Lyons Tara, Shannon Kate, Pierre Leslie, Small Will, Krüsi Andrea, Kerr Thomas
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Department of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada.
Subst Abuse Treat Prev Policy. 2015 May 7;10:17. doi: 10.1186/s13011-015-0015-4.
While considerable research has been undertaken on addiction treatment, the experiences of transgender individuals who use drugs are rarely explored in such research, as too often transgender individuals are excluded entirely or grouped with those of sexual minority groups. Consequently, little is known about the treatment experiences in this population. Thus, we sought to qualitatively investigate the residential addiction treatment experiences of transgender individuals who use illicit drugs in a Canadian setting.
In-depth semi-structured interviews were conducted with 34 transgender individuals in Vancouver, Canada between June 2012 and May 2013. Participants were recruited from three open prospective cohorts of individuals who use drugs and an open prospective cohort of sex workers. Theory-driven and data-driven approaches were used to analyze the data and two transgender researcher assistants aided with the coding and the interpretation of data in a process called participatory analysis.
Fourteen participants had previous experience of addiction treatment and their experiences varied according to whether their gender identity was accepted in the treatment programs. Three themes emerged from the data that characterized individuals' experiences in treatment settings: (1) enacted stigma in the forms of social rejection and violence, (2) transphobia and felt stigma, and (3) "trans friendly" and inclusive treatment. Participants who reported felt and enacted stigma, including violence, left treatment prematurely after isolation and conflicts. In contrast, participants who felt included and respected in treatment settings reported positive treatment experiences.
The study findings demonstrate the importance of fostering respect and inclusivity of gender diverse individuals in residential treatment settings. These findings illustrate the need for gender-based, anti-stigma policies and programs to be established within existing addiction treatment programs. Additionally, it is vital to establish transgender and/or LGBTQ specific treatment programs as recommended by the participants in this study.
虽然已经对成瘾治疗进行了大量研究，但在这类研究中很少探讨吸毒的跨性别者的经历，因为跨性别者常常被完全排除在外，或者与性少数群体归为一类。因此，对于这一人群的治疗经历知之甚少。于是，我们试图对加拿大环境中使用非法药物的跨性别者的住院成瘾治疗经历进行定性调查。
2012年6月至2013年5月期间，在加拿大温哥华对34名跨性别者进行了深入的半结构化访谈。参与者从三个吸毒者开放前瞻性队列和一个性工作者开放前瞻性队列中招募。采用理论驱动和数据驱动的方法分析数据，两名跨性别研究助理在一个名为参与性分析的过程中协助进行编码和数据解释。
14名参与者有过成瘾治疗经历，他们的经历因治疗项目中是否接受其性别认同而有所不同。数据中出现了三个主题，描述了个体在治疗环境中的经历：（1）以社会排斥和暴力形式表现出的污名化，（2）恐跨症和感知到的污名，以及（3）“跨性别友好”和包容性治疗。报告感受到并经历了包括暴力在内的污名化的参与者，在孤立和冲突后过早离开了治疗。相比之下，在治疗环境中感到被接纳和尊重的参与者报告了积极的治疗经历。
研究结果表明在住院治疗环境中促进对性别多样化个体的尊重和包容的重要性。这些发现表明，需要在现有的成瘾治疗项目中制定基于性别的反污名化政策和项目。此外，按照本研究参与者的建议，建立跨性别者和/或 LGBTQ 特定治疗项目至关重要。
