Overview: Evidence shows that while substance use disorders (SUDs) are relatively low in absolute terms among both cisgender and transgender populations, they are higher among trans people. Trans people in recovery often mention the need for more specialized services and trans-supportive environments to help them stay on the path to recovery.
Transgender People and Substance Use Disorders
Transgender people are individuals whose gender identity or presentation doesn’t align with the sex they were assigned at birth. This often creates severe cultural and social barriers for transgender people who express their proper gender identity. For example, trans women, in addition to the discrimination they face from employers for being trans, also face discrimination for being women, leading to more unemployment and less financial stability in the group.
These issues extend to health care and psychological care as well. Transgender people report significant barriers to receiving health care, including ignorance of their needs on the part of doctors and staff, bias at medical facilities, and financial concerns. This is particularly concerning as trans people have up to four times the risk of a mental health concern.
All of this means transgender people are more likely to develop substance use disorders. A recent study in the Journal of the American Medical Association comparing over 15,000 trans people to nearly 47,000 cisgender people found that transgender individuals are three times more likely to struggle with nicotine (16.6% vs. 5.4%) and alcohol (2.6% vs 0.9%) addictions.
Cannabis was the most common drug-related SUD with 2.1% (five times the cisgender rate), followed by opioids (1.3%, three times the cisgender rate) and cocaine (0.5%, five times the cisgender rate).
It should be noted, in part to fight a common stereotype of transgender people, that aside from nicotine consumption, these are extremely low rates in absolute terms. The vast majority of transgender people do not have SUDs. Those who do, however, will need more specialized treatment than they currently report receiving.
The Right Environment
Most fundamental to recovery is the understanding of what drives substance abuse behaviors. It is never because somebody is “sick” or “weak.” Rather, it’s because they have concerns that substance use seems to help in some way.
As we’ve discussed above, for transgender people, these concerns can be very different from those of cisgender people. However, that isn’t necessarily being reflected in their treatment.
An analysis of the Global Drug Survey by British and Australian researchers found that while trans people and cis people wanted help with recovery at the same rates, trans people were less likely to seek it. This seems almost entirely due to the lack of inclusive support groups and training among mental health professionals.
Fortunately, this can be fixed. Recovery professionals can seek out training on trans health care, and facilities can work to develop better LGBT+ support groups. And we can all work towards a better understanding of trans people as people, their needs and struggles, and how to be supportive.
How Harris House Can Help
At Harris House, we believe in treating the whole person, not just the addiction issue. We offer treatment programs that take into consideration the specific needs of the LGBT+ population.
Contact us to learn more about how Harris House can help you or a loved one with a substance use disorder get the best possible treatment.