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My LGBTQ Teen Has an Addiction Problem: Does She Need a Custom Program?

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT
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Adolescence is a time of radical transformation. This transitional period between youth and adulthood is characterized significant change in virtually every area of life. Teens develop physically, emotionally, intellectually, and socially. They form their own identities – separate and distinct from their parents – and engage in an evolving, instinctive process of trial and error to learn about themselves and find their place in the world. Through a series of success, failures, and everything in between, they create a vision of who they are, who they want to become, and how they want to live their life.

One of the primary areas of new growth – and often one of the scariest ones for adults to watch – is the formation of an individual sexual identity. Teens develop sexuality much the same way they develop other aspects of their personality – through exploration, experimentation, novelty-seeking, and risk-taking. It’s during this period that most teens discover whether they’re gay, lesbian, straight, or bisexual. They may feel most comfortable with a fluid concept of sexuality, not bound or connected to one category over another. For some teens, this is also when they question their gender identity. They may encounter a dissonance between their internal sense of self and their biological make-up. An individual born biologically female may develop a male gender identity, and vice-versa. Like sexuality, gender identity can be fluid, with individuals embracing each gender at different times and under different circumstances.

LGBTQ Teens and Substance Abuse

Studies conducted over the past three decades present contradictory data on rates of substance use, abuse, and addiction in LGBTQ youth. However, despite the conflicting evidence, there is consensus in the mental health community that LGBTQ youth are at greater risk for developing substance use disorders, as compared to their heterosexual peers. In their 2012 publication, “A Providers Introduction to Substance Abuse Treatment for Lesbian, Gay, and Transgender Individuals” the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a logical explanation:

“LGBT youth use alcohol and drugs for many of the same reasons as their heterosexual peers…However, LGBT youth may be more vulnerable as a result of the need to hide their sexual identity and the ensuing social isolation. As a result, they may use alcohol and drugs to deal with stigma and shame, to deny same-sex feelings, or to help them cope with ridicule or antigay violence.”

The stigma attached to members of the LGBTQ community is becoming less pronounced with each passing year, and it’s clear our society is moving toward acceptance – as demonstrated by the 2015 Supreme Court decision making same-sex marriage legal in all fifty states – but powerful and damaging stereotypes about LGBTQ individuals persist. LGBTQ youth are often forced to navigate a judgmental, negative, and unforgiving environment. Studies show they’re at high risk of verbal abuse, violence, and harassment by adults and peers alike. In response, according to the SAMSHA report, they risk developing and experiencing significant internal “…conflict, identity confusion, or even self-hate.”

LGBTQ-Responsive Addiction Treatment Works

LGBTQ youth struggling with addiction benefit from a compassionate, welcoming, and understanding therapeutic environment. Recovery is a challenging prospect for anyone. The added issues LGBTQ youth face – isolation, alienation, interpersonal aggression, lack of acceptance, and internal conflicts – can make achieving and sustaining sobriety all the more difficult. Decades of research prove a robust social support network is crucial in helping non-LGBTQ individuals live a life free of drugs and alcohol, and recent studies show targeted interventions – also centered around social support and an inclusive, non-judgmental milieu – are effective in reducing drug use, increasing coping skills, and helping LGBTQ individuals develop the skills necessary for recovery and lifelong sobriety.

How to Find Addiction Treatment for Your LGBTQ Teen

If your teen identifies as a member of the LGBTQ community and needs treatment for a substance use disorder, they may not necessarily require a program that’s exclusively designed for LGBTQ youth, but they will be best served by a treatment center staffed my mental health professionals experienced in the nuances of the issues they face and ready to offer specialized supports they need to begin their journey to recovery. When seeking treatment for your LGBTQ teen, ask any provider you consider if they employ therapists with expertise in helping LGBTQ youth, and most importantly, make sure the culture of the treatment facility not only accepts LGBTQ teens, but embraces them with warmth, compassion, love and understanding.

To help begin your search, you can use these two online resources:



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