Drug and Alcohol Dependence 87 (2007) 119–130
Sexual orientation, gender, and alcohol use in a cohort study
of U.S. adolescent girls and boys
Najat J. Ziyadeh
, Lisa A. Prokop
, Laurie B. Fisher
, Margaret Rosario
Alison E. Field
, Carlos A. Camargo Jr.
, S. Bryn Austin
Division of Adolescent and Young Adult Medicine, Children’s Hospital, 300 Longwood Ave., Boston, MA 02115, USA
Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School,
181 Longwood Ave., Boston, MA 02115, USA
Department of Psychology, City University of New York—City College and Graduate Center, NAC Building 7-120,
Convent Avenue and 138th Street, New York, NY 10031, USA
Received 31 March 2006; received in revised form 1 August 2006; accepted 2 August 2006
Background: Sexual minority youth may be at elevated risk for alcohol use relative to heterosexual youth, but the reasons underlying higher rates
and whether there may be gender differences in risk are not known.
Methods: Cross-sectional survey data from 9731 early and middle adolescent girls and boys in the Growing Up Today Study in 1999 were examined
to assess sexual orientation and gender patterns in alcohol use. Multivariable regression models estimated associations between sexual orientation
and alcohol-related behaviors, such as binge drinking and drinking before age 12 years. Models controlled for sociodemographic and psychosocial
factors, with heterosexuals as the reference.
Results: Girls who described themselves as “mostly heterosexual” and lesbian/bisexual girls were at elevated risk compared to heterosexual
girls on almost all alcohol-related behaviors and exposures. “Mostly heterosexual” boys were also at elevated risk. No signiﬁcant differences in
alcohol-related behaviors were observed between gay/bisexual and heterosexual boys. Gender-by-sexual orientation interactions were statistically
signiﬁcant for LGB but not other orientations, indicating that lesbian/bisexual girls experienced elevated risk above and beyond that of gay/bisexual
boys relative to same-gender heterosexual peers.
Conclusions: In early and middle adolescence, sexual minority girls and “mostly heterosexual” boys experienced consistent patterns of elevated
risk for alcohol use.
© 2006 Elsevier Ireland Ltd. All rights reserved.
Keywords: Alcohol; Adolescence; Sexual minority; Gay; Lesbian; Epidemiology
Alcohol use is a major cause of morbidity and mortality
among adolescents (Hingson et al., 2005; O’Malley et al., 1998;
Sindelar et al., 2004; Weinberg et al., 1998) and a priority public
health issue for lesbian, gay, and bisexual (LGB) communi-
ties (Gay and Lesbian Medical Association and LGBT Health
Experts, 2001). Several school-based studies have found that
sexual minority adolescents report more alcohol use than their
Corresponding author at: Division of Adolescent and Young Adult Medicine,
Children’s Hospital, 300 Longwood Ave., Boston, MA 02115, USA.
Tel.: +1 617 355 8194; fax: +1 617 730 0185.
E-mail address: firstname.lastname@example.org (S. Bryn Austin).
heterosexual peers (Bontempo and D’Augelli, 2002; Caldwell
et al., 1998; DuRant et al., 1998). However, gender and sex-
ual orientation patterns in alcohol use may be complicated. Two
studies with adolescents and young adults have reported sugges-
tive evidence of greater alcohol use by sexual minority females
versus sexual minority males relative to same-gender heterosex-
ual peers (Eisenberg and Wechsler, 2003; Russell et al., 2002),
while a third study found the reverse, with sexual minority ado-
lescent males more so than females reporting greater alcohol
use relative to same-gender heterosexual peers (Bontempo and
D’Augelli, 2002). The purpose of this report is to investigate dif-
ferences in alcohol use between female and male sexual minority
youth relative to heterosexual peers and to examine potential
risk and protective factors in alcohol use among sexual minority
0376-8716/$ – see front matter © 2006 Elsevier Ireland Ltd. All rights reserved.