Substance use and sexual functioning in bisexual women: A scoping review

Abstract (English)

Sexual minorities (SM) showed a higher prevalence of substance use and substance use disorder, including elevated use of alcohol, binge drinking, and other drugs compared to heterosexual individuals (Rosner et al., 2021). However, substance use is not homogenous among the SM population. Specifically, bisexual women show significantly higher rates of various substance use behaviors, including drinking, smoking, marijuana use, and illicit drug use throughout their lifetime compared to other sexual minority groups (Schuler & Collins, 2020; Schuler et al., 2018; Schuler et al., 2019). Previous research, primarily focused on heterosexual, cisgender individuals, investigated the relationship between substance use and sexual functioning, illustrating a significant relationship between these two outcomes. Each substance be differently related to sexual well-being. For instance, small amounts of alcohol and cannabis is linked with enhanced sexual arousal, performance, or desire (McKay, 2005). Marijuana use (e.g., with an average of 7 times a week) is associated with increased sexual frequency and does not appear to impair sexual function (Sun & Eisenberg, 2017). However, high doses of these substances may be related to inhibited sexual functioning (McKay, 2005). Despite a growing focus on mental health within the SM community, research specifically addressing sexually diverse cisgender women remains significantly deficient (Hughes et al., 2023). To date, there exists no scoping review on substance use and sexual functioning, particularly in the bisexual women population. A scoping review on this topic will provide a comprehensive view of how substance use is related to sexual functioning and offer a detailed examination of the association between specific substances and sexual satisfaction. This is particularly needed when considering the unique stressors (e.g., binegativity) that bisexual women experience. Following the guidance provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), this scoping review will be registered on Prism by Northwestern University Feinberg School of Medicine. Eligible criteria include peer-reviewed, published online accessible, and English language journal articles that include bisexual women in the study samples, with at least one study outcome addressing the association between any substances and sexual functioning. The research team developed search terms in collaboration with a research librarian, and the search will be performed in Ovid MEDLINE(R). Three reviewers will independently screen the titles and abstracts of the paper identified, and those initially selected articles will then be retrieved and undergo a full-text review to determine eligibility. Descriptive thematic analysis will be performed to describe and categorize the results of the included studies. Our study aims to establish what is known about substance use and its relationship to sexual functioning among bisexual women. We seek to assess the association of each substance with sexual functioning and further examine whether there is a distinction between short-term and long-term substance use in the relationship with sexual functioning. Our study will identify gaps in the literature and suggest further research and potential interventions that may improve both problematic substance use and sexual well-being in this population.