Background: In light of recent developments in identity-based language, individuals identifying as transgender and/or gender diverse (TGD) now have a broader lexicon at their disposal to articulate their gender identities. Although research in Australia is somewhat limited, both local and international data consistently reflect a growing number of individuals identifying outside the binary gender spectrum. However, a cursory examination of Victoria’s (Australia) state-based Alcohol and Other Drug (AOD) sector reveals a notable lag in adapting to the evolving landscape of gender identification. This lag often results in exclusionary practices rooted in traditional gender norms. In order to further explore rates of TGG inclusion this, research study was conducted.

Methods: This study was mixed methods in nature, involving an online survey and a series of key informant interviews. The survey included the administration of the Trans-Inclusive Behaviour Scale and the Trans-Inclusive Provider Scale, which are validated instruments assessing the levels of inclusion within their services and the general behaviours concerning TGD inclusivity. Key informant interviews were undertaken with industry experts to gain valuable perspectives on the AOD service sector's capacity to provide inclusive care to TGD community members.

Results: Findings from the survey (n=85), indicated insufficient levels of TGD inclusion within AOD services. Gaps included engaging in low-levels of TGD inclusive actions, including a demonstrated understanding and use of correct pronouns, and additional items required to deliver culturally sensitive and inclusive care to TGD people. In addition to this, key informant interviews provided helpful insight into highlighted sector gaps around TGD inclusion, specifically discussing a consistent lack of clear organisational policy, and possible harms associated with the pathologizatoin of diverse gender identities.

Discussion: Our research underscores a pressing need for specialised training to address barriers to service access. This includes enhancing staff knowledge and fostering positive attitudes towards TGD service participants.