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Substance Use in the LGBTQIA+ Community

People who identify as part of the LGBTQIA+ community have higher rates of substance use and abuse than people who identify as heterosexual and/or cisgender.

Why is this the case? While research behind finding why such differences exist is very limited, some studies have posited that the social stressors that arise from living in a historically homophobic society, contributes to mental health problems, including substance use disorders.

Substances are often used in the LGBTQIA+ community as a coping mechanism or form of self-medication. There can be high levels of stress from facing obstacles such as discrimination, social stigma, family rejection, and internalized homophobia.

Discrimination can be experienced on an individual level, like in the form of harassment, verbal harassment, violence, or sexual violence. It can also be experienced on an institutional level, like in the form of access to employment, medical care, or housing. There is also a social stigma associated with being lesbian, gay, bisexual, or trans, and there is often family rejection associated with “coming out.” There can be a lack of support from family members, friends, neighbors, coworkers, and their faith community.

LGBTQIA+ individuals also experience higher rates of homelessness, sexual violence, and suicide. LGBT teens are twice as likely to be bullied, and four times more likely to commit suicide. They also have a 120% higher risk of homelessness. LGB individuals are nearly four times more likely to be victims of violent crime, including rape, assault, and sexual assault. In fact, almost half of all trans people have been sexually assaulted in their lifetime, with rates even higher for trans people of color. Many people who are part of the LGBTQIA+ community are also uncomfortable asking for help from law enforcement, and even healthcare providers.

The heightened risk for substance misuse is likely as a consequence of living in a hostile and stressful social environment where LGBTQIA+ individuals are under the constant possible threats of harassment, discrimination, bullying, and hate crimes.

Coping and Treatment

Everybody has ways to cope with difficult emotions, but some coping strategies are healthier than others. Turning to substances may seem easier at times, but it can have negative side effects and added dangers. Healthy coping strategies are more helpful in the long run, and are safer for your mind and body. Here are four coping strategies to try:

  1. Express Your Emotions: One positive way to cope is to find a way to express your emotions. You can talk with somebody, cry, scream, write music, poetry, journal, paint, and so much more. Find what’s most comfortable and helpful for you.

  2. Get Involved: Another positive coping strategy is to find things you enjoy and to get involved. You can join a club, join a sport, join a band, or become a volunteer. You can meet new people–who you have at least one thing in common with–and you can spend your time doing something positive. It can take your mind off other things, give you a different perspective, or give you the opportunity to learn a new skill.

  3. Find Support: A third positive way to cope is to find support from somebody: Whether that’s from a trusted friend, family member, neighbor, counselor, local organization, or online community, it’s important to create a support system. If you ever need to reach out to a crisis counselor, call (1-866-488-7386). This is a help hotline supported by The​​ Trevor Project, with immediate support 24/7, 365 days a year, and 100% free. You can also message them at any time by texting ‘START’ to 678-678.

  4. Consider Therapy: If you find it hard to express your emotions, Another way of finding support and expressing your emotions can be through a therapist can help. However, it’s important to find a therapist that’s right for you and your specific needs–especially if you’re a member of the LGBTQIA+ community. Learn more about how to find a therapist that makes you feel safe and comfortable. If you’re seeking help from a treatment facility for a substance use disorder, it may be important to you to find a center that addresses the specific needs of LGBTQIA+ individuals. While in the past, not many programs offered specialized services for LGBT patients, it has been recognized that this is needed, and many are beginning to offer specialized programs. Mental Health America has created a list of questions to ask a potential treatment provider or facility and Partnership to End Addiction has created this list for parents seeking treatment for a LGBTQIA+ child.


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