Treatment for LGBTQ
When it comes to substance use, any kind of suffering or stress makes abuse of and addiction to that substance more likely. People often abuse substances to dull emotional pain or escape from the stress in their lives. Mental illness, poverty, and being subjected to prejudice and discrimination all increase life stress and suffering.1
Greenhouse Treatment Center, American Addiction Centers’ Texas rehab, offers an LGBTQ Treatment Track that caters to the unique needs of this community. There, we strive to provide addiction treatment and recovery support in an inclusive environment of like-minded peers. Learn more here.
LGBTQ Addiction Statistics
LGBTQ (lesbian, gay, bisexual, and transgender) people experience all of this at higher rates than heterosexual and cisgender (identifying with the gender assigned at birth) people. Due to these special circumstances, addiction treatment for LGBTQ persons needs to be approached differently than for the rest of the population.
The LGBTQ community is twenty to 30% more likely to abuse drugs and alcohol than the general population.2 This is compared to a 9% rate for the US population overall.2 Unfortunately, there isn’t very much information on the subject of substance abuse among this community despite it being such a severe problem. However, it’s generally theorized that the stress caused by the effects of prejudice are responsible for the high rates of abuse.3
Here’s what is known about substance use in this population:
- Tobacco: About 45% of adolescent girls and 35% of adolescent boys who reported same-sex attraction also reported smoking tobacco regularly, while 29% of the general adolescent population reported being smokers. Over 30,000 LGBTQ people die each year from diseases related to smoking tobacco compared to 480,000 people overall.4 However, only 3.8% of all Americans identify as LGBTQ.5
- Alcohol: About 25% of LGBTQ individuals abuse alcohol. The rate in the general population age 18 and older is just under 7%.6
- Amphetamines: Men who have sex with men use amphetamines roughly 12.2 times more often than men who do not have sex with other men.7
- Heroin: Abuse of this drug among gay or bisexual men is 9.5 times higher than the rate of abuse among the general male population.7
- Marijuana: Gay and bisexual men are 3.5 times more likely to use marijuana than the general male population.7
These are the best estimates gathered from what little data there is on the subject, but even if the data is off, there appears to be a clear trend of severely higher rates of substance use and abuse among the LGBTQ community.
Reasons for Substance Abuse in LGBTQ Community
Any marginalized societal group (whether it’s women, people of color, people with disabilities, or LGBTQ people) experiences stress associated with being subjected to discrimination and prejudicial attitudes. This is referred to as minority stress, and it still has a strong effect on the LGBTQ community today, even as laws in the US have become more egalitarian.
Despite laws prohibiting discrimination in the workplace, LGBTQ individuals still have more trouble finding employment than the general population.8 More alarming is the fact that LGBTQ people are not protected against employment and workplace discrimination. As such, a lack of employment and not feeling safe in the workplace can lead this at-risk population group to higher rates of depression and anxiety, not to mention financial constraints.
The LBGT community often experiences housing discrimination, with over half of all same-sex couples and nearly 70% of transgender people reporting some level of discrimination at their home.9 A significant issue among the LGBTQ population is homelessness caused by total rejection by their families. The additional stress of mental illness, homelessness, and poverty make substance abuse and addiction all the more likely.
Even if they are not rejected outright, LGBTQ youth still have to endure a higher rate of abuse from family members and bullying from peers. Misunderstanding and ignorance from loved ones can also be painful, especially when sexual orientation is not properly acknowledged or the family refuses to accept a transgender child’s gender identity. Being forced to remain in the closet is no better, with the fear of being discovered and the stress of living a lie a constant burden. These kinds of early and repeated traumas damage the young person’s sense of safety and dramatically increase the chance of developing a mental illness.
Marginalized populations, like the LGBTQ community, also have to endure frequent small stressors every single day. These microaggressions might seem insignificant when examined one by one, but over time, they add up to a significant amount of stress. For example, a same-sex couple might have to worry every time they go out together that people will give them strange looks if they hold hands, kiss, or are at all affectionate. A transgender person often has to worry about being referred to as the wrong gender or being mocked by strangers.
It’s thought that microaggressions are at least partially to blame for the higher rates of stress-related illness and mental illness among people in the LBGT community. Studies have found that lesbians are 2-2.5 times more likely than heterosexual women and girls to experience suicidal ideation.7 The threat of microaggressions can also lead to more social isolation – another predictor of substance abuse.
LGBTQ Treatment Barriers
Poverty, homelessness, and mental illness always make access to healthcare more difficult to reach. In the US, medical care for addiction treatment can be very expensive, even if a person has insurance. Depression and anxiety can make it more difficult to acknowledge a problem and get help, and many doctors do not know how to properly handle more severe mental illnesses.
LGBTQ people experience an entirely separate layer of barriers when they’re ready to seek treatment. Most notably is the discrimination they face from medical professionals. Doctors and others in medical fields are not immune from prejudice, whether it’s explicit or subconscious, and lack of training is still a significant problem. Most often, counselors report not feeling comfortable working with LGBTQ people because of a lack of training.
This is even more of an issue for anyone who identifies as transgender.10
Many doctors are still uneducated and don’t have a clear understanding of what it means for a person to identify as transgender. Some wrongly believe that being transgender is indicative of a mental illness or that people identify as trans to get attention. In these instances, instead of providing them with the care they need, physicians often refer them to therapists or even refuse to treat them all together.
Because these population groups often feel marginalized, they might turn to drugs and alcohol to cope with their feelings.11 Because of this, their mental health is at risk, which leads them to self-medicate. Even more problematic is the fact that 12-Step programs and treatment facilities might not be LGBTQ-friendly. If other members of these groups are hostile to LGBTQ people, this can easily make them feel unsafe and unable to trust their assigned sponsors. Without that feeling of being in a safe space with people who understand you, a support group is essentially worthless.
To ensure that their clients feel safe, there are addiction treatment resources and programs made specifically to address the special needs of the LGBTQ population. But finding these programs can be tough since the vast majority of substance abuse treatment programs don’t have specialized programs.11
Medical professionals in any LGBTQ-friendly program should be trained to understand the community’s issues as a whole and be able to use it to correct terminology to address sexual orientation and gender identity in a way that makes each client feel understood and validated.
There are also organizations dedicated to helping LGBTQ persons get access to treatment that will work for them, help them financially, and act as a go-between for them and any medical professionals they might have to deal with.
- The Center: A New York-based organization dedicated to promoting the health and wellbeing of LGBTQ persons. They hold support groups for LGBTQ individuals who are struggling with addiction and have several other recovery resources for the community.
- The Association of Lesbian, Gay, Bisexual, Transgender Addiction Professionals, and Their Allies: This organization was started in 1979 and is dedicated to preventing and treating substance abuse and addiction in its LGBTQ members.
- Friends Community Center: This community site provides substance abuse treatment and conducts research for gay and bisexual men as well as transgender women. It focuses primarily on methamphetamine use and prevention without relying on total abstinence.14
- Chicagoland LGBTQ Services Directory: This comprehensive online search directory features LGBTQ services in the Chicago area, including substance abuse treatment services.15
Once an LGBTQ-friendly addiction treatment resource is found, it’s much easier for individuals to get on the road to recovery. With the right kind of help, recovery is within any person’s reach.
- UCLA School of Law Williams Institute. (May 2020). Homelessness Among LGBT Adults in the US.
- Hunt, J. (Mar. 9, 2012). Why the Gay and Transgender Population Experiences Higher Rates of Substance Use. Center for American Progress.
- Denato, M. (Apr. 2012). The minority stress perspective. Psychology and AIDS Exchange Newsletter. American Psychological Association.
- Centers for Disease Control and Prevention. (Apr. 28, 2020). Tobacco-Related Mortality.
- Newport, F. (May 21, 2015). Americans Greatly Overestimate Percent Gay, Lesbian in US. Gallup Poll.
- National Institute on Alcohol Abuse and Alcoholism. (Feb. 2020). Alcohol Facts and Statistics.
- Stall, R., Wolitski, R., Valdiserri, R. (2008). Unequal Opportunity: Health Disparities Affecting Gay and Bisexual Men in the United States. Oxford University Press, Oxford, England.
- Movement Advancement Project. (May 5, 2020). Nondiscrimination Laws.
- Burns, C., Ross, P. (July 19, 2011). Gay and Transgender Discrimination Outside the Workplace. Center for American Progress.
- Grant, J., Mottet, L., Tanis, J., et. al. (2011). Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force.
- Mooney, E. (2011). The Need for Specialized Programs for LGBT Individuals in Substance Abuse Treatment. Southern Illinois University Carbondale Graduate School Research Papers.
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