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Substance Use and Mental Health Disorders Among Heterosexual Identified Men and Women Who Have Same-Sex Partners or Same-Sex Attraction: Results from the National Epidemiological Survey on Alcohol and Related Conditions

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Abstract

This study examined sexual orientation discordance, a mismatch between self-reported sexual identity and sexual behavior or sexual attraction, by describing the characteristics, substance use disorders, and mental health risks of heterosexual identified individuals who endorsed this pattern of sexual identification, behavior, and attraction. Using data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), we created three groups based on participants’ reported sexual identity and either their sexual behavior or sexual attraction: heterosexual concordant, homosexual concordant, and heterosexual discordant. Bivariate models assessed the relationship of discordant status and demographic correlates, lifetime substance use disorders, and mental health diagnoses. Logistic regression models tested associations between both behavior discordance and attraction discordance and the likelihood of having lifetime disorders of substance use, major depression, and generalized anxiety. Results of this study provided evidence of varying levels of substance use and mental health disorder risk by gender, discordance status, and discordance type. Behavioral discordance was associated with increased risk of mental health and substance use disorder among women (compared to heterosexual concordance). Findings among men were less consistent with heightened risk of alcohol and inhalant use only. Attraction discordance was notably different from behavioral discordance. The odds of substance use and mental health disorders were the same or lower compared with both the heterosexual and homosexual concordance groups. Future research should begin to test theoretical explanations for these differences.

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Acknowledgments

The National Epidemiological Survey on Alcohol and Related Conditions (NESARC) was conducted and funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), with supplemental support from the National Institute on Drug Abuse (NIDA). Support during article preparation was provided by The Chancellor’s Graduate Fellowship at Washington University in St. Louis (Gattis), Hartford Doctoral Fellows Program (Sacco) and National Institutes of Health training mechanisms: NIAAA #F31 AA018050-01 (Sacco) and NIDA #T32 DA015035; (Sacco, predoctoral trainee; Cunningham-Williams, Training Director). Special thanks to Edward L. Spitznagel, Jr., Ph.D., Professor of Mathematics, Washington University in St. Louis for statistical consultation.

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Authors and Affiliations

  1. School of Social Work, University of Wisconsin-Madison, 1350 University Ave., Madison, WI, 53706-1510, USA

    Maurice N. Gattis

  2. School of Social Work, University of Maryland-Baltimore, Baltimore, MD, USA

    Paul Sacco

  3. George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA

    Renee M. Cunningham-Williams

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  1. Maurice N. Gattis
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  2. Paul Sacco
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  3. Renee M. Cunningham-Williams
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Correspondence to Maurice N. Gattis.

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Gattis, M.N., Sacco, P. & Cunningham-Williams, R.M. Substance Use and Mental Health Disorders Among Heterosexual Identified Men and Women Who Have Same-Sex Partners or Same-Sex Attraction: Results from the National Epidemiological Survey on Alcohol and Related Conditions. Arch Sex Behav 41, 1185–1197 (2012). https://doi.org/10.1007/s10508-012-9910-1

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  • DOI: https://doi.org/10.1007/s10508-012-9910-1

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