LESBIANS AND ALCOHOL MISUSE

A GUIDE FOR ALCOHOL WORKERS

INTRODUCTION

This booklet has been compiled by Lesbian Information Service (LIS) in collaboration with Dashline, Halifax and Calderdale Health Promotion Centre.

The aim of the booklet is to raise awareness among alcohol workers regarding lesbians and alcohol misuse.

After reading the booklet we hope that you will:

- have a better understanding about why some lesbians are vulnerable to alcohol misuse;

- be more aware of what some of the specific effects of alcohol misuse are on lesbians;

- know where to find further information; and

- have a better idea about what you, as an individual, and your agency can do to provide a service which is more accessible to lesbians.

The booklet came out of the Lesbians and Alcohol Project (LAP) which was set up as a result of research conducted by Lesbian Information Service. We discovered that a high percentage of the lesbians interviewed (50%) had serious drink problems; material from this original research has been included in the booklet.

The booklet is by no means comprehensive! There are few papers published in Britain but in the U.S.A. the problems of lesbians misusing alcohol have been acknowledged for over twenty years with appropriate support developed and many papers published. To make this valuable information available in Britain, Lesbian Information Service have published a "Lesbians, Gays and Alcohol Resource List" (£4.50 - address at the back of this booklet).

As part of the Lesbians and Alcohol Project a survey of alcohol agencies in north west England was conducted, the results can be found in the in-depth report, "Treatment of Lesbians with Alcohol Problems in Alcohol Services in North West England" (£6.50), also available from LIS.

We would like to thank Comic Relief and the Alcohol Education and Research Council for the funding which has made publication of this booklet possible.

ARE LESBIANS VULNERABLE TO ALCOHOL MISUSE?

The simple answer to this is YES! U.S. research suggests that between 27-35% of lesbians have alcohol problems. One survey found that lesbians were five times more likely to be heavy drinkers than heterosexual women.(1)

Australian research conducted with 200 young lesbians in 1992 found that 100% of the participants drank alcohol weekly compared to another survey which found that 41.4% of young women in the same age group drank at all. The researcher discovered that across the range of legal and illegal drugs, use by young lesbians was around 50 to 100 percent higher than that of the general population.(2)

Recent British research(3) found that more than a third of the lesbians taking part in the study (326) drank over the recommended level for women while 8.5% labelled themselves as alcoholic or alcohol dependent.

Another British study(4) of 120 lesbians found that almost half (49%) regularly drank more than 14 units a week, a third of whom drank 22 units or more a week. These studies compare with 11% of women in the general population who drink over the recommended levels which suggests that lesbians in Britain are between 3 and 5 times more likely than heterosexual women to have a drink problem.

Qualitative research conducted by Lesbian Information Service into the needs of young lesbians found that all but 3 of the 20 participants used alcohol, 10 having serious problems which included:

* passing out after drinking too much,

* being hospitalised for drinking too much,

* attempting suicide under the influence of alcohol,

* getting arrested for being drunk and disorderly,

* not being able to socialise without getting drunk.

Of course, not all lesbians have drink problems. Some lesbians, through choice or for cultural reasons, will not drink at all. At the same time, it is impossible to provide an exact picture because the majority of lesbians hide their sexual orientation and will not, therefore, be visible in research. It is likely, however, that alcohol misuse will be worse among these women because of the emotional stress which comes from suppressing or hiding one's lesbianism.

"I misused alcohol for 12 years; it was especially bad when my relationships broke down, when I was afraid of my sexuality and as a result of the pressures of caring for my bed-ridden mother." Janet, 55-year-old, working class, white, lesbian.

"I was very reliant on alcohol until I came out." Rachel, 21-year-old, middle class, white, lesbian.

"I have always drunk, but not to the excesses that I did when my mother forced me to end my first lesbian relationship and I got married to please her." Julie, 34-year-old, working class, white, disabled, lesbian.

"I used to go out twice a week and get slaughtered, now it's once every few months but I still get pissed. If I go out I get pissed. I don't go out for a drink and not get pissed. It makes me feel good." Terry, 21-year-old, working class, black, lesbian.

WHY ARE LESBIANS VULNERABLE?

"Substance use often begins in early adolescence when youth first experience conflicts around their sexual orientation. It initially serves the functional purposes of (1) reducing the pain and anxiety of external conflicts and (2) reducing the internal inhibitions of homosexual feelings and behavior. Prolonged substance abuse, however, only contributes to the youth's problems and magnifies suicidal feelings."(5)

It is during adolescence when serious damage is done. Adolescence is a time when there is tremendous pressure for girls to conform to femininity and heterosexuality, to be dating and, more and more, to be having sex. Most important, this is happening round about the same time that many young women are becoming painfully aware that they are lesbian; a time when they are extremely vulnerable to harmful, negative, messages.

It is hard for heterosexuals to understand what it is like being lesbian and growing up with that knowledge in a society which hates and fears homosexuals. Everywhere you turn you hear something negative about homosexuality - on the television, in newspapers, from your friends, from parents, grandparents, brothers and sisters, from other kids at school, from teachers!

The stress of living with the conflict of knowing you are lesbian, having internalised the belief that lesbianism is a sin, a sickness, a perversion; being constantly bombarded with messages which say the same thing from both friends and family as well as the media and society at large - WITHOUT SUPPORT - often results in young lesbians either becoming depressed and suicidal or turning to alcohol or drugs for temporary relief.

Young lesbians hold onto years of pain, anger, fear, guilt, shame and sadness inside them. When their emotions do come out this often takes the form of self-harm.

Coming out - admitting first to ourselves and then to others that we are lesbian - is one of the most daunting tasks a lesbian faces. Coming out to someone and making contact with other lesbians - either at a group, club, pub or even telephoning a helpline for the first time - takes a great deal of courage. Many lesbians turn to alcohol for 'Dutch' courage or to 'calm their nerves.' Taking a drink to calm your nerves before going to meet other lesbians for the first time can be the start of a slippery slope to misusing alcohol, especially because alcohol consumption is such an important part of the gay scene. All too often, the drunken lesbian is the only role model available.

A group of young lesbians, talking about why lesbians drink, came up with the following reasons:

* To get out of everyday situations.

* Depression - to drown my sorrows.

* Not being able to express myself.

* Fear.

* Loneliness.

* Not having any social contact with lesbians.

* Not having any lesbian lovers.

* To build up my confidence.

* To help me do things.

* Because I've been rejected.

* To be able to say I'm attracted to another lesbian.

Having got into the habit of using alcohol or drugs to cope during adolescence, many lesbians who have come out continue to use it to deal with the pain and effects of everyday discrimination. U.S. research suggests that lesbians continue to use more alcohol than heterosexual women even in their mature years(6).

Part of the coming out process for some lesbians includes leaving behind mainstream culture and heterosexual friends for gay culture and gay friends. Alcohol and drugs are an integral part of gay culture and usually promoted by the gay media. Using alcohol to deal with discrimination is an accepted part of gay life and those who do not drink are considered abnormal!

"On a political level, minority groups are forced into addiction. Drugs and alcohol are provided in order to keep people under control....the job of the oppressor becomes easier when individuals engage in self-destructive behaviors and render themselves powerless."(7)

Gay pubs and clubs serve many purposes, not just as drinking places: they are places where lesbians and gays can be themselves, hold hands, kiss. However, because there are fewer lesbians who are out, lesbians are more isolated with fewer social or support services - the gay pub or club is usually the only place lesbians can go to meet other lesbians.

There are few lesbians who are completely out - most lesbians are only out to other lesbians and a few heterosexual friends; some lesbians are out to their parents but many are rarely out at school, college, or work. This is hardly surprising because one can be sacked or refused promotion just for being lesbian (the reason is usually covert); many lesbians experience verbal, physical and psychological harassment from work colleagues, pupils/students, parents and family members. The legal system in Britain supports discrimination on the grounds of sexual orientation. In other words, it is acceptable to be sacked simply for being lesbian; there is no anti-discrimination legislation concerning sexual orientation. Indeed, there is legislation which positively discriminates against lesbians and gay men.

The continued stress of living part of one's life in the closet often results in lesbians using alcohol or drugs to deal with the mental stress this causes. After pretending to be heterosexual most of the time, some lesbians drink to help them relax when they are in a safe environment.

Because of homophobia and isolation, many lesbians try to suppress their homosexuality with heterosexual sex, having children and getting married. Of the requests for help Lesbian Information Service receive from lesbians two-thirds are from young lesbians and the remainder from older women, the majority of whom knew about their sexuality when they were young and tried to suppress it. Alcohol, and often prescribed drugs, is then used to deal with the depression and conflict which comes from trying to maintain the pretence of heterosexuality.

When these women come out later in life (some never do) they will go through a similar, stressful, process which young lesbians experience in adolescence; alcohol in-take is likely to increase during this period. Many lesbians go through the pain and stress of losing their children in custody cases to their ex-husbands, simply on the basis of their lesbianism. The coming out period is a vulnerable time for lesbians of all ages.

SPECIFIC REASONS WHY LESBIANS ARE VULNERABLE TO BOTH ALCOHOL AND DRUG MISUSE AND TO DEPRESSION AND SUICIDE

* Adolescence: vulnerable time for all but particularly for homosexual youth as it often coincides with awareness of sexual orientation.

* Being aware of sexual orientation at an early age - longer period of conflict and isolation.

* Gender non-conformity (being a tomboy).

* Invisibility, bullying, taunts, lack of support and stress at school.

* Depression.

* Wall of silence surrounding homosexuality/lesbianism.

* Social isolation (friends heterosexual).

* Extreme isolation and despair of being unable to meet others like themselves.

* Lack of opportunities to develop peer group support.

* Being subjected to negative images about homosexuals/lesbians.

* No/few positive role models.

* Daily discrimination.

* Lack of access to accurate information.

* Pressure of trying to hide sexuality.

* Trying to force self to be heterosexual.

* Rejection/negative reactions by family/friends.

* Guilt caused through religious beliefs that homosexuality is a sin.

* Break up of a relationship.

* Low self-esteem.

* No access to support; this is particularly bad in small towns and in the country.

* Emphasis on alcohol, drugs and sex on gay 'scene.'

* Promotion of alcohol and drugs by the gay media.

* Lack of acknowledgement of the problem by the lesbian and gay community.

* Lack of support/inappropriate response from youth services, health services, alcohol treatment agencies, counselling services, doctors, nurses...

* Not having sexuality accepted by professionals go to for support who say "It's only a phase you're going through."

These experiences are likely to be made worse by:

* Multi-oppression - several layers of oppression.

* Sexual abuse and rape.

* Physical abuse and neglect.

* Being a runaway.

"I have 3-4 pints when I go out; but I don't go out often, maybe three times a week. I have never had any other drugs. I had a drinking problem: I'd drink when I was depressed. I made sure I had a bottle of vodka in the drawer and I'd just drink it." Jan, 23-year-old, middle class, white, lesbian.

"I knew I was different when I was eleven but talked to no-one for years and did not come out until I was 23 years old. At my 18th birthday party I got drunk and, because the girl I was in love with was hitting it off with a chap and I couldn't tell her about my feelings, I tried to walk under a moving car. That wasn't the first time I'd been drunk nor felt suicidal" Jane, 45-year-old, working class, white, lesbian.

"I was lonely and isolated ... it was when I was drinking. It got bad, I really hated myself. The only gay people I knew were a bad crowd. They were always fighting. They were a tight knit, rough, group who would go out with men or women, anybody. It was a rough life. I realised now I hated myself because of that." Karen, 24-year-old, working class, white, lesbian.

"Took drugs during whole period of marriage - 12 years - anti-depressants, sleeping tablets, tranquilisers, etc. Had physical break-down when finally came off drugs altogether." Susan, 40-year-old, middle-class, white, disabled, lesbian.

Alcohol misuse may give temporary relief from painful feelings but it does not deal with the underlying problem/s. On the contrary, it creates a second problem which must be dealt with before the underlying problem can be sorted out. For many lesbians the underlying problem is self-hate (internalisation of negative messages about homosexuality).

Internalised Stigmatised Identity

Research and development in the U.S.A. has provided another way of understanding why people who belong to oppressed groups are vulnerable to alcohol misuse; this theoretical framework involves understanding the stages a person might go through when internalising a stigmatised identity.(8)

"...at present, at least, we know of no lesbian women who use alcohol who seem fully self-accepting. We see alcohol use as one of several strategies for coping with the self-hate of simultaneously accepting and rejecting shaming messages. Alcohol use in combination with accepting shaming messages leads either to active suicide or to indirect suicide as a result of the progression of alcoholism."(9)

For lesbians, and other minority women, alcohol misuse stops the development of a positive self identity. All women who belong to oppressed groups, women who are lesbian, working class, black, minority ethnic, disabled, fat, internalise negative messages.

There are four stages we can go through in the process of moving from a negative to a positive self identity:

STAGE 1: We are unaware that we are different, but we have internalised negative messages.

STAGE 2: We become aware that we are different from the majority (most critically during adolescence) and try to conform to the 'norm.' This creates tremendous conflict.

STAGE 3: With access to positive role models, accurate information, meeting others like ourselves (especially peers), we can begin to challenge our internalised negative messages and replace them with positive ones, helping us to develop a positive self identity.

STAGE 4: This then makes us more able to deal with and challenge external oppression.

If, during stage 2, we use alcohol and/or drugs to cope with the conflict, we usually get stuck in this stage and our self-esteem remains low.

"...[Lesbians] often described being unable to accept fully the idea of being lesbian in a positive way before they stopped drinking and using drugs...Likewise, some of the African-American and Latina women interviewed described recovery as a process of accepting their racial and ethnic heritages and confronting painful racial conflicts that they had buried through their substance use."(10)

OTHER ISSUES REGARDING LESBIANS AND ALCOHOL MISUSE

Sexual Abuse

A significant number of lesbians, like heterosexual women, have been sexually abused. In fact, U.S. research suggests that lesbian and gay youth are more likely to be sexually abused than heterosexual youth because they appear vulnerable and abusers usually target vulnerable youngsters.(11)

The effects of sexual abuse are similar to the effects of internalised homophobia: low self-esteem and confidence, depression, severe mood disturbances, suicide attempts, alcohol misuse, drug abuse, fears, confusion, anger, guilt and shame, ill-health, grieving.(12) Lesbians who have been sexually abused are, therefore, doubly at risk of alcohol misuse.

It is not true that sexual abuse is a 'cause' of lesbianism. There is compelling research from the U.S.A.(13) which suggests that people are either pre-disposed to their sexual orientation and/or that it is likely to be formed before puberty. Environmental issues, such as sexual abuse, are likely to play a role in whether individuals become aware of, accept or suppress their homosexuality.

Sexual abuse is more likely to cause confusion about sexual orientation because, like the myth that it's a phase everyone goes through, people with internalised homophobia (everyone - heterosexuals and homosexuals) understandably want to believe such explanations. This, and other 'causes' are unhelpful and likely to prolong the conflict stage making individuals more vulnerable. Sexual orientation, internalised homophobia and sexual abuse must be treated as separate issues.

Gender Non-Conformity

'All lesbians are masculine' is another myth. It seems likely that there are just as many lesbians who are feminine as there are those who are masculine. The difference is one is more likely to spot a masculine lesbian (and she is, therefore, likely to experience more discrimination).

Butch lesbians, like heterosexual women who did not conform to the stereotyped image of femininity in their youth, are likely to have an extra layer of self-hatred because they have also internalised messages which conflict with their natural leanings towards masculinity (tomboyishness).

Some butch lesbians are likely to get into role-playing masculine roles including drinking pints and 'being able to drink men under the table.' Maintaining this tough image is obviously going to make butch lesbians vulnerable to drinking too much.

Lesbian Battering

As with all couples, alcohol misuse can have very serious effects on relationships with partners - family and friends - and lead to relationship breakdown. Because of discrimination and isolation lesbians already have tremendous stress placed on their relationships - with little/no support and nowhere to turn for support - add alcohol misuse to this and the problems multiply. Although it is rarely acknowledged violence within lesbian relationships does exist and alcohol is often involved.

Increased Risk of Suicide

If alcohol misuse, which increases anxiety, depression, tension and paranoia, is added to internalised self-hate one is likely to come up with a deadly concoction.

"...homosexual women have a high prevalence of alcohol abuse and depression. These conditions have been shown to be directly related to an increased risk of mortality from suicide."(14)

When Lesbian Information Service conducted research into the needs of young lesbians we found that only two of the 14 who had tried to kill themselves did not use alcohol and that ten of the twelve who drank and attempted suicide had serious drink problems.

"I was drinking pints of lager when I was 16 (1963) long before the women's movement made it acceptable - most working class, butch, lesbians drink pints, get drunk and smoke. As a result of the women's movement, more and more middle class women use pubs and drink pints. Drinking pints is now a part of feminist culture. There has been little stopping to think whether drinking alcohol is right or healthy for women." Jane, 45-year-old, working class, white, lesbian.

"My relationship is on the rocks because of Pauline's alcoholism. I've put up with it a long time, had enough. Yesterday she had a brawl in a pub with a woman from work. The woman's husband was there. Pauline had been chatting the woman up, even though she is straight." Cherry, 31-year-old, middle class, white, lesbian.

"Over-dosed on mogadon and booze; cut wrist at 18-20 years." Ronnie, 32-year-old, working-class, white, lesbian.

"Tried to drink myself to death - over a period of time - didn't work fast enough so I gave up." Janet, 55-year-old, working-class, white, lesbian.

WHAT CAN YOU DO?

1. Acknowledge there is a problem. EVERYONE is taught to be homophobic* through the negative messages put out by religion, medicine, law, family, media, education, language. ALL institutions - including your agency - are heterosexist.*

2. Give priority to dealing with the homophobia of all staff (including administrative workers and management):-

a. Conduct a survey to ascertain level of knowledge (contact LIS for copy of questionnaire).

b. Introduce homophobia awareness training for all staff and management.

c. Introduce assessments to identify attitudes towards lesbians/gays and other minority groups with appropriate procedures to deal with any staff member who is homophobic (this could include, for example, the organisation having a statement to the effect that it is working towards eradicating discriminatory attitudes and practices of staff; it could include a contract that all members of staff sign which includes a statement about anti-discriminatory practice, willingness to undergo training and procedures to be followed if staff continue to discriminate.

3. Challenge the heterosexism of the service - its policies, procedures, practices. For example,

a. Does your equal opportunities policy include lesbians and gays?

b. Is it more than a mere statement i.e. what procedures are there to back it up?

c. Does it apply to provision as well as employment?

d. Do you include sexual orientation in your initial assessment form - if not, why not?

e. Is it likely that a lesbian worker/client would feel able to use any grievance procedures? What help or support would she get? Could you introduce a system whereby a group or individual pursues the complaint on her behalf? Better still, erase homophobia of staff and heterosexism of the agency so that any procedures need never be used. But remember, just because there are no complaints doesn't mean that you've got it right.

4. Once a system has been set up that retrains staff and challenges heterosexist structures, an atmosphere should exist which is supportive of any lesbian/gay staff member or client being out:

a. Ensure that procedures deal with any repercussions of someone coming out, e.g. all new staff should be vetted at interviews for any homophobic, racist, etc., attitudes (religion is no excuse for homophobia!)

b. Make your policies known to all members of staff and clients (e.g. through publicity, welcoming posters,).

5. Develop staff knowledge about lesbians and alcohol misuse:

a. Further training.

b. Utilise the "Lesbians, Gays and Alcohol Resource List" to develop your own resource library.

c. Make links with local lesbian/gay organisations for referrals.

6. Identify, train and support a member of staff to support lesbian clients.

7. When dealing with lesbian clients:

a. Accept it when she says she is lesbian. DO NOT try and appease her with inaccurate statements like 'it's a phase.' DO NOT look at 'causes.' It may be there are experiences she wants to talk about, e.g. sexual abuse, but do not link them with her lesbianism.

b. Understand that YOU and your CLIENT will be homophobic (it takes years to get rid of internalised homophobia and even then it is probably not possible to totally eradicate it all). Most of us, especially lesbians, deny that we're homophobic.

c. Utilise your usual procedures but also bring into force ones that are specific for dealing with lesbian clients, e.g.

- Refer to specialist worker (accept the client may not be ready for this).

- Refer to local support and provide assistance for her to make contact with them and even help her to attend - remember, isolation is one of the main problems lesbians face.

- Provide reading materials, videos, to encourage the development of a positive lesbian identity.

- Set up a lesbian support group (for curricula contact LIS).

- Include partners of lesbians.

8. Evaluate and monitor your progress - ask your lesbian clients what they think. If you don't have any lesbian clients then it's not working!

9. Please let us know what you think of this booklet - has it met the aims and objectives set out in the Introduction? Is there anything else you would like to know?

10. Good luck!

*HOMOPHOBIA: The recognised or unrecognised fear or hatred of homosexuals or homosexuality that is present in both heterosexuals and homosexuals. Everyone is taught to be homophobic.

*HETEROSEXISM: Discrimination against homosexuals based on the belief that heterosexuality is superior to homosexuality. Heterosexism is built into all of our institutions.

RESOURCES

National Helplines

BISEXUAL PHONELINE LONDON: 0181.569.7500
Tue & Wed 7.30-9.30; EDINBURGH: 0131.557.3620 Thu 7.30-9.30

BLACK LESBIAN & GAY LINE 0171.620.3885 Tue & Thur 11.30-5.50

GAY AND LESBIAN LEGAL ADVICE (GLAD) 0171.837.5212 Mon-Thur 7-9.30

JEWISH LESBIAN/GAY LINE 0171.706.3123 Mon & Thur 7-10

LESBIAN SURVIVORS OF LESBIAN ABUSE 0171.328.7389 Thur 7-9

LESBIAN YOUTH SUPPORT INFORMATION SERVICE (LYSIS) 0161.303.7088 Wed 7-9

LESBIAN & GAY BEREAVEMENT PROJECT HELPLINE 0181.455.8894 nightly 7-12

LESBIAN AND GAY CHRISTIAN HELPLINE 071.739.8134 Wed & Sun 7-10

LONDON LESBIAN/GAY SWITCHBOARD 0171.837.7324 24 hours.

Organisations

* Catholic Lesbian Sisterhood, CLS, BM Reconciliation, London, WC1N 3XX.

* FFLAG (Families and Friends of Lesbians and Gays) c/o PO Box 153, Manchester, M60 1LP. 0161.628.7621.

* Gay's The Word, 66 Marchmont Street, London, WC1N 1AB, 0171.278.7654. (Lesbian and gay bookshop; postal service).

* Gemma, BM Box 5700, London, WC1N 3XX (Lesbians with and without Disabilities).

* Kenric, B/M Kenric, London, WC1N 3XX. (Social organisation for Lesbians over 18 years).

* Lesbian Custody Project at ROW, 52-54 Featherstone Street, London, EC1Y 8RT. 0171.251.6577.

* Lesbian Employment Rights, Unit 1G, Leroy House, Islingdon, London, N1 3QP. 0171.704.8066.

* PACE (Project for Advice & Counselling and Education), 34 Hartham Road, London, N7 9JL. 0171.700.1323. Mon-Fri 10-5.

* SHAKTI South Asian Lesbian & Gay Network c/o London Friend, 86 Caledonian Road, Kings Cross, London, N1

Books

Out From Under, Sober Dykes & Our Friends, ed. Jean Swallow, Spinsters/Aunt Lute, 1983.

Gay and Sober - Directions for Counselling and Therapy, T.O. Ziebold & J.E. Mongeon, Harrington Park Press, 1985.

Dual Identities: Counselling Chemically Dependent Gay Men and Lesbians, Dana G. Finnegan, Emily M.McNally, Hazeldean, 1987.

Making Visible, Improving Services for Lesbian and Gay Men in Alcohol and Drug Treatment and Health Promotion, Ian MacEwan, Paul Kinder, Alcohol Liquor Advisory Council, New Zealand, 1992.

Lesbians and Gay Men: Chemical Dependence Treatment Issues, ed. Dava L. Weinstein, Harrington Park Press, 1992.

Ghost Pains, Jane Severance, Sheba, 1992 (novel).

The Next Step, Lesbians in Long-Term Recovery, Out From Under, Volume 2, ed. Jean Swallow, Alyson Publications, 1994.

Addiction and Recovery of Gay and Lesbian Persons, Robert J. Kus, Haworth Press Inc. 1994.

REFERENCES

(1) Marcel T. Saghir, Eli Robins, Bonnie Walbran, Kathye A. Gentry, "Homosexuality IV," American Journal of Psychiatry, 1970, vol 127(2), pp147-154.

L. Fifield, T.A. DeCrescenzo, J.D. Latham, Alcoholism and the gay community, in: On My Way to Nowhere: Alienated, Isolated, Drunk: An Analysis of Gay Alcohol Abuse and an Evaluation of Alcoholism Rehabilitation Services for the Los Angeles County, Los Angeles Gay Community Services Center, 1975 (Cited in: Hellman, et al., Treatment of homosexual alcoholics in government-funded agencies: Provider training and attitudes, Hospital and Community Psychiatry, 1989, vol 40(1), pp. 1163-1168).

C.E. Lewis, M.T. Saghir, E. Robins, "Drinking Patterns in Homosexual and Heterosexual Women," Journal of Clinical Psychiatry, 1982, vol 43(7), pp277-279.

(2) Vic Barbeler, The Young Lesbian Report: A Study of the Attitudes and Behaviours of Adolescent Lesbians Today, A Project of the Young Lesbian Support Group, 1992,

(3) Elaine Creith, 1994, personal communication.

(4) Pam Bloor, Dykenosis, Issue 3, March 1995.

(5) Paul Gibson, Gay male and lesbian youth suicide in: Report of the Secretary's Task Force on Youth Suicide, 1989, vol 3, pp. 110-142 (U.S. Department of Health & Human Services).

(6) J. Bradford, C. Ryan, The National Lesbian Health Care Survey, Final Report, National Lesbian and Gay Health Foundation, P.O. Box 65472, Washington, DC 20035, U.S.A.

(7) L.K. Nicoloff and E.A. Stiglitz, Lesbian Alcoholism: Etiology, Treatment, and Recovery, "Lesbian Psychologies, Explorations and Challenges," edited by the Boston Lesbian Psychologies Collective, University of Illinois Press, 1987.

(8) See Lesbians Coming Out and Identity Formation Resource List, LIS.

(9) S. Deevey, L.J. Wall, How do lesbian women develop serenity? Health Care Women International, 1992, vol 13(2), pp.199-208.

(10) J.M. Hall, An exploration of lesbians' images of recovery from alcohol problems, Health Care Women International, 1992, vol 13(2), pp. 181-198.

(11) In an interview quoted in Quota Magazine, March 1994, Canada. Canadian academic Kaufman pointed out that there were higher levels of sexual abuse among lesbian and gay teens because "there is something different about them, they are easier to victimize and convince something's wrong with them."

(12) Mandana Hendessi, 4 in 10 Report on Young Women who become Homeless as a Result of Sexual Abuse, CHAR, 1992.

(13) J. Bridget, Treatment of Lesbians with Alcohol Prolbmes in Alcohol Services in North West England, Lesbian Information Service, 1994, p5. The British Medical Association have also publicly acknowledged this in relation to debates about lowering the age of consent for gay men.

(14) Saghir, et al, ibid.

©
Lesbian Information Service 1998