LGBTQ Adolescents, Bullying, and Increased Risk of Adult Alcohol and Substance Use

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There is increasing attention paid to the elevated mental health risks for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) teens, including a recent major public-awareness campaign with the slogan “It Gets Better,” which features celebrities sharing stories to help stop bullying of LGBTQ youth.

This type of positive public exposure is necessary because it addresses a persistent problem: LGBTQ youth and young adults face an elevated level of risk for depression, alcohol and substance use disorders, and other mental health disorders. One study found young adults who identify as LGBTQ have significantly higher rates of major depression, post-traumatic stress disorder (PTSD), suicide attempts, and other mental disorders, when compared to national samples.

Discrimination based on sexual orientation correlates with lower life satisfaction, issues with mental and physical health, and – perhaps most concerningly – high incidence of suicidal ideation and suicide attempts. Data suggests that one-third of people who identify as lesbian or gay attempt suicide at some point in their lives – a number much higher than the general population.

Positive public attention can help. It’s important to realize, though, that, while campaigns to raise awareness about bullying LGBTQ teens are often successful, bullying includes a range of behaviors, from simple teasing and name-calling, to more extreme behaviors such as harassment and assault. While some of these behaviors are easily forgotten, others can cause trauma — and that can have lasting effects. This can include PTSD symptoms and other negative outcomes that extend well into adulthood.

Alcohol and Substance Use Disorder in LGBTQ Adults

Early trauma – which includes bullying and discrimination based on sexual orientation during adolescence – is widely recognized as a contributing factor to alcohol and substance use disorder later in life.

The 2017 Youth Risk Behavior Survey, published by the Centers for Disease Control (CDC)

shows that, over the course of a school year:

  • 33% of LGBTQ youth report being bullied at school
  • 27% report being bullied online – i.e. cyberbullying
  • 10% of LGBTQ youth report not going to school for safety concerns

This survey becomes more relevant in light of the following data from the 2017 National Survey on Drug Use and Health, published by the Substance Abuse and Health Services Administration (SAMHSA):

  • Adults who identify as lesbian or gay are twice as likely to have an alcohol use disorder than those who identify as heterosexual
  • Adults who identify as bisexual are three times as likely to have a substance use disorder as those who identify as heterosexual
  • Adults who are unclear about their sexual identity are five times more likely to have a substance use disorder than people who identify as heterosexual

When we connect the dots between these two data sets, we learn something important: members of the LGBTQ population are particularly susceptible to developing alcohol and/or substance use disorders. Part of this increased risk can be explained by the early trauma associated with bullying, discrimination, and a general lack of support and understanding by families, peers, and society at large.

Seeking Treatment

It’s important to bear in mind that intense victimization during the teenage years can manifest in symptoms of many years’ duration. While bullying may fade from the victim’s mind, or even come to seem like a harmless bad memory, some experience more serious targeting due to their LGBTQ identity. This can include persistent harassment or even assault. If the targeting behavior persists over years, it requires special attention to heal. Trauma during the teen years is correlated with negative mental and physical health effects – including alcohol and substance use disorder – that can manifest years later. Higher rates of depression, anxiety, and other mood disorders are also common in LGBTQ adults who were bullied as teenagers.

The bottom line in all of this is that support, community, treatment, and care make a real and lasting difference. Therapeutic intervention for feelings of alienation and loneliness can have positive effects at any age, and support in the face of bullying can help teens and young adults devise positive mental habits and strategies that can help them deal with trauma and stress. For LGBTQ adults with alcohol and substance use problems, understanding how their teen experiences affect them as adults is often an important piece of the treatment puzzle, and help them make significant strides in recovery.