Addiction And The Transgender Community: Where To Get Help

Addiction is a chronic disease that can affect anyone, regardless of age, gender identity, race, or sexual orientation. Unfortunately, research shows that the transgender community is at an elevated risk.

Drugs and alcohol may be used to cope with gender dysphoria, lack of acceptance, discrimination, stigma, and other stressors commonly experienced by trans people.

These experiences can also serve as barriers to addiction treatment for people who are transgender.

Although rates of substance abuse are disproportionately higher among trans people compared to other communities, they often lack support in addiction treatment spaces.

Are Substance Abuse Treatment Centers Accepting Of Transgender Clients?

An increasing number of rehab centers in the United States offer LGBTQ+-friendly addiction treatment, which provides a fully inclusive healing environment for people with addiction.

Trans people make up less than 1% of the U.S. population, which could be one reason why many facilities did not begin offering trans-inclusive care until recent years, when more awareness has been brought to this community’s needs.

Continued efforts in research, education, and specialized training is needed to better serve the trans community.

Even if a rehab center doesn’t offer LGBTQ+-specific care, the staff can take steps to make transgender clients feel comfortable and supported while in recovery.

Common Barriers To Addiction Treatment For Trans People

Studies show that there are a number of common structural barriers faced by trans people with substance use disorders (SUDs) who either are considering or have sought treatment.

Common barriers to addiction treatment for transgender people can include the following.

Lack Of Gender-Affirming Spaces

One of the most significant barriers to effective treatment that many transgender people face relates to a lack of gender-affirming care and safe spaces at rehab centers.

Many inpatient and some outpatient rehab programs are gender-specific and separate people in treatment into two categories: man or woman.

This can cause several issues for trans people. First, they may be put into a treatment group that matches their assigned gender at birth (or AGAB) and not their gender identity.

Additionally, many trans and non-binary people do not adhere to the gender binary, the idea that there are only two genders. This includes gender-fluid people, whose gender isn’t fixed.

The result is an unsupportive and potentially stigmatizing environment for transgender people in recovery, making them more likely to drop out of these programs.

Lack Of Queer Representation Among Treatment Staff

Even with the best intentions to be compassionate, addiction treatment staff will still be ill-equipped to help trans people in recovery if they do not understand trans-specific issues.

They may intentionally or unintentionally perpetuate harmful stereotypes and stigmas against transgender people, leading these clients to feel unsupported or worse during treatment.

Staff without proper training in queer issues also will be unable to properly assist clients experiencing gender dysphoria, transphobia from loved ones, and other queer-specific problems.

Discrimination And Violence

A study by the UCLA School of Law found that trans people are four times more likely to be victims of violent crimes than cisgender people, or people whose gender identity matches their AGAB.

Transgender women of color are particularly vulnerable and often report being attacked in both public and private spaces.

Rehab center staff should be aware that the high rates of violence against trans people can make being in any space with strangers frightening, and they may experience threats or violence in unsupervised areas.

Stigma And Social Rejection

Addiction stigma is a pervasive problem that people with substance use disorders face, and it is often worse for transgender or non-binary people.

Transgender people may feel driven to hide parts of themselves or their struggles out of fear of rejection by treatment providers or others in their rehab program.

There may be pressure to try and present as “normal” during addiction treatment, which can prevent them from getting real help for their mental health or addiction problems.

Inequities In Healthcare

Accessing effective healthcare is often an uphill battle for transgender people since many medical centers still do not offer gender-affirming care.

Additionally, transgender people are more likely to experience mental illness, disabilities, and chronic conditions like asthma than cisgender people.

Despite their high risks for health issues, transgender people frequently avoid seeking out healthcare and necessary screenings due to frequent discrimination.

Providers may refuse to treat trans people, misgender patients by using incorrect pronouns, or simply lack basic knowledge about transgender healthcare procedures.

Financial Barriers

Transgender people often have to battle with insurance companies and healthcare providers to get healthcare paid for, and they often still fail to get proper coverage.

According to studies done by the Center for American Progress, roughly half of transgender people are denied coverage for gender-affirming care each year.

They may also not have any in-network providers available to them or experience other forms of discrimination from insurance companies, such as a refusal to change their name or gender.

Common Co-Occurring Mental Health Conditions For Trans People

The discrimination that transgender people experience can impact their physical and mental health significantly.

Transgender people have an increased risk for mental health issues such as:

• depression
• suicidal thoughts or attempts
• anxiety disorders
• eating disorders
• low self-esteem

The U.S. Transgender Survey found that 40% of trans people had attempted suicide at least once, and the Trevor Project found that more than half of trans people have considered suicide.

Transgender people are more than four times as likely as cisgender people to experience severe mental health disorders or symptoms, including substance abuse.

Additionally, transgender people who experience violence or discrimination may develop post-traumatic stress disorder (PTSD) and addiction.

Common Drugs Of Abuse For Transgender People

Research on the substance use behaviors of gender minorities and sexual minorities in the U.S. demonstrates that there are some substances that are more commonly used by trans people.

Common substances of abuse among trans people include:

• alcohol
• tobacco
• cannabis
• heroin
• methamphetamine (meth)

Because LGBTQ+ bars are often one of the few safe spaces for queer and trans people, alcohol abuse can be a negative side effect.

One study found that 47% of transgender adults reported recent binge drinking, compared to 17% of adults in the general population.

Behavioral addictions like gambling and food addiction are also higher in transgender communities, which correlates with their increased risk of eating disorders.

The Importance Of Trans-Inclusive Addiction Care

With roughly 50% of transgender people with SUDs avoiding treatment over concerns about discrimination, it’s critical to make rehab centers more inclusive.

Research shows that less than 5% of addiction treatment providers are trained to provide care for transgender people.

Offering inclusive, gender-affirming care can drastically increase transgender retention rates at rehab facilities and lower the chances that trans people will relapse or abandon treatment altogether.

Creating Better Access To Addiction Care For The Trans Community

Research into trans-inclusive care is ongoing, but there are already a number of known, effective ways to implement safe spaces for trans people in recovery care.

Inpatient programs can provide private rooms for transgender people so that they do not have to room with a stranger and can have a safe space to rest.

LGBTQ+ support groups can also be an invaluable resource for trans and non-binary people, giving them a space to talk about queer-specific issues without judgment and build community.

One of the most crucial aspects to trans-inclusive recovery care is properly training staff to work with LGBTQ+ people.

Treatment programs that advertise as queer- or trans-friendly are also more likely to reach their desired clients, and trans people, in turn, feel safer contacting these facilities.

Simply respecting a client’s true name and gender identity can also go a long way in making them feel more comfortable in treatment.

Identifying Trans-Friendly Addiction Treatment Centers

There are treatment centers in the U.S. that specialize in offering LGBTQ+-specific programs for addiction, mental health disorders, and co-occurring disorders.

There are also drug abuse treatment programs that, although not LGBTQ+ specific, offer addiction treatment for transgender clients in an inclusive treatment environment.

The Substance Abuse and Mental Health Services Administration (SAMHSA) classifies the degree of LGBTQ+ sensitivity offered by rehab centers as follows:

• anti-LGBTQ (the least accepting/unaccepting)
• traditional treatment (neutral)
• LGBTQ-naive
• LGBTQ-tolerant
• LGBTQ-sensitive
• LGBTQ-affirming (the most tailored to the specific needs of the LGBT community)

How To Find Trans-Inclusive Addiction Treatment

There are several ways to find LGBTQ+-friendly addiction treatment services.

You can try using an internet search or the SAMHSA treatment locator, which allows people to filter their search for gender-affirming care.

If you have a trusted healthcare provider who understands transgender health, you can try asking them for recommendations as well.

Other resources for transgender people include:

• Center of Excellence for Transgender Health: This nonprofit organization helps transgender people find affirming healthcare services.
• GLAAD Transgender Resources: Provides resources for transgender people in crisis as well as general support assistance.
• LGBT National Help Center: A peer support organization with youth and adult services and resources.
• Trans Lifeline: A hotline for transgender and non-binary people that can help connect callers to different resources around the country.

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Written by the Addiction Resource Editorial Staff