Self-reported sexual identity, sexual behaviors and health risks

SUMMARY Data from a population-based survey of low-income young women (n = 2,438) was used to examine substance use patterns and exposure to coerced sexual activity among women who self-identify as lesbian (n = 34) or bisexual (n = 91), or who report sexual behavior exclusively with other women (n = 17) or with both women and men (n = 189). Findings for women classified by self-identity and by sexual behavior are compared. Women who identified as bisexual or lesbian reported higher rates of lifetime and recent substance use and were more likely to report experiences of coerced sex than women who identified as heterosexual. Women with both male and female sex partners reported higher rates of substance use and coerced sexual experiences than did women with male partners only. Heterosexual women with both male and female partners were more similar to self-identified bisexuals, compared to heterosexual women with male partners only. The implications of assessing multiple dimensions of sexual orientation in research focusing on lesbians' mental health are discussed.