Gender-Sexuality Alliances as a moderator of the association between victimization, depressive symptoms, and drinking behavior among LGBTQ+ youth

Background: Victimization and depression are major stressors underlying drinking behavior among LGBTQ+ youth. There remains limited attention to setting-level factors that buffer their effects. Gender-Sexuality Alliances (GSAs) are school clubs that could promote the health of LGBTQ+ youth. We consider whether their presence in schools moderates associations between victimization, depressive symptoms, and recent alcohol use and heavy episodic drinking. Methods: LGBTQ+ youth (n = 5776) ages 13–17 in all 50 U.S. states with any prior history of alcohol use reported past 30-day alcohol use and heavy episodic drinking, victimization, depressive symptoms, and covariates including recent mental health counseling, perceived school safety, and demographics. Logistic regression models predicted youth's likelihood of any recent drinking and any heavy episodic drinking, with attention to GSA × victimization and GSA × depressive symptoms interaction effects. Findings: GSA presence moderated the extent to which victimization and depressive symptoms were associated with greater odds of recent heavy episodic drinking. GSA presence did not moderate these associations for lower thresholds of drinking (i.e., any drinking). Conclusion: For LGBTQ+ youth with any lifetime history of alcohol use, GSAs could protect against heavy alcohol use, particularly when they face victimization and depression. GSAs may provide them with social-emotional support or educate school health professionals on ways to support LGBTQ+ youth facing victimization or mental health concerns. GSAs may not protect against all drinking behavior because youth may view some levels as normative. Our findings begin to suggest for whom GSA presence could be most protective.