Trauma affects people of all ages and demographics. Still, one of the most affected groups today are members of the LGBTQ+ (lesbian, gay, bisexual, transgender, and questioning) community.[1] This often marginalised group is subject to many hate crimes based on gender and sexuality. Trauma in the LGBTQ+ community is prevalent worldwide. Research has found that this group are more likely than the rest of the population to experience trauma, mental and physical health issues, and discrimination.[2] As such, rates of suicidality, depression, anxiety, PTSD, and substance use disorder (SUD) are high in this group.
Trauma in LGBTQ+ Youth
Though LGBTQ+ people of all ages are subject to adverse experiences such as discrimination and hate crime, LGBTQ+ youth are some of the most affected. LGBTQ+ youth face a greater risk than their same-age counterparts of experiencing trauma.[3] The higher rates of trauma in this marginalised group lead to higher rates of PTSD and other mental and behavioural health issues throughout the lifespan. Sexuality in adolescence and young adulthood is a vulnerable topic. Many LGBTQ+ youth face discrimination based on their sexuality both in school and at home.
Understanding Trauma
Trauma is anything that poses a risk to our safety and has a lasting impact on our physical and psychological well-being.[4] Trauma can be both real and perceived. All of us will experience trauma to some degree at one point or another in our lives. Many can experience a potentially traumatic event but recover soon after the event has passed. Others, however, are subject to a range of health complications and health-risk behaviours in response to the overwhelming trauma they experienced.
Stress and distress tolerance play a huge role in how well we cope with trauma[5], as well as the availability of loving and compassionate support after a potentially traumatic event.[6] For members of the LGBTQ+, there is often a lack of appropriate support following traumatic incidents, which include:
- Sexual, verbal, physical abuse
- Bullying
- Exposure to violence
- Witnessing a death
- Family rejection/abandonment/neglect
- Marginalisation as a minority group
Understanding LBGTQ+ Trauma
The most common types of trauma experienced in the LGBTQ+ community include:
- Hate crimes
- Intimate partner violence
- Sexual assault
- Inadequate access to healthcare
- Discrimination/abandonment in the family
- Socio-cultural adversity
- Sexual abuse in childhood
Hate Crimes
According to the Federal Bureau of Investigation, members of the LGBTQ+ community are twice as likely as any other group to experience hate crimes.[7] The most common types of hate crimes in this group are:
- Verbal harassment
- Discrimination
- Physical violence
- Threats to one’s safety
One of the most recent and most impactful public LGBTQ+ hate crimes happened in Orlando in 2016. A young man entered Pulse, a gay nightclub in Orlando, armed with two guns. He killed 49 people in the nightclub and wounded 53 others before turning the gun on himself.
The mass shooting shocked the world and highlighted that, despite the great strides society has made in recent decades regarding tolerance and acceptance of LGBTQ+ people, we still have a long way to go.
Intimate Partner Violence
Bisexual and lesbian women report higher rates of intimate partner violence than their heterosexual counterparts.[8] Research reports that the lifetime prevalence of intimate partner violence among transgender people is between 24 – 47 per cent.[9]
Sexual Assault
According to the National Coalition of Anti-Violence Projects (NCAVP), almost one in ten LGBTQ+ survivors of intimate partner violence suffered sexual assault during their time with that partner.[10] Several studies have investigated the prevalence of sexual assault among transgender people and bisexual women and found around half will be exposed to sexual violence at some point in their lives.[11]
Inadequate Access to Healthcare
Members of the LGBTQ+ community face various degrees of discrimination. One of the most destructive forms of discrimination faced by this community is within the area of healthcare. Many of those struggling with their health face barriers to treatment because of their gender or sexual identity.[12] The fear of judgment and discrimination in treatment prevents many from seeking the help they need. Even when treatment providers do not directly discriminate against members of this group, there is often an air of bias or judgment that affects the affected individual’s mindset and overall well-being.
Discrimination/Abandonment in the Family
LGBTQ+ people, in particular LGBTQ+ youth, are subject to family-based discrimination, abandonment, and neglect.[13] When one’s sexual or gender orientation goes against socio-cultural norms, family members may not be as understanding or empathic as they could be, leaving LGBTQ+ youth at risk of abandonment from parents, siblings, and extended family members.
Home should be a safe space for anyone. When the home environment is one of judgment and discrimination, individuals are subject to experiencing neglect and abandonment trauma.
Socio-Cultural Adversity
Though non-heterosexuality and gender nonconformity are more widely accepted and tolerated today than ever before, members of the LGBTQ+ still face social and cultural discrimination. Marginalisation as a minority group can be a traumatic experience. It increases one’s risk of social adversity, poverty, and inadequate access to both healthcare, education, and employment.[14]
Further trauma occurs when a person feels they must conceal their identity to achieve some social success. Along with discrimination in the family, this can lead to a rejection of the self, leaving the individual feeling lost or fragmented.
Sexual Abuse in Childhood
Cases of sexual abuse are higher among LGBTQ+ youth than their heterosexual, cisgender peers.[15] These cases of sexual abuse are not a causal factor for a particular sexual orientation but rather a result of socio-culturally ingrained bias, judgment, and learned discrimination.
Risk Factors for Trauma-related Disorders in LGBTQ+ Community Members
There is a range of risk factors for the onset and development of trauma-related disorders in LGBTQ people, such as chronic stress and post-traumatic stress disorder (PTSD). These risk factors include:
- The frequency of exposure to traumatic events
- The severity of the trauma experienced
- The level of available support in the family and community following a traumatic event (belief in the individual, responsivity of institutions – school, company of employment)
- Level of family acceptance
- Exposure to bullying
- Body dysphoria
- Level of religious acceptance
- Unemployment or homelessness as a result of marginalisation
The Impact of Trauma on LGBTQ+ Community Members
Families who reject their non-hetero, non-cisgender children often palace enormous on those children to conform to heteronormative expectations. This rejection of the child’s unique self and self-exploration can have a lasting negative psychological impact on the child.
Rejection or neglect of LGBTQ+ children in the family has been found to cause eight times higher likelihood of attempted suicide, six times higher likelihood of self-reported depression, and three times higher likelihood of contracting a sexual disease such as HIV or other STDs.[16] These children are also three times more likely to use drugs, which increases the risk of substance dependence and addiction in the community.
Addiction is prevalent in the LGBTQ+ community.[17] Addiction often has its roots in earlier, unresolved trauma. The clear prevalence of trauma among this marginalised community indicates the risk for addiction in LGBTQ+ people.
Compassionate Trauma-informed Support for LGBTQ+ Community Members
To support LGBTQ+ trauma survivors heal from their traumatic experiences, treatment providers must offer a safe and welcoming space for their LGBTQ+ clients. Any treatment approach for mental health issues or SUD should be trauma-informed – taking into account the familial, social, and cultural norms that may affect or even re-traumatise an LGBTQ+ client.
Prevention of violence and discrimination is a key factor in reducing the prevalence of traumatic incidents within the LGBTQ+ community. Acceptance, tolerance, and non-judgment are important concepts to teach and practice in school and work settings to help members of the LGBTQ+ community feel as safe and comfortable as everyone else in the same environment.
If you have a client, or know of someone who is struggling to heal from psychological trauma, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).
[1] Russell, Stephen T, and Jessica N Fish. “Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth.” Annual review of clinical psychology vol. 12 (2016): 465-87. doi:10.1146/annurev-clinpsy-021815-093153
[2] Russell, Stephen T, and Jessica N Fish. “Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth.” Annual review of clinical psychology vol. 12 (2016): 465-87. doi:10.1146/annurev-clinpsy-021815-093153
[3] Mooney, Megan (2017) “Recognizing, Treating, and Preventing Trauma in LGBTQ Youth,” Journal of Family Strengths: Vol. 17 : Iss. 2 , Article 16. Available at: https://digitalcommons.library.tmc.edu/jfs/vol17/iss2/16
[4] Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/
[5] Marshall-Berenz, Erin C et al. “Multimethod study of distress tolerance and PTSD symptom severity in a trauma-exposed community sample.” Journal of traumatic stress vol. 23,5 (2010): 623-30. doi:10.1002/jts.20568
[6] Robinaugh, Donald J et al. “Understanding the relationship of perceived social support to post-trauma cognitions and posttraumatic stress disorder.” Journal of anxiety disorders vol. 25,8 (2011): 1072-8. doi:10.1016/j.janxdis.2011.07.004
[7] Park, H. and Mykhyalyshyn, I., 2021. L.G.B.T. People Are More Likely to Be Targets of Hate Crimes Than Any Other Minority Group. [online] Nytimes.com. Available at: <https://www.nytimes.com/interactive/2016/06/16/us/hate-crimes-against-lgbt.html> [Accessed 6 April 2021].
[8] Walters, M.L., Chen J., & Breiding, M.J. (2013). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Findings on Victimization by Sexual Orientation. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
[9] Ellis, A., 2021. Trauma and Post-traumatic Stress Disorder in Lesbian, Gay, Bisexual, Transgendered and Queer Individuals. [ebook] American Psychological Association. Available at: <https://www.apatraumadivision.org/files/56.pdf> [Accessed 6 April 2021].
[10] 2013. LESBIAN, GAY, BISEXUAL, TRANSGENDER, QUEER, AND HIV-AFFECTED INTIMATE PARTNER VIOLENCE In 2012. [ebook] 2013 New York City Gay and Lesbian Anti-Violence Project, Inc. Available at: <https://avp.org/wp-content/uploads/2017/04/ncavp_2012_ipvreport.final_.pdf> [Accessed 6 April 2021].
[11] HRC. n.d. Sexual Assault and the LGBTQ Community. [online] Available at: <https://www.hrc.org/resources/sexual-assault-and-the-lgbt-community> [Accessed 6 April 2021].
[12] Hafeez, Hudaisa et al. “Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review.” Cureus vol. 9,4 e1184. 20 Apr. 2017, doi:10.7759/cureus.1184
[13] Katz-Wise, Sabra L et al. “Lesbian, Gay, Bisexual, and Transgender Youth and Family Acceptance.” Pediatric clinics of North America vol. 63,6 (2016): 1011-1025. doi:10.1016/j.pcl.2016.07.005
[14] Baah, Foster Osei et al. “Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health-An integrative review.” Nursing inquiry vol. 26,1 (2019): e12268. doi:10.1111/nin.12268
[15] Mooney, Megan (2017) “Recognizing, Treating, and Preventing Trauma in LGBTQ Youth,” Journal of Family Strengths: Vol. 17 : Iss. 2 , Article 16. Available at: https://digitalcommons.library.tmc.edu/jfs/vol17/iss2/16
[16] Katz-Wise, Sabra L et al. “Lesbian, Gay, Bisexual, and Transgender Youth and Family Acceptance.” Pediatric clinics of North America vol. 63,6 (2016): 1011-1025. doi:10.1016/j.pcl.2016.07.005
[17] Green, Kelly E, and Brian A Feinstein. “Substance use in lesbian, gay, and bisexual populations: an update on empirical research and implications for treatment.” Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors vol. 26,2 (2012): 265-78. doi:10.1037/a0025424