Alcoholism in the LGBTQ+ Community

In the kaleidoscopic world of the LGBTQ+ community, where every shade of the rainbow shines bright, quieter narratives of the community’s unique struggles often get overlooked. Today, we celebrate a community built on resilience, diversity, and sexuality. At the same time, challenges of identity and belonging continue to contribute to an issue that disproportionately affects the LGBTQ+ community — alcohol use disorder (AUD).

We’ll explore this complex issue and the LGBTQ+ community’s unique challenges, from their historic roots in gay bars to today’s queer culture. We’ll look at the ways AUD is woven into the rich tapestry of LGBTQ+ life — and uncover strategies for nurturing a healthier, happier life without (or with less) alcohol.

History of Gay Drinking Culture

The early history of gay bars is unclear, as bars in the U.S. long operated under the nation’s legal and cultural radar. In the 1940s, in fact, psychologists and psychiatrists considered homosexuality an illness. It wasn’t until 1962 that Illinois
became the first state to decriminalize homosexuality. However, while the gay community worked tirelessly to push for LGBTQ+ rights, members continued to face extreme discrimination systemically and socially. Largely for this reason, LGBTQ+ community members frequented gay bars to be in safe and supportive company.

Today, decades after New York’s Stonewall riots, years after gay characters were introduced to film and television audiences, and after same-sex marriage became a right, gay bars remain sanctuaries for affirming identities and forging connections.

Individuals who identify as LGBTQ+ are fully recognized members of society today, but still, sexual identity stigmatization and other unique challenges persist. That reality underscores the importance of addressing the needs for greater equality in health and well-being. Let’s begin by identifying the specific risk factors for AUD among LGBTQ+ individuals and explore ways to overcome them.

Risk Factors for AUD in the LGBTQ+ Community

Specific risk factors that LGBTQ+ individuals face are primarily based on the minority stress theory. This theory posits that individuals with stigmatized social identities experience additional stressors beyond those outside of these groups. Here are key stressors that can contribute to the development of AUD in persons who are gay.

• Social discrimination. Those in the LGBTQ+ community may face social discrimination based on their sexual orientation due to a lack of acceptance and understanding from others. Stigma can lead to hate crimes, emotional abuse, and threats — all of which contribute to an increased risk of alcohol misuse and AUD. 
• Structural inequities. Although the U.S. has made some strides in equality for the LGBTQ+ community, the nation’s structural framework was built with heterosexual bias. Given that fact,  discrimination in the legal and justice system, healthcare, employment, and other institutions continues to present obstacles to equity.
• Lack of access to healthcare. Access to healthcare — or lack of it — impacts our physical and mental health. Noninclusive medical care often prevents those in the LGBTQ+ community from seeking care for trauma and abuse, leaving many physical and mental health conditions untreated. In addition, gender-affirming treatments are not always accessible, preventing transgender individuals from embracing their identity.
• Co-occurring disorders. Due to the interplay of many factors, including minority stress impacts, individuals in the LGBTQ+ community are at higher risk of co-occurring health and mental health issues. Among the conditions of significant concern are major depressive disorder, generalized anxiety disorder, high stress, self-harm, compulsive sexual behavior, sexual dysfunction, and sex- or HIV-related anxiety.


AUD can be caused by many factors. However, the LGBTQ+ community faces additional risk factors — making it even more prevalent in gay minority groups.3

Impacts of AUD on the LGBTQ+ Community 

AUD is not only more prevalent in the LGBTQ+ community than it is in the general U.S. population, but it also disproportionately affects minority groups. Drinking problems, including binge drinking, alcohol misuse, and AUD, affect about 25% of the LGBTQ+ community compared to 5% to 10% of those in the general population. 

Excessive drinking and alcohol use disorder impact our physical and mental health in many detrimental ways, including these issues:

• Liver disease 
• Cardiovascular conditions 
• GI issues 
• Memory loss
• Increased risk of certain cancers 
• Mood disorders 
• Negative social impacts

Along with these general impacts of AUD, the LGBTQ+ community faces additional consequences. According to the CDC, there are significant health disparities among the sexual youth — putting them at greater risk of HIV infection and other sexually transmitted diseases (STDs). This increased risk can be attributed to the link between alcohol and risky sexual behavior, which disproportionately affects LGBTQ+ communities. Major culprits of the disproportionate harm are the barriers to accessing treatment and support. 

Barriers to Treatment and Support

Minority groups like the LGBTQ+ community face greater obstacles in accessing treatment and support for AUD. These challenges include accessibility issues, social stigma, and systemic support barriers. 

Accessibility is a major component. It’s the reason why gas stations get away with bumping up their prices near freeways and why we often move to areas where resources are more abundant. Common accessibility barriers include geographic and financial barriers.

While we can argue that anyone can face these same barriers, when coupled with healthcare and other system barriers, LGBTQ+ individuals have more stacked against them. Healthcare disparities can include a lack of LGBTQ+-sensitive providers, discrimination in healthcare settings, and limited availability of tailored treatment programs. Along with limited support for treatment, social stigma can still limit access to treatment and support.

The queer community already faces discrimination based on sexual identity. With the added stigma surrounding AUD, the fear of being misunderstood or judged is even greater. However, having a better understanding of these unique challenges gives us insights into how we can help knock down these barriers to allow for greater equality in access to treatment and support. Let’s explore treatment options that can help everyone no matter where they are on their journey with alcohol. 

LGBTQ+ Rehab Options

Rehabilitation or other treatment options don’t have to be for just those struggling with AUD. In fact, early intervention is the most effective way to prevent AUD. With the many options available, it’s important to find the most appropriate one to fit the need.

• Specialized treatment. There are programs that cater to LGBTQ+ individuals specifically. Unique treatment plans help address such distinct challenges as navigating identity, overcoming societal stigma, and dealing with family dynamics. These programs provide a safe and affirming space where support is tailored to each individual’s experiences to ensure their care is not just effective but also deeply resonant with their personal journey.
• Medically supported detox. AUD is marked by a physical and neurological dependence on alcohol. When we stop drinking, we may experience alcohol withdrawal, which sometimes can require medical treatment. 
• Therapeutic methods. Psychological and behavioral therapies address the root issues of drinking and help develop positive strategies to work through these problems. Practitioners who are LGBTQ+-sensitive and understand the unique challenges of the queer community can help clients feel better understood.
• Support mechanisms. Peer support groups or family involvement also are beneficial as they help someone feel less alone. There are many inclusive or LGBTQ+-specific peer support group options available.

Intervention is important, but prevention can help nip the problem in the bud and avert a long list of alcohol’s detrimental effects.

Preventing AUD in the LGBTQ+ Community

Added risk factors and barriers to accessing treatment are deep-rooted issues that require social and systemic change. However, by making intentional choices on a personal level, preventing alcohol use disorder is possible. Here are several useful steps those of us in the LGBTQ+ community can take.

• Recognize the challenges of minorities. Acknowledging unique challenges and risk factors helps us take additional considerations into account when choosing to drink. 
• Quit or cut back on alcohol. Setting limits to quit or cut back on alcohol helps us prevent excessive drinking, which increases the risk of alcohol dependence. 
• Identify coping mechanisms. Drinking can often be an unhealthy coping mechanism for uncomfortable situations or emotions. Identifying positive coping strategies helps us avoid turning to alcohol when we’re stressed or anxious.
• Try alternatives. Ditch the booze and unpleasant aftermath with mocktails and more energy to pour into activities and relationships we care about. Have a list of mocktails handy for when you're out and about or sip on some nonalcoholic wine to toast a delicious home-cooked meal.
• Track consumption. Tracking our alcohol consumption helps us stay more mindful when we’re drinking. It also helps us get a better idea of what our drinking habits look like over a period of time — motivating us to make changes when we identify an issue.
• Seek support. Navigating AUD is no walk in the park and the good thing is, we don’t have to go through it alone. We can join peer support groups, open up to family and friends, and seek professional treatment options.

Small steps that can make a large impact stem from personal change and from those around us. As a friend or family member of an LGBTQ+ individual struggling with their relationship with alcohol, we can be instrumental in helping our loved one and the LGBTQ+ community as a whole get equal access to treatment and support. Let’s look at some action steps we can take. 

Supporting an LGBTQ+ Community Member Who Has AUD

Having a support system in AUD recovery can be incredibly beneficial. We can help motivate them to begin or maintain recovery and help them through challenging times. Aside from learning more about AUD and the unique challenges that LGBTQ+ individuals face, we can provide support through the following actions:

• Create a judgment-free space. Stigma is a major deterrent to accessing treatment or support. By creating a judgment-free space, those struggling with AUD may feel more comfortable opening up about their drinking habits.
• Encourage professional treatment. Recovery from AUD can be complex. While social support is beneficial, sometimes a more extensive approach is necessary. Recognize when professional support is needed, and don’t be afraid to (gently) encourage it!
• Support with accessing treatment. Difficulties finding treatment options, especially less common LGBTQ+ programs, can be major barriers to getting the support someone needs to start recovery. Helping people find treatment not only eases the stress, but it helps them feel supported and seen.
• Advocate for LGBTQ+ rights. Many of the additional risk factors for AUD that LGBTQ+ individuals face are due to systemic and social inequalities. Advocating for LGBTQ+ rights as an ally addresses the deeper issues that contribute to the development of AUD. 
• Take care of ourselves. Supporting someone in recovery also includes setting our own boundaries. This precaution helps prevent burnout and allows us to provide support in the long run.

As someone’s support system, we aren’t responsible for their recovery, but we can be instrumental in helping them embark on a brighter future.

Looking Ahead

Navigating the journey towards a better relationship with alcohol in the LGBTQ+ community involves embracing the unique stories and challenges that shape each individual’s experience. Alcohol misuse, often a refuge amidst the battles for acceptance and identity, can be addressed with understanding, solidarity, and support. By fostering inclusive spaces and nurturing self-love, we can rewrite the LGBTQ+ narrative around alcohol use, transforming it from a struggle into a triumph of resilience. Together, we can forge paths to healthier, more vibrant lives, celebrating each step forward in the quest for freedom, self-empowerment, and a brighter, healthier future!