Substance Abuse Challenges of the LGBTQIA2+ Community

Understanding the unique challenges of the LGBTQIA2+ community is a critical foundation for Mental Health Issues, Trauma, and Addiction Treatment. 

Each person has particular elements contributing to substance use disorder (SUD) and alcohol use disorder (AUD). To prompt effective, long-term wellness, addiction treatment should be tailored to meet their individual needs. However, in many cases, similar risk factors are shared by members of specific communities, such as individuals who identify as LGBTQIA2+.

Why Are the Risks So Great?

Throughout human history, people have experienced discrimination, been denied human rights, been persecuted, and even been killed for simply being who they are. These conditional quantifiers have a devastating impact on emotional, mental, physical, and spiritual well-being and create lasting repercussions for survivors, especially those dealing with constant fear and trauma.

The acronym LGBTQIA2+ stands for people who identify as:

• Lesbian
• Gay
• Bisexual
• Transgender
• Queer (also sometimes Questioning for some people)
• Intersex
• Asexual, Aromantic, Agender
• 2 Spirit

The + sign symbolizes affirmation for additional identities and communities, such as nonbinary and same-sex loving, “in recognition of all non-straight, non-cisgender identities,” according to GLAAD. Learn more about terms and language.

Members of the LGBTQIA2+ community have extraordinary challenges. Here are just a few examples:

• The National Institute on Drug Abuse indicates these individuals “often face social stigma, discrimination, and other challenges not encountered by people who identify as heterosexual. They also face a greater risk of harassment and violence. As a result of these and other stressors … [they] have increased risk for various behavioral health issues.”
• Rainbow Health Ontario reports that “racialized 2SLGBTQ people” not only have these challenges, but also suffer more from food insecurity, homelessness, school difficulties and lesser educational opportunities, and ongoing microaggressions: “subtle, derogatory behaviors—verbal or non-verbal, conscious or unconscious—directed at a member of a marginalized group that has a derogatory, harmful effect.”
• GLAAD highlights findings from a report released by the The National Coalition of Anti-Violence Programs (NCAVP) profiling “a spike in violence against LGBTQ people during the 2019 Pride season, and how “people of color and transgender people are disproportionately targeted. NCAVP reported that 91 percent of all LGBTQ homicide victims were Black, and 64 percent of homicide victims were Black transgender women.”

So for someone within this community who might already have some of the traditional risk factors for SUD and AUD—including family history, environmental and peer influences, and mental and emotional disorders, among others—these additional difficulties and lack of quality health care create a ripple of complications.

Mental Health Issues, Trauma, and Addiction in the LGBTQIA2+ Community

Here are some facts from Mental Health America:

• “In a survey of LGBTQ+ people, more than half of all respondents reported that they have faced cases of providers denying care, using harsh language, or blaming the patient’s sexual orientation or gender identity as the cause for an illness. Fear of discrimination may lead some people to conceal their sexual orientation or gender identity from providers or avoid seeking care altogether.”
• Further, it was only in 2011 that the Joint Commission, “an independent non-profit national organization that accredits and certifies more than 20,000 health care organizations and programs in the U.S.,” issued a requirement that hospitals and other health organizations “prohibit discrimination based on sexual orientation, gender identity, and gender expression in order to be accredited.”
• Nearly 40 percent of individuals identifying at LGBTQ+ “reported having a mental illness in the past year.”
• Data from the LGBTQ+ Mental Health: Insights from MHA Screening report features information from “300,000 LGBTQ individuals who took a mental health screen from 2017-2019—approximately 8 percent of LGBTQ+ individuals and nearly 27 percent of transgender individuals report being denied needed health care outright.” Additionally, “half of LGBTQ screeners report significant thoughts of suicide or self-harm, compared to only 33 percent of non-LGBTQ screeners.”

Kaiser Health News outlines additional critical issues members of the LGBTQIA2+ community face:

• Rape and intimate partner violence occurs at increased rates for bisexual women (46 percent and 61 percent in these categories), lesbian women (13 percent and 44 percent), and heterosexual women (17 percent and 35 percent). Sexual violence, such as coercion or harassment, affects approximately 75 percent of bisexual women and “more than four in ten heterosexual and lesbian women.”
• “Four in ten gay men and nearly half of bisexual men have encountered sexual violence other than rape. More than one-third (37 percent) of bisexual men have faced partner violence. Bisexual and gay men experience significantly higher rates than heterosexual men. For both men and women, the perpetrators were predominantly male.”
• “Heavy consumption of alcoholic beverages during at least one day in the past year was reported by more bisexual (47 percent) and gay or lesbian (36 percent) adults than heterosexual adults (28 percent). Rates among men of all sexual orientations were substantially higher than for women.”
• Additionally, research suggests that gay and bisexual men and other men who have sex with men (MSM) “have higher use of certain substances. One study has estimated that MSM are more than 12 times as likely to use amphetamines and almost 10 times as likely to use heroin as heterosexual men.”
• LGBT+ students are also more likely to engage in certain risk-taking activities compared to heterosexual students, “including having ever tried alcohol (75 percent vs. 63 percent), marijuana (53 percent vs. 38 percent), or cocaine (11 percent vs. 4 percent).”

Fair Oaks: An Ally for Healing

The core philosophy of our addiction treatment center in Sacramento is to honor the human dignity of every person we work with, and we feel privileged to support a process of change with our safe space of inclusion. Our professionals acknowledge collective challenges, but also strive to embrace each individual’s background and provide customized solutions for their future success. Ask a member of our admissions team how we can help you.