Substance Use Disorder in the Transgender Community

Transgender substance use disorder rates are high due to many varying factors

The lesbian, gay, bisexual, transgender, or questioning (LGBTQ) community struggle with challenges the heterosexual population doesn’t. Arguably, the transgender community typically faces even more social stigmas. Unfortunately, the rates of transgender substance use disorder are also higher. 

They face discrimination, social stigmas, and disownment from their families. All while learning to accept their true self. These struggles often lead to using drugs or alcohol. Because up to 30% of the transgender community struggles with addiction, transgender treatment centers offer specialized programs to meet their needs.

The Impact of Minority Stress and Transgender Substance Use Disorder

Minority stress is the health disparity among minorities due to stressors from the dominant culture. For the transgender community, living in a heterosexual dominant culture leads to discrimination, harassment, and victimization.

While the world has made progress in accepting the transgender community, they’re still often denied rights to marriage, healthcare, housing, and employment. Because of the added stress, depression and mental health disorders are much higher than the general population.

Discrimination in the Transgender Community

Discrimination in the Transgender Community

The high levels of discrimination against the transgender community affect every aspect of their lives. For example, transgender people have a more challenging time finding a job. As a result, they engage in risky behaviors such as sex work as well as misusing drugs and alcohol. 

Furthermore, the transgender community faces abuse and deep-seated stigmas in their homes, work, and medical facilities. When their rights to medical care are ignored, it worsens mental health and transgender substance use disorder as a whole.

Extreme Poverty May Lead to Transgender Substance Use Disorder

JAMA Pediatrics published a study of 300 transgender women. This study shows mental health and substance use disorders in the transgender community are 3.6 times higher than in the general population. But what causes this increase?

Most women in this study were jobless, didn’t have health insurance, and lived in extreme poverty. All of these are risks for mental health and substance use disorders. 

For example:

  • 40% of the women have mental health or substance use disorders
  • 20% have at least two mental health disorders
  • 33% struggle with clinical depression
  • 20% considered suicide in the past month
  • Anxiety and PTSD are also higher than in the general population.

However, a study of transgender youth supported by their family didn’t have an increase in depression. This is due to the support and reassurance of the people in their lives.

The Role of Family Rejection in Transgender Substance Use Disorder

No matter your gender identity, each person thrives with the support of family and friends. However, between religious beliefs and social embarrassment, many transgender individuals are disowned by their families. This can have severe emotional and social consequences. 

For example, those who experience moderate family rejection are twice as likely to attempt suicide. At the same time, those with high family rejection rates are three times more likely to attempt suicide. And it’s proven that mental health issues increase substance misuse.

Transgender Substance Use Disorder and Mental Health

Before 2013, the American Psychiatric Association (APA) treated being transgender as a mental health disorder. It was typically called gender identity disorder. However, the term gender dysphoria turns the focus to resolving the stress, not treating a disorder. 

While the APA recognizes gender nonconforming isn’t a mental health issue, the reality of their lives often leads to mental health problems. And with the level of discrimination in mental health facilities, it’s no wonder the transgender substance use disorder rates are high.

Trans Substance Use Disorder Rates Disproportionately High

In fact, transgender substance use disorder rates are disproportionately higher than in the general population. For instance, the general population addiction rate is almost 10%. But, the transgender substance use disorder rate is up to 30%. Furthermore,

  • Nearly 25%  drink to dangerous levels compared to 10% of the general population
  • 78% of transgender youth have attempted suicide due to bullying compared to the rest of the LGBTQ community
  • More than 50% of trans male teens have attempted suicide 

Smoking is also extremely high in the transgender community. While 29% of cisgender youth smoke, almost 45% of transgender men and 35% of transgender women smoke. In fact, smoking kills 30,000 LGBTQ individuals each year. 

Why is Transgender Substance Use Disorder Higher?

The Center for American Progress estimates almost 30% of the transgender community struggles with a substance use disorder. This number is compared to less than 10% of the general population. The reason is mainly due to the stress.

Trauma and intense stress levels are the main risk factor for substance use disorder. Some of the challenges and stressors they face include:

  • Stigmas and discrimination due to their sexual orientation
  • Emotional abuse, threats, public ridicule
  • Rejection from family members
  • Workplace discrimination
  • Self-hatred

Many transgender individuals have attempted suicide because their family members have made them feel so ashamed and wrong. As a result, using drugs and alcohol is a way to cope with the pain and stress. Depression and anxiety also increase the risk of substance use disorder. 

Common Substances Misused in the Transgender Community

There are five drugs most frequently misused by transgender people: 

  • Tobacco – used 200 times more than cisgender people
  • Alcohol – up to 25% of transgender people struggle with alcohol use disorder
  • Marijuana – transgender men are up to 3.5 times more likely to use pot than cisgender men
  • Amphetamines – individuals in the transgender community are up to 12 times more likely to use these drugs
  • Heroin – transgender individuals use up to 9.5 times more than cisgender people

The Obstacles in Transgender Substance Use Disorder Treatment

Common Substances Misused in the Transgender Community

With discrimination in the medical field against transgender individuals, they often refuse to seek treatment. In mental health treatment, bad past experiences and the fear of treatment are the main reasons they avoid treatment. These further triggers stress as they anticipate the same treatment. 

In addition, many treatment centers don’t offer transgender-specific treatment. Often, a transgender individual is grouped with other LGBTQ members. But, unfortunately, the transgender community also faces discrimination from the lesbian, gay, and bisexual communities. 

In some cases, transgender people may be excluded from programs altogether. A big obstacle in treatment is the regular hormone treatment needed in the transgender community. Many centers are not experienced in monitoring and administering hormones. 

Transgender Treatment Centers Meet the Needs of Transgender Individuals

Transgender treatment centers understand the unique needs of this community. With mental health and substance use disorders prevalent in the community, treating co-occurring disorders is one of the most critical aspects of treatment.

Although there are complex reasons that led to substance use disorder, according to Substance Abuse Treatment, Prevention and Policy, transgender individuals who experienced violence and social rejection left treatment early.

Transgender-Inclusive vs. Transgender Affirmative Treatment

While a treatment center states they welcome transgender individuals, they may only tolerate them. As a result, the center doesn’t offer programs that address the trauma, discrimination, and family issues that lead to substance use disorder. 

However, affirmative transgender treatment centers put the experiences of this community and identity validation at the core of their programs. These centers are often extremely involved in the transgender community, offering resources to address the core drivers in transgender substance use disorder.

Treatment Needs in Transgender Substance Use Disorder

Life as a transgender individual can be very stressful and challenging. But, when you are around people who accept the true you, you feel safe to express yourself. And treating substance use disorder requires a person to be open and honest about feelings and experiences. 

At Sana Lake Behavioral Wellness Center, our transgender substance use disorder programs offer evidence-based, trauma-informed therapies. We also understand the past trauma and discrimination a transgender person may have experienced from cisgender and other members of the LGBTQ community. 

So in therapy, transgender individuals receive treatment alongside peers with the same experiences. Members can safely explore and express their identity without fear of shame and ridicule. Transgender treatment centers typically offer therapies such as:

Individualized Treatment Programs in Transgender Treatment Centers

Individualized treatment plans are crucial to treating transgender substance use disorder. Working on the treatment plan helps members accept their identity and gives them the tools to cope with the challenges of being transgender. 

Inpatient transgender treatment centers allow members to focus on their recovery and self-acceptance without judgment and discrimination. Individual treatment plans may include:

  • Psychotherapy
  • Group therapy
  • Family therapy
  • Medical detox
  • Medication-assisted therapy (MAT)
  • Peer support
  • Recurrence of use prevention
  • Case management
  • Aftercare services

Transgender Substance Use Disorder Treatment at Sana Lake BWC

If you or someone you love is struggling with substance use disorder, we have a program to help. Our transgender affirmative treatment programs are dedicated to accepting each individual as they are in a welcoming and sensitive environment. Find out how our programs can help you find acceptance and Recovery for Life. Contact us today.

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