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Why Lesbians are at Risk for Substance Abuse

01 Oct Posted by in • Guest Writers | Comments Off on Why Lesbians are at Risk for Substance Abuse
Why Lesbians are at Risk for Substance Abuse

In my private practice, I often work with lesbians who have or still struggle with substance abuse. Some are newly sober, some have a hard time staying sober and many have been sober for a long time.

Regrettably, lesbians are at greater risk for substance abuse issues and other addictive disorders than the general population (Hughes & Wilsnack, 1997). The causes are, of course, complex and multidimensional, but one thing is clear – growing up in a heterosexist and lesbianphobic world compounds the problem. To understand how growing up lesbian in an unwelcoming or hostile world impacts addictive behaviors is an imperative part of getting better. Learning lesbian-affirmative root causes will help ameliorate them. Some of you may have heard of these terms and some of you may not have, but knowing about them will help all lesbians who struggle with addiction.

Heterosexism: Herek (1995) defined this idea best when he said, “an ideological system that denies, denigrates, and stigmatizes any non-heterosexual form of behavior, identity, relationship, or community” (p. 321).

Lesbianphobia: A concept I developed years ago to distinguish the difference between male focused homophobia and the kind of discrimination lesbians face being both same-sex oriented and women. By definition, it is the irrational fear and/or hatred of same-sex emotional, romantic, and erotic love between women – combined with the varying degrees of misogyny that exist in a patriarchal and heterosexist culture (Costine, 2009).

As lesbians grow up in a lesbianphobic and heterosexist world these concepts are internalized inside the growing psyche and eventually turned inward – creating intense suffering and interfering with the development of a healthy and stable sense of self. To make matters worse the voices inside are often subtle or masked by other critical statements thus making them confusing, but the internalized lesbianphobic voices often go like this – you are not really a lesbian-you can find a man attractive; lesbians are bad; you don’t want to be one of those; you can’t trust lesbians – they will hurt or reject you; the world hates lesbians; you’re too femme; you’re too butch; you’re not butch enough; your parents will never talk to you again if you come out; your parents were right – you are a sinner for being attracted to other women; you don’t deserve love; you’re not good enough – the list goes on and on.

While we all face a phobic world and many of us have to deal with parents that were unaccepting – internalized lesbianphobia creates the biggest problem by interfering with self-trust. When the bond with the self is under developed, the ability to move through the world with self-esteem and self-love is impaired and self-compassion does not exist. Substances and other addictions mask internalized lesbianphobia and therefore become a go to whenever the suffering arises. This way of coping is not conscious, but the draw to keep using anything that masks these voices and painful feelings is unmistakingly powerful. But don’t despair, there are solutions and, thankfully, with enough motivation to get better, there is liberation. Stay tuned for future articles where I will talk more about causes and solutions.

Costine, L. (2009). Lesbianphobia. Lecture from Lesbian liberation class. Antioch University Los Angeles.

Herek, G.; D’Augelli, A.R.; Patterson, C., (1995). Psychological heterosexism in the united states. In Lesbian, gay & bisexual identities over the lifespan, p321. 26p.

Hughes, T., Wilsnack, S., (1997). Use of alcohol among lesbians: Research and clinical implications. American journal of orthopsychiatry. 67(1). January.

Lauren Costine, Ph.D., is a licensed psychologist, educator, writer, activist & founding member of The LGBT Specialization in Clinical Psychology at Antioch University, Los Angeles where she teaches. She is the Clinical Director of The LGBT-Affirmative Program and Chair of the Clinical Subcommittee at BLVD Treatment Centers. With a specialization in LGBT-Affirmative psychotherapy, Addictions and Depth Psychology, she is in private practice in Beverly Hills where she works with individuals & couples and is currently working on two books. Her website is

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