Minority Stress as Traumatic Stress: The Relationship between Discrimination, Social Support, Posttraumatic Stress, and Alcohol Use for Bisexual Women

Background: Lesbian, gay, and bisexual (LGB) individuals are at increased risk of both psychological distress (e.g., depression and anxiety) and maladaptive behaviors (e.g., alcohol use) compared to heterosexual peers. The literature linking discrimination experiences to symptoms of posttraumatic stress disorder (PTSD) suggests that sexual minority stress may serve as a form of posttraumatic stress. Studies addressing within-group differences indicate that bisexual women are more likely than other LGB people to report poor physical and psychological outcomes, which may be explained by disparities in social support and symptoms of posttraumatic stress. Purpose: The current study measured the role of social support and symptoms of posttraumatic stress as potential mediators in the relationship between discrimination experiences (anti-bisexual and sexist) and alcohol use in sample of bisexual women. Method: Participants included bisexual women over the age of 18 from an archival data set (N = 256) with measures including self-reported discrimination experiences, social support, posttraumatic symptoms, and alcohol use. Two sequential, three-path mediation path models were analyzed to examine the direct effects of anti-bisexual discrimination and sexist discrimination on alcohol use, as well as the indirect effects through social support and posttraumatic stress. Results: Path analyses were conducted to analyze the relationships between discrimination experiences, social support, PTSD symptoms, and alcohol use. Neither social support nor PTSD symptoms mediated the relationships between either anti-bisexual experiences or sexist experiences and alcohol use. Most effects were found to not be significant; however, significant bivariate relationships were found between anti-bisexual and sexist experiences, as well as between both types of discrimination experiences and PTSD symptoms. In addition, multivariate relationships were found between anti-bisexual experiences and PTSD symptoms; sexist experiences and PTSD symptoms; social support and PTSD symptoms; and sexist experiences and alcohol use. Conclusion: Anti-bisexual and sexist experiences appear linked, and both of these prejudice experiences relate to bisexual women’s reported PTSD symptoms. Future research should address the sequential relationships between these variables, as well as other psychosocial factors not explored in the present study. Clinicians are advised to conceptualize prejudice experiences as interrelated, and bisexual women clients would benefit from practice that is affirmative and trauma-informed.