Gender Identity as a Foundation for Health

By The Fix staff 02/25/19

Often, symptoms of the trauma of gender dysphoria need to be lessened before substance use can be treated for transgender and queer people.

3 people at Inspire Recovery hugging and smiling

People with gender dysphoria experience an onslaught of trauma. First, there’s the turbulence and discomfort caused by society’s judgement that the body you have (which society defines typically masculine or feminine) does not align with the gender that you are. Then, there’s the stress of living in a society that is not often welcoming to or understanding of people who are transgender, queer or non-binary. Even allies can unknowingly cause microaggressions when they rely on an LQBTQ+ individual to educate them about gender and identity.

Unsurprisingly, these traumatic experiences often lead LQBTQ+ people to develop maladaptive coping strategies, including substance abuse, says Alicja Majer, the director of operations at Inspire Recovery, a treatment center in West Palm Beach, Florida that serves LQBTQ+ folks.

“A huge aspect of why we see such rates of self-harm, substance use disorder, eating disorders and suicide among LGBTQ+ people is because of all this internalized distress that is caused by incongruence between how they identify and the sex assigned at birth that resulted in their imposed declaration of male or female,” Majer explains.

When a transgender person enters treatment for substance abuse, professionals often focus on treating their addiction and mental health issues before addressing their gender dysphoria. However, Inspire Recovery takes the opposite approach. Founder and CEO Donna Weinberger explains that addressing the traumatic experience of gender dysphoria and helping clients live as the person they are lays a foundation for healing from trauma, including the substance use disorder.

“The first thing we’re going to deal with is making sure clients are comfortable, by being submerged into a trans and queer community as the mainstream culture, expressing freely, and if desired getting on hormones, then they can start working on recovery,” said Weinberger, who uses the gender-neutral pronoun “they.”

At Inspire Recovery, clinicians don’t pathologize people with gender dysphoria. Rather, they trust that people who are transgender, non-binary or queer are the experts of their own identity, and take the clients’ lead on how they would like to express themselves and what their identity is. Providers respect clients’ human rights over their body.

“What causes the trauma in people is growing up in a society that is trying to push people to live in an inauthentic way,” Weinberger says. Just allowing individuals to self-identify and honoring their identity is a critical first step for healing, they note. Oftentimes, people come to Inspire Recovery having been misdiagnosed with a myriad of mental health diagnoses, only to find that the symptoms can actually be explained by trauma caused by the experience of gender dysphoria and repressing their true identity.

“Those could be symptoms resulting from being forced to live in a way that doesn’t make sense to them,” Weinberger explains. “Maybe they don’t have all these diagnoses or maybe they do… maybe they’ve just been living in a world that has forced them to live against their own way, and that causes all these ‘symptoms’ people are determined to fix by labeling their symptoms with a mental health diagnosis before helping them to live authentic. We see a great number of symptoms fade away when people live their authentic self.”

Majer says that once people are able to express themselves how they desire and be open about their identity, they are less likely to engage in self-harm to their bodies, including abusing drugs or alcohol.

“If I don’t like my body, I’m more likely to disassociate from my body because I lost all the care for it, since no one sees me as who I am,” Majer explains. Just acknowledging a client’s true self provides a lot of healing, before the client even begins working through their trauma in therapy.

Transgender and LQBTQ+ folks are often stripped of their autonomy, so Inspire Recovery aims to empower them by putting them in control of their recovery process.

“We’re going to listen to the person and give them what they need and what they want because they’re the masters of their own bodies,” Majer says.

At other treatment centers, even those that are supportive of LQBTQ+ folks, clients often need to explain their identity or prove their need live their true self, Majer says. At Inspire Recovery, that’s not the case.

“That eliminates this huge piece where clients need to educate and advocate for themselves,” she says. Since clients don’t need to spend emotional energy doing this work, they are able to focus immediately on their own healing and recovery.

Transgender and queer clients often stay with Inspire for an extended time, during which they are able to express and identify as their true self. They also learn to replace their maladaptive coping strategies with healthy habits. One of the most powerful parts of the Inspire Recovery model is that it allows LGBTQ+ people to see others in their community living open and successful lives, which gives them hope for themselves.

“It becomes a super powerful tool to have that ‘me too’ experience and have other community members be able to inspire them,” Majer says.

Weinberger says that this peer-based, holistic approach to recovery is what they were aiming for when they founded Inspire Recovery.

“It’s one of the most important aspects,” they say. “It immediately takes away so much anxiety and depression. Now they have this whole community that has similar journeys and can share stories and experiences. It’s a whole new world.”

Inspire Recovery provides treatment for substance use disorder and mental illness for LGBTQIA+ individuals in West Palm Beach, Florida. Learn more on FacebookInstagramTwitter and YouTube.

Please read our comment policy. - The Fix

The Fix staff consists of the editor-in-chief and publisher, a senior editor, an associate editor, an editorial coordinator, and several contributing editors and writers. Articles in Professional Voices, Ask an Expert, and similar sections are written by doctors, psychologists, clinicians, professors and other experts from universities, hospitals, government agencies and elsewhere. For contact and other info, please visit our About Us page.