Finally, multiple studies have found that females receive fewer services than males, and exploring whether these sex differences persist across generations in a high-risk sample can inform public health and research endeavors related to treatment access among those with AUD. Being female decreases likelihood of seeking help among those with AUD (Gilbert et al., 2019; Ilgen et al., 2011), an effect that has been shown since the early 1990s (Chartier & Caetano, 2011). Treatment utilization rates also differ between males and females with females receiving significantly fewer services (Alvanzo et al., 2014; Chartier & Caetano, 2011; Gilbert et al., 2019; Raimo et al., 1999; Zemore et al., 2014). Accordingly, being male has been found to predict receiving any treatment as well as seeking help with alcohol or drug problems (Chartier & Caetano, 2011; Gilbert et al., 2019; Ilgen et al., 2011) and inpatient care (Raimo et al., 1999). Women have reported barriers to receiving services for substance use to be stigma, lack of support from family, difficulty finding services, and cost (Pinedo et al., 2019). These barriers are amplified due
