Gender Dysphoria and Substance Abuse

Risk factors of substance use and addiction are considerably higher for people with gender dysphoria, as they may use drugs or alcohol to cope with their symptoms.

Individuals living with gender dysphoria face many challenges in their everyday life. Risk factors of substance use and addiction are considerably higher for people with gender dysphoria. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), people with gender dysphoria are 2.5 times more likely than their peers to use cocaine and methamphetamines in their lifetime, and twice as likely to report the abuse of prescription pain medication. SAMHSA also found adolescents with gender dysphoria to be more likely to abuse opioids and prescription drugs, and three times more likely to use inhalants than other people their age.

Effects of Substance Abuse on Gender Dysphoria Disorder Symptoms

While substance abuse does not directly cause gender dysphoria disorder, substance use may cause anxiety and depression. Any substance that increases anxiety may intensify the symptoms of gender dysphoria. Individuals may use alcohol or drugs in an attempt to gain relief from social anxiety and may pursue more social events, though when the high wears off, they may experience a sudden sense of anxiety. Individuals with gender dysphoria may feel awkward or humiliated while socializing under the influence which can cause the anxiety and depression to worsen.  

Gender Dysphoria and Alcohol

Gender dysphoria patients may use alcohol as an escape from painful depression that they may live with. While the use of alcohol allows them to mentally discharge from their typical symptoms of feeling out of place, this use may also create a reliance on the harmful substance.

Individuals with gender dysphoria might begin using alcohol to reduce the intense emotional experiences that are part of the disorder. Casual use of alcohol for short-lived self-medication may lead to dependence developing.

Gender Dysphoria and Marijuana

An individual with gender dysphoria may be anxious or worried about circumstances in their life and may look to marijuana to help them calm their mind. Marijuana can allow the individual to relax and prepare for a social situation or help them to worry less about feeling out of place. Gender dysphoria patients may go to lengths to have a few moments of feeling at peace with who they are. Patients may explore marijuana and whether it gives them peace.

Marijuana only provides a temporary feeling. When the high is gone, the symptoms often return. Because of this short-lived feeling of ordinary emotions, the individual may begin to use marijuana more often until it becomes a daily routine.

Gender Dysphoria and Stimulants

Stimulants may create a temporary mood elevation for individuals who are sluggish or consumed with worry. Short-term effects of exhaustion and depression may follow the high, making the individual want the drug more often because of its temporary, positive effects.  

The Journal of Substance Abuse published a study on gender dysphoria and drug use. This study stated that transgender males and females who use stimulants are at high risk for continued substance use and developing dependency. Amphetamines were the drugs most often reported while the numbers of other drugs reported were minor. Though not self-reported as a common substance used, one-half of the individuals in the study tested positive for cocaine and opiates.

Stimulants can be addictive and may lead to feelings of paranoia, which people with gender dysphoria may already experience through constant concern of judgment. High doses may result in an irregular heartbeat, which may stimulate the anxiety already present.

Drug Abuse as a Cause of Gender Dysphoria Disorder

Substance abuse has not been shown to lead to the diagnosis of gender dysphoria. The effects of substance use often lead people to take actions they wouldn’t make under normal circumstances. These actions and their consequences can create feelings of great shame in an individual, though there is no known link from drug use to feeling uncomfortable in their given gender.

The combination of substance use and gender dysphoria can create social and emotional trauma for an individual living with mental pain and struggling with disliking who they are.

Drug Abuse as a Hindrance to Gender Dysphoria Treatment

When a mental health disorder like gender dysphoria co-occurs with drug or alcohol abuse, the first goal is usually detox and substance abuse treatment before moving forward with further treatment. If an individual continues to use alcohol and drugs as a short-term support mechanism to manage their symptoms, they may not overcome their disorder. If they begin therapy for gender dysphoria before starting treatment for substance abuse, they are likely to stop going as they become more dependent on the substance.

Statistics on Gender Dysphoria and Drug Abuse

The Centers for Disease Control and Prevention found that teenage students with gender dysphoria reported the lowest levels of depression, suicidal feelings and substance use when they were in a positive school climate where they do not experience teasing.

The Substance Abuse and Mental Health Services Administration (SAMHSA) states that gender dysphoria youth and adolescents whose parents support them show greater well-being, better general health and have a decreased risk for suicide, depression and substance abuse.

Individuals who have a substance use disorder and a co-occurring gender dysphoria disorder can receive help from one of The Recovery Village facilities that are located throughout the country. If you or a loved one have a substance use disorder along with gender dysphoria, call The Recovery Village to speak with a representative.

Editor – Thomas Christiansen

With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more

Medically Reviewed By – Krisi Herron, LCDC

Krisi Herron is an Adjunct Psychology Professor, a Licensed Chemical Dependency Counselor and a freelance writer who contributes to several mental health blogs. Read more