Author Name:   advocatesunita

Alcohol, Tobacco & Other Drug Problems & Transgender Individuals

Addiction Problems and the Trans-gender People

Abstract
Transgender is also a part of the society and they have equal right to everything in the world that is available to all other persons. The presence of such transgender is not new, but their presence is there from the time immemorial. The most important aspect we have to think is the discrimination which in turn yields alcohol, drugs and substance abuse. In the light of the Constitutional guarantees provided, there is no reason why Transgender Community should not get their basic rights.

This paper will enlighten the abuse of drugs by transgender, including health care and specifically within HIV prevention and treatment to describe not only identities but risk factors; within mental health as a condition and to describe sets ofbehaviors; and socio-politically both within the communities and the larger society.

Preamble
The term “transgender” is used most often to refer to people whose gender identity differs from their birth sex. Transgender people exist on every continent and are increasingly organising for rights and recognition. Gender presentations and local cultural understandings vary around the world and many different terms are used to describe individuals who live between or outside a male-female gender binary. Transgender people typify the potentiation of drug abuse secondary to discrimination by legal systems resulting in human rights violations.

Alcohol, Drugs And Substance Abuse

Lack of adequate research in this field makes it difficult to determine the extent of transgender substance abuse problems. But available studies indicate that TG people are more likely to use alcohol, tobacco and other drugs than the general population and are more likely to continue heavy drinking into later life. Their likelihood for doing so is heightened by personal and cultural stresses resulting from anti-gay bias. Reliance on bars for socialization, stress caused by discrimination, and targeted advertising by tobacco and alcohol businesses in gay and lesbian publications are all believed to contribute to increased pressures on transgender individuals to engage in substance abuse.

Drug use is associated with unsafe sex and the transmission of infections, including HIV (Mayer 2008). Several studies have also suggested higher rates of depression, anxiety, and suicidal ideation the transgender (Ruble 2008). Although attributed to the pathology of homosexuality or non-standard gender identity in the past, the higher rate of substance abuse and mental disorders in LGBT patients is now theorized to result from “minority stress”.

The main problems that are being faced by the transgender community are of discrimination, unemployment, lack of educational facilities, homelessness, lack of medical facilities like HIV care and hygiene, depression, hormone pill abuse, tobacco and alcohol abuse, penectomy and problems related to marriage and adoption.

Some GPs have been reluctant to treat trans people or have refused to do so. Where they received care related to gender reassignment, trans people have experienced an unsatisfactory ‘one size fits all’ approach. Trans people may also be at greater risk of isolation, alcohol abuse, suicide, self-harm, substance abuse and HIV infection, although these issues require further investigation.

According to existing research, homosexually active women have been shown to be more likely than other women to have drug or alcohol dependency syndromes (Cochran & Mays, 2000; Cochran, Keenan Schober & Mays, 2000). Alcohol and drug use and dependency rates have been shown to be higher among gay men and lesbians than for their heterosexual counterparts (Skinner, 1994; Cochran & Mays, 2000). In terms of tobacco use, gay and bisexual men have also been shown to have tobacco use rates substantially higher than their heterosexual counterparts (Stall, Greenwood, Acree, Paul & Coates, 1999.

Risk Factor for Addiction
Members of the transgender community are more prone to suffer from psychiatric disorders, including high rates of mood and anxiety disorders (Jorm, Korten, Rodgers, Jacomb & Christensen, 2002; ilman et al., 2001; Cochran, Sullivan & Mays, 2003), and as previously mentioned, substance abuse disorders.

One key stressor comes from the stigma and discrimination of homophobia and heterosexism (prejudice against LGBT persons), which remain a significant challenge for LGBT individuals. According to the Gay and Lesbian Medical Association, a majority of nurses teaching in nursing schools still believed being a lesbian is “unnatural” as recently as 1991 – nearly 20 years after the removal of homosexuality from the DSM (Gay and Lesbian Medical Association, 2001, p. 218).

Consideration For Service Providers
The transgender individuals cannot freely walk into a heath institution for checkup, treatment or even counseling like their counterparts. Often, LGBT individuals feel unable to disclose their sexual or gender identity to health providers in fear of adverse reactions from others. In fact, as recently as the late 1980’s between half and 61% of lesbian and gay people felt unable to come out to their medical providers (Gay and Lesbian Medical Association, 2001,p. 218). Doctors, mental health providers and faith leaders must offer the promise of nonjudgmental care.

Cultural Competence
Lack of cultural competence in medical and mental health settings may further discourage help‐seeking behavior in the LGBT community. Actual negative attitudes and beliefs about the LGBT community are still prevalent. Some physicians are uncomfortable treating the transgender. (Gay and Lesbian Medical Association, 2001, p. 218). The clear remedy here is education.

 

Future Directions
Despite clinical and empirical knowledge that LGBT individuals are at greater risk of developing addictive disorders, we have virtually no information about how addiction problems impacts this group. More research and data is needed for a fuller understanding of this phenomenon and to develop culturally sensitive and competent interventions.

Conclusion
The transgender/LGBT issue is a complex subject, whether under discrimination, harassment or drug issues. As stated above, I believe that the legislature, the law enforcers, medical/health and teaching institutions should be the stepping stone towards changing this.

References
1. Healthy People 2010: Companion Document for Lesbian, Gay, Bisexual, and Transgender(LGBT) Health(2001, Gay and Lesbian Medical Association)
2. American Psychiatric Association. (1987).Diagnostic and statistical manual of mental disorders(3rd ed.). Washington, DC: Author.
3. International Gay and Lesbian Human Rights Commission (IGLHRC), 7 May 2011.
4. Gay and Lesbian Medical Association & LGBT health experts. Healthy people 2010 companion document for Lesbian, Gay, Bisexual, and Transgender (LGBT) health. San Francisco, CA: Gay and Lesbian Medical Association, p. 218
5. Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment. (2001). A provider’s introduction to substance abuse treatment for lesbian, gay, bisexual and transgender individuals.
6. Preventing Alcohol and Other Drug Problems in the Lesbian and Gay Community(available in printed form only viawww.prta.com)
7. A Provider's Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, &Transgender Individuals(2001, AMHSA/CSAT)BKD392

The author can be reached at: advocatesunita@legalserviceindia.com

ISBN No: 978-81-928510-1-3
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