For years now, it has been increasingly acknowledged that the incidence of substance abuse and addiction is higher among people who self-identify as homosexual, bisexual, transgendered, or somewhere else on the gender or sexuality spectrum (LGBTQ).

This is confirmed by research reviews, such as one included in the journal Psychology of Addictive Behaviors, that highlight research demonstrating that LGBTQ persons are at higher risk of alcohol and drug abuse than the general population.

The issues that stem from this can be compounded by the fact that members of the LGBTQ community have historically had challenges in getting the healthcare they need without judgment or bias, including in the area of substance abuse and addiction treatment. However, over the course of the last few decades, there has been a shift in perceptions and attitudes toward people who identify as LGBTQ, which have made it easier to get the health treatment they need.

Because of this, the landscape of LGBTQ-friendly addiction treatment centers has changed throughout the US, with more facilities offering programs specifically to help gay, lesbian, and transgendered individuals recover from addiction and manage the specific issues that contribute to this higher prevalence of addiction. Still, some of these programs don’t necessarily escape bias – especially in the case of transgendered individuals – and sometimes it’s hard for those who identify as LGBTQ to find treatment that truly meets their needs without being confronted with negative prejudice.

By knowing what to look for, LGBTQ individuals can find the right treatment center to get them on the path to recovery.

Discrimination and Addiction in the LGBTQ Community

People who identify as LGBTQ have historically experienced extensive discrimination throughout their lives, both in their personal relationships and in the public sphere. A study published in the American Journal of Public Health shows the toll of this constant bias: LGBTQ persons who have experienced multiple forms of discrimination are four times more likely to develop some type of substance abuse disorder. Some of the contributing factors can include:

• Exclusion from social groups and activities.
• Physical abuse by family members or partners.
• Rejection by family of origin or by spiritual community.
• Job loss, loss of child custody, or other public discrimination.
• Violence based on sexual orientation or gender identification.
• Peer ridicule and rejection for LGBTQ youth.
• Sexuality discrimination combined with other forms of discrimination, such as gender, race, religion, etc.

An LGBTQ person struggling with addiction may have experienced multiple incidences of these or other factors; in other cases, it may just be the fear of these occurring that could contribute to the person developing an addiction disorder.

Because the stigma against the LGBTQ community is part of what contributes to the higher prevalence of substance abuse, it is easy to see that treatment is not likely to be successful if it perpetuates the discrimination or misunderstanding of these individuals

Addiction Rehab Options

Recognizing these issues can be especially important for residential treatment; something as simple as making sure transgendered individuals are housed with their self-identified gender can make an important difference in the result of their treatment. Also, being aware of the particular needs of gay men as compared to those of lesbian women, or the different needs of bisexual individuals or LGBTQ youth, can make a difference in the ability to provide treatment that can lead to long-term recovery.

Approaches such as these have been outlined in a manual for treatment providers by the Substance Abuse and Mental Health Services Administration; this manual, A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals, can help treatment providers become aware of the particular needs of the LGBTQ community when it comes to rehab, to better create programs that are truly beneficial to this demographic. In fact, these guidelines were adopted and augmented by the Association of Lesbian, Gay, Bisexual, Transgender Addiction Professionals and Their Allies, an organization that provides resources and advocacy for LGBTQ persons struggling with addiction.

Meeting the Particular Needs of LGBTQ Populations

A treatment center that is LGBTQ-friendly will recognize the above factors and implement the concepts in their practices. Through doing so, these treatment centers may develop more effective protocols to address several LGBTQ-specific issues, including the following reported in a research review on LGBTQ substance abuse by the Butler Center for Research:

• The higher incidence of marijuana and illicit drug abuse and addiction for gay men
• The prevalence of alcohol addiction and binge drinking for lesbian women
• The isolation that bisexual individuals may feel from both heterosexual and homosexual communities
• The mistrust of healthcare providers that can run high in the transgendered community
• How to manage the use of hormonal treatments during rehab therapies
• The emotional and physical challenges faced by younger people who identify as LGBTQ

These are just some of the practical needs that are important for a treatment center to be aware of in treating individuals who identify as LGBTQ, and what those who are seeking treatment may look for in a rehab program.

Finding LGBTQ-Friendly Treatment Centers

Because of the growing understanding of LGBTQ issues with drug and alcohol abuse and addiction, many treatment centers are asserting their ability to provide treatment that caters to the specific needs of this population. However, some of these programs may have underlying biases that somewhat counteract their good intentions. The challenge then becomes finding a facility that truly meets the needs of the individual seeking help with their addiction.

Addiction treatment experts recognize that the treatments more likely to result in long-term recovery for all populations include medically supported detox and rehab, along with therapeutic methods and support mechanisms to help individuals learn to manage their recovery in the months and years following rehab.

For LGBTQ individuals seeking treatment, as well as their loved ones, this first priority is balanced with the need to make sure that the program they enter is not only understanding of their particular personal, social, and psychological challenges, but also provides the support needed to help overcome other specific issues they may deal with during and after rehab, such as:

• Managing responses to discrimination from others.
• Dealing with depression, anxiety, and guilt that stem from sexual orientation or gender identity.
• Handling peer pressure and the club scene.
• Guidelines for accepting identity and coming out.

For residential rehab in particular, as referenced above, it’s important to ask whether transgendered individuals will be placed with their self-identified gender. Being forced to reside with their birth gender may perpetuate the stigma, and resultant mental and emotional struggles, that contributed to the substance abuse to begin with. Making sure that individuals are given respect and understanding of their identity is important to their paths to recovery.

Because of the potential for a dual diagnosis – LGBTQ persons who have substance abuse issues are often also dealing with issues of depression, anxiety, and other mental health issues – it can be helpful to make sure the treatment program can simultaneously treat these other issues as well as the substance abuse and addiction issue. This can help ensure that individuals have all the tools they need to manage their recovery after rehab.

As emphasized by the National Institute on Drug Abuse, the drug or alcohol rehab program most likely to help an individual achieve long-term recovery is one that is tailored or customized based on that individual’s specific needs.

For that reason, it is essential that a person who identifies as LGBTQ, and who is ready to enter substance abuse treatment, finds a program with experience treating those in the LGBTQ community.