Dry January: Does help for alcohol misuse need rethinking for LGBT+ people?

With Dry January putting a spotlight on our alcohol consumption, pioneering research by experts at University of Brighton for Drinkaware has resulted in the first comprehensive review of alcohol misuse in the UK’s LGBT+ communities. 

The study by researchers in the University’s Centre for Transforming Sexuality and Gender has now highlighted issues that include higher rates of alcohol use and failures in support networks following the pandemic.

READ THE FULL REPORT: ALCOHOL USE AMONG GENDER AND SEXUAL MINORITIES

There are around 2.5 million LGBT+ people living in the UK, and of the 29 studies examined by the University of Brighton and Anglia Ruskin University research team, all pointed to rates of alcohol misuse being higher among LGBT+ people (including trans and non-binary people) compared to heterosexual and cisgender people. Young people and women proved of particular concern, as was the longstanding nature of the trend.

Stresses arising from the COVID-19 pandemic may have been a contributory factor to recent rises in harmful alcohol use. LGBT+ people reported increased drinking during lockdown, but very few said they were able to access alcohol intervention services during this period. They reported difficulties accessing mainstream programmes such as Alcoholics Anonymous, for example, and there were perceptions that these services were not effectively tailored to address the specific needs of LGBT+ people.

While counselling provided one form of intervention that could help reduce harmful alcohol consumption, there was very little research exploring the specific experiences of trans, non-binary and intersex people in the broader LGBT+ community. It was thought more effective interventions would come through designing them with the involvement of LGBT+ people – either as practitioners or as participants.

Dr Laetitia Zeeman from the University of Brighton, said: ” Our findings indicate that there is a higher incidence of harmful alcohol use amongst sexual and gender minority communities in the UK, compared to their heterosexual and cisgender peers.

“Factors that contributed to excessive alcohol use were minority stress, low self-esteem, lack of family support and living in communities where alcohol use may form part of commonly accepted social practices. Protective factors against excessive alcohol use included social support for minority sexual and gender identities, questioning cultural norms around alcohol use as an accepted social practice, and being able to imagine a future without alcohol. Findings indicate that there is a need to develop dedicated LGBT+ friendly alcohol interventions and services, or for existing services to be re-designed to ensure that they are appropriately LGBT+ inclusive.”

Emma Catterall, Drinkaware’s Research and Evidence Lead, said: “Drinkaware is delighted to have worked with the University of Brighton on this vital project. This evidence review highlights the dearth of research on the experiences of LGBTQ+ people and their relationship with alcohol, as well as the woeful lack of specialist services to support them.

“There is so much we have yet to understand in this field, but we are taking the first steps to rectify it. This review has informed Drinkaware’s own research on alcohol use among LGBTQ+ communities and it will be published later this year.”

The review also examined issues that may lead to excessive drinking in the LGBT+ community. There are a number of known risk factors for harmful alcohol use, some of which may impact significantly on LGBT+ people such as mental health struggles due to anxiety or depression, minority stress and lack of family support – the vital information to create more effective and inclusive interventions and/or support structures.

The qualitative studies about UK LGBT+ people’s experiences of attending alcohol intervention services showed some difficulties, with people anticipating or experiencing homophobia, biphobia and transphobia or other problems whilst attending support group meetings. Also, some encountered presumptions that harmful alcohol use or mental difficulties were due to their sexual orientation or gender identity. There were difficulties with the religious overtones of alcohol intervention programmes, and people felt intimidated by mainstream services where they did not take account of LGBT+ specific needs.

The review saw novel interventions or promising practices, such as a game-based intervention for young people, and the introduction of an anti-homophobia policy. Both of these showed positive results. Other, better-known interventions included mindfulness and motivational enhancement, some of which were successful in reducing alcohol consumption, particularly gay-straight alliances and anti-homophobia policies in schools. Mindfulness was, however, shown to be among the less successful interventions.

Protective factors against excessive alcohol use in LGBT+ people included social support, resilience and maintaining dignity, questioning social norms, having a supportive religious climate, and imagining a future without alcohol.

The research team were: Dr Laetitia Zeeman, Prof Catherine Meads, Prof Nigel Sherriff and Dr Kay Aranda.