Purpose: Youth who identify as lesbian, gay, or bisexual (LGB) are at greater risk of being stigmatized compared to heterosexual peers, and are also more likely to report substance use. This study examined the relationship between stigma and problem substance use for Asian LGB and heterosexual youth, generating probability profiles to investigate the role that protective factors may play in reducing the likelihood of problem use, even in the presence of stigma.
Methods: The study was a secondary analysis of the 2003 Adolescent Health Survey, a province-wide stratified cluster survey of students in grades 7 through 12. The sample consisted of Asian girls (weighted n = 9,780) and boys (weighted n = 11,982) who reported alcohol or drug use, of which LGB youth were more likely than heterosexual peers to do so (63% vs. 43% for girls; 59% vs. 47% for boys). Problem substance use was defined as experiencing one or more problems (e.g., passed out, damaged property, argued with family) in the past year as a result of alcohol or drug use. Series of age-adjusted logistic regressions were performed separately by gender and sexual orientation. Final models containing enacted stigma as a risk factor as well as the most powerful protective factors were used to generate probability profiles of problem use.
Results: Thirty-two percent of heterosexual girls, 21% of LGB girls, and 31% of both heterosexual and LGB boys reported problem substance use. The most powerful protective factors included family connectedness, school connectedness, and having peers with prosocial attitudes. The likelihood of problem substance use was reduced in the presence of protective factors, even when youth were stigmatized, and regardless of sexual orientation. For example, in the case of LGB girls, when stigma was present without any protective factors, the likelihood of problem substance use was 84%, but decreased to 9% with all protective factors present, and dropped to less than 1% when no stigma but all protective factors were present. The likelihood of problem substance use similarly dropped from 58% to 29% to 15% for heterosexual girls, and from 55% to 29% to 14% for heterosexual boys. (A probability profile was not possible for LGB boys due to inadequate power and heterogeneity of response.)
Conclusions: The likelihood of problem substance use among Asian youth could be substantially lowered by strategies aimed at reducing experiences of stigma. Antibullying policies and education could benefit all youth, and efforts specifically targeting homophobia might serve to decrease enacted stigma for LGB youth. Furthermore, fostering connections to family, school, and peers may lower problem substance use, even in the presence of stigma.
Poon C, Saewyc E, Homma Y & Clark T. (2009). Reducing problem substance use in Asian sexual minority and heterosexual youth. [abstract] Journal of Adolescent Health, Volume 44, Issue 2, page S6. doi: 10.1016/j.jadohealth.2008.10.021.