Alcoholic or chemically dependent lesbians carry a double stigma in a society intent on denying the existence of both lesbianism and alcoholism or chemical dependency in women. The prevalence of alcoholism or chemical dependency in the lesbian community is unknown but presumed to be high.
An early study in the 1970’s done by M.T. Saghir and E. Robins (Male and female homosexuality, A comprehensive investigation) that is still often sited, used a small control group. They found that 35% of a samples of lesbians were alcoholic or abused alcohol at some point in their lives. Their findings were the most comprehensive at the time and are still widely quoted and comprised of the “best estimate” as to the prevalence of alcoholism and alcohol abuse in the lesbian community.
If the estimate even approximates the actual prevalence, alcoholism and alcohol and drug abuse are now in epidemic proportion in the lesbian community. Since this first comprehensive study, larger-scale studies have been done that have concluded a serious problem within our community that needs to be addressed.
Detailed information about lesbians’ habitual patterns of alcohol or drug consumption is largely unavailable and typically a matter of speculation. There does appear to be some evidence that lesbians engage in multiple substance abuses and exhibit mixed patterns of drug and alcohol use. Obviously, however, if we are to avoid speculation or erroneous extrapolation to lesbians, much work needs to be done to document the drug and alcohol consumption patterns in large and representative groups of lesbians.
There are some risk factors for lesbians. A larger than expected proportion of the lesbian community may be the adult children of alcoholic parents. Another risk factor for some lesbians is heavy reliance on lesbian bars or other public or private drinking settings to socialize and be “out.” Ambivalence or conflict concerning one’s lesbianism can also represent a risk factor that may represent a problem for development of chemical dependency or alcoholism.
Although the alcoholic or chemically dependent lesbian shares treatment issues with the larger group of alcoholic or chemically dependent woman, some issues are unique for the lesbian community.
Both Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) form the cornerstone of recovery for thousands of individuals, including many lesbians. Some women and some lesbians resist attending AA and NA meetings because many of the groups are male-dominated and members of some groups are homophobic. There is also resistance to attend these programs because of their emphasis on surrender and powerlessness and the meeting format for its focus on members’ personal recounting of adverse incidents that occurred during their years of alcoholic drinking or addiction.
Some feminists argue that women alcoholics and addicts in recovery have low self-esteem and are further burdened by guilt and shame when recounting or being reminded of their actions and behaviors while drinking or using drugs. Other advocates of the AA approach, many of whom are also feminists, argue that recognition of powerlessness over alcohol or drugs paradoxically empowers the alcoholic and addict and discussion of past events in an accepting and supportive atmosphere is an affirming experience and begins the process of self-forgiveness and self-healing.
Another issue that can be different for lesbians is denial and rationalization. Denial may play an adaptive role in staving off anxiety related to homophobia and living in a homophobic society.
Lesbians tend to experience more negative affect in their lives than other women. This would include depression, low self-esteem, isolation and feelings of rejection and anxiety. Generally, for some lesbians, particularly those who are heavily closeted or otherwise isolated from positive lesbian role models, negative affective states may be more pronounced than they are for chemically dependent heterosexual women.
Closely related to negative affective states is the issue of internalized homophobia, or the internalization of homophobic or negative societal attitudes and stereotypes of homosexuality. A convenient model for assessing the extent of internalized homophobia or for evaluating the extent of development of a positive lesbian identity is provided by V.C. Cass (Homosexual identity formation: A theoretical model. Journal of Homosexuality, 4, PP 219-235). Cass outlines six stages in the development of a positive homosexual self-identity, including Identity Confusion, Identity Comparison, Identity Tolerance, Identity Acceptance, Identity Pride and Identity Synthesis.
These stages of positive identity development for lesbians affect many more than those dealing with just alcohol and chemical abuse. All lesbians deal with these stages of development at various points in their lives and sometimes more than one at the same time.
The fact that some lesbians drink and do drugs to cope does not mean that all lesbians don’t have other ways of dealing with the challenging issues facing us. All addictive and unhealthy behaviors that are used to cope are risks. We need to build a strong support system within our lesbian communities that allows lesbians who need help with all ways of coping to “come out” and find accepting and genuine guidance and support.
