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Addiction Treatment Fails Transgender People

Transgender individuals face a higher rate of addiction. Health-care and treatment services often let them down.

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The health care system needs to step it up.
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By May Wilkerson

12/05/12

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Transgender people are at a much higher risk for substance abuse and addiction, according to a new report from the Center for American Progress. But ignorance and incompetencies in health care and addiction treatment may prevent them from receiving adequate care. An estimated 30% of transgender people abuse substances, compared to just around 9% of the general population, according to a Substance Abuse and Mental Health Services Administration (SAMHSA) study. “The stress that comes from daily battles with discrimination and stigma is a principal driver of these higher rates of substance use, as transgender people turn to tobacco, alcohol, prescription drugs, and other substances as a way to cope with these challenges," says the report. Transgender people face disproportionate levels of stress, due to social prejudice and discriminatory laws, say advocates. This can result in increased anxiety, depression and isolation, leading many to self-medicate with illegal or prescription drugs, or alcohol. Also, many trans people find a safe space in the bar or club scene, again increasing exposure to alcohol and drugs.

Those who do seek treatment are often directed towards inadequate or ineffective services. Medical professionals are often uneducated in trans people's specific needs, and most in-patient drug rehab centers are segregated by gender—making them an unsafe, alienating space for this population. Even rehabs that market themselves as "trans-friendly" often refuse to provide crucial hormone therapy, misguidedly considering it an "elective drug." The mental health and medical fields have much to do to improve this situation—but certain changes are underway. The term "gender identity disorder" will soon be removed from the Diagnostic and Statistical Manual of Mental Disorders; advocates say that pathologizing trans identity like this contributes to stigmas and subsequent inadequacies in services. Plans to replace the term with "gender dysphoria" (emotional distress over one's gender) were approved this past Saturday. This could usher in more comprehensive and organized care for trans people, according to Jack Drescher, a member of the American Psychiatric Association and an advocate for trans rights. “We know there is a whole community of people out there who are not seeking medical attention and live between the two binary categories," he says. "We wanted to send the message that the therapist’s job isn’t to pathologize.”

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