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The Intersection of Trauma and Minority Stress in the LGBTQ Community
By Nellie Galindo, MSW, MSPH

Early in my career, while I was working with youth with disabilities, a young man who was experiencing bullying at school came to my office. Not only did he have a learning disability but he also identified as gay. Because we were not an LGBTQ-specific organization, he was concerned about being judged for his sexual orientation. 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. 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 for emotional abuse. The risk is even higher among transgender individuals; upward of 91% of transgender people experience multiple traumatic events across their lifetime.

These and other traumatic experiences often push LGBTQ individuals to self-isolate, causing increased risk for negative health outcomes due to loneliness. As the coronavirus pandemic continues to drive communities into physical distancing, this social isolation can become even more difficult for LGBTQ individuals who are already experiencing anxiety, depression, and other mental health challenges. Therefore, it is critical for clinicians and service providers to understand the impact of trauma on the LGBTQ individuals they serve.

Individual Trauma Is Only Half the Battle
In addition to understanding their clients’ traumatic experiences, clinicians and social service workers need to understand the effects 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.

Minority stress includes the collective stressors—e.g., discrimination, micro aggressions, internalized stigma, and identity concealment—faced by a marginalized community. It has been shown to predict symptoms of mental illness, as well as an increased risk of trauma exposure and revictimization, and can be exacerbated by social isolation.

In addition to experiencing these stressors, many LGBTQ individuals grow up as the only person in their family who expressed a different sexual orientation or gender expression; this is very different 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 treatment models focused on minority stress. Nevertheless, using a framework of resilience through community building can help LGBTQ individuals better deal with the impact of trauma in their lives. This can include building social supports, connecting individuals 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 organizations) led to greater psychosocial adjustment for youth and young adults.

The current pandemic adds a complicated layer to the situation. Some LGBTQ youth may be physically distancing and staying home with family members who are not affirming of their identity or, worse, are 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 support their well-being. Clinicians can help by recognizing the barriers in place for LGBTQ individuals who are currently socially isolated and by working creatively with their clients to determine how to reconnect them with affirming and supportive communities.

As for the young man I worked with, we helped him establish a support group for disabled LGBTQ youth and create training for our organization on how to effectively work with LGBTQ individuals. Building his self-esteem and finding pride in both his disability identity and his LGBTQ identity, he became invested in other types of activism and even served as an intern at our organization.

If he came to me today, we would find different coping strategies for this unusual situation. The ability to build resilience for our LGBTQ clients may face more hurdles in the time of a pandemic, but building connection and community is still possible and necessary for positively coping with trauma.

— Nellie Galindo, MSW, MSPH, currently serves as a content marketing manager at Relias. Her passion is raising the voice of marginalized populations and educating others on the challenges they face to foster empathetic support. She worked with a variety of individuals in several different settings, including working as a direct service provider for individuals with mental illness and leading a youth program for young adults with disabilities. She has facilitated and created training curricula for individuals with intellectual and developmental disabilities in the areas of self-advocacy, healthy relationships, sexual health education, and violence and abuse prevention. Galindo has worked in state government assisting individuals with disabilities obtain accessible health information in their communities, as well as utilizing the Americans with Disabilities Act to ensure equal access to health care services. She has also authored and assisted in the development of online education courses that addressed providers in intellectual and developmental disabilities services as well as health and human service providers.