Research projects

The ALICE study: Alcohol and lesbian/bisexual women – insights into culture and emotions

Principal researchers

Associate Professor Ruth McNair1
Professor Dan Lubman2
Professor Tonda Hughes3
Associate Professor Kelsey Hegarty1
Mr Liam Leonard4
Dr Rhonda Brown5
Ms Amy Pennay2


1 The University of Melbourne
2 Turning Point Alcohol and Drug Centre
3 University of Illinois at Chicago (UIC)
4 La Trobe University.
5 Deakin University



Award type

Beyond Blue Victorian Centre of Excellence

Project completion year


Key messages

Messages for the LGBT community 

  • The importance of the finding that the normalised culture of drinking is no different in the LGBT community than the general Australian community, therefore there is no need to accept any blame or stigmatise the LGBT community for alcohol use. Further, for many same-sex attracted women (SSAW), drinking is a safe and harmless behaviour that enables social connection. 
  • Encouragement to access care for alcohol use, highlighting the high level of harmful use and current lack of perceived need for alcohol care. 
  • Encourage an increase in access for mental health, highlighting the relative under-utilisation compared with high levels of depression, anxiety, self-harm, suicidal thoughts. 
  • The importance of accessing a regular GP and disclosing if comfortable, because this will facilitate access to appropriate services for mental health and alcohol support. 
  • Work on increasing alcohol-free social events, particularly for people coming out, as SSAW start drinking at a much earlier age than heterosexual young people, which may be related to exposure to a drinking culture earlier during coming out, and increase their risk of harmful drinking in the future. 

 Messages for health care providers 

  • Barriers to access include fear of stigma regarding mental health and alcohol, as for any patient, and a lack of perceived need, particular regarding alcohol care. Almost one quarter of SSAW have had experiences of discrimination within health care. 
  • Open mindedness is vital to facilitating disclosure, which in turn encourages disclosure of other sensitive topics such as mental health and alcohol problems. Bisexual women need particular encouragement to disclose. 
  • Ask about sexual orientation and gender identity, understand the influences of minority stress on alcohol use and mental health, and the different experiences according to identity, but don’t assume it is the only reason for these issues. 
  • Avoid assumptions regarding heterosexuality, gender, and use neutral language. 
  • Access specific training around LGBT specific issues. 

 Messages for policy makers 

  • Facilitate awareness raising campaigns amongst general community and the LGBT community regarding the impact of discrimination, abuse and social isolation on mental health and alcohol use. 
  • Facilitate targeted health promotion initiatives for SSAW for primary and secondary prevention of problematic alcohol use, while ensuring that alcohol use per se is not problematised. 
  • Enable the development and sustainability of self-help and peer support programs for LGBT people regarding mental health support, using multiple platforms including online and social media. 
  • Increase the inclusion of sexual orientation and include gender identity in nationally representative datasets regarding mental health and alcohol use, to identify shifts in patterns of inequities over time. 

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