LGBTQ+ community experience alcohol-related health inequalities in Scotland

People who identify as LGBTQ+ are more likely to have problems with alcohol and experience major barriers in accessing alcohol services, according to researchers at Glasgow Caledonian University.

A new study launched today reveals the barriers the LGBTQ+ community experience when accessing alcohol services. Given the significant alcohol-related health inequalities experienced by LGBTQ+ people in Scotland, researchers are now calling for action to overcome these barriers.

The study on LGBTQ+ people’s experiences of alcohol services was led by Professor Carol Emslie with Dr Elena Dimova, Dr Rosaleen O’Brien, Professor Lawrie Elliott and Dr Jamie Frankis, from the University’s Substance Use and Sexual Health and Blood Borne Viruses research groups in the Research Centre for Health (ReaCH), and was funded by Scottish Health Action on Alcohol Problems (SHAAP).

Professor Emslie said: “We know that LGBTQ+ communities are at higher risk of alcohol-related harm, so it is important to learn about their experiences of alcohol services in Scotland. Our respondents reported their drinking was often a response to discrimination, family rejection or hiding their LGBTQ+ identity, but that service providers rarely explored how sexuality or gender identity might impact on alcohol use.

“Our report recommends that all staff working in alcohol services should receive LGBTQ+ diversity training and services should check they are reaching the LGBTQ+ community, and tailoring their services appropriately. At a broader level, alcohol-free spaces for LGBTQ+ people where drinking heavily is not the norm, and increased public acceptance of LGBTQ+ issues would reduce alcohol harm in this community.

“I hope our report will highlight the inequalities experienced by LGBTQ+ people around alcohol, ensure safe spaces for LGBTQ+ people to discuss their drinking and result in more inclusive alcohol services in Scotland.”

Dr Elena Dimova, a principal researcher on the project, added: “Our respondents talked about experiencing poor mental health and many said this was related to their drinking. One of our recommendations is that alcohol services need stronger links to mental health to ensure that clients receive seamless care.”

The study investigated both service users’ and service providers’ experiences, and includes some concerning findings.

Amongst service users interviewed, two primary themes surfaced in regards to alcohol in the LGBTQ+ community. The first was the central role of alcohol in the community and the second was the barriers to accessing treatment and support.

Respondents were concerned that excessive drinking was normalised among LGBTQ+ people and that there was a lack of LGBTQ+ alcohol-free spaces in Scotland. They also identified specific barriers to accessing alcohol services, including concerns about judgement and discrimination, services not being perceived as LGBTQ+ friendly, and a lack of discussion of sexuality and gender from service providers.

Interviews with clinicians and third sector service providers also highlighted a number of barriers for LGBTQ+ individuals accessing alcohol services. Service providers reported feeling uncomfortable in discussing gender and sexuality, with some even voicing their perception of a lack of relevance to alcohol treatment. However, providers felt that, with training, their confidence would improve in discussing this.

David Barbour, of the Glasgow LGBTQI Substance Use Partnership, commented: “Disproportionate numbers of LGBT+ people find themselves using alcohol to self-medicate for higher levels of stress, anxiety and depression, often caused by past or ongoing experiences of homo/bi/transphobia. Combined with the fact that alcohol plays such a dominant role in safe LGBT+ social spaces, it is crucial that alcohol services take steps to understand the scale of this problem and begin to address it. We will continue to work as a Partnership of LGBT+, substance use and recovery services and academics to implement these recommendations.

“We are delighted that several of our partner organisations, including alcohol, drug and smoking cessation services, have now signed up to the LGBT Youth Scotland LGBT Charter Award scheme, with others ready to follow. This should make a significant difference to how LGBT+ people having difficulties with alcohol experience services. We believe that it’s also crucial that substance use services proactively engage with LGBT+ services and the wider community to raise awareness of and address these disproportionate harms.”

Elinor Jayne, SHAAP Director commented: “Given the disproportionate alcohol harms experienced by the LGBTQ+ community, it is imperative that the needs of LGBTQ+ people are explicitly addressed in the upcoming Scottish Government Alcohol Treatment Guidance, in order to tackle these inequalities and reduce the stigma experienced by LGBTQ+ individuals in accessing alcohol treatment services. The Scottish Parliament should show leadership in generating more public understanding and acceptance of LGBTQ+ people and reduce the stigma they experience.”