Navigating your identity and questioning who your authentic self is can be challenging and isolating. Wrestling with this can bring up feelings of discomfort, especially if someone is in an unsupportive environment. Many members of the LGBTQ2SIA+ (lesbian, gay, bisexual, transgender, queer, two-spirited, intersex, asexual) community will struggle with these internal challenges while also facing discrimination and homophobia from outside communities daily. Experiencing these difficulties constantly can lead to the development of mental illnesses and an increase in substance and alcohol use as a coping mechanism. This discrimination, coupled with the stigma that those with substance or alcohol use disorders face, can create even greater barriers to housing and health care while increasing the levels of distress that leads to use.
Current Challenges
Fighting for the right to exist as you are is exhausting and can lead to feelings of depression, anxiety, fear and loneliness. This issue is the main factor that leads many members of this group to the unhealthy use of drugs and alcohol as a temporary fix to cope with the ever-present challenges they face. All these stressors have led to an increased prevalence of substance use and alcohol use disorders in members of the LGBTQ2SIA+ community.
A recent survey about sexual identity in America revealed that 21% of Generation Z identify as LGBTQ+. As this population continues to grow, the difficulties experienced by these individuals will affect more people. Recent social stressors such as the COVID-19 pandemic have led to mental health crises like depression and anxiety. As an increase in these diagnoses is seen, an increase in alcohol/substance use disorders will occur in tandem. Combining all these factors means the LGBTQ2SIA+ population will be at an even greater risk than they currently are.
New Developments To Improve Services
The Center for American Progress reported that an estimated 20–30% of the LGBTQIA+ population have substance use disorders, more than two to three times the rate experienced by heterosexual, cisgender populations. While this statistic is disheartening, there has been a shift in culture to be more inclusive and in health care, through private and governmental initiatives, to become more inclusive to meet the needs of this population.
Many public agencies like the U.S. Department of Health & Human Services, and non-government agencies like the National LGBTQIA+ Health Education Center, have created resources and a variety of training modules to enhance the care for this community by health care workers. Implementing these education modules has shown to effectively increase culturally competent care significantly in both urban and rural areas. For example, a study by D. R. Felsenstein examined the implementation of culturally competent practices in a Midwestern care facility and found that 72% of staff were more prepared for LGBTQ+ patient care after completing online education modules. As the cultural shift continues to spread from the most metropolitan areas to other areas of the country, improvements to practices should increase in care facilities across the nation.
Developments by, with and for the Community
Outside of these health care initiatives, many advancements for LGBTQ2SIA+ recovery communities have been made by members of the community to combat the discrimination experienced in everyday settings.
There are now inpatient and outpatient rehabilitation services that have programs that incorporate specific needs of this population into treatment. Programs that are offered at treatment centers like these are often developed and administered by members of the community with personal recovery experience. Many centers provide more than just detoxification services and in/outpatient treatment programs by offering additional support through counseling, peer-support programs and recovery maintenance information that is curated to address the specific challenges this population faces.
In addition to these treatment providers, sober living environments are also starting to create spaces for the community. A great example of one of these new and inclusive sober houses is Peter's Place RVA. This recovery home provides compassionate, accessible, trauma-informed care to the recovering LGBTQ2SIA+ members of the Richmond, Va., community to reduce the housing difficulties that are typically experienced. House staff also offer training and consulting to increase recovery capital as much as they can to areas beyond Richmond.
Current services like these and ones in current development aim to offer a variety of counseling services, rehabilitation centers and recovery housing to the LGBTQ2SIA+ recovery population. With time, they will be more accessible throughout the nation, help decrease the vulnerability this group faces, and allow the community to thrive.
Felsenstein, D. R. (2018). Enhancing Lesbian, Gay, Bisexual, and Transgender Cultural Competence in a Midwestern Primary Care Clinic Setting. Journal for Nurses in Professional Development, 34(3), 142–150. https://doi.org/10.1097/nnd.0000000000000450