Academic journal article Alcohol Research: Current Reviews

The Influence of Gender and Sexual Orientation on Alcohol Use and Alcohol-Related Problems: Toward a Global Perspective

Academic journal article Alcohol Research: Current Reviews

The Influence of Gender and Sexual Orientation on Alcohol Use and Alcohol-Related Problems: Toward a Global Perspective

Article excerpt

Although there are wide differences in alcohol use patterns among countries, men are consistently more likely than women to be drinkers and to drink heavily. Studies of alcohol use among sexual minorities (SMs), however, reflect a more complex picture. Such research has found higher rates of alcohol use and alcohol-related problems among SM persons than among heterosexuals and greater differences between SM and heterosexual women than between SM and heterosexual men. A variety of factors may contribute to differences in alcohol use and alcohol-related problems between men and women and between SM and heterosexual people. An improved understanding of these factors is important to guide prevention and treatment efforts. Although there is a dearth of literature on use of alcohol by SMs in many parts of the world, especially lower- and middle-income countries, we attempt to review and integrate the sparse data that are available from these lower-resourced countries. The global perspective presented in this article is the first attempt to go beyond a general review of literature in the Western world to document the gender paradox in alcohol use among heterosexuals and SMs in diverse countries worldwide.

Key words: Alcohol consumption; alcohol use patterns; heavy drinking; alcohol-related problems; gender; sexual orientation; sexual minority; heterosexual; men; women; global perspective; literature review


The prevalence of alcohol use and the contrast between the drinking patterns of men and women vary widely across the globe. For instance, rates of current drinking ranged from 3 percent and 37 percent for women and men, respectively, in the Indian state of Karnataka to 94 percent and 97 percent for women and men in Denmark (Wilsnack et al. 2009). Overall, however, men have higher rates of alcohol use than women, both in the United States (Substance Abuse and Mental Health Services Administration [SAMHSA] 2013) and globally. In a multinational study of 35 countries (Gender, Alcohol, and Culture: An International Study [GENACIS]), Wilsnack and colleagues (2009) found that men were consistently more likely than women to be current drinkers and to engage in high-volume drinking, high-frequency drinking (5 or more days per week), and heavy episodic drinking. Women were more likely to be lifetime nondrinkers and to be former drinkers.

These patterns are quite different among sexual-minority women (SMW) and sexual-minority men (SMM). Although many large-scale surveys of alcohol and other drug (AOD) use have not included questions about sexual orientation, those that do show smaller gender differences in alcohol use and related problems among SMs than among heterosexuals. Notably, sexual-orientation--related disparities in AOD use are larger for women than for men. That is, SMW differ more in their rates of AOD use and related problems from heterosexual women than SMM differ from heterosexual men (Drabble et al. 2005; McCabe et al. 2009; Talley et al. 2014). This article examines the relationships that Tonda L. Hughes, Ph.D., R.N., F.A.A.N., is professor and associate dean for global health and co-director, Building Interdisciplinary Research Careers in Women's Health (BIRCWH), University of Illinois at Chicago, Chicago, Illinois.

Sharon C. Wilsnack, Ph.D., is the Chester Fritz Distinguished Professor, Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine & Health Sciences, Grand Forks, North Dakota. gender and sexual orientation have to alcohol use and alcohol-related problems, using available literature in the United States and globally, and reviews some of the factors that seem to influence these relationships.

Sex versus Gender Differences in Alcohol Use and Related Problems

Sex differences refer to biological characteristics such as anatomy and physiology that distinguish female and male bodies. For example, differences in body composition partly explain why women consistently drink less than men. …

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