By Dr Elena Dimova, Prof Carol Emslie, Dr Jamie Frankis & Prof Lawrie Elliott, Glasgow Caledonian University (@SubMisuseGCU)

This blog post by researchers from Glasgow Caledonian University reports on their recent study for SHAAP "What are LGBTQ+ people’s experiences of alcohol services in Scotland? A qualitative study of service users and service providers", which highlights the difficulties LGBTQ+ people experience when trying to access alcohol services in Scotland. 

On 9 June, SHAAP is holding an event with policymakers at the Scottish Parliament to highlight our research about LGBTQ+ people and alcohol services. LGBTQ+ people (lesbian, gay, bisexual, trans, queer, questioning, non-binary or otherwise gender or sexually diverse) and allies come together in June to celebrate Pride in Scotland’s towns, cities and islands.  Pride celebrates the achievements of LGBTQ+ rights and highlights the need for acceptance, education, and the continuing fight for equality. It also commemorates the Stonewall riots in June 1969, when patrons of the Stonewall Inn in New York City resisted police harassment and persecution. As American LGBT activist and columnist Tyler Curry suggests, there are strong links between alcohol and LGBTQ+ identity:-  

“The modern-day LGBT rights movement was practically born in a bar […] when the people at the Stonewall Inn finally decided that enough was enough. Even now, gay bars are where many young men and women first learn to become comfortable with their true identity”
(Tyler Curry)

LGBTQ+ people experience more harm from alcohol than many other groups in society.  They are more likely to drink alcohol, to drink heavily and to experience alcohol dependence. This may be partly because of historic and ongoing inequality and discrimination, rejection by family and friends and hiding sexual orientation or gender identity from others.  Indeed, Glasgow Caledonian University research shows this stigma means LGBTQ+ people experience worse mental health than others in society.  Drinking alcohol is also an important part of identity for many LGBTQ+ people: much of the commercial gay scene revolves around alcohol and it is difficult to find LGBTQ+ safe spaces which are alcohol-free.  The alcohol industry capitalises on this too, when they target alcohol marketing at LGBTQ+ people and sponsor Pride events. Yet despite being more likely to experience an alcohol problem, LGBTQ+ people face barriers when accessing alcohol services. These include concerns about stigma and judgment from service providers, and about confidentiality within services.

Our recent study, funded by SHAAP, explored both LGBTQ+ service users’ and service providers’ views and experiences of alcohol services in Scotland.  

We interviewed LGBTQ+ people who had used an alcohol service in Scotland. They told us:

• Drinking is often related to LGBTQ+ identity, as a response to shame, stigma, or family rejection.
• Connections between sexuality or gender identity and alcohol use were rarely raised or explored by service providers.
• Trans people and lesbian and bisexual women felt vulnerable in some group settings.

We also interviewed service providers. We found:

• Some service providers were uncomfortable asking about and discussing sexuality and gender identity
• Training around LGBTQ+ issues (particularly trans issues) and appropriate language would help them overcome fears about upsetting clients and improve the experience of alcohol services for LGBTQ+ people.
• Service providers reported that some clients face multiple issues and inequalities and increased public acceptance of LGBTQ+ issues would help reduce alcohol-related harm.

How can we better support LGBTQ+ people?

1. Alcohol services should monitor gender identity, trans status and sexual orientation and ensure they have appropriate equality, diversity and inclusion policies.
2. LGBTQ+ diversity training, especially trans-specific training, should be undertaken by all staff working in alcohol services.
3. Flexible, non-judgemental, low threshold services are required which emphasise discretion, signal LGBTQ+ inclusivity and are easy to engage with.
4. Alcohol services need stronger links to mental health and other services, to ensure that clients receive seamless and timely care.
5. At a broader level, more public understanding and acceptance of LGBTQ+ people would improve their health and make it easier for them to access services.

The Scottish Parliament has already provided leadership on this issue.  Emma Roddick MSP led a debate that highlighted our research findings and explored some of the issues around alcohol and alcohol services faced by LGBTQ+ people. This debate included contributions across the political spectrum. At our event in June, we will ask the Scottish Government to treat the LGBTQ+ community as a group with specific needs within the forthcoming UK Alcohol Treatment Guidelines, and to prioritise the need for alcohol-free spaces within the LGBTQ+ community.  There is excellent work going on in Scotland to address substance use in the LGBTQ+ community (Glasgow LGBTQI+ Substance use partnership), but still much to be done.

The full report can be downloaded here.

The #KinderStrongerBetter campaign highlights substance use in the LGBTQ+ community and signposts to helpful resources and services across Scotland.

Acknowledgement: The report referred to in this blog was authored by Dr Elena Dimova, Dr Rosaleen O'Brien, Prof Lawrie Elliott, Dr Jamie Frankis and Prof Carol Emslie.  

All SHAAP Blogposts are published with the permission of the authors. The views expressed are solely the authors' own and do not necessarily represent the views of Scottish Health Action on Alcohol Problems.