ABSTRACT
This chapter examines the meaning of concepts such as sex, gender, gender identity, gender expression and sexual orientation. It then considers the complex interface between substance misuse, gender identity and sexual orientation. Gender goes beyond the binary division of male and female, and includes people who identify as transgender or gender fluid. Gender difference in relation to substance misuse is not confined to biological difference but includes social and cultural influences. Gender impacts on the person's journey into substance misuse, their willingness to access support and help, as well as influencing the way society and professionals interpret and respond to the person's needs. Gender sensitive services means that professionals are knowledgeable of existing gender differences and are competent to incorporate these differences into care. A failure to systematically take gender differences into account results in existing inequities being perpetuated and reinforced.
