Bridging the Gap: A Conversation on Addiction and LGBTQIA+ Issues
June is a time for celebration and reflection, as we mark Pride Month, honoring the diversity and strength of the LGBTQIA+ community. Yet alongside the vibrant parades and uplifting messages, it is also crucial to acknowledge the challenges that persist and how factors like discrimination and trauma can impact recovery. Emily Beatty, CleanSlate Regional Director of Behavioral Health, is a clinical expert in addiction treatment and LGBTQIA+ health and has worked extensively in addressing the unique needs and challenges of the LGBTQIA+ community.
*Please note: this interview contains terminology regarding identity that is broad and general in its use. We recognize and honor that identity is highly individualized and do not intend to be exclusionary or discriminatory in the word choices used during the interview.
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What is your experience in addiction treatment and what inspired your interest in it?
Emily Beatty: I’m the Regional Director of Behavioral Health with CleanSlate for Massachusetts and Pennsylvania. I’m an LICSW (licensed independent clinical social worker) by trade and by license. What brought me to CleanSlate and to the addiction field in general—in addition to the topic we’re talking about today—is the intersectionality between mental health and substance use. It is being recognized more and more, and I’m happy to see that trend happening in the healthcare field. CleanSlate is mirroring that through their integration of behavioral health and mental health services, which is a significant part of my role here.
Can you explain the connection between addiction and mental health in the LGBTQIA+ community?
Emily Beatty: A lot of it looks like it does for the general public, with disorders like anxiety and depression and more severe ones like bipolar and other mood disorders. These often co-occur with substance use for a multitude of reasons. Either people are trying to medicate their symptoms and make themselves feel better, or they’re experiencing mental health disorders because of lifelong substance use. And of course there’s trauma.
The LGBTQ community experience higher rates of mental health and substance use in a statistically concentrated way, and that makes sense given the social stressors and discrimination that any minority or oppressed group in our society experiences. So then you see more mental health and substance use disorders because of that.
Why might members of the LGBTQIA+ community be more susceptible to substance abuse and addiction?
Emily Beatty: There are institutional factors, especially now, with direct laws being implemented that are discriminatory against the LGBTQ community—legally taking away human rights—in addition to day-to-day social discrimination. The oppression and discrimination they experience on an institutional and social level causes a lot of stress, fear and trauma for individuals and the community as a whole.
There is also the psychological process of internalization, where members of the LGBTQ community feel self-hatred, negative self-concept and low self-esteem. All of these things really heighten the reasons we see more depression, anxiety and more substance use specifically.
How does intersectionality, or overlapping social identities (e.g., being LGBTQIA+ and a person of color), influence the risk of addiction?
Emily Beatty: Being a member of the LGBTQ community and a person of color, for example, influences the risk of addiction in a number of ways. Someone who is gay, lesbian or transgender and a person of color (for example) will experience compounded levels of social stress and discrimination. People navigating the different parts of their culture, community, social spheres (family and friends) and our larger societal oppression, face an additional layer of stress and internalization that influences mental health, substance abuse and stigma associated with both.
Can you discuss the role of supportive communities and networks in preventing addiction among LGBTQIA+ individuals?
Emily Beatty: Just as support communities work for anyone with addiction, they’re a huge, pivotal piece of recovery. They’re particularly important for any groups that experience oppression—the LGBTQ community specifically. We see a lot of support out there, and Pride Month is a good example of emphasizing that people are loved, valued and cared for. Having peer support and community support allow people to feel that they do fit in somewhere and feel less isolated. Those are two factors of recovery for anybody.
How can addiction treatment be made more inclusive and effective for LGBTQIA+ individuals?
Emily Beatty: As treatment providers we need to stay educated, stay up to date on the research on behavioral health, psychological and social aspects of both. We need to recognize healthcare disparities in general and not unintentionally reinforce disparity in our practice. That includes everything from the questions we ask in assessments to the conversations we have with patients, and the way we treat them when they’re in our centers. Those are all ways we can avoid contributing to the problem.
People need to trust us in order to receive help from us. We need to stay educated and informed, and ensure we always display a sense of cultural humility with our patients—no matter what their background is or how they identify.
How does addiction affect trans and non-binary people differently than cisgender people within the LGBTQIA+ community?
Emily Beatty: I’m sure there are a million ways that I can’t speak to in great detail. I know that in the healthcare field and in this country in general trans people have a lot of uphill battles in having their identity honored. If you go to get a detox bed, for example, sometimes you have to pick male or female according to our larger social standards rather than how someone identifies. And that applies to going to an emergency room too. There are a lot of challenges and stigma for folks when they’re seeking healthcare in general that might prohibit someone from accessing care.
What are some harm reduction strategies that are particularly relevant for the LGBTQIA+ community?
Emily Beatty: For both substance use and healthcare generally, there are many forms of harm reduction, for example, safe sex, HIV reduction and Hep C reduction. While those issues are important for the general public, it is also important for the LGTB community to feel safe and equal in accessing that care.
Harm reduction is really just based on meeting someone where they are and letting them teach you about their life, about their community and about where they are in their recovery. It is exceptionally important in the LGBTQ community, especially for heterosexual and cisgender providers who really need to take a learning stance from their patients on these issues.
How can we as a society contribute to reducing the stigma of addiction within the LGBTQIA+ community?
Emily Beatty: The first thing to do is talk about it and make it more commonplace. That reduces stigma and shame, allowing people to seek help and look for other people in their community who might be struggling too. Funding for research by organizations like SAMHSA highlights these issues and helps to change laws. On both the local and national levels, training for healthcare providers is so impactful.
Are there any final thoughts you’d like to share on the intersection of addiction and LGBTQIA+ issues?
Emily Beatty: It’s about prevention, treatment and human rights. That’s the intersectionality we’re seeing as a healthcare company in the addiction field.
If you’re an LGBTQIA+ individual struggling with addiction or know someone who is, please remember that help is available. Begin your journey to recovery today (833) 505-4673.
