Like smoking in the lesbian population, the fact that the LGBT population is at a greater risk for substance abuse was not a new fact for me. In addition to all the risks that the general population faces for substance abuse and dependence, when it comes to the LGBT community you also throw in stigma, self-loathing, depression, isolation, a social scene that often revolves around drugs and alcohol, the not uncommon need for a catalyst to lower our own inhibitions, and the aforementioned advertisers (this time beer instead of philip-morris).
What I hadn't thought about was what would happen if a queer patient sought treatment: folks getting turned away because they're LGBT, folks too scared to come out and thus unable to address possibly a critical player in their abuse motivators, practitioners who don't understand the difficulties of being LGBT, folks not even being diagnosed in the first place because the pattern of abuse in LGBT folks can be different.
And the lack of data. So much data unknown. For example, it's been shown that alcohol use in teenagers (and thus theoretically alcohol abuse and dependence) can be reduced through school programs that focus on resisting peer pressure and the dangers of drug use and drunk driving. But does that work for the queer teenager who drinks because s/he doesn't know how else to deal with coming to terms with being queer?
According to the National Center On Addiction and Substance Abuse, the rate for the general population is around 18%. Statistics vary in their estimates of substance abuse/dependence in the LGBT community but the range seems to be something like 30-55%. I don't cite any studies because there are none worth citing. They're all old. They're all small. Nobody has looked. Not even organizations that do annual surveys. They can't bother to tack on another question.
Undoubtedly, they've experienced more homophobia than I ever have and perhaps ever will. And yet, there they are, still together, and still smiling. Even I'm surprised at how touched I am to see them together. Why do I have tears in my eyes?
And then I realize how much anxiety I must have been squashing down for the past few years. Gone are the years inside the protective bubble of college. And while the prospect of full-fledged adulthood is exciting, it also brings colder realities. Homophobia is no longer just hurtful, it carries real life consequences like residency applications, poor rotation evaluations, marriage, health insurance, and family planning. With no way to really resolve these issues, I've just been pretending they aren't there.
Looking back, it occurs to me that previous to this moment, I didn't actually know any older lesbians. Though I've believed them to exist, I had never even SEEN any in real life. Once, I saw a couple in a movie, but it was a really sad story. And now I'm suddenly faced with Dana and Emily and I realize that that it is possible. They have not only endured but also thrived, and the relief that comes along with finally knowing, and not just hoping and reassuring myself, that it is, in fact, possible to "make it", is overwhelming.