Skip to main content

Advertisement

Log in

A Multidimensional Measure of Sexual Orientation, Use of Psychoactive Substances, and Depression: Results of a National Survey on Sexual Behavior in France

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

Using data from a large national representative survey on sexual behavior in France (Contexte de la Sexualité en France), this study analyzed the relationship between a multidimensional measure of sexual orientation and psychoactive substance use and depression. The survey was conducted in 2006 by telephone with a random sample of the continental French speaking population between the ages of 18 and 69 years. The sample used for this analysis consisted of the 4,400 men and 5,472 women who were sexually active. A sexual orientation measure was constructed by combining information on three dimensions of sexual orientation: attraction, sexual behavior, and self-definition. Five mutually exclusive groups were defined for men and women: those with only heterosexual behavior were divided in two groups whether or not they declared any same-sex attraction; those with any same-sex partners were divided into three categories derived from their self-definition (heterosexual, bisexual or homosexual). The consumption of alcohol and cannabis, which was higher in the non-exclusively heterosexual groups, was more closely associated with homosexual self-identification for women than for men. Self-defined bisexuals (both male and female) followed by gay men and lesbians had the highest risk of chronic or recent depression. Self-defined heterosexuals who had same-sex partners or attraction had levels of risk between exclusive heterosexuals and self-identified homosexuals and bisexuals. The use of a multidimensional measure of sexual orientation demonstrated variation in substance use and mental health between non-heterosexual subgroups defined in terms of behavior, attraction, and identity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Bajos, N., & Beltzer, N. (2008). Les sexualités homo-bisexuelles: d’une acceptation de principe aux vulnérabilités sociales et préventives. In N. Bajos & M. Bozon (Eds.), Enquête sur la sexualité en France: Pratiques, genre et santé (pp. 243–295). Paris: La Découverte.

    Google Scholar 

  • Bajos, N., & Bozon, M. (Eds.). (2008). Enquête sur la sexualité en France: Pratiques, Genre et Santé. Paris: La Découverte.

    Google Scholar 

  • Beresford, T. P., Blow, F. C., Hill, E., Singer, K., & Lucey, M. R. (1990). Comparison of CAGE questionnaire and computer-assisted laboratory profiles in screening for covert alcoholism. Lancet, 336, 482–485.

    Article  PubMed  Google Scholar 

  • Binson, D., Michaels, S., Stall, R., Coates, T. J., Gagnon, J. H., & Catania, J. A. (1995). Prevalence and social distribution of men who have sex with men: United States and its urban centers. Journal of Sex Research, 32, 245–254.

    Article  Google Scholar 

  • Bolton, S. L., & Sareen, J. (2011). Sexual orientation and its relation to mental disorders and suicide attempts: Findings from a nationally representative sample. Canadian Journal of Psychiatry, 56, 35–43.

    Google Scholar 

  • Bostwick, W. B., Boyd, C. J., Hughes, T. L., & McCabe, S. E. (2010). Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. American Journal of Public Health, 100, 468–475.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bux, D. A. (1996). The epidemiology of problem drinking in gay men and lesbians: A critical review. Clinical Psychology Review, 16, 277–298.

    Article  Google Scholar 

  • Cochran, S. D. (2001). Emerging issues in research on lesbians and gay men’s health: Does sexual orientation matter? American Psychologist, 56, 931–947.

    Article  PubMed  Google Scholar 

  • Cochran, S. D., Ackerman, D., Mays, V. M., & Ross, M. W. (2004). Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population. Addiction, 99, 989–998.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cochran, S. D., Keenan, C., Schober, C., & Mays, V. M. (2000). Estimates of alcohol use and clinical treatment needs among homosexually active men and women in the U.S. population. Journal of Consulting and Clinical Psychology, 68, 1062–1071.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cochran, S. D., & Mays, V. M. (2000). Relation between psychiatric syndromes and behaviorally defined sexual orientation in a sample of the US population. American Journal of Epidemiology, 151, 516–523.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cochran, S. D., & Mays, V. M. (2007). Physical health complaints among lesbians, gay men, and bisexual and homosexually experienced heterosexual individuals: Results from the California Quality of Life Survey. American Journal of Public Health, 97, 2048–2055.

    Article  PubMed Central  PubMed  Google Scholar 

  • Conron, K. J., Mimiaga, M. J., & Landers, S. J. (2010). A population-based study of sexual orientation identity and gender differences in adult health. American Journal of Public Health, 100, 1953–1960.

    Article  PubMed Central  PubMed  Google Scholar 

  • Dilley, J. A., Wynkoop Simmons, K., Boysun, M. J., Pizacani, B. A., & Stark, M. J. (2010). Demonstrating the importance and feasibility of including sexual orientation in public health surveys: Health disparities in Pacific Northwest. American Journal of Public Health, 100, 460–467.

    Article  PubMed Central  PubMed  Google Scholar 

  • Drabble, L., Midanik, L. T., & Trocki, K. (2005). Reports of alcohol consumption and alcohol-related problems among homosexual, bisexual and heterosexual respondents: Results from the 2000 National Alcohol Survey. Journal of Studies on Alcohol and Drugs, 66, 111–120.

    Article  Google Scholar 

  • Gilman, S. E., Cochran, S. D., Mays, V. M., Hughes, M., Ostrow, D., & Kessler, R. C. (2001). Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. American Journal of Public Health, 91, 933–939.

    Article  PubMed Central  PubMed  Google Scholar 

  • Haas, A. P., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D’Augelli, A. R., et al. (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendation. Journal of Homosexuality, 58, 10–51.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hatzenbuehler, M. L. (2009). How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychological Bulletin, 135, 707–730.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hatzenbuehler, M. L., Corbin, W. R., & Fromme, K. (2008). Trajectories and determinants of alcohol use among LGB young adults and their heterosexual peers: Results from a prospective study. Developmental Psychology, 44, 81–90.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hayes, J., Chakraborty, A. T., McManus, S., Bebbington, P., Brugha, T., Nicholson, S., et al. (2012). Prevalence of same-sex behavior and orientation in England: Results from a national survey. Archives of Sexual Behavior, 41, 631–639.

    Article  PubMed  Google Scholar 

  • Herek, G. M., & Garnets, L. D. (2007). Sexual orientation and mental health. Annual Review of Clinical Psychology, 3, 353–375.

    Article  PubMed  Google Scholar 

  • Hughes, T., Szalacha, L. A., & McNair, R. (2010). Substance abuse and mental health disparities: Comparison across sexual identity groups in a national sample of young Australian women. Social Science and Medicine, 71, 831–834.

    Article  Google Scholar 

  • Igartua, K., Thombs, B. D., Burgos, G., & Montoro, R. (2009). Concordance and discrepancy in sexual identity, attraction and behaviour among adolescents. Journal of Adolescent Health, 45, 602–608.

    Article  PubMed  Google Scholar 

  • Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: The National Academies Press.

  • Jorm, A. F., Korten, A. E., Rodgers, B., Jacomb, P. A., & Christensen, H. (2002). Sexual orientation and mental health: Results from a community survey of young and middle-aged adults. British Journal of Psychiatry, 180, 423–427.

    Article  PubMed  Google Scholar 

  • Julien, D., & Chartrand, E. (2005). Recension des études utilisant un échantillon probabiliste sur la santé des personnes gaies, lesbiennes et bisexuelles. Canadian Psychology, 46, 235–250.

    Article  Google Scholar 

  • King, M., & Nazareth, I. (2006). The health of people classified as lesbian, gay and bisexual attending family practitioners in London: A controlled study. BMC Public Health, 6, 127.

    Article  PubMed Central  PubMed  Google Scholar 

  • King, M., Semlyen, J., See Tai, S., Killaspy, H., Osborn, D., Popelyuk, D., et al. (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry, 8, 70.

    Article  PubMed Central  PubMed  Google Scholar 

  • Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago Press.

    Google Scholar 

  • Lhomond, B. (1991). Les enquêtes sur les comportements sexuels, de Kinsey au Rapport Gai. In M. Pollak, R. Mendes Leite, & J. Van dem Borghe (Eds.), Homosexualités et sida (pp. 29–35). Lille: Cahiers G.K.C.

    Google Scholar 

  • Lhomond, B., & Saurel-Cubizolles, M. J. (2006). Violence against women and suicide risk: The neglected impact of same-sex sexual behaviour. Social Science and Medicine, 62, 2002–2013.

    Article  PubMed  Google Scholar 

  • Lhomond, B., & Saurel-Cubizolles, M. J. (2009). Orientation sexuelle et santé mentale: Une revue de la littérature. Revue d’Epidémiologie et de Santé Publique, 57, 437–450.

    Article  PubMed  Google Scholar 

  • Marshal, M. P., Friedman, M. S., Stall, R., King, K. M., Miles, J., Gold, M. A., et al. (2008). Sexual orientation and adolescent substance use: A meta-analysis and methodological review. Addiction, 103, 546–556.

    Article  PubMed Central  PubMed  Google Scholar 

  • Mays, V. M., & Cochran, S. D. (2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 91, 1869–1876.

    Article  PubMed Central  PubMed  Google Scholar 

  • McCabe, S. E., Hughes, T. L., Bostwick, W. B., Morales, M., & Boyd, C. J. (2012). Measurement of sexual identity in surveys: Implication for substance abuse research. Archives of Sexual Behavior, 41, 649–657.

    Article  PubMed Central  PubMed  Google Scholar 

  • McCabe, S. E., Hughes, T. L., Bostwick, W. B., West, B. T., & Boyd, C. J. (2009). Sexual orientation, substance use behaviors and substance dependence in the United States. Addiction, 104, 1333–1345.

    Article  PubMed Central  PubMed  Google Scholar 

  • McNair, R., Cavanagh, A., Agius, P., & Tong, B. (2005). The mental health status of young adult and mid-life non-heterosexual Australian women. Australian and New Zealand Journal of Public Health, 29, 265–271.

    Article  PubMed  Google Scholar 

  • Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697.

    Article  PubMed Central  PubMed  Google Scholar 

  • Michaels, S., & Lhomond, B. (2006). Conceptualization and measurement of homosexuality in sex surveys: A critical review. Cadernos de Saude Publica, 22, 1365–1374.

    Article  PubMed  Google Scholar 

  • Midanik, L. T., Drabble, L., Trocki, K., & Sell, R. L. (2007). Sexual orientation and alcohol use: Identity versus behavior measures. Journal of LGBT Health Research, 3, 25–35.

    Article  PubMed  Google Scholar 

  • Pathela, P., Hajat, A., Schillinger, J., Blank, S., Sell, R., & Mostashari, F. (2006). Discordance between sexual behavior and self-reported sexual identity: A population based survey of New York City men. Annals of Internal Medicine, 145, 416–425.

    Article  PubMed  Google Scholar 

  • Rich, A. (1980). Compulsory heterosexuality and lesbian existence. Signs, 5, 631–660.

    Article  Google Scholar 

  • Ross, L. E., Dobinson, C., & Eady, A. (2010). Perceived determinants of mental health for bisexual people: A qualitative examination. American Journal of Public Health, 100, 496–502.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rothblum, E. D. (2000). Sexual orientation and sex in women’s lives: Conceptual and methodological issues. Journal of Social Issues, 56, 193–204.

    Article  Google Scholar 

  • Sandfort, T. G. M., De Graaf, R., Bijl, R. V., & Schnabel, P. (2001). Same-sex sexual behavior and psychiatric disorders. Findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Archives of General Psychiatry, 58, 85–91.

    Article  PubMed  Google Scholar 

  • Savin-Williams, R. C., Joyner, K., & Rieger, G. (2012). Prevalence and stability of self-reported sexual orientation identity during young adulthood. Archives of Sexual Behavior, 41, 103–110.

    Article  PubMed  Google Scholar 

  • Steele, L. S., Ross, L. E., Dobinson, C., Veldhuizen, S., & Tinmouth, J. M. (2009). Women’s sexual orientation and health: Results from a Canadian population-based survey. Women and Health, 49, 353–367.

    Article  PubMed  Google Scholar 

  • Vrangalova, Z., & Savin-Williams, R. C. (2012). Mostly heterosexual and mostly gay/lesbian: Evidence for new sexual orientation identities. Archives of Sexual Behavior, 41, 85–101.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by a grant from the Groupement d’Intérêt Scientifique Institut du Genre, CNRS, France. The Group ‘CSF: Contexte de la Sexualité en France’ includes: Nathalie Bajos and Michel Bozon (principal investigators), Nathalie Beltzer (coordinator), Armelle Andro, Michèle Ferrand, Véronique Goulet, Anne Laporte, Henri Leridon, Charlotte Le Van, Sharman Levinson, Laurent Toulemon, Nicolas Razafindrastima, Josiane Warszawski, Lucette Aussel and Caroline Laborde. The survey was funded by the French Agence Nationale de Recherche sur le Sida (National Agency for AIDS Research). The Fondation de France, the Institut National de la Prévention et d’Education pour la Santé and the Direction de la Recherche, de l’Evaluation, des Etudes et des Statistiques (DRESS) also contributed to the funding.

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to Brigitte Lhomond.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lhomond, B., Saurel-Cubizolles, MJ., Michaels, S. et al. A Multidimensional Measure of Sexual Orientation, Use of Psychoactive Substances, and Depression: Results of a National Survey on Sexual Behavior in France. Arch Sex Behav 43, 607–619 (2014). https://doi.org/10.1007/s10508-013-0124-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-013-0124-y

Keywords

Navigation