Modern evidence-based addiction treatment requires gender responsive care. There are many biological and sociological sex and gender differences that play a role in developing a substance use disorder. Women typically respond to substances differently than men. They may have more cravings than men and may be more likely to relapse after treatment. Important differences between genders need to be reflected in the treatment approach.

One example is traumatic life events. While trauma is frequently also an important factor in men’s addiction, women are more likely to have been exposed to childhood and adult trauma, especially sexual assault, and to have experienced interpersonal conflicts.

If it doesn’t conform to social expectations, gender identity itself can be a major stressor driving an addiction. Transgender people are frequently traumatized by violent attacks and persistent discrimination and are at an elevated risk of developing substance use disorders because of that. An estimated 20–30 percent of transgender people misuse substances, compared to around 9 percent of the general population in the United States.

Men, too, benefit from gender-responsive care. They are more likely than women to use almost all types of illicit drugs, and have a much higher rate of alcohol use disorder (AUD). Males start using drugs at an earlier age. Men misuse drugs more often and in larger amounts.

Many men with addiction have been socialized to assume they have to be strong in all situations. They feel they need to be the main provider of the family, and consider showing emotions too effeminate. These distorted assumptions about manhood can cause problems and need to be addressed in therapy.

All these gender differences need to be addressed to make addiction treatment effective and recovery sustainable. Thus, creating gender responsive care. Addiction is a biopsychosocial disease and socialization, biological sex, sexual orientation, and gender identity all have an impact on the recover process.