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LGBTQ Mental Health and Addiction Treatment

Studies show that people who identify as lesbian, gay, bisexual, transgender, queer/questioning, or somewhere else on the sexuality or gender spectrum (LGBTQ) have an increased risk of substance use disorders (SUDs) and addiction than the general population.1 A variety of factors contribute to this, such as discrimination and social stigmas, as well as certain barriers that make it harder to find effective LGBTQ substance abuse treatment. Sexual and gender minorities (SGM) also have some unique treatment needs that clinicians should be aware of and sensitive toward. Fortunately, specialized detox centers and drug addiction treatment programs exist to effectively meet the needs of this community.

Risk Factors for Substance Use in the LGBTQ Community

Many risk factors can increase the chances of substance use among LGBTQ people. Minority stress is a theory that views the way internal and external factors come together to create a harmful social setting that can lead to harmful coping strategies.2,3 This includes social stigma and discrimination, as well as the expectations of being discriminated against or stigmatized.1,4 Stigma can also be internalized, commonly leading to feelings of shame, anger, or guilt.4,6 People in the LGBTQ community are also at greater risk for emotional and physical abuse and trauma, violence, and homelessness.1,4

Further, many people in the LGBTQ community feel pressured to hide their identity.5 The coming out process can be a stressful time and include fears about rejection.5 Some people may use substances to dull these emotions, feel more comfortable with their sexual or gender identity and expression, or to cope with trauma.5,6 Substance use may also ease socialization, such as in bars or clubs, and can be viewed as a cultural norm in some circles.3,5

LGBT addiction statistics show that:6–9

  • Gay, lesbian, and bisexual adults experience addiction at almost twice the rate of heterosexual adults.
  • Transgender people experience addiction at nearly 4 times the rate of cisgender (someone whose gender identity matches their birth sex) people.
  • LGBT people who have been discriminated against due to sexual orientation, gender, or race are 4 times as likely to develop an SUD than those who weren’t discriminated against.
  • In the United States in 2019, 2.6 million LGB adults had an SUD. More than half of these adults had issues with illegal drugs, while almost 65% had issues with alcohol.

That said, LGBTQ people with social supports and positive coming out experiences are less likely to use substances.7

Co-Occurring Disorders in the LGBTQ Community

A co-occurring disorder is when someone with an SUD also has other mental health disorders, which is common in the LGBT community.10 LGBT persons are more likely to develop mental health issues such as depression, anxiety, and post-traumatic stress disorder (PTSD), and have a higher suicide risk than non-LGBT people.2,6 This can be caused by the same risk factors as those that lead to substance use, as well as the substance use itself.2,6

Studies demonstrate that:7,11

  • LGB adults have more than twice the risk of developing a mental health issue than heterosexual adults.
  • Lesbian, gay, and bisexual youth report symptoms of depression, including chronic hopeless or sadness, at more than twice the rate as heterosexual youths.
  • Transgender people are almost 4 times as likely as cisgender people to develop a mental health issue.
  • Transgender youth report symptoms of depression and suicidal thoughts at twice the rate of cisgender youths, even those who are lesbian, gay, bisexual, or questioning.
  • Lesbian, gay, and bisexual older adults face a higher risk of disability and mental distress, are more likely to smoke and engage in excessive drinking, and are less likely to be partnered or married.

Specialized LGBTQ Addiction Treatment Programs

It is important to offer specialized treatment for substance abuse in the LGBT community, since traditional facilities commonly overlook the unique needs of this population.6 Specialized LGBT addiction recovery programs can offer a safe, supportive environment that respects and acknowledges your gender and sexual identity and expression, coming out, and experiences with prejudice without the fear of discrimination or stigma.6 Therapies such as motivational interviewing, cognitive behavioral therapy, and contingency management can help treat trauma, issues within the family, and co-occurring disorders as well as help you develop social supports and learn to manage triggers (the people, places, and things that make you want to use substances).10

When choosing an LGBT-friendly addiction treatment center, you may want to consider the following:12

  • Is it important to you that members of your care team share aspects of your sexual or gender identity and expression?
  • Has the center’s staff had any training or certification in working with LGBTQ communities?
  • Avoid any treatment centers that offer “conversion,” “reorientation,” or “reparative” therapy. These are not evidence-based therapies and are harmful.
  • Are the restrooms gender-specific or not? Are transgender clients housed according to their gender identity?
  • Does the treatment center have experience in working with people who identify as you do?

Knowing your answers to these questions can help you further narrow down treatment centers that will be a good fit for you.

Finding LGBT Rehab Centers Near Me

If you are searching for specialized LGBTQ treatment centers, you can start by asking for assistance within your community. This can include LGBTQ healthcare providers, community centers and other resources, or friends, and insurance companies often have filters on their search pages that help you find providers who specialize in treating LGBTQ individuals.7

American Addiction Centers is a leading provider of evidence-based treatment for addictions and co-occurring disorders, including depression, anxiety, and PTSD. It is easy to check your insurance coverage with us by calling one of our admissions navigators at .

Note: Variations of the LGBTQ+ acronym are used in this article to reflect that substance use studies have historically been limited to LGB populations and use binary identity classifications.