10 Ways to be an LGBTQ Ally in the Substance Use Disorder Community

Substance use disorders and mental health disorders have been on the rise in the LGBTQ community. Studies have shown that the LGBT community is at an increased risk for substance use disorders and suicide rates compared to the non-LGBTQ population. Individuals in the LGBTQ community will often use alcohol and drugs to self-medicate from the stigma they face daily. Alcohol and drugs are commonly used to temporarily numb negative emotions and thoughts that are often associated with depression, anxiety, and anger. 


This population of individuals has deemed a higher risk for developing substance use disorders, and co-occurring disorders. The stigma associated both with the LGBTQ community and treatment for mental health disorders is astounding and are the main reasons why so many individuals in this community do not seek treatment. Unfortunately, members of this community struggle to find treatment for their substance use disorder due to the lack of LGBTQ friendly resources, especially in some regions of the United States where the stigma is more significant. 

  • LGTBQ adolescents were 90 percent more likely to use substances than heterosexual adolescents
  • One study found that only 7.4 percent of programs offered specialized services for LGBTQ individuals. 
  • Transgender students were 2.5 times more likely than non-transgender students to use cocaine and methamphetamines in their lifetime, according to a study. 
  • The LGBT community is at a higher risk of bullying and has even been the center points for violent attacks.


Becoming an ally to the LGBTQ community 

Unfortunately, many healthcare professionals play a considerable part in the stigma associated with the LGBTQ community and substance use disorders. Many healthcare professionals cannot relate to this community for the following reasons: their cultural norms conflict with this community, they do not recognize this community is a high risk, and fail to look passed the client’s gender and sexual orientation. Due to this lack of support, many younger LGBTQ individuals are shying away from traditional therapy. They are exploring alternative models instead of waiting for professionals in the substance use disorder treatment realm to catch up. 

As a practitioner in the substance use disorder community, it is our job to be even more empathetic, compassionate, and knowledgeable in regards to at-risk populations such as the LGBTQ community. Becoming an ally to the LGTBQ community can increase your client retention rate, improve treatment adherence and compliance, and increase patient satisfaction. You do not have to be an advocate and march in the Pride Parade. Still, by educating yourself on this population and providing a high equal standard of care, you can become an ally to this population, which can help reduce the stigma in this community and allow these individuals better access to treatment. 


How can treatment professionals support the LGBTQ community?

As a substance abuse treatment professional, there are several ways you can provide compassionate and well-rounded therapy to your LGBTQ client:

  • If they inform you about their sexual orientation or gender, then acknowledge, accept it, do not treat it as a “phase,” and focus on the issue at hand; the reason why they asked for your help.
  • Ask your client which pronouns they would like you to use, especially if they are nonbinary. Some LGBTQ folk prefer her/she or his/he or they/them. Learning to use language that your client is comfortable with and accepting who your client is can help you and your client get to the root of their issue. 
  • Do your homework and learn the difference between cis, trans, nonbinary, binary, lesbian, queer, gay, transsexual, and bisexual. It is your job to be informed of his community and to learn how to use appropriate language with a compassionate and empathetic tone. 
  • Make your intake form LGTBQ friendly. Include questions such as gender identity, preferred pronoun, sexual partners, sexual orientation, hormonal use, and HIV status. 
  • Connect with what’s working. Learn more about local health centers, programs, clinics, etc. that focus on LGBTQ health in your city, state, and region. Research organizations such as PFLAG, LGBTQ community centers, and youth groups.
  • Listen with intent and compassion about the rooted issue at hand. If a client comes to you for depression, focus on their depression rather than their sexuality. If their sexuality is a deep-rooted issue associated with their depression, then this may reveal itself at a later session. Do not force it right away because your client may think you are not focused on their depression. 
  • Attend LGTBQ trainings to get a better understanding of this community. A lot of education and knowledge within this community is about wording and language, and saying one wrong word can have a significant effect on the client. 
  • Ask the right questions. Instead of asking, “are you married” ask, “are you in a relationship.” When taking a sexual history, ask, “do you have sex with men, women, or both?” 
  • Include the partner/spouse. Treat a patient’s partner or spouse as you would any other patient’s husband/wife. Include the partner in consultations, explanations, treatment planning, etc.
  • Post the policy. Signal your support for LGBTQ clients by posting a non-discrimination policy that includes sexual orientation, gender identity, and expression someplace visible in your waiting room or office.


At Casa Palmera, our goal is whole-person healing; we treat the whole person and not just the disorder. We are LGBTQ friendly and understand that this is a special community that requires state of the art treatment. Our dedicated treatment team goes underneath the surface of a presenting problem to determine the underlying triggers and address the root so that it doesn’t manifest itself in other ways. Our goal is not to treat the wound with a Band-Aid but instead develop a permanent solution to problems that are preventing you from living your happiest and healthiest life. Our clinical staff works with you to develop an individualized treatment plan that includes therapy approaches for your specific needs and tools that will improve your life on a holistic level. Learn more about Casa Palmera here and see how Casa Palmera’s programs can transform your mind, body, and soul. 


Kristen Fuller, M.D., is a clinical content writer and enjoys writing about evidence-based topics in the vital world of mental health and addiction medicine. She is a family medicine physician and author, who also teaches and contributes to medicine board education. Her passion lies within educating the public on preventable diseases, including mental health disorders and the stigma associated with them. She is also an outdoor activist and spends most of her free time empowering other women to get outside into the backcountry.