Research shows that substance use disorders (SUDs) are more common among people who identify as lesbian, gay, bisexual, transgender, queer/questioning, or somewhere else on the gender and sexuality spectrum (LGBTQ) than they are within the general population.¹

Many factors contribute to this, such as discrimination and social stigmas, as well as barriers that make it harder to find effective LGBTQ substance abuse treatment. Sexual and gender minorities (SGM) also have some unique treatment needs that treatment staff should be aware of and sensitive toward. Fortunately, there are specialized rehab centers and alcohol addiction treatment programs that can meet the needs of this community.

Addiction in the LGBTQ Community

In the United States in 2019, 2.6 million LGB adults had a substance use disorder (SUD). Almost 65% of these adults struggled with alcohol misuse.²

There are several risk factors specific to sexual and gender minorities (SGM) that may contribute to a higher rate of substance misuse and addiction in LGBTQ people than non-LGBTQ people. One theory that may explain why SGM groups are at an increased risk of developing SUDs is minority stress. This theory looks at how certain risk factors influence negative mental health consequences and connected coping behaviors, such as the use of substances to deal with related stressors.³ These risk factors can occur on a societal, personal, and family level and include:⁴

Discrimination. One study found LGBT people who have been discriminated against due to sexual orientation, gender, or race are 4 times as likely to develop an SUD than those who weren’t discriminated against
Increased risk of anxiety and depression.
Experiencing trauma, violence, and harassment because of sexual or gender identification.
Being ostracized or excluded.
Stress related to internalized transphobia or homophobia—that is, fear of rejection or retaliation—in those who aren’t publicly “out.”

In a study of LGBTQ young adults with a probable SUD published in Psychiatric Services, researchers highlighted how substances are often used to cope with these stressors. In addition, the availability of substances at LGBTQ social events may also contribute to the development of an SUD.³

On the other hand, research shows that LGBTQ adolescents with access to LGBTQ community organizations, programs, and support are less likely to use substances.⁵

Co-Occurring Disorders in the LGBTQ Community

Similar to the prevalence of SUDs, studies show that LGB adults are at a greater risk of severe mental illness (SMI) than non-LGB adults. In 2015, 37.4% of LGB adults had an SMI compared to 17.1% of non-LGB adults.⁶

When a mental health disorder and a substance use disorder are present at the same time, this is called a co-occurring disorder.⁶Studies show that:^1,7

In 2019, 1.9 million LGB adults had both a mental health disorder and an SUD.
Lesbian, gay, and bisexual youth report symptoms of depression, including chronic hopelessness or sadness, at more than twice the rate as heterosexual youths.
Transgender youth report symptoms of depression and suicidal thoughts at twice the rate of cisgender (someone whose gender identity matches their birth sex) youths, even those who are lesbian, gay, bisexual, or questioning.

LQBTQ Addiction Treatment Options

It is important to offer specialized treatment for substance abuse in the LGBT community, since traditional rehab centers commonly overlook the unique needs of this population.⁸ Specialized LGBT addiction recovery programs can offer a safe, supportive environment that respects and acknowledges your gender and sexual identity and expression, coming out, and experiences with prejudice without the fear of discrimination or stigma.⁸

Therapies such as motivational interviewing, cognitive behavioral therapy, and contingency management can help treat trauma, issues within the family, and co-occurring disorders as well as help you develop social supports and learn to manage triggers (the people, places, and things that make you want to use substances).¹ These therapies are offered in many different rehab settings, which may include:

American Addiction Centers (AAC) recognizes the importance of addressing the unique needs of the LGBTQ community and offers specialized LGBT treatment tracks in many states across the country.

What to Look for in LQBTQ Rehab Centers

There are a number of factors to consider when seeking LGBTQ-competent care. These may include:^3,9

Is it important to you that members of your care team share aspects of your sexual or gender identity and expression?
Does the rehab center create, implement, and enforce non-discriminatory policies regarding gender or sexual identity and expression?
Does the rehab center offer gender-neutral restrooms?
Does the rehab center offer ongoing professional training for staff that includes cultural affirming care for the LGBTQ community?
Avoid any rehab centers that offer “conversion,” “reorientation,” or “reparative” therapy. These are harmful therapies that are not evidence-based.
Does the rehab center ask about gender pronouns and use them accordingly with the understanding that these pronouns may change while in treatment?
Does the rehab center express acceptance, openness, and nonjudgmental attitudes toward patients as well as avoid assumptions about gender and sexual identity, expression, and behaviors?

Knowing your answers to these questions can help you further narrow down treatment centers that will be a good fit for you.

Finding LGBT-Friendly Rehab Centers Near Me

American Addiction Centers (AAC) offers specialized alcohol addiction treatment programs for members of the LGBTQ community as well as treatment for co-occurring disorders such as anxiety, depression, and post-traumatic stress disorder (PTSD). AAC also offers free screenings.

If you’re ready to start your recovery, call to speak to a compassionate admissions navigator about your options. Your call is completely confidential, and our alcohol hotline is open 24 hours a day, 7 days a week.

Additional LGBTQ Resources

Various groups offer support especially for the LGBTQ community. These include:

APA Office on Sexual Orientation and Gender Diversity. This is the American Psychological Association’s website on sexual and gender identity, and it offers resources, news, and advocacy efforts.
Association of LGBTQ+ Psychiatrists. This website has resources about how healthcare providers can better support LGBTQ people, informational fact sheets, and a referral list of LGBTQ-informed psychiatrists.
The National Center for Transgender Equality. This site offers information about various topics related to transgender people, transgender rights, and various supportive resources.
SAGE National LGBT Elder Hotline. This is a hotline that offers crisis management and support for older LGBT people, as well as offering a range of educational resources online.
Society for Sexual, Affectional, Intersex, and Gender Expansive Identities (SAIGE). This site is an offshoot of the American Counseling Association, offering education, resources, and a database of counselors who are understanding of LGBTQ+ issues.
The Trevor Project. This website offers support and resources through access to trained counselors around the clock, as well as offering educational information and a safe place to socialize online.

Note: Variations of the LGBTQ+ acronym are used in this article to reflect that substance use studies have historically been limited to LGB populations and use binary identity classifications.