OBJECTIVE: Studies of alcohol use among lesbians have typically used convenience samples with uncertain generalizability or general population samples with small numbers of lesbians. Here we compare rates of high-risk and problem drinking in a large sample of Chicago-area lesbians and a national sample of age- and education-matched urban heterosexual women. METHOD: Data came from comparable face-to-face interviews with 405 self-identified Chicago-area lesbians and with 548 urban women from a U.S. national sample. Rates of hazardous drinking (heavy episodic drinking, intoxication, drinking-related problems, alcohol-dependence symptoms) were compared for exclusively heterosexual, mostly heterosexual, bisexual, mostly lesbian, and exclusively lesbian subgroups. RESULTS: Exclusively heterosexual women had lower rates than did all other women on all measures of hazardous drinking. Exclusively heterosexual women also reported less childhood sexual abuse, early alcohol use, and depression. Bisexual women reported more hazardous drinking indicators and depression than did exclusively or mostly lesbian women. CONCLUSIONS: These results indicate that sexual minority women are likely to have elevated risks of hazardous drinking. The differences between lesbian and bisexual women suggest that more attention is needed to subgroup differences among sexual minority women. Health care providers need to know the sexual identity of their patients and how their sexual identity may affect their risks for hazardous drinking. Higher rates of childhood sexual abuse, early drinking, and depression among sexual minority women suggest that these experiences may be important in assessing and treating problems related to their drinking, and in developing prevention and early intervention strategies.
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