A Multidimensional Measure of Sexual Orientation,Use of Psychoactive Substances,and Depression: Results of a National Survey on Sexual Behavior in France

Using data from a large national representative survey on sexual behavior in France (Contexte de la Sexualité en France), this study analyzed the relationship between a multidimensional measure of sexual orientation and psychoactive substance use and depression. The survey was conducted in 2006 by telephone with a random sample of the continental French speaking population between the ages of 18 and 69 years. The sample used for this analysis consisted of the 4,400 men and 5,472 women who were sexually active. A sexual orientation measure was constructed by combining information on three dimensions of sexual orientation: attraction, sexual behavior, and self-definition. Five mutually exclusive groups were defined for men and women: those with only heterosexual behavior were divided in two groups whether or not they declared any same-sex attraction; those with any same-sex partners were divided into three categories derived from their self-definition (heterosexual, bisexual or homosexual). The consumption of alcohol and cannabis, which was higher in the non-exclusively heterosexual groups, was more closely associated with homosexual self-identification for women than for men. Self-defined bisexuals (both male and female) followed by gay men and lesbians had the highest risk of chronic or recent depression. Self-defined heterosexuals who had same-sex partners or attraction had levels of risk between exclusive heterosexuals and self-identified homosexuals and bisexuals. The use of a multidimensional measure of sexual orientation demonstrated variation in substance use and mental health between non-heterosexual subgroups defined in terms of behavior, attraction, and identity.