Gender-responsive addiction treatment: Centering women's voices to advance trauma-informed and transformative care (2026)

Background: Women with substance use disorders face distinct and compounding barriers to addiction treatment, including trauma histories, caregiving responsibilities, stigma, and structural inequality. Despite increased interest in gender-responsive treatment, few studies centre women's lived experiences to inform trauma-informed and transformative care.
Methods: This qualitative study draws on in-depth interviews with 60 women engaged in alcohol and drug services across Belgium, including women-only as well as mixed-gender programmes. Data were analysed using conventional content analysis to identify key themes related to gender-responsive and trauma-informed care.
Results: Five core themes emerged: (1) safety - emotional, relational, and environmental - as a foundation for recovery; (2) nuanced preferences for women-only versus mixed-gender settings; (3) the importance of peer support and lived experience in fostering trust and motivation; (4) the need for holistic, person-centred, and body-aware treatment; and (5) comprehensive care that respects women’s social roles and realities. Women emphasized that meaningful recovery extends beyond abstinence to dignity, connection, and systemic support.
Conclusion: Gender-responsive alcohol and drug treatment goes beyond mere adaptation to transformation of power, practice and purpose. Centering women's voices reveals the need for flexible, trauma-informed, and structurally aware care that addresses both individual recovery and the social conditions that shape it. [Author's abstract]