Substance Use in Sexual Minority Emerging Adults: Insights Into Use by Pansexual and Asexual Individuals

Research consistently reveals that sexual minority individuals (e.g., lesbian, gay, bisexual, pansexual, asexual, questioning, and others) engage in higher rates of substance use compared to their heterosexual counterparts. However, sexual minority participants are often grouped together as one uniform group in comparison to heterosexual participants. This study examined differences in the frequency of substance use among sexual orientation groups, particularly understudied identities: pansexual and asexual. Negative binomial regression analyses were conducted using a sample of 1,853 sexual minority emerging adults aged 18-29 recruited cross-sectionally from Prolific in March 2020. Significant differences were found among groups (gay/lesbian, bisexual, pansexual, asexual, and others) in the use of alcohol, tobacco, cannabis, cocaine, hallucinogens, prescription opioids, ketamine, and methylenedioxymethamphetamine (MDMA). Frequency patterns emerged, particularly among pansexual and asexual individuals. For example, pansexual participants reported significantly higher levels of cannabis, cocaine, ketamine, MDMA, prescription opioids, and hallucinogens. Asexual participants reported significantly less cannabis, tobacco, alcohol, and cocaine use. This study reveals the heterogeneity of sexual minority substance use. Practitioners assessing substance use in this community should include a full list of sexual orientation identities to best assess differences within the larger sexual minority community.