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Women reporting greater identity uncertainty are more at risk for hazardous drinking

Mostly lesbian and bisexual women reported the most depression, anxiety, and physical health symptoms; mostly lesbian women reported the highest levels of hazardous drinking. Among those who reported drinking, mostly lesbian women drank the most frequently and reported the most alcohol-related consequences. Mostly lesbian women reported the most identity uncertainty.

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Fact: In research, “mostly lesbian” women are typically grouped with “exclusively lesbian” women, although they are sometimes grouped with “bisexual women”. A study is now saying that this grouping is problematic since it doesn’t fully show the experience of mostly lesbian women – e.g. that they are at higher risk for hazardous drinking.

In “Health Disparities Among Exclusively Lesbian, Mostly Lesbian, and Bisexual Young Women“, written by Robin J. LewisSarah J. EhlkeAlexander T. ShappieAbby L. Braitman and Kristin E. Heron and published in LGBT Health, it was noted that health disparities have been identified between groups of diverse young sexual minority women (SMW) and heterosexual women. “This approach may generate sufficient group sizes for statistical analyses but obscures important differences. Moreover, some young women may not identify as ‘lesbian’ or ‘bisexual’ but somewhere in between.”

And so, to best understand varying experiences, researchers saw it best to examine health and sexual minority identity-specific outcomes among three groups of SMW — i.e. women who identify as “exclusively lesbian,” “mostly lesbian,” and “bisexual.”

For this study, participants were 990 young (18–30 years old) SMW (exclusively lesbian: n = 305, mostly lesbian: n = 133, bisexual: n = 552) who completed an online survey, including information about mental and physical health symptoms, hazardous drinking, and identity uncertainty. Those who reported alcohol use in the past 30 days responded to questions about their alcohol use and alcohol-related negative consequences.

The study found that, controlling for demographic differences, “health outcomes varied significantly by identity. Mostly lesbian and bisexual women reported the most depression, anxiety, and physical health symptoms; mostly lesbian women reported the highest levels of hazardous drinking. Among those who reported drinking, mostly lesbian women drank the most frequently and reported the most alcohol-related consequences. Mostly lesbian women reported the most identity uncertainty.”

The researchers stressed that “describing and classifying SMW is a complex endeavor, and collapsing across identities may mask important differences among these subgroups.”

Although the common conceptualization of sexual identity includes mostly lesbian women under the bi+ umbrella, there may be important factors that lead women to adopt this sexual identity that sets them apart from their bisexual peers. This research “suggests that women who identify as mostly lesbian may be unique from their exclusively lesbian and bisexual peers by reporting greater identity uncertainty and more hazardous drinking. Moreover, if trying to subsume them within lesbian or bisexual identities, they fall into different patterns for different outcomes.”

The researchers are recommending further research to be done to improve understanding of the development of nonmonosexual identities, and researchers should be mindful that operationalization of sexual identity may affect outcomes.

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