Psychological trauma is a common experience, with over 70% of the U.S. adult population having experienced at least one traumatic event in their lifetime. Unfortunately, trauma in the LGBTQ community is much more common. Despite this fact, many providers (outside of those who directly serve LGBTQ individuals) are unaware of how much this can impact their ability to best serve this population.
Early in my career, I coordinated a youth program for individuals with disabilities. One day, a young man came to my office who was experiencing bullying at school. Not only did he have a learning disability that required him to attend self-contained classes, but he also identified as gay.
He told me he was concerned about receiving services from us because he didn’t want to be judged for who he was. He also had poor experiences with other service providers in the past due to his identity.
We were not an LGBTQ-specific organization. In fact, we only had one staff member who openly identified as queer. How could we best serve him and help him feel comfortable in our program?
Trauma Is Part of the LGBTQ Experience
My client’s history of bullying is unfortunately not unique – interpersonal violence, adverse childhood experiences, and other traumatic events are much more prevalent among LGBTQ individuals than their straight peers.
These traumatic events often begin in childhood, which includes victimization due to their sexual identity and/or gender expression. Numerous studies have found LGBTQ children have much higher rates of victimization – up to two times higher for sexual and physical abuse and 1.5 times higher for emotional abuse. The risk is even higher among transgender individuals, where studies have found up to 91% of transgender people experience multiple traumatic events across their lifetimes.
Victimization at school is especially common – a study from the Gay, Lesbian, Straight Education Network (GLSEN) found 95.3% of LGBTQ students frequently heard homophobic remarks throughout their school day. 70% reported being verbally harassed at school, and 29% reported physical harassment.
Despite this, most school systems do not offer any formal form of protection for their LGBTQ students. The frequent mistreatment of LGBTQ students and a lack of community protection from their school environment often contribute heavily to the high suicide rate of LGBTQ youth.
These traumatic experiences often push LGBTQ individuals to self-isolate, causing increased risk for negative health outcomes due to loneliness. As we have seen throughout the coronavirus pandemic, the required physical distancing and subsequent social isolation can be very difficult for LGBTQ individuals who are already experiencing depression, anxiety, and other mental health challenges.
This is why it is critical for clinicians and service providers to understand the impact of trauma on the LGBTQ community and the individuals they serve.
Minority Stress and Trauma in the LGBTQ Community
Understanding the individual’s experiences with trauma is only half the battle – clinicians and social service providers also need to understand the impacts of the individual’s environment. Recognizing the impact of minority stress on LGBTQ populations, in conjunction with traditional trauma-informed care methods, can provide a more well-rounded and culturally appropriate approach for this population.
Minority stress includes the collective stressors — discrimination, micro aggressions, internalized stigma, identity concealment — faced by a marginalized community. Minority stress has been shown to predict symptoms of mental illness, as well as an increased risk of trauma exposure and revictimization.
The impact of minority stress on the LGBTQ community can be exacerbated by social isolation. For example, many LGBTQ individuals grow up as the only person in their family who expressed a different sexual orientation or gender expression — a very different experience from other minority populations. This kind of social isolation has the potential to increase feelings of depression, anxiety, and hopelessness.
Build Community, Build Resilience
Unfortunately, there are few minority-stress focused treatment models for clinicians to take advantage of. Nevertheless, using a framework of resilience through community building has been identified as one of the best ways to help LGBTQ individuals deal with the impact of trauma in their lives.
Building resilience can include bolstering social supports, connecting the individual to community groups, and helping them engage in activism. In fact, one study found that engaging in LGBTQ-specific coping strategies (such as getting involved in LGBTQ-serving organizations) leads to greater psychosocial adjustment for youth and young adults.
The pandemic added a complicated layer to this — some LGBTQ youth may have been physically distancing with family members who were not affirming of their identity, or worse, were abusive toward them because of it. Other LGBTQ individuals may feel cut off from chosen family or friends who would normally provide a strong support system in a culture where they often face homophobia or transphobia.
Additionally, older adults who are LGTBQ are twice as likely to live alone and often do not have legal spouses or children who can provide them support. Clinicians must recognize the barriers in place for LGBTQ individuals who are currently socially isolated and be creative in working with their clients to determine how best to re-connect them with an affirming and supportive community.
We All Serve the LGBTQ Community
As for the young man who came to me all those years ago, we helped him establish a support group for disabled LGBTQ youth at our nonprofit. This helped him build his self-esteem and find pride in both his disability identity and his LGBTQ identity. Our staff members helped him create a training for our organization on how to effectively work with LGBTQ individuals. He became invested in other types of activism and even served as an intern at our organization.
If he came to me today, these coping strategies would probably look very different. His group might have been held virtually, and his activism efforts may have been primarily performed online. However, even with the challenges of a pandemic, the ability to build resilience for our LGBTQ clients is still possible, and necessary, for positively coping with trauma.
As physical distancing restrictions are lifted and more individuals are able to seek community support, it’s important to remember how trauma impacts the LGBTQ community specifically. Whether your organization or program specifically serves LGBTQ individuals or not, we all serve the community at large, directly or indirectly. We all have an important role to play when it comes to healing trauma in the LGBTQ community.
Special thanks to Social Work Today for their permission to re-print and revise this blog post.
Creating a Trauma-Informed System of Care: Addressing Individuals, Professionals, and Organizations
Trauma-informed care (TIC) has become a widely recognized paradigm for creating safe spaces for individuals who have experienced trauma and reducing the likelihood that accessing services would cause re-traumatization. TIC is different from other models of care as it can be used in any type of service setting or organization. By using this approach, you can gain awareness of ways to anticipate and avoid institutional practices that are likely to re-traumatize persons served.
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