Guest blog: Alcohol in the LGBTQ+ community
Dr Callum Phillips (he/they), advisor to GLADD, the UK’s Association of LGBTQ+ Doctors and Dentists and Deputy Editor-in-Chief of the British Student Doctor Journal discusses alcohol harm in the LGBTQ+ community.
It takes a painfully short time to find the evidence that LGBTQ+ people are more likely to have a problematic relationship with alcohol. 16%1 of us drink alcohol nearly every day, a number which rises to 33% for those over 65. 37% of lesbian and gay people and 31% of bisexuals misuse alcohol2 - far higher than our cisgender heterosexual counterparts.
The reasons for this are complex and multifaceted, whilst also lacking attention. Research suggests alcohol may be used as a way of facing up to bullying,2 marginalisation, or stigma and escaping from heteronormativity. We also know that drinking as a coping strategy3 for unfair treatment is more likely in queer folk. LGBTQ+ minority stressors clearly4 play a role, and it is likely that these deepen when they interact with discrimination against other characteristics such as race or disability.
We also have a culture which seems to promote drinking - in fact, there is evidence to suggest the LGBTQ+ community tend to drink more heavily when around other queer people5. This could be as a result of how alcohol has been marketed to queer audiences, persistent peer pressure, or behaviour learned when alcohol was used to boost confidence when first ‘coming out’.
Some of this may be historical – the criminalisation of homosexuality pushed queerness to the boundaries, to the hushed corners of bars spoken in whispers of Polari. In some ways, we haven’t left these dark spaces − being hyperaware of and overly subject to criticism and trauma is exhausting. Alcohol can offer a reprieve from these voices, and is readily found in our safe spaces, those very same bars and pubs offering an escape route from reality. But, we are slowly pushing back against this with sober queer spaces on the rise, such as London’s LGBTQ+ Community Centre and the more national Queers Without Beers.
What alcohol does to the body
Alcohol, or ethanol, is an addictive sedative drug (a depressant) that can result in feelings of disinhibition and relaxation.
Long term alcohol use can result in damage across the body, increasing your risk of heart and liver disease and at least seven types of cancers. Drinking regularly and excessively can also increase your risk of pancreatitis, dementia, and brain damage. As well as your physical health, alcohol can also negatively impact your mental health making stress and anxiety harder to deal with.
Drinking can also result in aggression, risk taking, and poor judgement. Even low blood alcohol concentrations can increase the risk of unintentional injuries, and even being below the legal limit puts yourself and others at greater risk of road traffic accidents so if you’re thinking to drive it’s always safest to avoid alcohol completely. Alcohol is also packed full of calories – an alcoholic drink can contain approximately 7 calories per gram, almost as many as pure fat. Drinking a lot of alcohol in a short space of time can also lead to alcohol poisoning which can be extremely dangerous and stop the body from working properly. There is no minimum amount of alcohol that can cause alcohol poisoning, and in serious cases it can be fatal. Some people can also become addicted to alcohol - the behavioural syndrome in which there is a compulsion for use of alcohol (the shifting of liking alcohol to always wanting alcohol) and can lead to alcohol dependence.
How much is too much?
Alcohol is measured in units. The number of units in 1 litre of alcohol is the same as its ABV %. 1L of 40% ABV whiskey contains 40 units. A 25ml shot contains 1 unit. A pint of a regular-strength beer comes in at around 2 units. There is no ‘safe’ drinking level when it comes to alcohol, only lower risk.
To keep health risks to a minimum the UK’s Chief Medical Officers’ low risk drinking guidelines recommend drinking no more than 14 units a week, spread evenly throughout the week with several drink-free days.
Support for LGBTQ+
Despite it being promised in the UK government’s 2018 ‘LGBT Action Plan’ - there is no national data monitoring6 of queer health outcomes, even with the disparities highlighted during the pandemic. This makes it harder to carry out research and targeted interventions to help the LGBTQ+ community. We need to remind them of this promise and the importance of treating our community as equals. Compounding this, there remains an exclusion problem1 in medicine, with LGBTQ+ people having worse access to and experience of healthcare. This may result in delayed diagnoses and inferior outcomes. If you find yourself in this position, remember the NHS has a legal duty to protect your human rights and promote equality. If you face discrimination, Citizens Advice has a helpful guide of what to do next. You can also seek advice from organisations such as the Switchboard LGBT Helpline.
It you think you need help with a drinking problem, Drinkaware has a list of support services which may be helpful for members of the LGBTQ+ community. If you feel you can’t reduce or stop your drinking on your own, your GP surgery can also provide advice or signpost you to services for reducing your alcohol intake. Please do not delay seeking help if you need it– taking the first step can often be the hardest.
 LGBT in Britain Health. 2018. Accessible at: www.stonewall.org.uk/system/files/lgbt_in_britain_health.pdf
 Mental health disorders and alcohol misuse more common in LGB people. 2021. Accessible at: https://www.ucl.ac.uk/news/2021/feb/mental-health-disorders-and-alcohol-misuse-more-common-lgb-people
 Mental health among UK inner city non-heterosexuals: the role of risk factors, protective factors, and place. 2015. Accessible at:
 Stress, coping, and context: Examining substance use among LGBTQ young adults with probable substance use disorders. 2021. Accessible at:
 The role of alcohol in identity construction among LGBT people: a qualitative study. 2017. Accessible at: https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.12605
 How Covid-19 has exacerbated LGBTQ+ health inequalities. 2021. Accessible at: https://www.bmj.com/content/372/bmj.m4828?int_source=trendmd&int_medium=cpc&int_campaign=usage-042019
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