The Transgender Community and Substance Use: Positive Coping Skills

transgender drinking


Drugs and alcohol are the greatest escape they say. When you don’t accept yourself or your body or gender, sometimes drinking or getting high is the quickest way to cope with those feelings. But, is it healthy and is it a valid way to relieve pain? Drinking and drugs are never the healthiest way to deal with pain. Honestly, what they accomplish is always temporary. I understand that drugs and alcohol offer release of suffering for many people.

Why do you drink?

It is not my intention to shame anyone who use drugs or alcohol as their release. It is my intention to first offer understanding, then options for change. When you look in a mirror or are with other people or are alone in your room and what you see is not congruent with who you are that can certainly lead to disappointments. It can be through those feelings of dissatisfaction with ourselves that we choose to drink or get high.

You may feel many positives with your substance use, or you may feel guilt, but not know any other way to cope or feel free or feel release. I often hear clients say they drink at the end of a work day. This makes more sense when you realize that often people who are transgender, have to go to work as a person they really are not. Or, they have to face family in the wrong gender.


So, if it’s not healthy and it’s not a positive way to cope, what else can be done besides drink and use drugs? Something you can is to create a positive affirmation about yourself. This is a statement that uses only positive thoughts such as, ” I am beautiful”. Another positive affirmation could be “I am uniquely me”. Practice saying your affirmation to yourself daily. Say it ten times a day. Be sure to say it when you want to drink or use drugs.

An affirmation can be written on post it notes and placed on your bathroom mirror or better yet, on your refrigerator to see before you drink.  Put it on the container you keep your drugs in. Put it where you can see it when you want to use.

Physical Activity

Another thing that can be done in place of alcohol and drugs is to exercise or be physically active. Exercise alters your brain chemicals, close to how drugs and alcohol do. Except this alteration is positive and healthy. Physical activity releases endorphins in your body in a healthy manner.  Physical activity can be a great release from stress, but if you are a person with an addiction, you can get addicted to it too.  There’s a good list online of 50 things you can do besides drink. 

12 step programs?

What about AA or NA? While alcohol anonymous and narcotics anonymous may be great options for some people, others they aren’t.  Trying to walk into an AA or NA meeting in a small non accepting town can be frightening if you are in the transgender or gender non conforming community.  Some people also have difficulty with the religious aspect at the meetings when they are struggling with their own faith.  There are 12 step programs in metro areas that focus on the LGBTQ community.

Individual Therapy

But, your drinking or drug use could be to cope with societal discrimination or your own disregard of your body of how you look and feel. What do you do in this instance? I suggest finding a good, competent gender therapist. You probably need to process your emotions about yourself and circumstances. You probably need an advocate that listens and understands you. An affirming therapist can sit with you and offer support for your drinking. I wrote a blog here about how to find a good therapist and I cover using a sliding fee scale and insurance.

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