The Other High Risk Group:
GLBT Students At Risk
Kari Kuka M.S.
Associate Director of Operations
• Why are GLBT students at higher
risk behavior and other health issues
than the general student population
• Data collection and research
• What peer education groups can do
Cultural Gay Trivia
Why They Are High Risk?
o Shame
o Fear
o Harassment
o Non-acceptance from family members
o Uncertain about sexuality
o Depression
o Anxiety
o Social events involve drugs and alcohol
Why They Are High-Risk
• Cognitive Isolation - lack of information about gays and
lesbians, how gay and lesbian couples function, how long
they stay coupled, how they determine gender roles, and
how they solve relationship problems.
• Social Isolation - lack of contact with positive role models
reinforces the negative value that society places on
• Emotional Isolation - poor social support and few resources.
For example, lower social support from families, fewer
resources in the community, stigmatization (may increase
the impact of stressful life events), and legal discrimination
(homosexual behavior is still considered illegal in 24 of the
United States).
Five Substance Abuse-Specific Risk
Factors for LGBT Adolescents:
1. Sense of self as worthless or bad.
2. Lack of Connectedness to supportive adults
and peers
3. Lack of alternative ways to view “differentness”
4. Lack of access to role models
5. Lack of opportunities to socialize with other
GLBT’s outside of bars
6. Risk of contracting HIV
• Nearly two-thirds of LGBT students
(64%) said they feel unsafe in
school because of their sexual
orientation, according to the 2005
National School Climate Survey.
• Additionally, four out of five LGBT
students reported experiencing
physical, verbal or sexual
harassment at school during the
past year.
Coming Out
• About two thirds (64%) report having
first come out by age 21, including
one third (32%) who came out by age
18. A majority (59%) report that
nearly all their lesbian, gay and
bisexual friends are out.
Coming Out Stages
• Self-recognition as GLBT
• Disclosure to others
• Socialization with other GLBT
• Positive self-identification
• Integration and acceptance
On Campus
• College campuses are often stereotyped
as liberal meccas of progressive ideals.
But lesbian, gay, bisexual and
transgender (LGBT) students, staff and
faculty are not immune to harassment
and discrimination. Among those on
campus, 20 percent fear for their physical
safety due to their perceived sexual
orientation or gender identity.
About the Data
• Limited surveys ask about sexual
• Surveying a small, hidden population
• Terminology used in survey
• Limited funding is available to
research this population
Why Separate from the
General Population
What are their special educational
Safe environment
Special mental health needs
Positive roll models
Health Disparities Revealed
• Alcohol and drug abuse
• Tobacco use
• Exercise, Nutrition and Eating
• Mental Health issues
Over All Health Risks
• GLBT youth who self-identify during high
school report disproportionate risk for a
variety of health risk and problem
– suicide
– victimization
– sexual risk behaviors
– multiple substance use
• These findings suggest that educational
efforts, prevention programs, and health
services must be designed to address the
unique needs of the GLBT population
• Los Angeles Pride - Bud Light and
• Denver Pride - Coors Light and Stoli
• San Diego Pride - Bud Light and
• Boston Pride -Bud Light and Smirnoff
• Alcohol dependence and alcoholrelated consequences differ by
sexual orientation, particularly
among women.
• There is a need for the inclusion of
sexual-orientation items in
population-based surveys so that
prevalence rates within these
subgroups can be effectively
• Homosexual and bisexual women
and men spend more time than
heterosexual individuals in heavier
drinking environments.
• Being in heavy drinking
environments does not appear to
be associated with heavier drinking
for men, but may be related to
heavier drinking among some
groups of women.
Drug Use
• There is a moderate elevation of drug,
particularly marijuana, use and
dependence in gay and bisexual men and
women when compared to heterosexual
men and women.
• Gay men use substances at a higher rate
than the general population, and not just
in larger communities such as New York,
San Francisco, and Los Angeles. These
include a number of substances ranging
from amyl nitrate ("poppers"), to
marijuana, Ecstasy, and amphetamines.
Drug Use
• Crystal Meth in combination with Viagra
has drastically increased the spread of
HIV among MSM
• Gay, lesbian, and bisexual orientation
was associated with an increased lifetime
frequency of use of cocaine, crack,
anabolic steroids, inhalants, “illegal,” and
injectable drugs
• Gay, lesbian, and bisexual youth were
more likely to report using tobacco,
marijuana, and cocaine before 13 years of
Tobacco Use
• Tobacco companies promote specific brands to
LGB populations through outdoors advertising,
ads in gay-oriented magazines, nightclub
promotions, and event sponsorships.
• In the mid-1990s, tobacco control professionals
discovered documents that revealed the tobacco
industries marketing campaign, Project SCUM
(Sub Culture urban Marketing). This campaign
was an aggressive attempt to increase smoking
and brand loyalty of homeless people and
lesbian, gay, and bisexual adults in San
Francisco’s Castro district.
• Top ad categories in Out magazine: tobacco,
alcohol, HIV treatments, arrangements to sell life
Tobacco Use
• The GLBT community is approximately 40-70%
more likely to smoke than non-GLBT individuals
• Lesbians, bisexual females, and gay men had
significantly higher cigarette smoking
prevalence rates than their heterosexual
• Several factors such as higher levels of social
stress, frequent patronage of bars and clubs,
higher rates of alcohol and drug use, and direct
targeting of LGB consumers by the tobacco
industry may be related to higher prevalence
rates of tobacco use among some LGB groups.
Exercise, Nutrition, and Eating
• Data supports the hypothesis that
homosexual orientation is associated
with greater body dissatisfaction and
problem eating behaviors in males, but
less body dissatisfaction in females.
The possible role of sociocultural
influences or gender identification on
these relationships is discussed.
Exercise, Nutrition, and Eating
• Research confirms that lesbians have higher body
mass than heterosexual women. Obesity is
associated with higher rates of heart disease,
cancers, and premature death.
• Gay men are much more likely to experience an
eating disorder such as bulimia or anorexia
nervosa. The use of substances such as anabolic
steroids and certain supplements can adversely
affect health.
• Overweight and obesity are problems that also
affect a large subset of the gay community.
Mental Health
Mental Health
• Gay, lesbian, bisexual, or not sure youth
report a significantly increased frequency
of suicide attempts.
• Sexual orientation has an independent
association with suicide attempts for
• For females the association of sexual
orientation with suicidality may be
mediated by drug use and
violence/victimization behaviors.
Mental Health
• Lesbian and bisexual women
were found to have a higher
prevalence of several
important risk factors for
breast cancer, CVD, and poor
mental health and functioning
What Can You Do?
• Keep educating yourself
• Understand this community is unique and
has their own special needs
• Recruit them
• Educate others on campus
– Faculty
– Staff
– Health care providers
– Counseling staff
What Can You Do?
• Co-sponsor events with the GLBT
• Provide safe zone training annually
• Look at polices that may
discriminate against GLBT students
• Educate resident assistants
• Bring in speakers that address the
issues of this population
Tang H, Greenwood GL, Cowling DW, Lloyd JC, Roeseler AG, Bal DG.
Cigarette smoking among lesbians, gays, and bisexuals: how serious a
problem? Cancer Causes Control. 2004 Oct;15(8):797-803
Garofalo R, Wolf RC, Kessel S, Palfrey SJ, DuRant RH. The association
between health risk behaviors and sexual orientation among a schoolbased sample of adolescents. Pediatrics. 1998 May;101(5):895-902
Drabble L, Midanik LT, Trocki K. Reports of alcohol consumption and
alcohol-related problems among homosexual, bisexual and heterosexual
respondents: results from the 2000 National Alcohol Survey. J Stud
Alcohol. 2005 Jan;66(1):111-20
Trocki KF, Drabble L, Midanik L. Use of heavier drinking contexts among
heterosexuals, homosexuals and bisexuals: results from a National
Household Probability Survey. J Stud Alcohol. 2005 Jan;66(1):105-10.
Cochran SD, Ackerman D, Mays VM, Ross MW. Prevalence of non-medical
drug use and dependence among homosexually active men and women in
the US population. Addiction. 2004 Aug;99(8):989-98.
Resources Continued
French SA, Story M, Remafedi G, Resnick MD, Blum RW. Sexual
orientation and prevalence of body dissatisfaction and eating disordered
behaviors: a population-based study of adolescents. Int J Eat Disord. 1996
The Kaiser Family Foundation Inside-OUT: A Report on the Experiences of
Lesbians, Gays and Bisexuals in America and the Public’s Views on Issues
and Policies Related to Sexual Orientation
Garofalo R, Wolf RC, Wissow LS, Woods ER, Goodman E. Sexual
orientation and risk of suicide attempts among a representative sample of
youth. Arch Pediatr Adolesc Med. 1999 May;153(5):487-93.
Case P. Austin SB. Hunter DJ. Manson JE. Malspeis S. Willett WC.
Spiegelman D. Sexual orientation, health risk factors, and physical
functioning in the Nurses' Health study II. [Journal Article] Journal of
Women's Health. 13(9):1033-47, 2004 Nov.

The Other High Risk Group: GLBT Students At Risk