PTSD in the LGBTQIA+ community
PLEASE NOTE: PTSD UK uses LGBTQIA+ to refer to people with diverse gender and sexual identities. The LGBTQIA+ acronym represents individuals who identify as lesbian, gay, bisexual, transgender, queer or questioning, intersex, or asexual. The “+” indicates any other minoritised identities such as pansexual or non-binary. In our effort to be inclusive, we embrace the term ‘LGBTQIA+’ as an umbrella term, however, we acknowledge that LGBTQIA+ people do not exist as one group.
Pride Month, observed throughout June, signifies a period of celebration, but also recognition of the challenges faced by the LGBTQIA+ community globally. The selection of June as Pride Month stems from its alignment with the Stonewall Riots. The Stonewall riots, also known as the Stonewall uprising, were a series of spontaneous protests by the LGBTQIA+ community in response to a police raid at the Stonewall Inn in New York City on June 28, 1969. Patrons and neighbourhood residents fought back when the police turned violent. These riots marked a significant turning point in the fight for LGBTQIA+ rights.
As we come together to celebrate and show our support for Pride Month, we want to shed light on this important topic: the connection between LGBTQIA+ individuals and PTSD and C-PTSD. The risk of developing PTSD is disproportionately higher within the LGBTQIA+ community, with studies indicating that as many as 48% of lesbian, gay or bisexual individuals and 42% of transgender and gender diverse individuals meet the criteria for PTSD.
Throughout history, LGBTQIA+ people have been subjected to systemic discrimination, stigmatisation, and violence. The lived experiences of this community often encompass a wide spectrum of traumatic events, including but not limited to hate crimes, harassment, bullying, rejection from families and communities, and societal marginalisation.
Despite advances in LGBTQIA+ rights and greater societal acceptance in some regions, the scars of past and ongoing discrimination persist. The weight of these traumas, coupled with the challenges of navigating identity and self-acceptance, contributes to a higher prevalence of mental health issues within the LGBTQIA+ community, including Post Traumatic Stress Disorder.
Factors that put LGBTQIA+ people at higher risk of PTSD/C-PTSD
Post-Traumatic Stress Disorder (PTSD) or Complex-PTSD (C-PTSD) are conditions that some people develop after experiencing or witnessing a traumatic event or events. It’s estimated that 50% of people will experience a trauma at some point in their life. The defining characteristic of a traumatic event is its capacity to provoke fear, helplessness, or horror in response to the threat of injury or death and therefore can affect anyone. Research shows that people within the LGBTQIA+ community are at higher risk of experiencing a number of diverse yet common traumas.
Research shows that lesbian, gay, and bisexual people often face higher rates of victimisation throughout their lives when compared to those with a heterosexual identity. This includes instances of child abuse, as well as sexual and physical assault. Research shows that LGBTQIA+ people are nearly four times more likely to experience violent assaults, such as rape or sexual assault, robbery, and various forms of assault, than their cisgender (i.e. individuals whose gender identity aligns with the sex they were assigned at birth), heterosexual counterparts.
A recent report has unveiled that a significant 77% of people within the LGBTQIA+ community face the harrowing ordeal of experiencing a hate crime at least once in their lifetime. The reality is that for many, this hateful treatment becomes an all-too-familiar occurrence, with repeated incidents of hate targeting their identity.
This often begins at school age where almost half of LGBTQIA+ youth face bullying due to their sexual orientation or gender identity. Statistics also show that one in ten trans pupils have received death threats, and over two in five have attempted suicide.
Intimate partner violence
Studies have shown that bisexual and lesbian women experience higher rates of intimate partner violence compared to their heterosexual counterparts.
Additionally, research indicates that between 24 to 47 percent of transgender individuals have experienced intimate partner violence at some point in their lives.
Sexual Assault and harassment
Research findings consistently reveal high rates of sexual assault within the LGBTQIA+ community. Studies indicate that approximately half of gay and bisexual men have encountered sexual assault at some point in their lives. A similarly alarming proportion (50%) of transgender individuals and bisexual women, too, have experienced sexual violence.
A significant majority of LGBTQIA+ people (approximately seven out of ten,) have encountered some form of sexual harassment in the workplace.
An estimated 29% of LGBTQIA+ youth have been thrown out of their homes, run away, or become homeless. Everyone deserves to feel safe and secure in their own home, however, when the environment at home is filled with judgment and discrimination, individuals can suffer from the painful effects of neglect and abandonment trauma. In an attempt to cope with the difficult emotions from rejection, some people may turn to unhealthy coping mechanisms such as alcohol, reckless behaviours, or drugs. It’s important to recognise that those who face familial rejection are at a higher risk of experiencing depression, engaging in substance abuse, and even contemplating suicide compared to their non-rejected peers.
Members of the LGBTQIA+ community frequently encounter subtle acts of hostility or discrimination, known as micro-aggressions or micro-traumas. Although micro-traumas are commonly discussed in relation to racial or ethnic minorities, they also affect LGBTQIA+ individuals and other marginalised groups. Over time, these cumulative micro-traumas can have a profound impact on mental and physical well-being.
While individuals experiencing micro-traumas may not meet the criteria for a PTSD diagnosis, the effects are still significant. LGBTQIA+ people often face minority stressors, including internalised phobia, sensitivity to rejection, marginalisation, and discrimination, both in their personal lives and within healthcare settings. These stressors can have a profound negative impact on their overall health.
These stressors, often referred to as ‘minority stressors’ or ‘micro-traumas’, encompass both external and internal experiences.
- Distal/External Experiences: include instances of discrimination, violent victimisation, and structural discrimination at various levels of society, such as laws and policies that provide limited protection for LGBTQIA+ individuals. This may also include institutional discrimination such as workplaces, or places of worship.
- Proximal/Internal Experiences: LGBTQIA+ individuals may struggle with identity concealment, which can have psychological and interpersonal consequences. Balancing personal safety and the decision to reveal one’s identity can be mentally taxing. Internalised stigma, including internalised homophobia or transphobia, can amplify distress for LGBTQIA+ people. Anticipation or fear of rejection from others can make it challenging to navigate relationships and social interactions.
Issues within Healthcare and Support
It’s clear that people in the LGBTQIA+ community may experience unique health disparities due to increased exposure to violence, added stress related to their identity, and limited access to quality treatments. These factors combined can lead to higher levels of distress and make it more challenging to identify the key elements impacting their mental well-being. But many LGBTQIA+ patients report negative experiences with healthcare. This highlights the pressing need for enhanced education and sensitivity among healthcare providers to deliver patient-centred care and, if necessary, to rectify past experiences related to mental health treatment.
By prioritising education and fostering a deeper understanding of LGBTQIA+ experiences, clinicians can create a more inclusive and supportive environment for their patients. This includes being aware of unique healthcare needs, addressing any biases or prejudices, and actively working towards building trust and rapport with LGBTQIA+ individuals seeking care.
Improving the healthcare experiences of LGBTQIA+ patients requires ongoing efforts to ensure that they feel respected, heard, and validated. By embracing diversity, cultural competence, and open-mindedness, clinicians can help create a healthcare system that meets the needs of all individuals, regardless of their sexual orientation or gender identity.
In exploring the connection between the LGBTQIA+ community and PTSD/C-PTSD, we see the enduring realities faced by many individuals who have experienced discrimination, violence, and trauma. While we cannot immediately eradicate all forms of discrimination and violence, we can all actively contribute to a more inclusive environment.
When people feel accepted and supported, they are more likely to seek help, share their experiences, and access the necessary support networks. By dismantling barriers and embracing inclusivity, we pave the way for a healthier and more resilient world.
Creating safe spaces enables people to acknowledge their trauma, establish connections with others who share similar experiences and have access to the treatments required. In a supportive environment, people can find solace, acceptance, and understanding, allowing them to navigate their struggles and embark on a path towards a more fulfilling and joyful life.
Whether it be your school, workplace, business or at home, here are some tips from Encompass Network to creating ‘safe places’:
- Take prompt action in addressing any instances of anti-LGBT+ behaviour.
- Avoid making assumptions about someone’s gender or sexual orientation; embrace diversity.
- Encourage each other to be accountable for promoting an environment free from discrimination.
If you’re looking for more support for your business, or for your employer to focus more on workplace inclusion, Stonewall offer workplace trainings, resources and information to ensure LGBTQIA+ employees feel safe and valued at work, by transforming the workplace culture to make it a more welcoming, diverse and inclusive space for everyone.
By embracing the reality of trauma within the LGBTQIA+ community, we take a vital step towards healing and growth. It is through being more informed, developing empathy, compassion and understanding, that we can collectively begin to contribute to well-being and resilience for everyone.
For more information and advice, please contact:
- Galop provides support to all LGBT+ people who’ve experienced hate crime, domestic abuse or sexual violence. www.galop.org.uk 0800 999 5428 (Monday – Thursday, 10am to 8:30pm Friday, 10am to 4:30pm) firstname.lastname@example.org
- Gendered Intelligence Charity supporting young trans people aged under 25, and information for their parents and carers. genderedintelligence.co.uk
- LGBT Foundation Advice, support and information for people identifying as LGBTQ+. 0345 3 30 30 30 lgbt.foundation
- Switchboard Listening services, information and support for lesbian, gay, bisexual and transgender people. 0800 0119 100 hello@switchboard/lgbt
- Mind Out is a mental health service run by and for lesbians, gay, bisexual, trans, and queer people. https://mindout.org.uk/
- All Sorts Youth provide specialist services directly to LGBT+ children & young people (ages 5-25). www.allsortsyouth.org.uk
- The Clare Project are a self-supporting transgender support and social group based in Brighton and Hove open to anyone wishing to explore issues around gender identity. www.clareproject.org.uk
- Mermaids Supports gender-diverse young people aged 19 and under, and their families and carers. Offers a helpline and and webchat. 0808 801 0400 mermaidsuk.org.uk
- MindLine Trans+ Free, confidential listening service for people identifying as trans or non-binary, and their friends and families. 0300 330 5468
- Families and Friends of Lesbians and Gays (FFLAG) Offers support to parents, friends and family members of those who identify as LGBT+. fflag.org.uk
Livingston NA, Berke D, Scholl J, Ruben M, Shipherd JC. Addressing Diversity in PTSD Treatment: Clinical Considerations and Guidance for the Treatment of PTSD in LGBTQ Populations. Curr Treat Options Psychiatry. 2020;7(2):53-69. doi: 10.1007/s40501-020-00204-0. Epub 2020 Mar 16. PMID: 32421099; PMCID: PMC7223966.
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Treatments for PTSD
It is possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help. For some, the first step may be watchful waiting, then exploring therapeutic options such as individual or group therapy – but the main treatment options in the UK are psychological treatments such as Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT).
Traumatic events can be very difficult to come to terms with, but confronting and understanding your feelings and seeking professional help is often the only way of effectively treating PTSD. You can find out more in the links below, or here.