Dangerous Disparity

While four drinks in about two hours for women meets the standard definition of binge drinking, new University of Maryland research suggests the practice may be even more intense—and dangerous—for non-heterosexual women.

A new study by Jessica Fish, assistant professor of family science in the School of Public Health, found that lesbian and bisexual women were two to three times more likely than straight women to engage in high-intensity binge drinking: as many as 12 to 15 drinks per day. 

By contrast, the research found that gay and bisexual men were equally or less likely to engage in high-intensity binge drinking as heterosexual men. The study, which relied on data from the National Epidemiologic Survey on Alcohol and Related Conditions, was published in the journal LGBT Health.

“With high-intensity binge drinking, there are far more health-related consequences—more accidental injury and death. We’ve seen stories of death by asphyxiation, blackout behavior, just generally more wear and tear on your body,” Fish said. 

The Centers for Disease Control and Prevention has called binge drinking the most common and deadly kind of excessive alcohol use. Fish’s study is the first to use nationally representative data to document disparities in high-intensity binge-drinking behavior based on sexual orientation or identity. 

The reasons for the higher rate of high-intensity binge drinking among sexual minority women remain in question, but Fish offered several theories. One involved “sexual minority women’s tendency to rebuke traditional gender norms,” she said. “Most people perceive alcohol use as being an unfeminine or masculine type of behavior, so if you have women who aren’t necessarily aligning themselves with traditional gender roles, they may be more likely to drink.” 

Another possible factor is perceptions among the lesbian and bisexual communities that other sexual minority women are drinking heavily. Higher rates of victimization may also contribute, Fish said. 

“There’s a pretty strong understanding within the sexual minority health literature that stigma, victimization and discrimination is what’s driving a lot of the disparities we see in mental health and also substance abuse,” she said.

Early prevention efforts—such as greater inclusion and support for LGBTQ+ people in middle and high school—and LGBTQ-specific treatment and intervention strategies can mitigate substance abuse issues, Fish said.

“One thing I think we need to make crystal clear is that there are social forces at work that are addressable that are likely driving these differences,” she said.