Barriers to Alcohol Use Disorder Treatment Among Cisgender and Transgender Individuals in the Netherlands: A Qualitative Study

Transgender individuals have a higher risk of developing alcohol use disorder (AUD). However, most existing research focuses on cisgender individuals, while the negative consequences of AUD are suggested to be higher for transgender individuals. Perceived barriers to treatment seeking for both transgender and cisgender individuals, therefore, need to be examined to create more accessible care regardless of gender. The current study investigated AUD treatment-seeking barriers among cisgender women, cisgender men, and transgender individuals. 62 participants were included, of which n = 23 (38.1%) cisgender women, n = 17 (27.0%) cisgender men, and n = 22 (34.9%) transgender individuals. All participants met the DSM5 criteria for AUD and considered seeking treatment in the past 12 months. Participants who met the inclusion criteria filled out an open-ended survey with questions on barriers to treatment seeking. Results identified different barriers to treatment seeking based on gender identity. Transgender individuals reported a lack of trust in the healthcare system as a major barrier, whilst cisgender women reported shame, guilt, stigma, and treatment inaccessibility, and cisgender men reported treatment inaccessibility, psychoeducation around alcoholism, and limited social support. The findings highlight the importance of addressing AUD treatment-seeking behavior in a gender-sensitive manner.