Trauma can often have a deep impact on a person’s overall health and wellbeing. As an oppressed minority population, LGBT people disproportionately experience traumatic events such as childhood abuse, hate violence, sexual assault, and homelessness. It’s critical for healthcare providers to understand the root causes of trauma in the LGBT community, and how that trauma may manifest in self-destructive behaviors. LGBT patients especially need culturally competent care in order to avoid retraumatization.
A newly released book aims to educate healthcare professionals about the effects of trauma on the health of LGBT patients and explain how to use clinical encounters to promote resilience in LGBT patients to facilitate recovery. Trauma, Resilience, and Health Promotion in LGBT Patients, which was co-edited by Dr. Jennifer Potter, Co-Chair of The Fenway Institute at Fenway Health, is the first of its kind to offer these types of guidelines for physicians and other healthcare professionals. Other Fenway Health staff who contributed to the text are Kerith Conron, MPH, ScD; Kevin Kapila, MD; Matthew J. Mimiaga, MPH, ScD; and Sarah M. Peitzmeier, MSPH, PhD.
LGBT people experience what is known as minority stress. This means that an individual’s marginalized status in society – in this case, as sexual and gender minorities – increases their vulnerability to traumatic and non-traumatic stressors.
As the book notes, trauma – especially childhood trauma – can have a profound effect on personal development. Individuals with a history of trauma may become more prone to risk-taking behaviors such as unprotected sex or substance abuse. LGBT people, most frequently transgender or gender non-conforming people, often have stigmatizing healthcare experiences that may cause them to avoid routine checkups. For example, lesbians, transgender men, and nonbinary assigned female at birth (AFAB) people are less likely to get Pap tests to screen for cervical cancer than non-LGBT people.
Addiction is a common health concern for LGBT people, as research shows they are more likely to smoke, take recreational drugs, and abuse alcohol than their heterosexual and cisgender counterparts. What is not discussed as frequently is how often addiction is born out of a need to cope with trauma, as Dr. Potter explains. Ultimately, it is the job of the clinician to address addiction and other self-destructive coping mechanisms through compassionate, trauma-informed care.
“This book shows providers the connections between trauma and unhealthy coping mechanisms, and explains how they can welcome LGBT people into healthcare in a nonjudgmental way to help them access care that is supportive and enhances resilience,” said Dr. Potter. “It’s important to identify problematic coping mechanisms without blaming the patient. Once you do that, you can help them find healthier stress coping patterns. It’s all about affirmation and harm reduction.”
The authors hope that by addressing trauma in LGBT communities using the strategies outlined in this book, LGBT health disparities will be reduced and clinicians themselves will understand how they can serve as role models for the larger societal changes needed to eradicate the stigma, violence, and discrimination faced by LGBT people.
“Above all, this book focused on the incredible resiliency of the LGBT community, and how we can help make it even more resilient,” Dr. Potter said.