Improving Accessibility and Inclusion for Women and Gender Minorities at Safe Consumption Sites

Safe consumption sites (SCS) are an important harm-reduction response to the overdose crisis, providing overdose prevention, sterile drug supplies, supervised spaces, and connections to other social and healthcare services. However, these sites are not always experienced the same way by every individual who uses them. Women and gender minorities may face specific barriers related to stigma, violence, privacy concerns, as well as a lack of gender-affirming care. This report explores how safe consumption sites can be made more inclusive and accessible for women and gender minority participants. Using existing literature and real-life examples of gender-responsive harm reduction programs, it examines how social and structural barriers shape individuals’ experiences when accessing these services. The report argues that accessibility within SCS should be understood as more than whether a service exists; it should also include whether participants feel respected, safe, and supported using the service without additional discomfort or fear. The recommendations presented focus on realistic ways safe consumption sites can better support women and gender minorities, while still recognizing limits around policy, space, staffing, and funding.