Gender Norms Still Shape Cannabis Use, but Legalization May Be Changing the Rules | Research

The takeaway

Interviews with 23 Canadians in cannabis treatment revealed that recreational use is still socially constructed as masculine, women face extra stigma for using, but legalization may be challenging these norms by increasing visibility of women who use cannabis.

Addiction treatment providers, gender researchers, and policymakers interested in equity impacts of cannabis legalization.

Women face "double stigma" of substance use and gender norm violation

What the researchers found

Three themes emerged: (1) Masculine Dominance of Cannabis Use: recreational smoking is socially constructed as a masculine behavior; (2) Cannabis Use as Deviation from Femininity: women and gender-diverse people face extra stigma and are framed as inauthentic users; (3) Rejecting and Reconfiguring Gender Norms: legalization may be catalyzing challenges to masculine dominance by increasing visibility of women using cannabis.

Why it matters

Gender norms influence who uses cannabis, how they use it, and whether they seek treatment. Understanding these norms is essential for developing gender-responsive interventions that do not inadvertently reinforce stigma against women and gender-diverse cannabis users.

The numbers in context

23 participants in treatment for cannabis-related harms in Toronto. 3 main themes generated. Study conducted post-legalization (Canada legalized in 2018).

How the study worked

In-depth one-on-one interviews with 23 adults in Toronto, Ontario who had been in treatment for cannabis-related harms. Reflexive thematic analysis using Connell's masculinities framework and critical femininities scholarship.

What this study cannot tell us

Small qualitative sample from one Canadian city. Participants were in treatment, so their perspectives may differ from non-treatment-seeking users. The analysis framework (masculinities/femininities scholarship) shapes interpretation.

How to read the evidence

Small qualitative study providing rich thematic insights. Cannot quantify the prevalence or impact of these gender norms.

When this study was published

Published in 2025.

The bigger picture

The historical gender gap in cannabis use is narrowing, but this study shows the social norms underlying that gap have not fully caught up. Women who use cannabis still face a "double stigma" of both substance use and gender norm violation, which may delay treatment-seeking.

Questions still open

Would gender-responsive CUD treatment improve outcomes for women? Has legalization measurably reduced gender-based cannabis stigma at the population level?

Common questions

Do gender norms affect who gets cannabis treatment?

Yes. This study suggests women face additional stigma for using cannabis, which may delay or prevent treatment-seeking. Gender-responsive treatment approaches could help address this barrier.

Has legalization changed gender norms around cannabis?

Participants perceived that legalization has increased visibility of women using cannabis, which may be slowly challenging the association between cannabis use and masculinity. But the norms have not disappeared.

Read the original research

Exploring perceived gender norms about cannabis among treatment-seeking adults in the era of cannabis legalization in Canada: A qualitative analysis.

Journal of substance use and addiction treatment, 172, 209684

View on PubMed ↗Publisher’s paper ↗

Citation

Matheson, Justin; Wright, Madison; Watson, Tara Marie; Sproule, Beth; Le Foll, Bernard; Brands, Bruna. (2025). Exploring perceived gender norms about cannabis among treatment-seeking adults in the era of cannabis legalization in Canada: A qualitative analysis.. Journal of substance use and addiction treatment, 172, 209684. https://doi.org/10.1016/j.josat.2025.209684