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Try out PMC Labs and tell us what you think. Learn More. The current study examined the role of gender atypical self-presentation on the alcohol, tobacco, and marijuana use, as well as symptoms of substance abuse, of an ethnically diverse sample of 76 young ages 14 — 21 years lesbian and bisexual women who were interviewed between in New York City.

Even after controlling for age, sexual identity, and social desirability, young butch women reported drinking alcohol more frequently and in greater quantity, smoking more cigarettes, and using marijuana more frequently than young femme women. Despite the small convenience sample, these findings suggest that intervention efforts to address the higher levels of substance use among young lesbian and bisexual women may increase effectiveness by also addressing experiences of gay-related stress and emotional distress of young butch women. Over the past decade, an extensive body of research has examined potential disparities in substance use and abuse between lesbian, gay, and bisexual individuals and their heterosexual peers.

This greater risk for substance use and abuse has been documented in adult women Burgard et al. The reasons why and the conditions under which some lesbian and bisexual women may or may not report high levels of substance use and abuse remain far less examined.

There are a of potential reasons to hypothesize that women who are more butch in their self-presentation would be more likely to use alcohol, tobacco, and marijuana with greater frequency and in greater quantity than women who are more femme in their self-presentation. First, heavy drinking, cigarette smoking, marijuana use, and substance abuse are more frequent among heterosexual males than heterosexual females Grunbaum et al.

Therefore, it might be expected that butch lesbians would engage in higher levels of substance use because it would be consistent with their more masculine self-presentation in other domains e. Representative studies of high school students have found that victimization is much more common among LGB than heterosexual youths 2. These high levels of gay-related stressful events may, in turn, lead young butch women to use alcohol, tobacco, and marijuana in order to cope.

In addition, gay-related stressors may place young butch lesbians at greater risk for emotional distress e. Alternatively, there is reason to suggest that women with a more femme self-presentation may report higher levels of alcohol, tobacco and marijuana use than more butch women. Indeed, in an earlier report on this sample, femmes were less comfortable than butches with disclosing their sexuality to others Rosario et al.

However, given the lack of research into this question and the numerous theoretical reasons to hypothesize differences albeit, conflicting suggestions about the direction of these differencesfurther research is needed.

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Such research would provide important information about which young lesbian and bisexual women may be at risk for substance use and thereby suggest which women may be in most need of substance use prevention and treatment efforts. Meetings were held with the study investigators to introduce the study and invite the adolescents to participate in a study of lesbian, gay, and bisexual youths.

In addition, youths were approached individually and invited to participate. These recruitment efforts were conducted by a gender and ethnically diverse study staff who were college educated and trained to follow a common recruitment procedure.

Attempts were made to recruit every youth attending the recruitment site. The current report focuses on these lesbian and bisexual female youths. Of the 81 young women interviewed, 1 was excluded because she was older than 21 years and 4 were excluded because they were heterosexual in both identity and lifetime sexual behavior.

The resulting sample of 76 female youths reported a mean age of Thirty-eight percent reported that they had a parent who received welfare, food stamps, or Medicaid. Voluntary and ed informed consent was provided by all youths.

In addition, for youths under age 18 years, parental consent was waived by the Commissioner of Mental Health for New York State. The university and recruitment sites approved the study. Youths participated in a 2- to 3-hour interviewer-administered questionnaire battery at Time 1, with follow-up assessments 6 and 12 months later. Interviews were conducted between fall and springwith follow-up through summer Interviewers were matched to the youths on gender.

Interviews were conducted in a private room at each recruitment site at Time 1, with follow-up interviews conducted either at the recruitment site or another private location convenient for the youths. The was adapted from several national survey measures of substance use among youths and it was tailored to include the street terms commonly used for these substances in New York City see Rosario et al.

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All questions assessed substance use in the past 3 months at Time 1, and within the past 6 months since the last interview at each subsequent assessment. The quantity of alcohol and marijuana use was assessed as how many drinks youths typically have when they drink or how many ts they usually have when they use marijuana.

Because data for quantity of alcohol and marijuana were positively skewed, the quantity of alcohol was computed as 0, 1, 2, or 3 or more drinks, and the quantity of marijuana was computed as 0, 1, or 2 or more ts. The also included symptoms associated with abuse of alcohol or illicit drug abuse. These symptoms were assessed at all three assessments using an item measure e. Youths responded yes or no to each item. These items have demonstrated strong test-retest reliability Rosario et al.

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Responses to the three items were combined such that young women who identified only as butch, or as butch and androgynous were classified as butch, whereas youths who identified as femme or as femme and androgynous were classified as femme. Youths who identified as butch and femme, as butch, femme, and androgynous, or only as androgynous were classified as androgynous.

The rationale for this classification system is available elsewhere Rosario et al. Following the same classification system outlined above, we computed a single variable for each assessment period that classified the young women as butch, femme, androgynous, or none of the above.

Because the interviewer ratings were obtained at Time 3 only, no test-retest data were available. Three aspects of gay-related stress were assessed at Time 1.

Butch/femme differences in substance use and abuse among young lesbian and bisexual women: examination and potential explanations

The experience of gay-related stressful life events e. The count of stressful events was positively skewed; thus we computed a dichotomous measure indicating whether female youths had experienced no events 0 or one or more events 1. In addition, we assessed two aspects of internalized gay-related stress, that is, internalized homophobia.

The NHAI was selected because more contemporary measures e. A factor analysis of this measure on the full sample of youths in this study identified 2 factors: negative attitudes toward homosexuality, with 11 items e. The attitudes toward homosexuality measure was negatively skewed, therefore we used the exponential e to normalize the distribution. Three aspects of emotional distress were assessed at Time 1. The BSI was selected because it has been validated among adolescent samples Derogatis, and it or its parent scale, the Symptom Checklist Derogatis,has been and continues to be used extensively with LGB youths e.

In addition, conduct problems were assessed using a item index e. This measure has been ly used in a study of gay and bisexual male youths Rotheram-Borus et al. A count of the of problems was computed.

Two of the 33 items were removed because they were inappropriate for youths. A factor analysis revealed 12 items that loaded on a single factor. The mean differences between butches and femmes on substance use and abuse are presented in Table 1. All ificant and trend differences indicated that butches more frequently used and consumed larger quantities of tobacco, alcohol, and marijuana over time than femmes. Butches also reported more symptoms of substance abuse at Time 3.

Several potential confounds e. Generally, the inclusion of these covariates had no effect on the original magnitude of bivariate relations see Table 2. Specifically, young butches still were found to report ificantly more cigarette use, more frequent alcohol use at Time 1 only and more frequent marijuana use than did young femme women.

In some instances the inclusion of the covariates enhanced the magnitude of the bivariate relations. Whereas the bivariate findings found butches to consume a greater quantity of alcohol only at Time 1, with the inclusion of the confounds, young butches were found to report drinking more alcohol than femmes at all three assessments. Only infrequently did the covariates explain i. Specifically, although bivariate analyses found that butches reported both greater quantity of marijuana use at Time 2 and more substance abuse at Time 3 than young femmes, after imposing controls these two associations became nonificant.

In order to explore potential reasons why young butches were found to report greater substance use than young femmes, another set of regression analyses was conducted in which we controlled for both the confounds and potential Time 1 explanatory factors of gay-related stressful events, internalized homophobia i.

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The current report suggests that gender atypicality may be one critical factor in understanding which lesbian and bisexual women are at greatest risk for substance use. Specifically, young women with a more butch self-presentation were found to use alcohol and marijuana more frequently and to consume larger quantities of cigarettes and alcohol than young femme women.

This pattern of findings generally held even after controlling for potential confounders of these relations, namely age, sexual identity as lesbian or bisexual, and social desirability. We examined potential theoretical reasons why young butch women reported using more alcohol, cigarettes, and marijuana.

Specifically, aspects of emotional distress and gay-related stress both internalized homophobia and external stressful events were found to for the higher levels of cigarette and marijuana use found among young butch women. This suggests that tobacco and marijuana may be used by young butch women as a coping strategy to manage stress or self-medicate emotional distress potentially caused by stress.

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As noted earlier, butches may experience more stressful experiences and consequent distress than femmes because they are more easily identified as lesbian and, thus, are more likely to experience anti-gay abuse, prejudice, discrimination, and violence.

In contrast, the greater frequency and quantity of alcohol use found among young butch women were largely unexplained by gay-related stress and emotional distress. Thus, alcohol use by young butch women may not be a coping strategy and other factors e. The findings reported here have a of important research and intervention implications.

First, they highlight the need to consider gender atypicality as a potential risk factor for substance use among young lesbian and bisexual women.

Although not all young lesbian and bisexual women were found to be at risk for high levels of substance use, young butch women were at particular risk. Consequently, intervention efforts to reduce substance use may want to target young butch women.