Etiology of alcoholism in homosexuals
People with a homosexual orientation are, of course, subject to all of the multiple risk factors for addiction discussed above. They also have some psychosocial predisposing factors common to all hated minorities, and some unique to the homosexual population. There are many different types of alcoholics; there are many different types of homosexuals, and there are even more types of alcoholic homosexuals (Nardi, 1982).
Common to all hated minorities is the damage done to self-image by the internalization of that hatred. Erikson (1959) asserts that it is impossible for any member of a hated minority to escape that internalized hatred.
Homosexuals are subject to unique stresses, as well. Starting in youth, sometimes as early as school age, sometimes before the homosexual himself is aware of any sexual orientation, he learns some of the dangers of being homosexual: public derision ("Joey is a fagot!"), discrimination ("We don't want a queer on the baseball teem"), and physical harm ("Hit the sissy again!"). The child may be rejected by her family implicitly (Mother overheard: "I'd rather my daughter be dead than be one of those lez-bines.") or explicitly (Father overheard: "You are a homo, you are not my son. Get out of my house.") (Savin-Williams, 1994). In later life he will face discrimination in the workplace and the possibility (only today less prevalent) of arrest and imprisonment for "unnatural acts." Rosario, Hunter & Rotheram-Borus (1992) note,
. . . the experience of being gay or bisexual in our society overwhelms any potential differences in social categories involving age, ethnicity, race, social class or geographical region of the country (p. 19).
The homosexual is unique among minorities in facing hatred and discrimination in that she usually has no role model, no positive example in her family, no loving parent who has gone through the same experience, to support her in her pain. Those discriminated against because they are (for instance) Jewish or African-American usually have families or communities for which this is a common problem. But gay youths are all too often rejected even by their families (Savin-Williams, 1994) and too seldom have yet found their supportive peers and communities.
Facing this external view of herself, no wonder that the homosexual internalizes this hatred and has difficulty with accepting her identity, building self-esteem, and expressing her sexuality. About 65% of all homosexuals seek therapy and give as a reason depression which is a result of adjusting to their homosexuality; of these, 50% started therapy between the ages of 18-21 (Diamond-Friedman, 1990).
In turn, these difficulties lead some to increase their consumption of alcohol or other drugs to aid in the coming-out process, or to medicate the anxiety or depression associated with concealing their identity or facing rejection from family and friends, discrimination in employment and housing, physical assault, arrest or imprisonment.
Colcher (1982) hypothesizes that homosexuals use substances to dull the pain of feeling "different and alone," to reduce "sexual inhibitions" relating to internalized homophobia, and to reduce the stress of the keen competition for good-looking sexual partners.
Nardi (1982) hypothesizes that homosexuals are more at risk of drinking to the point of addiction because the gay life style often revolves (or revolved in 1982) around gay bars, which have a history of permissiveness and protectiveness:
The absence of significant subculturally valued alternatives to drinking settings . . . contributes to the dependency on alcohol as an acceptable solution to feelings of anxiety, alienation and low self-esteem(p.21).