Cheryl A. Parks, PhD, MSW, School of Social Work, University of Connecticut, 1798 Asylum Avenue, West Hartford, CT 06117, 860-570-9017, cheryl.parks@uconn.edu and Tonda L. Hughes, PhD, RN, FAAN, Department of Public Health, Mental Health and Administrative Nursing, University of Illinois at Chicago, College of Nursing, M/C 802, 845 S. Damen Ave, Chicago, IL 60612.

Alcohol abuse appears to be prevalent and to pose serious health risks among women who identify as lesbian. Stress associated with “coming out” as lesbian is one common explanation for high rates of heavy drinking and drinking-related problems within this population; however, this explanation does not account for differences in stress levels experienced over the course of the identity development process. Previous research suggests substantial variability in at-risk drinking patterns occurs as women move through different phases in coming to terms with a non-heterosexual identity. As part of an NIAAA-funded study on the health and life experiences of women who self-identify as lesbian, we examined changes in drinking and identity among a diverse group of 448 self-identified lesbians. Data were collected in face-to-face structured interviews. Retrospective data on sexual identity development (e.g., ages of first awareness, first deciding, and first disclosing a lesbian identity), and drinking trajectories (ages of first regular use and of subsequent changes in level of use), were examined. Associations between identity milestones, changes in alcohol use, and drinking outcomes (heavy drinking; lifetime alcohol-related problems) were explored to identify points of correspondence between identity development and drinking. Significant associations were found between phases of identity development and changes in drinking behavior. Heavy drinking and lifetime alcohol-related problems were associated with earlier awareness of same-sex sexual feelings and earlier same-sex sexual involvement. Implications include more targeted prevention and intervention strategies that address developmental differences in stressors experienced and resources needed to reduce risk for alcohol problems among lesbians.

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