A Qualitative Exploration of Sexual Minority Women’s Substance Use Experiences in Emerging Adulthood

Sexual minority women (SMW) experience unique challenges influencing harmful substance use (Selingo, 2024). While occupational therapy (OT) can holistically address such use, the profession faces barriers to effective care that have significant implications for serving SMW (Selingo, 2024). This dissertation study explored the lived experiences of SMW in emerging adulthood who use substances, and used a qualitative phenomenological approach (Giorgi, 1997) with multi-faceted recruitment methods. Higher education SMW (ages 18 to 29) who self-identified as using one or more substances across the use spectrum were recruited. Photovoice (Wang & Burris, 1997) and individual phenomenological interviews (Giorgi, 1997) were implemented. Photovoice workshop sessions included 4 online sessions and a 5th optional community sharing session. Co-researchers chose to complete most Photovoice sessions individually. The 15-question interviews facilitated SMW’s reflections across use behaviors and experiences, healthcare access, and recommendations for practitioners. Reflexive thematic analysis (Braun & Clarke, 2020) was used to analyze the data, which included Photovoice pieces, Photovoice workshop and interview session transcripts, and study facilitator field notes. Twelve women participated, with 3 completing the Photovoice process and all engaging in phenomenological interviews. The 7 resulting themes included the spectrum of defining substance use and misuse, familial impacts on use and sexual identity, and experiencing discrimination. Co-researcher recommendations for providers emphasized practicing without prejudice, being knowledgeable of supportive resources for harmful use, and creating safe disclosure spaces. Findings affirm the nuanced role of substance use in SMW’s lives, including barriers and supports within and outside the queer community. Co-researcher recommendations can synergize a best practice approach for addressing SMW’s substance use.

References

Braun, V., & Clarke, V. (2020). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 328–352. https://doi.org/10.1080/14780887.2020.1769238

Giorgi, A. (1997). The theory, practice, and evaluation of the phenomenological method as a qualitative research procedure. Journal of Phenomenological Psychology, 28(2), 235–260. https://doi.org/10.1163/156916297X00103

Selingo, L. (2024). Exploring the Lived Experiences of Sexual Minority Women in Emerging Adulthood Who Use Substances (Publication No. 3519) [Doctoral Dissertation, University of Wisconsin-Milwaukee]. ProQuest Theses and Dissertations Global. https://dc.uwm.edu/etd/3519

Wang, C., & Burris, M. A. (1997). Photovoice: concept, methodology, and use for participatory needs assessment. Health education & behavior: the official publication of the Society for Public Health Education, 24(3), 369–387. https://doi.org/10.1177/109019819702400309