Beyond the binary: The intersection of substance use and lgbtq+ identity

Authors

• Allyana Musa, James Madison UniversityFollow

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Date of Graduation

8-2026

Semester of Graduation

Summer

Degree Name

Educational Specialist (EdS)

Department

Department of Graduate Psychology

First Advisor

Deborah Kipps-Vaughan

Second Advisor

Tammy Gilligan

Third Advisor

Tiffany Hornsby

Abstract

Substance use among LGBTQ+ youth remains a significant public health concern, with rates of alcohol, marijuana, and other substance use consistently exceeding those of their heterosexual peers. This systematized review examines the literature on substance use interventions for LGBTQ+ youth, with a focus on identifying the program components and theoretical orientations associated with effective and affirming outcomes. Following PRISMA guidelines, a systematic search of ERIC and PsycINFO was conducted to identify peer-reviewed studies published between 2016 and 2026 that addressed substance use among LGBTQ+ youth. Eligible studies included quantitative, qualitative, mixed methods, and conceptual research examining substance use, risk and protective factors, or intervention approaches relevant to LGBTQ+ populations.

Six major themes emerged from a thematic analysis of 31 eligible studies: minority stress-informed interventions, identity-affirming and culturally responsive practices, family-based interventions and support systems, school-based and environmental interventions, structural and systemic barriers, and intersectionality and subgroup-specific considerations. Overall, the literature suggests that interventions are most effective when they integrate identity affirmation, address minority stress, and engage multiple systems of support, including families, schools, and communities. School-based interventions that promote safety, belonging, and access to affirming resources demonstrated particular promise for supporting positive outcomes among LGBTQ+ youth. However, methodological variation across studies, limited long-term outcome data, and underrepresentation of diverse LGBTQ+ populations restrict the generalizability of findings. Implications for school psychologists and directions for future research are discussed.