The lesbian, gay, bisexual and transsexual communities in the United States face challenges and concerns every day, but one of the less-considered issues that affects the various gay and transgendered communities is that of substance abuse, particularly when it comes to alcohol. Dangerous drinking affects everyone, regardless of sexual orientation, but alcohol abuse in the gay community is a very specific problem, with its own causes, effects and solutions.
Facts and Figures About Alcohol Abuse in LGBT Communities
In terms of substance abuse and the use of dangerous substances, the gay and lesbian community often shows up in much higher numbers than the straight population. For example, a study by University of Missouri researchers found that 35 to 40 percent of the state’s LGBT population smoked, as opposed to just 21 percent of the general population.
That study was picked up by ThinkProgress, who, in an article entitled “Making Sense of the LGBT Community’s High Rates of Substance Abuse,” explained that there are three common factors that can affect the likelihood of a LGBT person developing a substance abuse problem:
- Minority stress, which the American Psychological Association explains is the conflict experienced by minority group members with the social environment. With regards to LGBT people, this can mean social prejudice and discriminatory laws in daily life, like employment discrimination, relationship stigma, and access to health care. To that effect, the Center for American Progress notes that as many as 43 percent of gay people have experienced “some form of discrimination” in the workplace, while 90 percent of transgender workers report “harassment or mistreatment on the job.”
- The lack of cultural competency in health care systems, which can dissuade LGBT individuals from seeking treatment, and puts them at risk for receiving diminished, or even negligent, treatment.
- Focused marketing by alcohol companies that exploit gay and transgender individuals who use bars and nightclubs as safe havens and spaces for socialization. Such companies also provide easy access to alcohol, which can be dangerous for LGBT people who are going through stress as a result of the factors mentioned above. Furthermore, a writer for The Advocate points out that “[gay and transgendered] culture very heavily revolves around the bar scene,” which significantly increases the risk factor of LGBT individuals developing alcohol abuse.
As a result, explains ThinkProgress in their article, 25 percent of the gay and transgender population use alcohol in dangerous amounts, while only five to 10 percent of the general population has the same problem.
Another report by the Center for American Progress explains that “many [LGBT individuals] use [drugs and alcohol] to cope with discrimination and prejudice.” Citing studies done by the Substance Abuse and Mental Health Services Administration that estimate between 20 and 30 percent of gay and transgender people struggle with substance abuse (as opposed to only nine percent of the straight population), the report expands upon the points put forward in the ThinkProgress article. Specifically, it goes into greater depth into the various forms of discrimination that LGBT people endure: employment, housing, education and relationship recognition (when same-sex couples cannot access public resources intended to benefit a family’s economic security, such as Social Security benefits, child care tax credits, etc.).
The report also details the discrimination in health care, pointing out weaknesses and deficiencies in America’s health care system that harm gay and transgendered people. With higher rates of lack of insurance among LGBT people than straight people, as well as targeted exclusions, denied coverage for transgendered people, and a negligible quality of care offered to gay and transgendered people, the Center for American Progress sums up the end result as “additional emotional stress and pressure” for LGBT people, which can drive them to alcohol abuse.
The “negligible quality of care” refers to ignorance from health care professionals who are unaware of the medical and psychosocial issues confronting the LGBT communities, or hostility from homophobic individuals or policies within the health care industry. Gay and transgendered people may be reluctant to turn to health care services for this reason. The lack of trust and communication between the health care and LGBT communities can impede necessary diagnosis and treatment in the event of medical conditions, which adds layers of physical, mental and emotional stress that LGBT people may try to remedy on their own with the dangerous use of controlled substances like alcohol.
Similarly, The Independent ran a story in September 2012 that quoted researchers at the Lesbian and Gay Foundation and the University of Cambridge, who warned that people of a sexual minority risked exclusion from traditional drug treatment services. The story quoted an outreach manager of England’s only substance abuse program for LGBT teens, saying that fear, shame and rejection – usually around sex – are what drive people to unhealthy alcohol (and drug) consumption.Confirming the point about bars and nightclubs that ThinkProgress mentioned, a London-based blogger told The Independent “all our methods of socializing revolve around drink or drugs,” and that people can become dependent as a result.With regards to the “negligible quality of care” mentioned above, The Independent quoted a woman who was bullied for her homosexuality and turned to drugs and alcohol as coping mechanisms. The woman told The Independent that health care workers need to be trained to deal with the issues that LGBT people have to deal with. A lack of training can make for treatment that is ineffective and perhaps even harmful.Another factor behind alcohol abuse in the gay community may stem from a refusal – or even a denial – to acknowledge or confront the issue. An editorial in The Advocate entitled “Why Aren’t We Talking About Alcoholism?” (mentioned above) suggests that the gay and transgendered community’s focus on legalizing same-sex marriage has led to “very few efforts” made to address the topic of problem drinking.
The writer of the editorial theorized that individuals within the LGBT community may be afraid of drawing attention to the concern of alcohol abuse for fear that it will reflect negatively on gays and transgendered people on the whole. Instead, the writer says, LGBT community members and voices may choose to spotlight bigger issues, such as same-sex marriage, to the exclusion of other troubling challenges facing gay and transgendered people.
Treatment Options for LGBT People
A gay or transgendered person who is struggling with alcohol abuse should look for treatment from sources that have the required training and understanding of the causes and concerns that face the LGBT community. Therapeutic treatment offered by standard substance abuse rehabilitation facilities may not fully address all the various manifestations of homophobia that can drive a gay or transgendered person to drinking; and what treatment such facilities do offer may be half-measured or inadequate.
This is especially true when the treatment turns to psychotherapy, which helps the patient understand the harmful patterns of thought and behavior that led them to abuse alcohol. If a therapist does not understand the dynamics of homophobia, then he or she will have very limited effectiveness in showing their patient how to adopt more positive and healthier attitudes to the triggers that caused the drinking.
For that reason, a treatment facility that has dedicated programs for working with LGBT people, or that staffs therapists who have experience dealing with LGBT individuals, is often preferred. Staff members at these facilities have the necessary education and insight on how best to work with their gay and transgendered patients, and to address their needs in ways that directly speak to the abuse of homophobia. Even a choice of words – referring to a same-sex partner as a “partner” instead of a more traditionally gender-based term, such as “husband” or “wife” – can create a more nuanced welcoming and hospitable environment.
Staff at such facilities will also be aware of the greater hill that LGBT patients have to climb. A 2004 report in the Journal of Substance Abuse Treatment reported that LGBT clients enrolled in treatment programs with “more severe substance abuse problems […] when compared with heterosexual clients.” Treating gay and transgendered people for their substance abuse can be completely different than treatment for straight people, and mental health professionals who cannot work with that knowledge – no matter how good their intentions might be – are not in a position to provide the necessary treatment, resources, and care to LGBT patients.
We understand that our gay and transgendered clients have a number of specific needs and concerns. They may be dealing with the effects of being discriminated against for their sexuality; they may be battling an alcohol problem; and they may be wondering if we can really show them how they can overcome the many challenges in their lives. But that’s why we are here: to answer all of your questions, and to provide you with resources, information and ultimately treatment that speak to you on a personal and individual level. Please call us today and ask how we can help you. Our admissions coordinators are standing by to work with you on starting your journey of health, healing and happiness today.