Academic journal article Alcohol Research

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

Academic journal article Alcohol Research

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

Article excerpt

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 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. Because women's bodies generally contain less water than men's bodies, alcohol becomes less diluted, and women therefore reach higher blood alcohol levels than men even if both drink the same amount (Holmila and Raitasalo 2005).

Gender influences refer to the socially constructed roles, responsibilities, attitudes, behavioral norms, and relative power that a society differentially attributes to women and men. Research shows that countries or cultures with the largest differences in gender roles also have the largest differences between men's and women's drinking (Wilsnack et al. 2000). Therefore, social and cultural factors must be considered when attempting to understand gender differences in alcohol use across countries.

Gender Roles and Alcohol Use

Differences in men's and women's alcohol use often reflect gender roles and cultural expectations. Men may use drinking to demonstrate masculinity, facilitate aggression, exert power, and take risks. For these reasons, men may have greater motivation to drink than women. For example, research shows that risk taking is associated with heavy drinking among men but that women are more likely than men to use risk- reduction strategies when drinking (Iwamoto et al. 2011; Nguyen et al. 2011). In addition, a culture's acceptance of public drinking and intoxication for men but not women can serve to reinforce male superiority over women in status and authority in that culture. Whereas men have used drinking as a way to excuse themselves from responsibilities at work or home, women's drinking has traditionally been limited by their roles as mothers and caretakers and by the belief that drinking may have a more detrimental effect on their social behavior and their ability to fulfill responsibilities and to control their sexuality (Kuntsche et al. 2009, 2011). Women also are often expected to rein in the drinking of their male partners (Holmila and Raitasalo 2005). …

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