Mental Health and Substance Use Among Sexual Minority Women Who Report Childhood Sexual Abuse: A Systematic Literature Review

Objective: A growing body of literature provides evidence that sexual minority women (SMW; e.g., lesbian, bisexual) are at greater risk of negative mental health and substance use outcomes than are heterosexual women. While minority stress may partially explain these disparities, it does not fully account for them. Therefore, it is necessary to identify how other risk factors (i.e., childhood sexual abuse [CSA]) contribute to SMW's increased risk of negative mental health and substance use outcomes. Method: We conducted a systematic literature review to identify and synthesize the state of knowledge about CSA and mental health and substance use outcomes among SMW. Two independent reviewers screened 347 articles identified in searches of five databases (Web of Science, PsycInfo, CINAHL, PubMed, and Embase). Eligible articles were peer-reviewed, reported quantitative or mixed methods results focused on mental health or substance use outcomes among adult SMW with a history of CSA. Results: Twenty-four papers were included in the review. Findings clearly show that SMW report higher rates of CSA than heterosexual women. Findings also suggest that CSA may mediate the relationship between minority sexual identity and some negative outcomes. Conclusions: Future studies should include minority stress factors, a broader range of mental health outcomes (apart from substance use and suicide), and more nuanced measures of CSA.