Early drinking onset moderates the effect of sexual minority stress on drinking identity and alcohol use in sexual and gender minority women

Purpose: Our aim was to (a) describe alcohol use in a community-based sample of young sexual and gender minority (SGM) women, (b) determine the influence of sexual minority stress, early drinking onset, and a drinker self-schema on alcohol use, and (c) determine subgroup difference in these effects. Method: Fifty-three women (mean age = 20.5) from a larger cross-sectional study of identities and behavior in LGBT people aged 16 to 24 were recruited using flyers posted in and near a communitybased health center that provides services for SGM persons. Participants completed a computer-assisted self-interview that included questions about alcohol use (last 90 days), age of drinking onset, drinker self-schema (extent to which drinking is a central source of self-definition), and sexual minority stress. Results: Lesbians were less likely to define themselves in terms of alcohol and reported lower levels of alcohol use (.22 drinks/day) compared with other SGM women (bisexual/transgender/curious/prefer no labels 58-.63 drinks/day). Sexual minority stress was associated with high drinker self-schema scores for women who started drinking prior to the age of 15 (p =.016), but not for those who started drinking later (p =.93). High drinker self-schema scores were associated with high levels of alcohol use (p = 004). Findings held for bisexual and transgender women, but were muted for lesbians. Conclusions: Interventions to prevent early drinking onset and sexual minority stress may prevent alcohol from becoming an important source of self-definition that contributes to high levels of alcohol use for bisexual and transgender women, but longitudinal studies with larger probability samples of SGM women are needed.