men, and 122 behaviorally bisexual women participating in a sexual health seminar assessed substance use among these three groups. Among transgender participants, 20 percent reported abusing alcohol, compared with 30 percent of men who have sex with men and 16 percent of bisexual women; 16 percent of transgender participants used marijuana, compared with 26 percent of men who have sex with men and 24 percent of bisexual women; and 3 percent of transgender participants used other drugs, compared with 9 percent of men who have sex with men and 2 percent of bisexual women (Bockting et al., 2005a).

Childhood Abuse

A small amount of research has documented higher rates of childhood abuse among sexual-minority men and women. Using data from the NHSII, Austin and colleagues (2008) compared rates of childhood abuse among self-identified lesbian, bisexual, and heterosexual women. They found that, compared with heterosexual women, lesbians and bisexual women were more likely to report physical and sexual abuse during childhood and adolescence. In a newer study using the same data set, Austin and Irwin (2010) showed that increased physical and sexual abuse among self-identified lesbian and bisexual women was positively associated with risk of tobacco and alcohol use as well as greater use in adolescence. Another study examining data from the National Survey of Midlife Development in the United States compared childhood maltreatment experiences among 2,917 self-identified heterosexual (n = 2,844), homosexual (n = 41), and bisexual (n = 32) individuals aged 25–74. For the purposes of analysis, homosexual and bisexual respondents were grouped together. The authors found that, compared with the heterosexual respondents, the homosexual/ bisexual respondents reported higher rates of major physical maltreatment by their parents.

While little is known about experiences of childhood sexual abuse among sexual minorities, some evidence, derived from a probability sample of urban men who have sex with men (n = 1,078), suggests that such abuse may be common (20 percent) among sexual-minority men (Catania et al., 2008). Moreover, a few studies suggest that childhood sexual abuse may be linked with negative health outcomes in adulthood. In a study examining risk factors for obesity among a community sample of lesbians (n = 416), childhood sexual abuse was associated with obesity even after adjusting for age, race/ethnicity, and education (Aaron and Hughes, 2007). Similarly, high rates of childhood sexual abuse among a probability sample of Latino gay and bisexual men (n = 912) predicted HIV and mental health outcomes (Arreola et al., 2009). Feldman and Meyer (2007a) examined the relationship between childhood sexual abuse and eating disorders



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