From Marty Mann To “Mom” Women Still Face Double Stigma
Marty Mann is widely considered the “First Lady” of Alcoholics Anonymous. She was born into an affluent family and was successful in her own rite. In 1939, Mann’s psychiatrist encouraged her to attend an Alcoholics Anonymous meeting. Bill Wilson was her sponsor for over 30 years. She was deeply connected to the recovery community throughout her life and was a speaker at the 1980 AA International Convention three-weeks before she died at the age of 75 (National Council of Alcohol and Drug Dependence). Ms. Mann was an active crusader who worked to establish the National Institute for Alcohol Addiction and was credited with a breakthrough article in the then popular Saturday Evening Post that brought AA to national attention.
Less known was her relapse to alcohol use. Fearing that this knowledge would tarnish the new organization’s reputation, the founders and Mann worked to conceal her relapse. They also worried that the knowledge of her homosexuality would serve as a barrier to other women joining AA. Of course, relapse is common. Then, however, lesbians were deeply closeted. Despite her success individually and on behalf of AA, Marty Mann suffered a triple stigmatism of addiction, her gender, and her sexual preference.
“Mom” was a television sitcom that aired for eight seasons on CBS. “Mom” follows a dysfunctional mother/daughter relationship between Allison Janney as Bonnie Plunkett and Anna Farris as her daughter Christy Plunkett. After having been estranged for years while both struggled with addiction, they attempt to pull their lives together by trying to stay sober.
Mom” follows their lives, Christy’s children, and their friends in Alcoholics Anonymous. The situations are dramatized as one would expect from primetime, broadcast TV including extraordinarily frank discussions of past sex lives, criminal behavior and jail time. In the main, though, the show is faithful to the difficulties in staying sober, mending relationships, forming new relationships, family life, and the support women provide to each other in their recovery journey.
The juxtaposition between how Marty Mann’s relapse was handled and the way the fictionalized lives of women in recovery is presented speaks to the progress that has been made in overcoming stigma that has long plagued people with addiction. Noteworthy, too, is the public recognition of women in addiction and in recovery when “Mom” was first aired in 2013. Nevertheless, the stigma of substance abuse, as well as behavioral health issues, is far from gone away and that stigma is amplified in the case of women.
A large body of research notes that stigma is long standing, persistent, pervasive, and rooted in the belief that addiction is a personal choice reflecting a lack of willpower and a moral failing. This stigmatization of alcohol and drug addiction has been a part of American culture from its founding. Rehabs.com (July 2025) provides a high level overview. Temperance was a part of early American culture and closely associated with religion. There were temperance societies in almost all American cities throughout the 19th century. Temperance as a widely held tenet in America lasted until their ultimate victory in Prohibition. Prohibition was a miserable failure, and repeal marked the beginning of the end of the wide influence of the Temperance movement.
Throughout the 19th century people with opiate addiction were generally thought to be only people of color and the caricature of the “Chinaman” as an opiate addict was widely held. Opiate users were considered morally inferior and their children were “born criminals” who could not be rehabilitated.
While drug use and alcohol abuse have always been criminalized, the Harrison Act in 1914 began aggressive enforcement of strict laws against drunkenness and any drug use. The War on Drugs initiated during the Reagan administration solidified the view that drug use and drunkenness should best be addressed as a criminal issue.
There were also lovable drunks such as Otis on the Andy Griffith Show. Otis was harmless and was allowed to sleep it off in his own jail cell. Otis was by implication inferior and incurable. The lovable “stoners” of the Cheech and Chong movies were also characterized as harmless and leading a lifestyle that did not foreshadow any end to their marijuana abuse. They are not depicted as contributing members of society although they are depicted as lovable characters.
All of this, of course, while the American Medical Association was evolving to define addiction as a disease. The medical community had long considered alcoholism to have its roots in the brain. That work was accelerated by the efforts of E.M. Jellinek and others in the first half of the 20th century. Finally, in 1956 the AMA, encouraged by psychiatric disciplines, defined alcoholism (and later drug addiction) as a brain disease with biologic and environmental influences.
A systematic review of the literature concerning gender bias in stigma, both as perceived by women and as women users are perceived, was published on the PubMed Site in 2022 (“The Intersection of Gender and Drug Use-Related Stigma: A Mixed Methods Systematic Review and Synthesis of the Literature”, S A Meyers et al, Drug and Alcohol Dependence,2021).
The report notes, “In contrast with the quantitative literature, the synthesis of the qualitative literature demonstrates that there is nearly universal agreement that women experience heightened levels of drug use-related stigma, particularly in healthcare settings, from societal expectations of women’s morality, cleanliness, and motherhood. Qualitative research methods are uniquely positioned to explore these experiences, processes, and meaning-making surrounding drug use-related stigma through describing these phenomena in women’s own words. As such, the qualitative literature on gender- and drug use-related stigma has been able to capture the intersectional nature of stigmatized identities in a way that the quantitative measures of stigma have, thus far, not.”
The literature supports the notion that despite the progress made in women’s equality and in defining addiction as a biologic condition, women continue to face the dual issue of gender and addiction based biases.
Remarkably, the studies indicate that these biases exist within the healthcare community and negatively impact care. That same study reports that rates of stigma remain high both in the general public and within professions whose members interact with people with addiction, including the health care professions. Research demonstrates that stigma damages the health and well-being of people with substance use disorder and interferes with the quality of care they receive in clinical settings. Stigma toward people with substance use disorder can be seen at all levels of care within health care settings.
A review of literature relating to women-centered treatment for substance use disorders was published for the American Journal of Drug and Alcohol Abuse (“A systematic review of gender-responsive and integrated substance use disorder treatment programs for women with co-occurring disorders”, Samantha Johnstone et al, American Journal of Drug and Alcohol Abuse, October 2025). The programs reviewed approach women’s SUD issues from a comprehensive viewpoint including biologic, mental health, emotional health, and noting the trauma many experienced. The studies reviewed included twelve, women specific approaches to treatment. They found, “ Integrated gender-responsive treatments are a promising approach to treating women with co-occurring substance use and mental health concerns, and broad clinical implementation stands to benefit women. However, there remains a lack of studies evaluating substance use treatments in women with severe mental illness (e.g., psychotic-spectrum disorders) who differ in their needs and capacity.”
Related to the double stigmatization the study found, that, “In women-only groups, participants reported feeling less guilt and shame, more comfortable about sharing trauma, and feeling better supported, relative to mixed-gender groups.”
Advocates for gender equality (that would include us) are not well served by failing to note the progress that has been made in the last fifty years. It would be similarly disingenuous for others to suggest that we have completely overcome gender inequality. This inequity may be nowhere more evident than in issues of alcohol and other drug abuse and addiction. This double stigma not only serves as a barrier for women to seek help but too often negatively impacts the treatment that is provided. Fortunately there are approaches focused on women’s needs in recovery. We must all continue to promote addiction as a disease, to encourage women to seek treatment when called for, and to promote proven, gender specific approaches.
Gene Gilchrist
