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 use disorder are disproportionately higher among trans people compared to other communities, they often lack support in addiction treatment spaces.

Are Substance Use Disorder 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.

Estimates of the transgender population vary, but a 2022 Gallup survey found approximately 1.6% of U.S. adults identify as transgender, a figure that has grown as social acceptance and awareness have increased.

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

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 trans people face some common structural barriers with substance use disorders (SUDs) who 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 will also 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 to 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 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 lack in-network providers or experience other forms of discrimination by insurance companies, such as refusals to change their name or gender.

Navigating A Changing Policy Landscape

Access to transgender-inclusive healthcare has become more complex in recent years, as numerous states have passed laws restricting or limiting gender-affirming care.

Transgender people seeking addiction treatment should be aware that the legal landscape for gender-affirming services varies significantly by state. SAMHSA’s treatment locator and Trans Lifeline can help identify affirming providers regardless of location.

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

According to the 2022 U.S. Transgender Survey, 47% of transgender respondents reported having seriously considered suicide in the past year, and 12% reported attempting suicide in that same period. These rates far exceed the general population.

The Trevor Project’s 2023 National Survey found that 41% of LGBTQ+ youth seriously considered suicide in the past year, with transgender and nonbinary youth reporting even higher rates.

Research consistently documents elevated rates of depression, anxiety, and PTSD among transgender people.

A 2024 study in Frontiers in Psychology found depression rates of approximately 44% among transgender individuals compared to 18% in the general population, while a 2025 study in JAMA Network Open found gender diverse people had 2.77 to 3.67 times higher odds of PTSD compared to cisgender peers.

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

Commonly Misused Drugs 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.

Commonly misused substances 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 use disorder can be a negative side effect.

Research published in the American Journal of Public Health has found that transgender adults report binge drinking at significantly higher rates than the general population. Some studies reportl rates approaching 47% among transgender respondents compared to roughly 17% 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 substance use disorder 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.

Find Addiction Treatment Today

Browse our directory or reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about addiction recovery.

Written by the Addiction Resource Editorial Staff