Gender and drugs: Experiences of stigma/toxicophobia and narcofeminist narratives

Background: Women who use drugs are often presented as vulnerable subjects. Relationships to drugs are linked to political and social systems and are subject to social relations of gender and oppression that need to be explored, in order to go beyond an approach focused on biological vulnerability. We conducted a French-Canadian research including a community-based collaboration with feminist activist groups, with the aim to document the experience of women who use drugs as well as to produce new knowledge about the structural inequalities linked to gender. 

Methods: The methodology includes bi-monthly focus groups discussions and semi-structured interviews (N=50) with women, and photo-voice to document their experiences. A narcofeminist approach of auto-ethnography was implemented. The research has been conducted on a long period, between 2019 and 2023.

Results: Our research highlights that women are often experiencing stigma according to their psychoactive substances use. Being a woman using drugs implies social reprobation, linked to gender norms that produce women as vulnerable people. Two main types of specific gender attributes/expectations were mentioned in the narratives: those of fragility and those of moderation, which are imposed on women in the different social spaces of their lives: in society, at school and in the family. The women who participated to our research labeled this stigma as a “toxicophobia” experience. In the semi-structured interviews, women describe avoiding individual contact with health professionals so as not to endure discourses about them that often oscillate between ”infantilization” and “false benevolence”. These experiences highlight the gender stereotypes linked to the imaginary of "the vulnerable woman" who should be "protected from psychoactive substances". Toxicophobia is also revealing how prohibition is shaping discourses and practices according to gender and drugs by impeding women to express themselves about their pleasure. Toxicophobia may also have a negative impact for helping women to access to treatment and harm reduction services.  

Based on focus groups and photovoice approaches, women are building a collective story situated within logics of empowerment, that denounces relations of oppression with the idea that disclosing experiences of “toxicophobia” can make representations evolve: "Society should work on representations” while “users are systematically put in a position where they have to justify themselves, to apologize for drug use.” These guilt-inducing representations are particularly significant for women and can lead them to avoid to ask for help, to hide their drug use practices and to be less well supported in their harm reduction/recovery process.

Conclusion: Our research shows that a narcofeminist approach produces new subjectivities and invents new forms of resistance to discrimination. It can help to enhance the integration of gender-transformative services in drug policy area.