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Abstract
This article explores the complexities of treating professionals who are addicted and who are also gay, lesbian, bisexual or transgend-ered. It provides an overview of the special needs of this population, focusing on denial issues, defenses and resistance. In addition, it offers detailed case examples which illustrate specific complications, including medical and psychiatric co-morbidity, internalized and societal homophobia, codependency, return to practice and monitoring issues, and challenges encountered by gay, lesbian, bisexual and transgender persons participating in Twelve-Step programs. Emphasis is placed on the most effective approaches for providing training and ongoing supervision for addiction treatment professionals working with these patients.