Abstract
Historically, researchers have theorized a positive relationship between internalized heterosexism and higher substance abuse rates among lesbian, gay, and bisexual individuals. This theory posits that internalized heterosexism induces anxiety, depression, low self-esteem, and other intrapsychic problems that lead to using alcohol and drugs to ameliorate these effects. Over the past 20 years, few studies have provided clear support for this theory, which raises the question whether internalized heterosexism indeed has a positive relationship with these increased rates. This article critiques these studies and explores important factors that may help to refine theoretical assumptions. Subsequently, implications for research and practice are offered in light of this analysis.