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. Author manuscript; available in PMC: 2018 Nov 28.
Published in final edited form as: J Gay Lesbian Ment Health. 2017 Aug 10;21(4):316–326. doi: 10.1080/19359705.2017.1353472

A descriptive analysis of where and with whom lesbian versus bisexual women drink

Brian A Feinstein 1, Elizabeth R Bird 2, Anne M Fairlie 3, Christine M Lee 3, Debra Kaysen 3
PMCID: PMC6261480  NIHMSID: NIHMS965815  PMID: 30505375

Abstract

Purpose

Sexual minority women (SMW) are at increased risk for alcohol use disorders and related problems. Social context (e.g., where and with whom one drinks) has been identified as an important factor associated with drinking behavior, but little is known about social context among SMW. An improved understanding of social context among SMW has the potential to inform efforts to reduce problematic drinking and its consequences in this high-risk population.

Methods

We examined where and with whom SMW drink in a national sample recruited via social media (N = 1,057).

Results

SMW reported more frequent drinking in private locations (compared to public locations), with friends and romantic partners (compared to family members and strangers), and in locations with both heterosexuals and sexual minorities (compared to mostly or exclusively sexual minorities). Additionally, lesbians reported more frequent drinking in bars and in locations with more sexual minorities compared to bisexual women.

Conclusion

Interventions to reduce problematic drinking among SMW may benefit from addressing social context.

Keywords: sexual minority, lesbian, bisexual, alcohol, social context, drinking

Introduction

Compared to heterosexual women, sexual minority women (SMW; e.g., lesbians, bisexual women) are at increased risk for alcohol use disorders and they report greater alcohol consumption, binge drinking, hazardous drinking, and alcohol-related problems (Burgard, Cochran, & Mays, 2005; Dermody et al., 2014; Drabble, Trocki, Hughes, Korcha, & Lown, 2013; Green & Feinstein, 2012; Hatzenbuehler, Corbin, & Fromme, 2011; Hughes & Eliason, 2002; McCabe, Hughes, Bostwick, West, & Boyd, 2009; Trocki, Drabble, & Midanik, 2005). For example, in a national United States sample, 13.3% of lesbians and 15.6% of bisexual women met criteria for past-year alcohol dependence compared to 2.5% of heterosexual women (McCabe et al., 2009). Additionally, young SMW may be at particularly high risk for problematic drinking, given evidence that SMW ages 20–34 reported greater alcohol consumption and less abstinence than older SMW (Gruskin, Hart, Gordon, & Ackerson, 2001). The literature on alcohol use has identified social context (e.g., where and with whom one drinks) as an important factor associated with drinking behavior (Brown et al., 2008; Thombs, Wolcott, & Farkash, 1997), but little is known about the social context of drinking among SMW.

Research on the social context of drinking has identified numerous factors associated with greater alcohol consumption. For instance, people tend to drink more in public locations (e.g., bars) compared to private location (e.g., at home) (Clapp, Reed, Holmes, Lange, & Voas, 2006; Demers, 1997; Harford, Wechsler, & Rohman, 1983), with friends compared to family members (Clapp & Shillington, 2001; Demers et al., 2002; Orcutt, 1991), and in larger groups compared to smaller groups (Demers et al., 2002). Additionally, even though people tend to drink more in groups compared to alone, solitary drinking is also associated with excessive alcohol consumption, alcohol-related problems, and alcohol use disorders (Christiansen, Vik, & Jarchow, 2002; Keough, O’Connor, Sherry, & Stewart, 2015). Despite documented disparities in alcohol use and related problems among SMW, the social context of drinking has received limited attention in the literature on SMW.

Historically, drinking locations (e.g., bars, clubs) have been social centers for lesbian, gay, bisexual, transgender, and queer (LGBTQ) people and qualitative studies have highlighted their influence on drinking (Condit, Kitaji, Drabble, & Trocki, 2011; Gruskin, Byrne, Kools, & Altschuler, 2006). In fact, compared to heterosexual women, lesbian/bisexual women spend more time at bars/parties and bisexual women drink more alcohol in both locations (Trocki et al., 2005). Further, reliance on bars to socialize is also associated with heavier drinking among lesbians (Heffernan, 1998). In contrast, among college students there is evidence that lesbians drink less often at fraternity/sorority houses and off-campus parties compared to heterosexual women, while bisexual women drink less often at fraternity/sorority houses and bars/restaurants compared to heterosexual women (Coulter, Marzell, Saltz, Stall, & Mair, 2016). While these studies provide a foundation for understanding where SMW drink, a comprehensive understanding of drinking context is necessary to inform prevention and intervention efforts. Further, it has been suggested that the number and popularity of gay bars/clubs has been decreasing due to structural changes in gay communities (Simon Rosser, West, & Weinmeyer, 2008), especially for lesbian social spaces and among younger lesbians (Fobear, 2012). Therefore, there is a need for current data on the extent to which young SMW drink in different locations.

Drinking contexts are not only characterized by locations, but also by who is present in the environment. Despite evidence that one’s own drinking is influenced by other people’s drinking (Clapp et al., 2006; Clapp & Shillington, 2001; Demers et al., 2002), little is known about the people who frequent the locations where SMW drink. Specifically, no published studies have examined the proportion of LGBTQ versus heterosexual individuals in different drinking locations, but evidence suggests that gay/lesbian individuals tend to drink in settings with other sexual minorities, while bisexual individuals tend to drink in mixed settings (Trocki & Drabble, 2008). Given that drinking is influenced by the extent to which it is perceived as normative and acceptable (Cullum, O’Grady, Armeli, & Tennen, 2012; Thombs et al., 1997), identifying where and with whom SMW drink can improve our understanding of contextual influences on drinking and, in turn, inform prevention and intervention efforts. Finally, research has focused on lesbians (Parks, Hughes, & Kinnison, 2007) or SMW (Condit et al., 2011) without examining differences between lesbians and bisexual women. Bisexual women are at particularly high risk for problematic drinking (McCabe et al., 2009), lack of support from LGBTQ individuals (Hequembourg & Brallier, 2009), and face prejudice from heterosexual and gay/lesbian individuals (Brewster, Moradi, Deblaere, & Velez, 2013). Thus, they may be less likely to drink in settings with other sexual minorities.

To understand the social contexts in which SMW drink, our goals were to describe: (1) how often SMW drink in specific locations; (2) the proportion of LGBTQ versus heterosexual individuals in each location; (3) how often SMW drink with specific companions; and (4) differences between lesbians and bisexual women. We hypothesized that drinking rates would be higher for private locations (compared to public locations), alone as well as with friends and partners (compared to with family members, dates, and strangers), and that lesbians would drink in settings with more LGBTQ individuals compared to bisexual women.

Methods

Participants were 1,057 women who identified as lesbian (40.5%) or bisexual (59.5%) and provided baseline data in a national longitudinal study (see Litt, Lewis, Rhew, Hodge, & Kaysen, 2015). Women were 18–25 years old (M = 20.9, SD = 2.1, 49.0% were 21 and older) and identified as White (67.8%), multi-racial (15.6%), Black (10.0%), Asian (2.6%), “other” (3.0%), American Indian/Alaska Native (0.8%), and Native Hawaiian/Pacific Islander (0.1%). All participants were female assigned at birth, most identified as female (97.4%), and 2.6% identified as other genders (e.g., transgender, genderqueer). Participants were recruited on Facebook and Craigslist and screened for eligibility (female assigned at birth, 18–25 years old, lesbian/bisexual-identified, live in the US, have e-mail). A total of 4,119 women completed the screener and 1,877 were eligible and invited to participate. Participants who completed the baseline assessment received $25. Procedures were approved by the Institutional Review Board.

Measures

Demographics

Participants reported sexual identity (0 = lesbian, 1 = bisexual) and age (0 = under 21, 1 = 21 and older).

Social context

Participants were asked, “When you drink, where do you usually drink?” Locations included: home, friends’ homes, relatives’ homes, bars, restaurants, parties, dances, and cars. Responses were: 0 = never, 1 = less than 1x/month, 2 = more than 1x/month or weekly, and 3 = more than 1x/week, almost daily, or daily. Next, participants were asked, “Who are the majority of people in each setting where you drink?” Responses were: 0 = mostly/exclusively heterosexual, 1 = mixed, and 2 = mostly/exclusively LGBTQ. Finally, participants were asked, “When you drink, who do you normally drink with?” Companions included: alone, friends, dates, boyfriends/girlfriends, partners/spouses, parents, siblings, and strangers. Response options were the same as for locations. Boyfriends/girlfriends and partners/spouses were collapsed using the highest value.

Data Analysis

First, descriptive statistics were used to examine the percentage of participants who endorsed different frequencies of drinking in specific locations and with specific companions as well as the proportion of LGBTQ versus heterosexual individuals in each drinking location. Then, ordinal logistic regression was used to examine the associations between sexual identity (lesbian versus bisexual) and drinking context. Ordinal logistic regression was used because the dependent variables were measured on ordinal scales (i.e., ordered categorical response options). Age was included as a covariate to account for differential access to alcohol based on the legal drinking age in the United States. Although 22% of the sample reported not drinking in the past month, we included these participants in analyses because the outcome measures focused on the social context of drinking in general (i.e., not specific to the past month). Analyses focused on the proportion of LGBTQ versus heterosexual individuals in each drinking location excluded participants who reported “I don’t drink in this setting” because that response option precluded providing relevant data. Odds ratios and 95% confidence intervals are reported in Tables 1–3. Confidence intervals that do not include 1.0 are significant (p < .05).

Table 1.

Percent of sexual minority women who endorse frequencies of drinking in specific locations and associations with sexual identity and age.

Never (%) Less than 1x/month (%) More than 1x/month or weekly (%) More than 1x/week, almost daily, or daily (%) Lesbian (vs. bisexual)OR (95% CI) ≥ 21 (vs. < 21)OR (95% CI)
Home 25.4 28.8 28.8 16.9 1.05 (.84, 1.31) 3.39 (2.70, 4.25)
Friends’ homes 19.9 31.6 41.8 7.7 1.05 (.84, 1.32) 1.51 (1.21, 1.88)
Relatives’ homes 60.8 28.2 9.0 2.0 .90 (.70, 1.15) 1.68 (1.31, 2.14)
Bars 50.6 20.4 23.8 5.2 1.31 (1.01, 1.70) 17.60 (13.14, 23.57)
Restaurants 52.5 25.7 19.5 2.4 - -
Parties 27.9 32.6 33.1 6.5 .98 (.78, 1.23) 1.17 (.94, 1.46)
Dances 65.9 19.7 11.7 2.8 1.16 (.90, 1.49) 1.58 (1.23, 2.03)
Cars 81.1 12.6 5.0 1.2 1.07 (.79, 1.46) .88 (.65, 1.20)
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Notes. OR = odds ratio; CI = confidence interval; significance (p < .05) is indicated with bold font; ORs greater than 1 indicate greater frequency of drinking in that location; ORs are not reported for “restaurants,” because there was one cell with a frequency of zero; N = 1052–1056.

Table 3.

Percent of sexual minority women who endorse frequencies of drinking with specific companions and associations with sexual identity and age.

Never Less than 1x/month (%) More than 1x/month or weekly (%) More than 1x/month, almost daily, or daily (%) Lesbian (vs. bisexual)OR (95% CI) ≥ 21 (vs. < 21)OR (95% CI)
Alone 54.6 26.0 13.7 5.8 .83 (.65, 1.06) 2.55 (2.00, 3.26)
Friends 11.2 26.0 46.8 15.9 1.12 (.88, 1.41) 2.01 (1.59, 2.53)
Dates 53.2 23.8 19.3 3.6 .93 (.73, 1.18) 1.72 (1.35, 2.19)
Partners 31.0 22.8 33.8 12.4 1.03 (.82, 1.30) 2.10 (1.67, 2.64)
Parents 58.8 32.7 7.4 1.1 1.01 (.78, 1.30) 1.93 (1.50, 2.48)
Siblings 63.3 26.7 8.4 1.6 1.07 (.82, 1.38) 1.83 (1.42, 2.37)
Strangers 56.6 23.9 16.5 3.0 .88 (.69, 1.13) 1.48 (1.16, 1.88)
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Notes. OR = odds ratio; CI = confidence interval; significance (p < .05) is indicated with bold font; N = 983–1025.

Results

Drinking locations

Table 1 reports frequencies of drinking in each location. Results indicated that SMW were more likely to drink in private locations (e.g., home, friends’ homes) compared to public locations (e.g., bars, restaurants). For example, 16.9% of SMW reported drinking at home more than once per week, while 5.2% reported drinking at bars more than once per week. Additionally, lesbians endorsed more frequent drinking in bars compared to bisexual women. In contrast, lesbians and bisexual women did not differ on frequency of drinking in any other locations. SMW ages 21 and older endorsed more frequent drinking in most locations (home, friends’ homes, relatives’ homes, bars, dances) compared to SMW under 21.

People in drinking locations

Table 2 reports the proportion of LGBTQ versus heterosexual individuals in each location. Results indicated that SMW were more likely to drink in locations with both LGBTQ and heterosexual individuals compared to locations with mostly or exclusively LGBTQ individuals. For example, 20.7% of SMW reported drinking in bars with both LGBTQ and heterosexual individuals, while 9.8% reported drinking in bars with mostly or exclusively LGBTQ individuals. Additionally, lesbians endorsed drinking with more LGBTQ individuals in most locations (home, friends’ homes, bars, parties, dances, cars) compared to bisexual women. SMW ages 21 and older endorsed drinking at dances with more LGBTQ individuals compared to SMW under 21.

Table 2.

Percent of sexual minority women who endorse proportions of heterosexual versus LGBTQ individuals in specific drinking locations and associations with sexual identity and age.

I don’t drink in this setting (%) Mostly or exclusively heterosexual (%) Mixed (%) Mostly or exclusively LGBTQ (%) Lesbian(vs. bisexual)OR (95% CI) ≥ 21(vs. < 21)OR (95% CI)
Home 26.0 34.1 26.8 13.1 3.21 (2.43, 4.24) 1.25 (.95, 1.64)
Friends’ homes 19.1 29.8 37.5 13.7 3.33 (2.53, 4.38) .94 (.73, 1.22)
Relatives’ homes 59.2 33.0 6.8 1.0 1.55 (.95, 2.52) 1.12 (.68, 1.83)
Bars 49.4 16.7 24.1 9.8 2.30 (1.65, 3.21) .84 (.56, 1.25)
Restaurants 51.4 25.4 20.7 2.5 - -
Parties 27.3 25.9 37.4 9.4 2.17 (1.63, 2.89) 1.05 (.80, 1.39)
Dances 63.6 8.9 18.4 9.1 3.60 (2.39, 5.44) 1.50 (1.02, 2.22)
Cars 78.6 7.1 8.9 5.4 3.79 (2.22, 6.47) 1.00 (.61, 1.63)
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Notes. OR = odds ratio; CI = confidence interval; significance (p < .05) is indicated with bold font; ORs greater than 1 indicate greater proportion of LGBTQ individuals in that location; ORs are not reported for “restaurants,” because there was one cell with a frequency of zero; for analyses focused on sexual identity and age, N varied depending on how many participants endorsed drinking in that location (N = 781 for home, 853 for friends’ homes, 428 for relatives’ homes, 533 for bars, 545 for restaurants, 766 for parties, 383 for dances, and 225 for cars).

Drinking companions

Table 3 reports frequencies of drinking with each companion. Results indicated that SMW were more likely to drink with friends and romantic partners compared to others companions (e.g., family members, strangers). For example, 15.9% of SMW reported drinking with friends more than once per week and 12.4% reported drinking with romantic partners more than once per week. In contrast, 1.1% reported drinking with parents more than once per week, 1.6% reported drinking with siblings more than once per week, and 3.0% reported drinking with strangers more than once per week. Lesbians and bisexual women did not differ in frequencies of drinking with each companion. SMW ages 21 and older endorsed more frequent drinking alone and with all companions compared to SMW under 21.

Discussion

The social context of drinking has received attention among heterosexual individuals, but little is known about where and with whom SMW drink. In contrast to heterosexual individuals (Clapp et al., 2006), we found that SMW reported drinking more frequently in private locations compared to public locations. While the proportion of SMW who endorsed drinking in public locations was still sizable, more frequent endorsement of drinking in private locations goes against the traditional view of sexual minorities drinking in bars as their primary means to socialize. This is consistent with evidence that there are fewer lesbian social spaces now compared to in the past and that lesbian bars/clubs have become less popular, especially among younger lesbians (Fobear, 2012). Given increased visibility and acceptance, SMW may rely less on bars if their social networks already include other sexual minorities. This has implications for where SMW are recruited for research and interventions, such that a focus on public settings is likely to miss a large segment of the SMW population.

We also found that SMW were more likely to drink in mixed settings compared to mostly/exclusively LGBTQ settings. Therefore, it is important to consider the influence of various social groups (e.g., heterosexual and LGBTQ individuals) on drinking behavior among SMW. Although speculative, drinking in mixed settings may be influenced by various factors related to sexual orientation, such as outness, comfort with one’s sexual orientation, and discrimination. For instance, SMW may drink to cope with enacted or internalized stigma, especially in mixed settings. Additionally, given that bisexual women have unique stigma experiences (e.g., having their sexual orientation invalidated, being sexualized by heterosexual men; Brewster et al., 2013; Hequembourg & Brallier, 2009), they may be particularly likely to drink to cope in mixed settings. However, it will be important for future research to empirically test these hypotheses.

Additionally, we found that lesbians reported more frequent drinking in bars compared to bisexual women. Coulter et al. (2016) also found that lesbian college students reported drinking more often in bars compared to bisexual women. However, they statistically compared lesbians and bisexual women to heterosexual women rather than comparing lesbians and bisexual women to each other. We also found that lesbians reported more frequent drinking in locations with more LGBTQ individuals compared to bisexual women. It has been suggested that people return to specific drinking locations where they can find people like themselves (referred to as assortative drinking) (Gruenewald, 2007). Given that lesbians report more involvement in and connectedness to the LGBTQ community compared to bisexual women (Balsam & Mohr, 2007; Feinstein, Dyar, & London, 2016), they may feel more comfortable and accepted in settings with other LGBTQ individuals. Another possibility is that lesbians may drink in settings with more LGBTQ individuals to meet romantic/sexual partners. Most lesbians in relationships have same-gender partners, while most bisexual individuals in relationships have different-gender partners (Parker, 2015). Therefore, lesbians may frequent LGBTQ settings to drink, because they are more likely to meet partners there than in mixed settings. Again, it will be important for future research to test these possibilities in order to advance our understanding of the differences in where and with whom lesbians versus bisexual women drink.

Finally, we found that SMW were most likely to drink with friends and partners. Although speculative, these relationships may have stronger influences on drinking behavior among SMW compared to other relationships. Social situations where drinking is perceived as normative and acceptable can increase risk for heavier use (Kuendig & Kuntsche, 2012). Therefore, the extent to which SMW perceive their friends and partners as drinking heavily is likely to influence their drinking behavior, and perceived norms for alcohol consumption are likely different for friends and partners versus other individuals. In fact, social norms (e.g., perceptions of peer drinking) are one of strongest predictors of one’s own alcohol consumption (Neighbors, Lee, Lewis, Fossos, & Larimer, 2007). SMW may also feel more comfortable and safer drinking larger amounts with friends and partners, given concerns about impression management and potential safety threats with dates and strangers. If research confirms these possibilities, then prevention and intervention efforts may benefit from addressing the unique influences that different companions can have on drinking behavior.

Given that we found differences in drinking context based on sexual identity, it is possible that interventions for problematic drinking may need to focus on different targets for lesbians versus bisexual women. Interventions that address sexual minority-specific drinking norms may be particularly important for lesbians, given that they reported drinking in locations with more LGBQ individuals compared to bisexual women. People often overestimate peer drinking, and greater perceptions of peer drinking norms is associated with increased alcohol consumption (Collins & Spelman, 2013). Interventions that educate people about their own drinking in comparison to other people’s drinking have been found to be effective at reducing alcohol consumption (Cronce & Larimer, 2011), especially when tailored for specific groups (Lewis & Neighbors, 2007). Given that greater misperceptions of SMW-specific drinking norms are also associated with increased alcohol consumption (Litt et al., 2015), tailored interventions may be particularly effective for lesbians.

Findings should be considered in light of several limitations. First, despite a large sample, all participants were 18–25 years old. In our sample, SMW ages 21 and older endorsed drinking more frequently in most locations and with all companions compared to SMW under 21. Given that the legal drinking age in the United States is 21, these findings likely reflect differential access to alcohol based on the legal drinking age. It will be important for future research to examine age differences in where and with whom SMW drinking using samples with larger age ranges. Second, 22% of our sample reported not drinking in the past month and findings may be different for heavier drinkers. Third, while using the internet to recruit a national sample is a strength, findings may not generalize all SMW. Fourth, our sample did not include a heterosexual comparison group, so we were not able to test the extent to which drinking context differed between SMW and heterosexual women. Finally, data were self-report and subject to bias (e.g., reports of LGBTQ versus heterosexual people in each drinking locations may be inaccurate). Despite limitations, these findings are among the first to describe where and with whom SMW drink. Future research should consider other aspects of social context and the implications of drinking in different contexts.

Acknowledgments

Data collection for this study was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (R01AA018292; PI: Kaysen). Brian A. Feinstein’s time was supported by a grant from the National Institute on Drug Abuse (1F32DA042708-01). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse. We thank all of the participants for their contributions to this study.

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