Understanding the social and community support experiences of sexual and gender minority individuals in 12-Step programs

Abstract

Sexual and gender minority individuals (e.g., gay, bisexual, non-binary, transgender; SGMI) are 2-6 times as likely as cisgender heterosexual individuals to experience alcohol or other substance use disorders. SGMI participate in 12-Step groups, such as Alcoholics Anonymous (AA), at high rates. Though social support is an established mechanism through which 12-Step programs support reductions in substance use, little is known about SGMI’s experiences of the social support in 12-Step programs. This qualitative study aims to understand the experiences of social and community support among SGMI involved in 12-Step programs. This study employed thematic analysis to interpret open-ended responses from 302 SGMI who had participated in 12-Step programs. Data was from The PRIDE Study, a large, national, online, longitudinal, cohort study of SGMI. Two themes emerged about how SGMI experienced social and community support in 12-Step programs: beneficial connections and harmful environments. Beneficial connections included a sense of community, shared experiences, and skills provision. Harmful environments included marginalization, oppression, violence, and bullying. This study highlights the variability of experiences of SGMI participating in 12-Step programs. These findings suggest that many SGMI may benefit from 12-Step programs but may need support in coping with potential harms that can emerge through participation.

Keywords:

• Mutual help groups
• substance use
• social support
• sexual and gender minority individuals
• LGBTQ-affirming services

Acknowledgements

The PRIDE Study is a community-engaged research project that serves and is made possible by LGBTQ + community involvement at multiple points in the research process, including the dissemination of findings. We acknowledge the courage and dedication of The PRIDE Study participants for sharing their stories; the careful attention of PRIDEnet Participant Advisory Committee (PAC) members for reviewing and improving every study application; and the enthusiastic engagement of PRIDEnet Ambassadors and Community Partners for bringing thoughtful perspectives as well as promoting enrollment and disseminating findings. For more information, please visit https://pridestudy.org/pridenet.

Disclosure statement

Dr. Juno Obedin-Maliver has the following disclosures, none of which are seen to provide a direct conflict of interest with the work presented here: Sage Therapeutics (5/2017, 1-day advisory board, honorarium), Ibis Reproductive Health (a non-for-profit research group; 3/2017-5/2018, 9/2020-present, worked as a consultant), Hims Inc. (2019 – present, worked as a consultant), Folx Inc. (2019–present, worked as a consultant).

Dr. Lunn has the following disclosures, none of which are seen to provide a direct conflict of interest with the work presented here: Hims Inc. (2019–present, worked as a consultant) and Folx Inc. (2019–2021, worked as a consultant).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

Research reported in this publication was supported by the National Institutes of Health under Award Number 5P50AA005595. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, or the National Institute on Drug Abuse. Dr. Annesa Flentje’s work on this project was partially supported by K23DA039800 from the National Institute on Drug Abuse. Research reported in this article was partially funded through a Patient‐Centered Outcomes Research Institute [www.pcori.org; PPRN‐1501‐26848] to Dr. Mitchell R. Lunn. The statements in this article are solely the responsibility of the authors and do not necessarily represent the views of Patient‐Centered Outcomes Research Institute, its Board of Governors or Methodology Committee, or the National Institutes of Health.