As an LGBTQ+ person, it can be hard to find supportive, affirming treatment for addiction. In some cases, it can actually be dangerous to disclose certain aspects of your life to a provider. Other doctors may have good intentions, but lack cultural competency. And if your care team struggles to understand you, recovery can be much harder than it needs to be.
Today, we’re in the middle of a cultural shift. Information about LGBTQ+ issues is increasingly accessible. And doctors are starting to understand why that matters. A growing number of rehab centers cater to the unique needs of LGBTQ+ patients.
Finding the Right Rehab for You
Recovery means building a life that works for you. Everyone has unique values, regardless of their gender or sexual orientation. In an affirming rehab, your team will guide you through that process without judgment. When you’re ready to choose a treatment program, you can ask these questions to see if a particular center is a good fit:
- What experience does your team have treating people of my identity?
- I prefer to be called a name that doesn’t match my ID or insurance. Will your staff respect that?
- Does your standard intake form ask for new patients’ pronouns?
- Is your program faith-based? If so, how does that inform your approach to treatment?
- Do you have a dress code? If so, what is it?
- Are rooms assigned by gender?
- Are private rooms available?
- Are any activities segregated by gender?
- What types of medical care do you offer?
- Does anyone on your team specialize in hormone replacement therapy (HRT)?
- Which support groups can I attend during treatment, if any?
- Do you offer family therapy? If so, can I include my chosen family?
You have the right to get answers to these questions, and any others you might have. And with those answers, you’ll be able to assess whether a rehab can support your recovery goals.
What is LGBTQ+ Affirming Treatment?
The healing process is different for everyone. And skilled providers will understand that there’s more to you than your gender or sexuality. But most LGBTQ+ affirming programs should have certain qualities in common.
Respectful Therapy
The goal of therapy is to become your best self, not to artificially “fix” who you are. Culturally competent therapists honor their patients’ identities. Your counselor will help you define your own values, instead of urging you to change them.
1:1 therapy may focus on your personal history and your emotional experience. But feelings don’t happen in a vacuum. LGBTQ+ affirming therapists also understand the cultural context that informs your life. Or, if your lifestyle is new to them, they’re willing to learn. Their job is to support you in defining yourself; not to debate your identity. And as you become your best self, you can also start building healthier relationships.
Chosen Family Therapy
A family is just a group of people who have things in common. Some families share DNA, or a last name, or an address. But family can also include people with shared history and values, no matter where you first met them.
For many LGBTQ+ people, the idea of “family” is complex and even painful. You might be much closer to your chosen family than your family of origin. No matter how you define the word, your health can have a huge impact on your loved ones. Because of this, family therapy is an important part of addiction recovery.1
LGBTQ+ affirming rehabs offer treatment for both biological and chosen families. Connecting with your loved ones can give you valuable insight into your sense of self.
Body Image
There may be a link between body image issues and drug addiction.2 And body image is an issue for people of any gender or sexuality. However, it might be an even greater concern for LGBTQ+ people.
One study found trans and non-binary people are 2-4 times more likely to have eating disorders.3 According to the National Eating Disorders Association (NEDA), this may be due to a few types of social pressure. If you’re bullied or targeted because of your identity, you might be more vulnerable. But social pressure within LGBTQ+ communities is also a risk factor.
Fortunately, inpatient treatment isn’t just for addiction. You can also go to rehab for a number of mental health issues, including eating disorders. In LGBTQ+ affirming therapy, you’ll do more than work through your feelings about your body. You’ll also consider the social pressures that contribute to those feelings. The right therapist will be able to help you find balance, without asking you to give up your community.
LGBTQ+ Youth
Historically, it’s been difficult to find adequate health care for young LGBTQ+ people. At its worst, treatment forced vulnerable teens into living inauthentic lives. Mental health care has come a long way since that time, and there’s still a long way to go.
Today, there are many more resources available for LGBTQ+ youth. Providers aim to support this population as they come out and grow into healthy adults. With or without support from their families of origin, LGBTQ+ kids and teens deserve care.
And some rehabs have a special focus on family therapy. For instance, Paradigm Teen & Young Adults Treatment teaches parents and guardians to publicly support their LGBTQ+ teens. This heals much more than interpersonal family dynamics. It also helps young patients connect with community resources. Providers teach that when a family can accept a teen as they are, “it helps a community to do the same.”
If you’re a parent or guardian looking to send your teen to rehab, these programs can help. LGBTQ+ people face unique challenges. And it’s possible to get your teen the exact type of support they need. This can include anything from a change of scenery to specialized medical care.
Medical Care for Trans People on HRT
Drug use can change the way your body responds to other medications. And when you detox, things will likely change again. This can be a serious concern for trans patients who are on hormone replacement therapy (HRT). Don’t let this be a barrier to treatment. You can absolutely start recovery without losing access to these important prescriptions.
At some rehabs, like Caron Ocean Drive, endocrinologists offer support for transgender patients. These experts ensure your access to gender-affirming care throughout detox and recovery. They’ll even help you find a qualified provider for ongoing treatment after rehab.
Mental Health Stressors in LGBTQ+ Communities
Certain factors put LGBTQ+ people at higher risk for mental health issues.4 People in this demographic face discrimination, harassment, and a lack of community support. These external stressors make you more vulnerable to mental health issues. And mental health problems can lead to addiction.5
Minority Stress
With or without a diagnosed mental illness, many LGBTQ+ people experience minority stress.6 Minority stress is the state of living under discriminatory conditions. Experts agree that this constant pressure has noticeable negative impacts on your health. Minority stress is common among people who experience oppression,7 including queer and BIPOC communities.
Even people without acute trauma can get worn down by these constant challenges. This is partly because minority stress can affect your conception of self. Experts describe “internalized homonegativity,” in which LGBTQ+ people lack self-esteem and self-respect. While these are mental health issues, they may have external causes. And while rehab can’t take those stressors away, it can help you learn to navigate them.
Trauma and Mental Health Issues
People who do experience severe trauma are likely to develop mental health disorders. For example, LGBTQ+ youth are at higher risk for PTSD.8 With that in mind, many rehabs offer trauma-informed care. These programs help you work through difficult memories, and teach you to handle triggers as they come up.
You can even attend rehab to treat addiction and PTSD as co-occurring disorders. In that case, treatment will help you explore the relationship between these conditions.
Addiction in the LGBTQ+ Community
LGBTQ+ people are at higher risk for substance use disorders9 than other demographics. One study found that 20-30% of LGBTQ+ people had addictions, compared to about 9% of the total population. And in the 2015 National Survey on Drug Use and Health, LGBTQ+ people had a high risk of mental health issues.10
Addiction and mental health issues can amplify each other. Most people need professional help to break out of this cycle. And many LGBTQ+ people lack access to mental health services.11 This may be due to discrimination, or the fear of discrimination due to past trauma. These concerns are valid. And LGBTQ+ affirming rehab centers can address them.
Take Pride in Recovery
Recovery is the process of healing yourself as a whole person. In rehab, you’ll integrate each aspect of your identity, and focus on the parts of your life that bring you joy. But this work can only happen if you have the right support. An LGBTQ+ affirming program will help you become your best and most authentic self.
Connect with one of the many rehabs offering LGBTQ+ affirming care to learn more about their unique approaches to treatment, insurance options, and community programs.
Reviewed by Rajnandini Rathod
- Filges, T., Andersen, D., & Jørgensen, A.-M. K. (2018). Effects of multidimensional family therapy (Mdft) on nonopioid drug abuse: A systematic review and meta-analysis. Research on Social Work Practice, 28(1), 68–83. https://doi.org/10.1177/1049731515608241 [↩]
- Grant, J. E., Menard, W., Pagano, M. E., Fay, C., & Phillips, K. A. (2005). Substance use disorders in individuals with body dysmorphic disorder. The Journal of Clinical Psychiatry, 66(3), 309–405. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2504687/ [↩]
- Gordon, A. R., Moore, L. B., & Guss, C. (2021). Eating disorders among transgender and gender non-binary people. In J. M. Nagata, T. A. Brown, S. B. Murray, & J. M. Lavender (Eds.), Eating Disorders in Boys and Men (pp. 265–281). Springer International Publishing. https://doi.org/10.1007/978-3-030-67127-3_18 [↩]
- Stress & Trauma Toolkit. (n.d.). American Psychiatric Association. Retrieved from https://www.psychiatry.org/psychiatrists/cultural-competency/education/stress-and-trauma/lgbtq [↩]
- Mental health and substance use co-occurring disorders | mentalhealth. Gov. (n.d.). Retrieved from https://www.mentalhealth.gov/what-to-look-for/mental-health-substance-use-disorders [↩]
- Minority stress model—An overview | sciencedirect topics. (n.d.). Retrieved from https://www.sciencedirect.com/topics/psychology/minority-stress-model [↩]
- The minority stress perspective. (n.d.). Https://Www.Apa.Org. Retrieved from https://www.apa.org/pi/aids/resources/exchange/2012/04/minority-stress [↩]
- Higher risk of PTSD for gay, lesbian, bisexual, ‘mostly heterosexual’ youth. (2012, June 19). Harvard Gazette. https://news.harvard.edu/gazette/story/newsplus/higher-risk-of-ptsd-for-gay-lesbian-bisexual-mostly-heterosexual-youth/ [↩]
- Why the gay and transgender population experiences higher rates of substance use. (n.d.). Center for American Progress. Retrieved from https://www.americanprogress.org/article/why-the-gay-and-transgender-population-experiences-higher-rates-of-substance-use/ [↩]
- McCabe, S. E., Hughes, T. L., Bostwick, W. B., West, B. T., & Boyd, C. J. (2009). Sexual orientation, substance use behaviors and substance dependence in the United States. Addiction, 104(8), 1333–1345. https://doi.org/10.1111/j.1360-0443.2009.02596.x [↩]
- Moagi, M. M., van Der Wath, A. E., Jiyane, P. M., & Rikhotso, R. S. (2021). Mental health challenges of lesbian, gay, bisexual and transgender people: An integrated literature review. Health SA Gesondheid, 26, 1487. https://doi.org/10.4102/hsag.v26i0.1487 [↩]
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