“For some, it is much easier to reveal that they are in recovery than it is for them to disclose their sexual orientation. This may, in part, be the result of society’s willingness to say, “Oh, alcoholism is a disease.” Disease is much easier for the family to deal with than the fear of homosexuality. Homosexuality has frequently been presented as a family’s moral failure that, in turn, results in personal guilt and blame.” ~Drs. Sheppard B. Kominars, Ph.D. and Kathryn D. Kominars, Ph.D., Accepting Ourselves and Others: A Journey into Recovery from Addictive and Compulsive Behaviors for Gays, Lesbians, Bisexuals Finding proper help when you are suffering from an active substance abuse disorder is hard, and it’s made even harder when you identify as LGBT. Addiction treatment professionals are often woefully unprepared to handle the specific therapeutic needs of people who are lesbian, gay, bisexual, or transsexual.
The Hurdles to LGBT Rehab
One of the biggest impediments to effective addiction treatment for LGBT individuals is the fact that there simply aren’t enough qualified substance abuse counselors who have real-life experience in treating LGBT patients within the unique cultural context experienced by non-heterosexuals. According to the 2010’s LGBT TriStar report, less than 7% of addiction counselors are specifically trained in LGBT issues. In 2007, researchers contacted 854 treatment facilities that were listed in the National Survey of Substance Abuse Treatment Services as providing specialized services to LGBT clients. Despite the listing, 71% of those facilities acknowledged that there were, in fact, no specialized programs exclusively for LGBT patients. Complicating the matter is the fact that so many LGBT substance abusers ALSO have co-occurring mental disorders–almost three times more likely to struggle with depression or anxiety. Even fewer addiction professionals are well-versed in treating both substance abuse and comorbid disorders among LBGT patients. “Even if treatment providers have good intentions in an attempt to provide optimal treatment for all of their clients, the possibility remains that subtle biases against LFBT clients may influence the treatment process,” reported the Journal of Homosexuality in 2007.
What Kind of Biases May Exist Against LGBT People in Substance Abuse Treatment?
Without the expertise and experience that comes from regularly helping LGBT clients, a therapist may unconsciously focus more on a person’s sexual orientation or gender identification than the disorder that made them seek treatment in the first place. Long-time practitioners may still rely on “traditional” treatment methods, rather than the Evidence-Based Therapy offered at today’s best substance abuse treatment facilities. This can make a MAJOR difference. Homosexuality was classified as a mental illness until 1973, and still considered a “sexual orientation disturbance” until 1987. Even the World Health Organization did not remove homosexuality from its list of mental disorders until 1992. It still lists “ego-dystonic sexual orientation” as a disorder where people “wish their sexual preference were different”. Labels – even ones applied innocently – can also damage the trust that has to exist between the counselor and the patient – “male”, “female”, “gay”, “straight”, “masculine”, “feminine”, “he”, or “she” – all have fluid meanings within the LBGT community. Some feel that even “LBGT” doesn’t go far enough to accurately represent the entire spectrum of sexual orientation, identity, and expression. Now, the acronym that is gaining popularity is “LBGTQ+” – lesbian, bisexual, gay, transsexual, queer, and questioning. Another issue might be the provider placing LGBT individuals in peer groups that are ill-for their particular needs. For example, if a young homosexual client is placed in a therapy group comprised completely of heterosexuals, it could worsen their feeling of social isolation, which in turn could leave them even more vulnerable to addictive self-medication.
How Hard Is It for an LGBT Person to Get Unbiased Substance Abuse Treatment?
According to the 2016 Healthcare Equity Index, most LGBT individuals have already experienced discrimination or bias when seeking healthcare.
- More than half of all LGBT clients – 56% – and more than two-thirds of all transgender/gender non-conforming clients– 70% – report some degree of discrimination in the healthcare they have received.
- An estimated 70+% of transgender respondents and almost 30% of bisexual respondents perceived that they received different treatment from medical personnel because of their LGBT identification.
- Almost 10% of all LGB and more than 50% of all transgender respondents believe that they might be refused medical services.
What to Look for in Effective LGBT Addiction Treatment
If asked, every facility will tell you that they are “non-discriminatory”, but to find a treatment program that has specialized offerings for LGBT clients can be challenging. Luckily, there are some questions that you can ask to help narrow the search and give you a better idea as to whether or not a particular program offers the types of services that you need –
- What percentage of your clients are LGBT?– Although privacy laws prevent the release of information on any specific client, you should still be able to get information about the demographics of those attending.
- Do you offer LGBT-only therapy groups? –Every program already has specific groups–men’s, women’s, and youth groups are all common. It is entirely reasonable to ask if there are LGBT groups.
- What classes related to LGBT-specific issues are offered? – Most drug rehab programs also teach life skills, such as parenting, effective communication, conflict resolution, etc. Again, it is entirely reasonable to ask if they also address LGBT issues such as “coming out to your family”, “how to deal with unnecessary shame”, etc.
- What Special Training or accreditation do your counselors have in order to offer LGBT drug addiction treatment?– Do they follow the guidelines of the Association of Lesbian, Gay, Bisexual, Transgender Addiction Professionals, and Their Allies?
In the end, effective LGBT drug rehab is all about trust and comfort – can you trust the facility and the professionals it employees to welcome you and treat you as an individual? Do they have the understanding and empathy to create a treatment plan that addresses your unique needs as a member of the LGBT community? If you feel comfortable that they DO, then you can start the journey of your recovery right away.