increased depression, anxiety, and stress, which can in turn increase one’s risk for alcohol and/or substance abuse. This cycle exacerbates the disparity between LGBT and heterosexual individuals and requires further research from public health officials. Contained in this essay is a review of the literature focused on the effects of homophobia on substance abuse in LGBT individuals. Of the studies reviewed, the results were mixed. Many studies found a significant positive relationship between homophobia and substance abuse while some found a significant inverse relationship. A few however, found no relationship between the two. Regardless, the proposed health disparity among LGBT individuals is an issue of public health significance that merits attention