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Journal of Gay & Lesbian Mental Health

ISSN: 1935-9705 (Print) 1935-9713 (Online) Journal homepage:

Minority Stress, Homonegativity, Alcohol Use and

Mental Health Among College Gay Males
John Flood BA , Chris McLaughlin PhD & Garry Prentice PhD
To cite this article: John Flood BA , Chris McLaughlin PhD & Garry Prentice PhD (2013) Minority
Stress, Homonegativity, Alcohol Use and Mental Health Among College Gay Males, Journal of
Gay & Lesbian Mental Health, 17:4, 367-386, DOI: 10.1080/19359705.2013.800006
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Date: 18 October 2016, At: 10:03

Journal of Gay & Lesbian Mental Health, 17:367386, 2013

Copyright Taylor & Francis Group, LLC
ISSN: 1935-9705 print / 1935-9713 online
DOI: 10.1080/19359705.2013.800006

Minority Stress, Homonegativity, Alcohol Use
and Mental Health Among College Gay Males
School of Psychology, Trinity College, Dublin, Ireland


School of Nursing, University of Ulster, Londonderry, Northern Ireland
School of Arts, Dublin Business School, Dublin, Ireland

Minority stressors, extent of disclosure, and connection to the gay

community were examined in relation to alcohol use and psychological strain in gay male students. This study examined whether
membership in a campus-based lesbian, gay, and bisexual society
acts as a cultural vulnerability for alcohol use while at the same
time providing important coping resources that result in lower levels
of psychological distress. Members did not differ from nonmembers
in relation to binge drinking, social support, psychological strain,
or overall alcohol consumption, but they were less likely to abstain.
A variety of measures of minority stress predicted binge drinking
KEYWORDS sexual identity, sexual minority, mental health, substance abuse

Alcohol use and misuse have been reported to have an increased prevalence among college students, with higher rates of heavy drinking than their
nonstudent peers (Hingson & White, 2012). The harmful effects of alcohol
abuse among students are well documented and include mental health difficulties (Wechsler & Nelson, 2001), suicidal ideation (Schaffer, Jeglic, & Stanley, 2008), academic impairment, monetary problems, risky sexual behaviors
Address correspondence to Garry Prentice, PhD, Dublin Business School, School of Arts,
13/14 Aungier Street, Dublin 2, Republic of Ireland. E-mail:


J. Flood et al.

(Hope, 2008), an increased likelihood of being taken advantage of sexually (Mouilso, Fischer, & Calhoun, 2012), and engagement in other harmful
health behaviors (Schaffer et al., 2008).
Gay and lesbian students have been found to be at increased risk for
alcohol and drug use during this formative period (Ford & Jasinski, 2006a;
Reed, Prado, Matsumoto, & Amaro, 2010), but research examining the aetiology of such use has produced inconsistent results and its generalizability
may be suspect due to an insufficient geographical spread. To extend the literature, this research examined the contribution of the two most commonly
hypothesised determinants of substance use and mental health difficulties
among lesbian and gay individuals: minority stress and connection to the
gay community (Green & Feinstein, 2012; Meyer, 2003). Furthermore this
research explored the relationship among minority stressors, connection to
the gay community, and membership of a campus-based lesbian, gay, bisexual, and transgender (LGBT) society in relation to alcohol use behaviors
and psychological strain among gay male college students in the Republic
of Ireland.


The past decade has seen an increase in research on the psychological and
behavioral well-being of gay students (Hill & Pettit, 2012; Manning, Pring,
& Glider, 2012); however, results tend to be inconsistent in relation to the
etiology of substance use and psychological strain among this population.
Research has reported increased alcohol consumption, binge drinking, drug
use, and mental health problems in gay youths compared with their heterosexual counterparts (Amadio, 2006; Baiocco, DAlessio, & Laghi, 2010;
Cochran, Sullivan, & Mays, 2003; Marshal et al., 2008; Wong, Kipke, & Weiss,
2008). Similar studies have reported increased alcohol consumption (DeBord,
Woods, Sher, & Good, 1998), psychological distress (Reed et al., 2010), illegal drug use (McCabe, Boyd, Hughes, & dArcy, 2003), and more negative
consequences of alcohol and other drug (AOD) use (Reed et al., 2010) within
gay student populations.
In contrast, other studies found gay males less likely to binge drink
(McCabe, Hughes, Bostwick, & Boyd, 2005; McCabe et al., 2003) or endorse
harmful drinking norms (Ford & Jasinski, 2006b). Inconsistencies may be
due to varying environmental factors such as minority stressors, campus
support programs, and how active the LGBT group is on campus. Furthermore, as Green and Feinstein (2012) suggest, elevated rates of binge
drinking in college campuses may cancel out the typical divergence in alcohol consumption found between heterosexual and lesbian or gay (LG)

Mental Health Among College Gay Males


Much research examining substance use and mental health difficulties within
LG populations has adopted a minority stress perspective. Such stress refers
to the experience of stigmatization for being gay in a society in which homosexuality is negatively sanctioned and includes the experience of victimizations, rejection, and other stressful events (Rosario, Schrimshaw, &
Hunter, 2004). Drawing on Lazarus and Folkmans (1984) concept of distal and proximal stressors, Meyers (2003) minority stress model has found
support within the literature (Chen & Tryon, 2012; Woodford, Krentzman,
& Gattis, 2012). Stressors most distal to the self are considered objective
stressors and include events and conditions which occur regardless of the
individuals actions; for the LG individual, these include stressors found in
the heterosexist environment such as prevailing antigay stereotypes, prejudice, and discrimination. These in turn contribute to more proximal stressors
that involve the individuals appraisal of their social environment as threatening and hostile, and attempts to suppress, deny or reject their sexuality
(Frost & Meyer, 2009), leading to negative behavioral and psychological
In particular, research suggests an association between internalized
homonegativity (Amadio, 2006; Cherry, 1996; Szymanski, Kashubeck-West,
& Meyer, 2008) and perceived discrimination (Chakraborty, McManus,
Brugha, Bebbington, & King, 2011; Herek & Garnets, 2007; Hughes, McCabe, Wilsnack, West, & Boyd, 2010; McCabe, Bostwick, Hughes, West, &
Boyd, 2010) with increased levels of binge drinking, substance use, depression, psychological distress, and numerous additional negative psychological and behavioral correlates. In contrast, other studies have reported no
relationship between internalized homonegativity and the use of alcohol
(Ross et al., 2001; Newcomb & Mustanski, 2011), or reported an association among lesbians but not within gay male samples (Amadio & Chung,
A further minority stress faced by LGBT student is stigma consciousness,
the extent to which individuals are self-conscious about being members of
a stigmatized group and expect to be stereotyped due to their minority status (Pinel, 1999). For LG individuals, perceived stigma consciousness may
motivate them to adopt various stigma management strategies, including attempts to pass as heterosexual, to avoid enactments of stigma. Although such
coping strategies can reduce the risk of discrimination and harassment, they
also significantly disrupt the lives of the individuals and are associated with
reduced social support, increased relationship problems, heightened psychological distress, limited behavioral options, and increased risks of physical
and psychological illnesses (Herek & Garnets, 2007; Lewis, Derlega, Clarke,
& Kuang, 2006; Lewis, Derlega, Griffin, & Krowinski, 2003). There is limited
research examining the effects of stigma consciousness on substance use in


J. Flood et al.

LG populations, although research among ethnic minority groups may provide some indication. Among ethnic minorities high stigma consciousness
has been associated with a twofold risk of problem drinking (Mulia, Ye, Zemore, & Greenfield, 2008) and an elevated risk for alcohol related problems
and alcohol dependence (Mulia, Ye, Greenfield, & Zemore, 2009). However,
the generalizability of such findings to LG populations is suspect (Liddle,
2007), so further research is needed.
These divergent findings in the relationship between minority stressors
and alcohol abuse may be a function of insensitivity of the measures used,
sampling bias, a nonlinear relationship between the minority stressor and
substance use, or an unstable and changing relationship between the stressors and substance use (Cabral, 2007). Furthermore, many studies do not
take into account the manner in which sexual orientation is operationalized
and the individuals connection to the LGBT community (Green & Feinstein,


Consistent with Meyers (2003) model, minority status is not only related
with adverse stressors but also coping resources such group cohesiveness, solidarity, and social support. These resources act to protect members from the adverse psychological and physiological correlates of minority
stress (Miller & Major, 2000; Noh & Kaspar, 2003; Postmes & Branscombe,
2002). Closely linked to social support is the acceptance and disclosure
of their sexual orientation to others; which not only acts as an indication of self-acceptance and reduces stress about concealing ones sexual
identity but also serves as a precursor to obtaining community support
(Herek, Gillis, & Cogan, 2009). Within this population, disclosure of ones
gay identity is related to positive self esteem, greater social support, and
psychological adjustment (DAugelli, Grossman, & Starks, 2005; Rosario,
Schrimshaw, & Hunter, 2009), as well as hypothetically decreased substance use. However, the research remains inconsistent in regards to the
Though acceptance of ones gay identity, disclosure, and social support
have been found to lead to better health outcomes (Hershberger & DAugelli,
1995; Kertzner, 2001; Peplau & Fingerhut, 2007), other research reports no
relationship between disclosure and substance use (Wright & Perry, 2006), or
a relationship only between negative reactions on disclosure and subsequent
substance abuse (Rosario et al., 2009). Furthermore, some studies have found
that those lesbian and gay individuals who disclosed to friends were more
likely to have increased drug and alcohol use (McKirnan & Peterson, 1988;
Stall et al., 2001). The reasons for these inconsistencies may be a function of
the nature of gay communities.

Mental Health Among College Gay Males


Much research has focused on the nature of gay communities due

to the important role they play as a source of social interactions and
romantic relationships, as well as providing a refuge from heteronormative society, and a network of social support (Ellis, 2007; Liddle, 2006).
However, the central role of gays bars in Western countries may create an environment in which drinking is not only accepted but expected
(Zhankun, 2003), and consistent with the literature on peer group influence
on AOD use (Lemke, Brennan, Schutte, & Moos, 2007), alcohol use may
increase a sense of belonging or connectedness to a bar orientated subculture (Beatty et al., 1999; Greenwood et al., 2001). Consequently, although
there is a lack of research examining the role played by campus based
LGBT societies they may provide a source of social support while simultaneously acting as a risk factor for alcohol abuse (Eisenberg & Wechsler,


There are several compelling reasons for colleges, university and others interested in public health to learn more about subgroups of student who are
at increased risk of alcohol use, associated as it is with numerous deleterious
effects on the academic performance, social interaction, psychological wellbeing, and physical health of the student (Ham & Hope, 2003; Hope, 2008).
Although the minority stress model provides a useful theoretical framework
for understanding the aetiology if substance abuse among LG individuals,
only a small number of studies have directly assessed alcohol use and psychological distress in LG populations and often with inconsistent findings.
Even fewer studies have applied this model to gay male college students
or examined the influence of membership in a LGBT society in relation to
psychological well-being and alcohol use.
The current study was an exploration of the association of students
connection to the gay community, extent of disclosure, and experience of
minority stressors, with alcohol use behaviors and psychological strain. In
particular, this study examined whether membership of a campus-based
LGBT society acts as a risk factor for alcohol use while at the same time providing important coping resources that result in lower levels of psychological
strain. It was hypothesized that (1) gay male members of an LGBT group
would differ significantly from nonmembers in relation to social support,
alcohol use behaviors, and psychological strain; and (2) gay male members
of an LGBT organization would differ significantly from nonmembers in minority stress factor levels (stigmatization, internalized homonegativity. public
identification as gay, social comfort with gay men, and perceived discrimination). Furthermore it was hypothesized (3) that the presence of minority
stressors, age, connectedness to the gay community, out to parents and


J. Flood et al.

others would significantly impact on levels of alcohol consumption, binge

drinking, and psychological strain.

Procedure and Participants
Once ethical approval was gained, calls for participation in this study were
emailed to college-based LGBT groups, and it was advertised on college
websites, gay community websites, and Internet forums within the Republic
of Ireland. To elicit responses, an incentive was offered in the form of entry
into a voluntary lottery for a modest clothing voucher. Participants were
advised of the nature of the study and that confidentially would be assured
at all times. They were also informed of the criteria for inclusion and directed
to the website where the study was hosted. When participants entered into
the on-line survey they were directed to an introductory page, followed
by the self-report demographic and psychological and behavioral measures.
Once all questions were completed the survey participants were invited to
provide their college email address for entry into the lottery. To be eligible
individuals had to be biologically male, in college in the Republic of Ireland,
and either self-identify as gay or express primarily same sex attraction.
Ninety-two males (N = 92) responded to the survey; their mean age was
22.33 years (SD = 4.04) with all participants reporting to be Caucasian. The
majority of the participants stated they were out to their parents (76.1%,
n = 70). When asked about the degree they considered themselves to be
out to others, 37.0% (n = 34) stated completely so, 32.6% (n = 30) stated
very much so, 22.8% (n = 21) stated moderately so, 5.4% (n = 5) stated
partly so, and 2.0% stated not at all (n = 2). In regards to binge drinking,
in response to the question In the last two weeks, how many times have you
had five or more drinks in a row? 22.8% (n = 21) stated zero, 20.7% (n =
19) stated once, 25.0% (n = 23) stated twice, 14.1% (n = 13) stated three
times, 7.6% (n = 7) stated four times, and 9.8% (n = 9) stated five or more

The General Health Questionnaire-12 (GHQ-12: Goldberg & Williams, 1988)
was utilized to measure levels of psychological strain focusing primarily
on the inability of individuals to carry out normal daily functions. Participants were asked to assess changes in their mood, feelings, and behavior over the previous two weeks and indicate their response on a
four-point scale, ranging from less than usual (0) to much more than
usual (3). Examples of statements were Been able to concentrate on
whatever you doing and Been feeling unhappy and depressed. All items

Mental Health Among College Gay Males


were summed with higher scores indicating more psychological strain.

Previous studies have indicated acceptable internal reliability ( = .76;
Sanchez-Lopez & Dresch, 2008). Examination of internal consistency revealed a score of .86 (Cronbachs coefficient alpha) indicating good internal
Patterns of alcohol consumption were measured (Strength (ABV) x Volume (ml) 1000 = No. of Units) in order to calculated the average units
drank by each participant on a night out. These results were then used in
conjunction with the reported regularity of nights out to establish the total
volume of alcohol consumed per month. Prevalence and regularity of binge
drinking, drinking more than 10 units on a single occasion (McAlaney &
McMahon, 2006), was measured by asked the participants: In the last two
weeks, how many times have you had five or more drinks in a row (Wechsler
& Nelson, 2001).
Stigma consciousness was assessed using the 10-item Stigma Consciousness Scale (SCS; Pinel, 1999). This measure assessed respondents
expectations of prejudice and discrimination; an example would be My
being homosexual does not influence how people act with me. All items
were measured on a seven-point Likert scale ranging from strongly agree
(0) to strongly disagree (6) with higher scores denoting higher levels
of stigma consciousness. Previous internal consistency statistics reported
an acceptable alpha of .81 (Pinel, 1999) with an alpha .72 found in this
The Short Internalized Homonegativity Scale (SIHS; Currie, Cunningham, & Findlay, 2004) is a 12-item self-report measure of covert expressions
of negative attitudes toward, and discomfort with, the gay experience. The
SIHS is a single higher order structure of internalised homonegativity, and it
contains also three lower order factors: Public Identification as Gay, Sexual
Comfort with Gay Men, and Social Comfort with Gay Men. Previous internal
consistency statistics for these factors were .73, .71, and .68, respectively
(Currie et al., 2004). However, due to ethical constraints, only two factors
were employed in this study; Public Identification as Gay (PIAG), and Social
Comfort with Gay Men (SCGM), with an alpha of .77 and .72, respectively.
Statements included I am comfortable about people finding out that I am
gay and I feel comfortable in gay bars for both factors, respectively. Agreement or disagreement with the items was assessed using a seven-point Likert
scale. Scores of each item were summed and the total score utilized in the
study as an overall individual measure, with higher scores denoting increased
levels of internalized homonegativity.
Experiences of perceived discrimination were measured by four questions which examined individuals experiences of being discriminated against,
for example: Have you ever been discriminated against or victimized because of your sexuality? and Have you been discriminated against or
victimized because of your sexuality in past last 12 months? Responses


J. Flood et al.

were given on a no (1) or yes (2) which were summed; higher scores
indicated more negative perceptions of discrimination based on their sexual orientation. Examination of internal constituency revealed an alpha of
Levels of perceived social support (SS) were assessed which consisted
of three statements with which individuals indicated their level of agreement,
for example, In times of need, I can get support from my friends and In
times of need, I can get support from my family. Respondents indicated their
agreement or disagreement to statements on a seven-point Likert scale ranging from strongly disagree (1) to strongly agree (7). Responses of items
were summed to create an overall score with higher scores indicating higher
levels of perceived social support. Examination of internal constituency revealed an alpha of .74.
Connection to the gay community was assessed by means of a single
question, How connected do you feel to the gay scene. Participants indicated
their sense of connection on a five-point Likert scale ranging from not at
all connected (1) to extremely connected (5) with higher scores indicating
more connectedness.

In order to support the first aim of this study, a Pearson Chi-square revealed
that members of LGB societies were significantly less likely to abstain from
alcohol (0%) compared with those who were not members (7.2%; 2(1, N
= 92) = 6.58, p = .015). Independent t-tests revealed no significance in the
difference between members and nonmembers in relation to frequency of
binge drinking or units of alcohol consumed per month. Based on this finding and in furtherance of our second hypothesis, an independent samples
t-test was conducted (see Table 1) with the predictor variables. The analyses
identified significant differences in two predictors; namely, SCS and SIHS
reported significant differences when comparing those who were members
of an LGBT society with those were not. In relation to SCS, those males
who were members reported feeling significantly less fear of discrimination than those who did not join (Yes: M = 26.76; SD = 8.89, No: M =
31.66; SD = 8.56; t(90) = 2.67, p < .01). Likewise, those participants who
belonged to a LGBT society felt significantly less discomfort about the gay
experience (SIHS) than those who did not join (Yes: M = 21.94; SD = 7.59,
No: M = 27.39; SD = 9.31; t(90) = 3.09, p < .01). However, in regards
to the two subscales of PIAG and SCGM, significance was found only in
relation to PIAG (No: M = 13.15; SD = 5.77, Yes: M = 9.75; SD = 4.28;
t(90) = 3.24, p < .01). There were no significant differences in perceptions about being discriminated against (PD) or levels of social support from


Mental Health Among College Gay Males

TABLE 1 Differences in Predictor Variables by Membership of LGBT Society


























Key: PD = Perceived Discrimination, SCS = Stigma Consciousness Scale,

SIHS = Short Internalized Homonegativity Scale, PIAG = Personal Identification as Gay,
SCGM = Social Comfort with Gay Men, SS = Social Support

Prediction of Monthly Alcohol Use

In order to explain monthly alcohol use, a regression analysis was conducted
with monthly alcohol units regressed on age, PD, SCS, PIAG, SCGM, SS, extent to which the individual considers themselves out, disclosure to parents,
membership of an LGBT society, and connectedness to the gay community
(see Table 2). The results reported that none of the underlying predictors
had a significant influence on monthly alcohol intake units. Furthermore they
did not significantly explain a sizable amount of variance (8%) in monthly
alcohol intake units (Adjusted R 2 = .08; F(10, 80) = 1.83, p > .05).

Prediction of Binge Drinking

In regards to predicting binge drinking behaviors, a further regression was
conducted (see Table 3). Binge drinking was regressed on age, PD, SCS,
TABLE 2 Predicting Alcohol Intake Units per Month Among Gay Males

Out to Parents

Adj. R 2








J. Flood et al.

TABLE 3 Predicting Binge Drinking Behavior Among Gay Males

Out to Parents

Adj. R 2







PIAG, SCGM, SS, membership of an LGBT society, extent to which the individual considers themselves out, disclosure to parents, and connectedness to
the gay community. The results reported the extent to which the individual
is out ( = .33, p < .05) and experience of discrimination ( = .25, p < .05)
significantly influenced binge drinking behaviors. Though both predictors
had only a moderate influence, it would suggest that within this population
being out to others, and perceptions of being discriminated against, increase
the risk of having more than five drinks in a row within one sitting. The
other predictors did not have a significant influence on binge drinking. Despite two of the predictors having a significant influence on binge drinking,
the overall model did not significantly explain a sizable amount of variance
(4%) in binge drinking behaviours (Adjusted R 2 = .04; F(10, 81) = 1.36,
p > .05).

Prediction of Psychological Strain (GHQ)

In the last regression analysis, psychological strain (GHQ) was regressed
on age, PD, SCS, PIAG, SCGM, SS, extent to which the individual considers themselves out, out to parents, membership of an LGBT society, and
connectedness to the gay community. The results reported (see Table 4)
that only PD had a weak significant influence on psychological strain ( =
.25, p < .05) suggesting that gay males who feel more discriminated against
were slightly more likely to report higher levels of psychological strain.
Though this predictor had a significant influence on psychological strain,
the overall model did not significantly explain a sizable amount of variance
(7%) in psychological strain (Adjusted R 2 = .07; F(10, 81) = 1.70, p > .05).
The other predictors did not have a significant influence on psychological


Mental Health Among College Gay Males

TABLE 4 Predicting Psychological Strain Among Gay Males

Out to Parents

Adj. R 2







Previous research has highlighted an increased prevalence of substance use
and psychological distress in LG populations. Recently, in an effort to gain a
clearer understanding of this link between sexuality and both substance use
and psychological strain, attention has focused on the role played by minority stressors experienced by LG individuals in subsequent negative health
behaviors and outcomes (Hamilton & Mahalik, 2009; Woodford et al., 2012).
Meyer (2003) proposed that interaction among internalized homophobia,
stigma consciousness, perceived discrimination, social support, group solidarity, and individual coping style may account for the high rates of AOD
use in LG populations. Although little research has been conducted in northern European countries, the growing international literature has explored
the influence of stressors in negative health and behavioral outcomes in LG
individuals but has produced inconsistent results. The aim of the current
study was to examine psychological and behavioral differences between
members and nonmembers of campus-based LG societies, and those factors
that are associated with heightened levels of alcohol abuse and psychological strain among gay college students. Factors that may account for these
negative outcomes were examined, including self-disclosure, age, social support, relationship with the gay community, and experience of minority stress.
Relationships between predictor variables were also examined.

Membership of LGBT Society (Hypotheses 1 and 2)

Contrary to our first hypothesis no significant difference was found between
members and nonmembers of LGBT societies in relation to binge drinking
and monthly alcohol consumption, suggesting that membership does not
function as a risk factor in the development of problem drinking behavior.


J. Flood et al.

These results are surprising and differ from previous research, which reported that access to campus-based LG resources is directly associated with
gay mens binge drinking behavior (Eisenberg & Wechsler, 2003). However, members of college LGBT societies in our study were significantly
less likely to abstain from alcohol, suggesting that membership of a society
plays some role in alcohol use behavior. Although these results may seem
contradictory, this discrepancy might be a function of the overall high rate
of alcohol use reported among Northern European college students (Hope,
Dring, & Dring, 2005; Wicki, Kuntsche, & Gmel, 2010), reducing differences
between members and nonmembers in relation to binge drinking and consumption. Simultaneously the previously reported centrality of the gay bar in
the gay community and the expectation that individuals will consume alcohol
(Zhankun, 2003) may create a social environment in which members are less
likely to abstain. Such an interpretation is consistent with research demonstrating the important role played by peer behavior and the social structures
of an individuals social group in shaping patterns of alcohol consumption
(Baiocco, DAlessio, & Laghi, 2010; Lemke et al., 2007).
In addition, the results failed to support our first hypothesis that the
community support provided by an LGBT society would be concomitant
with lower levels of psychological strain. Prior research has highlighted the
important role played by social support in the psychological well-being of
LGB individuals (Peplau & Fingerhut, 2007), and consequently the lack of
association found in this study between perceived social support and membership of a LGBT society may account for this finding. Furthermore, they
may tentatively be proposed to relate to the increased acceptance toward
homosexuality in Northern European society (Gerhards, 2010; Smith, 2011)
allowing many gay college students to obtain social support from sources
other than their gay peers.
Of additional interest are the lower rates of stigma consciousness and
homonegativity reported by members of LGBT societies (Hypothesis 2). Although no causal relationship can be demonstrated, these results may infer
that fear of stereotype and lack of comfort with their sexuality discourages
some gay students from accessing LGBT resources on campus and offers
further support to the literature indicating that those with high levels of
stigma consciousness adopt various stigma management strategies to ward
off potential negative regard (Lewis et al., 2003, 2006).

Alcohol Use and Psychological Strain (Hypothesis 3)

In relation to the third hypothesis of the study, our regression model
failed to reach significance in accounting for monthly alcohol consumption,
binge drinking behavior, and psychological strain. Additionally, age, selfdisclosure, connection to gay community, social support, levels of stigma
consciousness, disclosure to parents, or internalized homonegativity did not

Mental Health Among College Gay Males


significantly influenced overall alcohol consumption, and only the extent of

self-disclosure and level of perceived discrimination influenced binge drinking behavior. These results are surprising and differ from previous empirical
and theoretical work, which proposes that these stressors may influence
rates of alcohol and substance use among LGB individuals (Meyer, 2003;
Newcomb, Heinz, & Mustanski, 2012). Of note is the failure of internalized homonegativity to predict either measure of alcohol use suggesting
that Hulls self-awareness model of alcohol consumption, which posits that
individuals with negative self-concept may consume increased amounts of
alcohol as intoxication reduces their level of self-awareness, may not be directly applicable in understanding alcohol use in gay students (Hull, 1981).
It offers further support to the work of Ross et al. (2001) and others who
found no direct relationship between IH and substance use behavior. The
moderate influence of experience of perceived discrimination on frequency
of binge drinking and level of psychological distress suggests that experience of enacted stigma takes a psychological toll on its targets leading to
increased levels of alcohol abuse and bolsters the literature on the negative
behavioral outcomes of discrimination (McCabe et al., 2010; Woodford et al.,
2012). Previous research has suggested that the inconsistency in the reported
link between extent of self-disclosure and alcohol use may be related to the
nature of the gay community. Results failed to support this contention with
extent of connection to the gay community failing to significantly influence
frequency of binge drinking or overall monthly alcohol consumption. This
finding may be a function of the overall high rates of alcohol use reported
among male college students (Hope, 2008; Wicki et al., 2010) obscuring the
difference found among previous studies of the wider LG population.

Strengths and Limitations
The current study is among the first European studies to examine the psychological and behavior associates of membership of an LG society and has
extended the literature on the determinants of psychological strain and alcohol abuse in gay students by examining the role played by minority stressors,
connection to the gay community, and social support. Although the current
research provides an important investigation into an understudied topic and
has implications for the future development of theory and practice, certain
strengths and limitations deserve consideration in the interpretation of this
work. Previous research has highlighted the importance of defining how homosexuality is operationalized (Green & Feinstein, 2012). As young adults
and adolescents are more likely to endorse same sex attractions, desires,
and experiences but less likely to self-identify as homosexual (Floyd & Stein,
2002), and requiring same sex behavior as part of the definition may exclude


J. Flood et al.

individuals who have not had sexual contact but who identify as homosexual, this study adopted a multidimensional inclusion criteria based on either
self-identification as gay or expressing primarily same sex attraction. In addition this study recruited from colleges throughout Ireland increasing the
geographic diversity of the sample and improving its generalizability. The
anonymity of student responses was made clear to participants as is advised
in the collection of sensitive information (Aday, 1996).
Analysis was based on cross-sectional data and a passive research design which allows us to draw conclusion only on associations and not on
causation. Consequently it is important to consider alternative interpretations
of the results that reverse the causal relations implicit in the analysis of this
data. A further limitation that applies to this study is that of response bias.
The sample was not randomly selected and hence may not be generalizable to the population of gay students. Although the online nature of the
research gave the participants a sense of anonymity, students who were
uncomfortable with, or unsure of, their sexuality were less likely to have
completed the survey. Furthermore, although self-report measures of substance use have been shown to have validity (Del Boca & Darkes, 2003), it
is possible that social desirability coloured responses. Of note is that class
and social background were not measured in this study and hence their effect is unknown. An additional concern is the lack of racial diversity among
the participants with 100% identifying as Caucasian. As previous research
has demonstrated class, race and culture shape interpretation of sexuality,
and impact on minority stressors (Brooks, Bowleg, & Quina, 2009; Kertzner,
Meyer, Frost, & Stirratt, 2010), these demographic issues should be addressed
in future research.

It is an axiom in the public health literature on substance abuse that primary
prevention is essential in tackling the problem and must occur prior to the
initiation of the targeted behaviour. Accordingly, these findings which indicate that there is a high rate of alcohol abuse among gay college students
suggest that prevention methods should focus on gay youth. Furthermore,
effective interventions, with individuals or groups, require information about,
and sensitivity toward, the unique risks and concerns of the target population
(McKleroy et al., 2006). Consequently, it is important to understand which
segments of the gay student population are most at risk of alcohol abuse,
psychological strain, and other forms of ill-health so targeted interventions
can be formulated. Findings presented in this work suggest, for instance, that
those students who have experienced higher levels of enacted stigma have
an increased likelihood of engaging in heavy episodic drinking. Of particular
worry is the strong association found in previous research between heavy
episodic drinking behavior and high risk sexual activity (Vanable et al., 2004),

Mental Health Among College Gay Males


and consequently college authorities should aid LGBT societies in providing appropriate information to their members regarding sexual health and
also in the provision of contraceptives and similar paraphernalia. Similarly,
gay students who are members of LGBT societies are less likely to abstain
from alcohol use and are at increased risk of alcohol misuse in later life,
suggesting that college authorities and society officers should encourage the
society to hold nonalcoholic events, provide appropriate and adequate educational material for the members of the society regarding the prevalence
and consequences of alcohol use, and ensure the society is not dependent
on sponsorship from gay bars or alcohol companies. Finally, this study indicates that despite experiencing high rates of minority stressors many gay
students cope effectively with such stress and hence emphasises the need
for further research to determine the complex interactions implicated in this

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