What are the barriers that cisgender men, cisgender women (people whose gender identity matches their sex assigned at birth), and transgender individuals (people whose gender identity does not match their sex assigned at birth) face when seeking help for addiction? Anne Marije Kaag, a cognitive neuroscientist at VU Amsterdam, examined these experiences and concluded that there are significant differences between these groups.
Shame and Distrust
Previous research, particularly from the US, on barriers to seeking addiction treatment has often focused on men. They frequently encounter obstacles such as viewing alcohol as a coping mechanism, believing that treatment is unnecessary, and practical barriers like a lack of time or financial constraints.
"Limited research on cisgender women indicates that they face unique barriers, such as shame, unemployment, inequalities in health insurance, and childcare responsibilities," Kaag explains. Fear of child protection services interfering presents an additional hurdle. Moreover, transgender individuals have often been excluded from previous studies, which were primarily conducted in the US, making their findings not directly applicable to the Dutch healthcare system.
Kaag’s research, recently published in Alcoholism Treatment Quarterly, was conducted via an online survey completed by sixty participants recruited through social media. She identified three key themes from the responses: shame, distrust in healthcare, and long waiting times.
“There were clear differences between gender groups. Nearly three-quarters of women cited shame and stigma as barriers. Almost three-quarters of transgender individuals reported distrust in existing healthcare services, partly due to previous negative experiences. This is concerning, as addiction is significantly more prevalent among transgender individuals than among cisgender people,” Kaag explains. “Among men, the reported barriers were more varied, with no single dominant theme.”
Practical Implications
These findings have important implications for practice, Kaag concludes. “The results highlight the need for a gender-specific approach in addiction care. For cisgender women, it is crucial to develop interventions specifically aimed at reducing shame and stigma. For transgender individuals, rebuilding trust in healthcare is essential. And for cisgender men, a more varied approach is needed, taking different barriers into account.”
Kaag also stresses the importance of addressing long waiting times for all groups. Additionally, she urges researchers, healthcare professionals, and policymakers to be aware of the particular vulnerability of transgender individuals. Kaag states: “Only with gender-inclusive addiction care can we ensure that everyone receives appropriate support.”