Gay and bisexual men may be unusually prone to compulsive gambling, a small study has found, adding to growing evidence linking homosexuality to various addictions and mental illnesses.
The results require confirmation by future studies, researchers say, but underscore concerns that gays and lesbians might require special attention and care for a range of mental disorders.
The findings could also fuel a charged debate over whether these conditions stem from homosexuality itself, or rather from the stress of suffering anti-gay discrimination.
“Gay and bisexual male pathological gamblers may require more intensive or specialized treatment” than other ones, wrote the authors of the study, published in the November-December issue of the research journal Comprehensive Psychiatry.
Such therapies may also “need to address a wide range of impulsive behaviors,” added the researchers, Jon Grant of the University of Minnesota Medical School in Minneapolis, Minn., and Marc Potenza of Yale University Medical School in New Haven, Conn.
Compulsive gambling—also called pathological or addictive gambling—is habitual, excessive betting with severe personal, social or legal consequences. A brain disease, it appears similar to disorders such as alcoholism and drug addiction, according to the U.S. National Institutes of Health.
These illnesses tend to involve problems in a brain region tied to behaviors such as eating and sex, sometimes called the “pleasure center,” and strongly associated with a chemical messenger called dopamine. Pathological gamblers, predominantly men, often say they’re looking for “action” or excitement in the activity.
Grant and Potenza studied 105 men who had sought treatment for pathological gambling and had responded to ads or referrals to join the research. Twenty-two of these men—21 percent—identified themselves as gay or bisexual, they found. That’s four to seven times higher than the percentage that these groups represent of the whole population, by most middling estimates.
Gays and bisexuals also tended to be among the most addicted gamblers, the researchers reported; these patients were also likelier to suffer additional impulse-control or substance-abuse conditions, and to be single. The group consisted of 15 gays and seven bisexuals.
Limitations of the study, the scientists wrote, were its small size and its inclusion of only treatment-seeking men, who might be unrepresentative of the wider population.
The results fit with a trend, though.
There’s a “growing concern that homosexually active individuals are at increased risk for psychiatric morbidity,” or illness, wrote another group of scientists in the June 2001 issue of the American Journal of Public Health. “Several surveys have found elevated rates of some anxiety disorders, mood disorders, and substance use disorders among homosexuals.”
The reasons are unclear, wrote the authors, with Harvard Medical School in Boston and other institutions. One possibility, they added, is that gays and lesbians are more frequent victims of early-life abuse.
A second, they continued, is that “lesbians and gay men simply lead riskier lives.”
Yet another explanation, for which they cited substantially more evidence, was that “stigmatization and exposure to discriminatory behavior lead to higher rates of mental disorders. This hypothesis is consistent with the finding that lesbians and gay men experience discrimination in multiple domains of life,” which in turn is tied to psychological distress. Other disadvantaged groups also face higher-than-average risk for psychological problems, they wrote.
The alternative explanations are linked to deeply, even bitterly opposed political views. The idea that unhealthy risk-taking is inherent in homosexuality tends to satisfy gay-rights opponents, most of whom see same-sex orientation as abnormal. The stigmatization hypothesis pleases gay-rights supporters, who view discrimination, not homosexuality, as the problem.
The question of what explains the homosexuality-addiction statistics is “the big one,” wrote Grant in an email. “I don’t think there’s either an easy answer or, based on our limited scientific knowledge currently, an answer that doesn’t have some sort of sociopolitical overtones. I think of this research as a very small piece of the bigger puzzle.”