Gender-sensitive training for substance use disorder treatment: Results and implications of a pilot health professionals needs assessment

Queer and using substances, a ‘double whammy’: results from a needs assessment of substance use treatment professionals in South Africa

“…Their responses cast light on the gendered structures of SUD treatment that hampered the treatment of queer clients. These included better-known healthcare challenges faced by queer people – such as challenges related to living with a non-binary gender in a cis-normative bureaucratic system (Jacobs, 2021; Meer & Müller, 2017) – as well as challenges specific to SUD treatment (Jacobs, 2019). Issues discussed included how to house queer clients within gender-segregated in-patient facilities, the placement of queer clients into gender-segregated treatment groups, and facilitating therapy with discriminatory families.…”

“…Women may be collected into exclusive groups for protective purposes – to discuss ‘womens’s issues’ in private or shelter them from trauma resulting from gender-based violence. This system may be adequate to address the needs of cisgender men and women, but research has begun to identify its shortcomings when it encounters gender-diverse and sexually diverse clients (Jacobs, 2019).…”

“…In the context of this study, 'queer' clients included anyone receiving treatment who identified as other than cisgender or heterosexual. This is due to previous work (Jacobs, 2019) finding that healthcare practitioners can conflate gender and sexuality in their treatment of clients. Secondary topics included the recognition of, and policies regarding gender issues within their facilities and context-specific issues such as programme materials, and differences between group and individual treatment.…”

“…South African surveillance data do not account for sexual orientations, but the small amount of data on queer gendered people suggest very low enrolment in treatment (Dada et al, 2021). Low enrolment can imply the presence of access barriers and although the reasons for low enrolment can vary (Myers et al, 2010; Pretorius et al, 2009), healthcare practitioners are cited as a particular point of friction for queer healthcare users (Jacobs, 2019; Müller, 2016; Scandurra et al, 2019), due to a combination of discrimination and inadequate training.…”