Women remain under-represented in addiction treatment due to shame, stigma, and fear of legal and social repercussions, among other obstacles
By Xochitl Mejía M. – Struggling with addiction can be daunting for many. For women and LGBT+ people however, it can be even more challenging since they have to face obstacles that hinder their access to appropriate treatment. Ranging from social stigma to lack of dedicated resources, these barriers require urgent attention to ensure equal opportunities and wellbeing for all.
Under-representation in addiction treatment
The under-representation of women and LGBT+ people in addiction treatment programmes worldwide is a widely recognized problem.
According to a United Nations Office on Drugs and Crime (UNODC) report published in 2022, there is a significant gap in access to treatment services for women compared to men. The report highlights that women face specific barriers, such as social stigma, lack of services tailored to their needs and lack of awareness of addiction issues in the context of gender. One example of this can be found among women amphetamine users, with only one in five accessing treatment for amphetamine-type stimulants, while almost half of amphetamine users are women.
With regard to LGBT+ people, some studies highlight the difficulties they face when seeking addiction treatment. A literature review, published in the Journal of Homosexuality in 2019, found that LGBT+ people frequently experience barriers such as stigma, discrimination, lack of culturally sensitive abilities on the part of service providers, as well as a lack of dedicated services.
Women and LGBT+ people are less likely to seek specialized treatment services for substance use disorders seemingly due to the specific barriers they face. The term ‘barriers’ refer to the various causes that prevent people from using treatment services, whether for substance use disorders or other behavioural problems. Some of these gender barriers are as follows:
Stigma and discrimination
Social stigma and discrimination are significant barriers for women and LGBT+ people seeking addiction treatment. People often face judgement and prejudice based on their gender or sexual orientation, which may lead them to hide their problems for fear of being stigmatized or discriminated against. This only generates more feelings of shame and guilt, especially when they feel that asking for help is no longer an option to avoid punishment and social rejection.
In many instances, women are viewed as the sole home care and childcare providers. As a result, their families or partners tend to oppose their starting or completing treatment programmes. The opposite is true for men – while their drug use is no cause for satisfaction, they’re usually given the support they need, by their families and partners, to engage in a rehabilitation process.
Lack of specific resources
The lack of resources specific to the needs of women and LGBT+ people is another important gender barrier. Many treatment centres lack programmes and services tailored to their needs, limiting the care options available. Inclusive spaces and addiction professionals that have been trained to address addiction from a gender and sexual orientation perspective are essential.
In addition, the lack of resources adapted to the specific needs of women, such as day care centres, environments adapted to the stay of newborns or infants, and legal advice and support on child custody issues, makes it difficult for women to remain in treatment.
Gender gap in research and care
Historically, research and medical care has been largely male-centred, leading to a gender gap in knowledge and treatment approaches to addiction. This has left women at a disadvantage when seeking help. In addition, the lack of specific data and research on LGBT+ addiction makes it difficult to understand the particular needs of this community and their access to effective treatment.
Social and economic factors
Economic barriers also play an important role in accessing addiction treatment. Women and LGBT+ people often face social inequalities and financial hardship that may impede their ability to access quality treatment services. Access to health coverage programmes that include addiction treatment is critical to ensure that all people, regardless of gender or sexual orientation, have the opportunity to recover.
Lack of awareness and education
Lack of awareness and education about addiction in the context of gender and sexual orientation contributes to the perpetuation of barriers to access. It is critical to promote awareness and education both in society at large and among health professionals so that they can understand and adequately address the specific needs of women and LGBT+ people struggling with addiction problems.
The lack of sensitivity and training on the part of service providers contributes to women’s and LGBT+ people’s retraumatization and double stigma, making services both unsafe and unreliable. Attempting rehab in such an environment is unthinkable.
For all of the above, it is necessary to continue working on ensuring equal opportunities and equal access to addiction treatment for all people, regardless of gender or sexual orientation. It is essential to shape a future that is more fair and more empathetic. Only through an inclusive and equality-focused approach can we overcome these barriers and provide the adequate services to those who ask for help.
- Dustin Z. Nowaskie & John S. Sowinski (2019) Primary Care Providers’ Attitudes, Practices, and Knowledge in Treating LGBTQ Communities, Journal of Homosexuality, 66:13, 1927-1947, DOI: 10.1080/00918369.2018.1519304
- United Nations Office on Drugs and Crime [UNODC] (2022a). World Drug Report 2022.