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In the short term substance-abuse treatment programs and services need to become fully culturally competent and able to effectively and appropriately serve gay and transgender people.

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This stress is triggered by general social prejudice against being gay or transgender, as well as discriminatory laws and policies.

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Moreover, most private and public plans including Medicare, many state Medicaid programs, and plans sold through the Federal Employees Health Benefits Program specifically target transgender people with exclusions that deny coverage for transition-related care.

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Given that many gay and transgender people smoke because of stress factors related to their sexual orientation or gender identity, they might not feel comfortable enrolling in these programs or, if they do enroll, the programs might not address the root causes of their addiction.

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Fifty-six percent of gay individuals and 70 percent of transgender individuals, however, report experiencing some form of discrimination in housing based on their sexual orientation or gender identity.

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Why the Gay and Transgender Population Experiences Higher Rates of Substance Use

Many tobacco-cessation programs are not welcoming of gay and transgender people, for example. These and other forms of discrimination work together to make life for gay and transgender people more expensive, complicated, and difficult. Drugs Men who have sex with men are 3. Hearing these attacks on a regular basis increases antigay social prejudice and its negative impact on gay people. The stress that comes from daily battles with discrimination and stigma is a principle driver of these higher rates of substance use, as gay and transgender people turn to tobacco, alcohol, and other substances as a way to cope with these challenges. Note that there is little national data on gay and transgender people overall, so the statistics here are best estimates of these rates. Tobacco and alcohol companies have exploited gay and transgender social networks to aggressively market their products for decades.

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