Behavioral Risk Factor Surveillance System (BRFSS); Binge Drinking; Bisexual; Legal Epidemiology; Lesbian; Structural Stigma


Lesbian, Gay, Bisexual, and Transgender Studies | Public Health | Public Policy


Purpose Studies examining binge drinking disparities by sexual identity focus on intra- and inter-personal minority stressors experienced by lesbian, gay, and bisexual (LGB) populations. State-level statutes are powerful tools that can reduce health disparities. We examined how state-level nondiscrimination statutes that include sexual orientation as a protected ground (i.e., inclusive statutes) are associated with binge drinking disparities between LGB and straight adults. Methods We combined data from the 2015-2018 Behavioral Risk Factor Surveillance System (BRFSS), the Movement Advancement Project (MAP), and administrative data sources for information on binge drinking, sexual identity, nondiscrimination statutes, and individual and state-level factors. We included an interaction term in the logistic regression models to test whether inclusive nondiscrimination statutes modify the association between sexual identity and binge drinking. Results Inclusive statutes modified the association between sexual identity and binge drinking among women, but not men. In states without inclusive statutes, the odds of binge drinking among lesbian [1.71 (95%CI: 1.27–2.31)] and bisexual [1.83 (95% CI: 1.54–2.17)] women were significantly higher compared with straight women. In states with inclusive statutes, the odds of binge drinking comparing lesbian and straight women were not significantly different [1.19 (95% CI: 0.92–1.53)]. The odds ratio for binge drinking comparing bisexual and straight women was 26.8% lower in states with [1.34 (95% CI: 1.13–1.60)] versus states without inclusive statutes. Conclusions The enactment of nondiscrimination statutes inclusive of sexual orientation at the state-level are associated with narrower binge drinking disparities between lesbian, bisexual, and straight women.