A systematic review of rates and levels of involvement and substance use outcomes of sexual and gender minority individuals in mutual help groups

Despite mutual help programs being the most common source of support for substance use-related problems and sexual and gender minority (SGM) individuals being disproportionally likely to experience substance use-related problems, only a modest body of research, and no known prior systematic reviews, have captured the rates/levels of involvement and substance use outcomes of SGM individuals involved in mutual help groups. In this systematic review, we identified twelve articles that captured SGM individuals’ rates/levels and substance use outcomes of mutual help group involvement. A small and limited body of research generally found sexual minority individuals to be as likely or more likely to participate in 12-Step programs relative to heterosexual respondents. An even more modest body of research suggests that greater involvement in 12-Step programs may be associated with greater reductions in substance use among sexual minority individuals relative to lesser involvement; due to the methodological limitations of these studies, significant caution should be utilized in interpreting these results. The most critical gaps identified in this review are the paucity of research exploring the rates/levels of participation and outcomes of SGM individuals in alternative mutual help groups (e.g., SMART Recovery), minimal research exploring the involvement and outcomes of transgender and other gender diverse individuals, and differences in experiences of sexual and gender minority subpopulations across intersecting identities. Such information is critical for supporting these vulnerable populations in accessing the best available resources for addressing substance use-related challenges.