WILSNACK ET AL. 129 Drinking and Drinking-Related Problems Among Heterosexual and Sexual Minority Women* SHARON C. WILSNACK, PH.D., † TONDA L. HUGHES, PH.D., R.N., F.A.A.N., † TIMOTHY P. JOHNSON, PH.D., † WENDY B. BOSTWICK, PH.D., M.P.H., † LAURA A. SZALACHA, PH.D., † PERRY BENSON, M.A., FRANCES ARANDA, M.P.H., † AND KELLY E. KINNISON, M.A. † Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, P.O. Box 9037, Grand Forks, North Dakota 58202-9037 Received: May 10, 2007. Revision: September 11, 2007. *This research was supported by National Institute on Alcohol Abuse and Alcoholism grants R01 AA004610 (to Sharon C. Wilsnack) and K01 AA00266 and R01 AA13328 (to Tonda L. Hughes) and National Institute on Drug Abuse grants T32 DA07293 and T32 DA07267 (to Wendy B. Bostwick). † Correspondence may be sent to Sharon C. Wilsnack at the above ad- dress or via email at: swilsnac@medicine.nodak.edu. Tonda L. Hughes, Laura A. Szalacha, Frances Aranda, and Kelly E. Kinnison are with the Depart- ment of Public Health, Mental Health, and Administrative Nursing, College of Nursing, University of Illinois at Chicago, Chicago, IL. Timothy P. Johnson is with the Survey Research Laboratory, University of Illinois at Chicago, Chicago, IL. Wendy B. Bostwick is with the Adler School of Professional Psychology, Chicago, IL. 129 ABSTRACT. Objective: Studies of alcohol use among lesbians have typically used convenience samples with uncertain generalizability or general population samples with small numbers of lesbians. Here we compare rates of high-risk and problem drinking in a large sample of Chicago-area lesbians and a national sample of age- and education- matched urban heterosexual women. Method: Data came from compa- rable face-to-face interviews with 405 self-identified Chicago-area lesbians and with 548 urban women from a U.S. national sample. Rates of hazardous drinking (heavy episodic drinking, intoxication, drinking- related problems, alcohol-dependence symptoms) were compared for exclusively heterosexual, mostly heterosexual, bisexual, mostly lesbian, and exclusively lesbian subgroups. Results: Exclusively heterosexual women had lower rates than did all other women on all measures of haz- ardous drinking. Exclusively heterosexual women also reported less childhood sexual abuse, early alcohol use, and depression. Bisexual women reported more hazardous drinking indicators and depression than did exclusively or mostly lesbian women. Conclusions: These results indicate that sexual minority women are likely to have elevated risks of hazardous drinking. The differences between lesbian and bisexual women suggest that more attention is needed to subgroup differences among sexual minority women. Health care providers need to know the sexual identity of their patients and how their sexual identity may af- fect their risks for hazardous drinking. Higher rates of childhood sexual abuse, early drinking, and depression among sexual minority women suggest that these experiences may be important in assessing and treat- ing problems related to their drinking, and in developing prevention and early intervention strategies. (J. Stud. Alcohol Drugs 69: 129-139, 2008) A LTHOUGH RESEARCH ON DRINKING and drink ing-related problems in women has increased dramati- cally in recent decades (e.g., Plant, 1997; Wilsnack and Beckman, 1984), less attention has been given to similari- ties and differences among subgroups of women (e.g., by age, race/ethnicity, social class, or sexual orientation). This article addresses one important subgroup, sexual minority women. Given that sexual minorities make up an estimated 1% to 3% of the U.S. population (Laumann et al., 1994), lesbians and other sexual minority women represent a sub- stantial number of individuals at risk for hazardous drink- ing. Information about sexual minority women’s drinking is critical for understanding similarities and differences across various subgroups of women, and for planning ef- fective prevention and treatment strategies. Healthy People 2010 (Department of Health and Human Services, 2000) designated sexual minorities as one of six groups with sig- nificant health disparities, and the Institute of Medicine re- port on lesbian health (Solarz, 1999) emphasized that studies of lesbians’ health are also important in their own right, given the increased risks and special characteristics of this population. When research on women’s drinking has given attention to sexual orientation, the research has often used small or seriously biased samples. For example, several early stud- ies (e.g., Fifield et al., 1977; Saghir and Robins, 1973) drew their samples primarily or in part from gay bars, resulting in findings that suggested high rates of heavy drinking and drinking-related problems among lesbians. Recent studies with convenience samples have avoided the biases of ear- lier gay-bar-based samples by recruiting participants from a wider variety of sources, including mailing lists of les- bian and gay organizations and newspapers, and gay/les- bian cultural events (e.g., Bergmark, 1999; McKirnan and Peterson, 1989a,b; Skinner, 1994). Our own research, de- scribed in more detail below, has used convenience sam- pling but with extensive efforts to recruit subgroups of lesbians underrepresented in most previous research, includ- ing older lesbians, lesbians of color, and lesbians of lower