The epidemiology of problem drinking in gay men and lesbians: A critical review

This review examines research on the prevalence of problem drinking among gays and lesbians, and discusses various theories as to the etiology of drinking problems in this population. Early reports on alcohol problems in this population suggested that gay men and lesbians were at alarmingly high risk for alcohol problems; however, methodological flaws call these results into question. More recent research suggests that gay men are not at significantly higher risk for drinking heavily or for developing drinking problems than heterosexual men. Problem drinking may exist at somewhat higher rates among lesbians than among heterosexual women, although not at the high rates reported in early studies. Both gay men and lesbians appear to be less likely to abstain from alcohol than their heterosexual counterparts. Numerous theories have been proposed to explain the etiology of problem drinking in this population, including subcultural phenomena, self-medication hypotheses, and social and cultural pressures. However, none of these theories has more than minimal empirical support. Clinical implications and recommendations for further research are discussed.