Treating Complex Trauma in the LGBTQIA+ Community

Table of ContentsView AllTable of ContentsUnderstanding Complex TraumaComplex Trauma in the LGBTQIA+ CommunityImpactTrauma-Informed CareHealing and RecoveryAdvocacy and Support

Table of ContentsView All

View All

Table of Contents

Understanding Complex Trauma

Complex Trauma in the LGBTQIA+ Community

Impact

Trauma-Informed Care

Healing and Recovery

Advocacy and Support

Close

When somebody has repeated exposure to traumatic events and experiences, they may develop complex trauma.

Complex trauma is one of the LGBTQIA+ community’s biggest challenges – it affects LGBTQIA+ people at a higher rate than the population as a whole, for reasons including discrimination, bullying, abuse, and isolation.

If you are seeking support for issues with coming out, relationships, bullying, self-harm, and more, contact theLGBT National Hotlineat1-888-843-4564for one-to-one peer support.For more mental health resources, see ourNational Helpline Database.

If you are seeking support for issues with coming out, relationships, bullying, self-harm, and more, contact theLGBT National Hotlineat1-888-843-4564for one-to-one peer support.

For more mental health resources, see ourNational Helpline Database.

Complex trauma often forms through exposure to incidents or experiences from which someone feels as though they can’t escape.

Children are more likely to develop complex trauma than adults, though complex trauma can develop at any age. LGBTQIA+ people may develop complex trauma through oppression, discrimination, and bullying. Meanwhile,neglect in childhood, as well as physical, emotional, and sexual abuse, can all contribute to the development of complex trauma.

According toEmily Haas, MD, director of the Triumph Program at Silver Hill Hospital, violent assault is four times more likely to be a cause of trauma in LGBTQIA+ individuals, with sexual assault, rape, and child sexual abuse all more common causes of trauma, including PTSD, in LGBTQIA+ people.

And, she says that over 40% of LGBTQIA+ people meet the criteria for a diagnosis of PTSD at any point.

But there are other stressors, too, which may not be so overtly traumatic but can stack up cumulatively – closer meeting the definition of complex trauma. “When you think about PTSD, initially, someone has to have a major trauma to meet the criteria,” explains Dr Haas.

“But oftentimes in this community, it’s actually a series of smaller stressors as well that amount to be a larger trauma, and so it’s something that actually gets missed more often than because they may not have had, like a single car accident trauma sort of thing, but they have a series of chronic traumas over time that you have to ask about, and that can actually meet the threshold ofcriteria for PTSD.”

But oftentimes in this community, it’s actually a series of smaller stressors as well that amount to be a larger trauma.—EMILY HAAS, MD

But oftentimes in this community, it’s actually a series of smaller stressors as well that amount to be a larger trauma.

—EMILY HAAS, MD

It’s important to consider other causes of complex trauma, thatmay intersectwith the complex trauma LGBTQIA+ individuals are more likely to experience. For example, an LGBTQIA+ person of color may develop complex trauma from racism as well ashomophobiaor transphobia, and the idea that beingcisgenderand heterosexual is ‘normal’ or ‘correct’.

This is a form of cultural violence – but anti-LGBTQIA+ cultural violence is almost unique in that it often comes from places like the family.And, LGBTQIA+ people who experience rejection from their family are more likely to be at higher risk of homelessness, self-harm, suicide, and various mental health conditions.

Likewise, an LGBTQIA+ person may also develop complex trauma from living in poverty – LGBTQIA+ people disproportionately live in poverty – from violence, war, or terrorism, or from having a family member who struggles with mental health orsubstance use disorder.

PTSD From Emotional Abuse

Prevalence of Complex Trauma in the LGBTQIA+ Community

While anyone can develop complex trauma, it’s more prevalent in LGBTQIA+ individuals. Research from 2017 suggests that around 3% of people have complex trauma,while it’s thought that LGBTQIA+ young people are disproportionately exposed toadverse childhood experiences (ACEs)and potentially traumatic events (PTEs) when compared to non-LGBTQIA+ young people. And, there’s a correlation between these events and an increased risk of both mental and physical health difficulties.

People in the LGBTQIA+ community may be at higher risk of experiencing things that can cause complex trauma to develop. This can range frommicroaggressionsto bullying and discrimination to abuse,intimate partner violence, and homophobia, biphobia, and transphobia.

And, on a larger scale, the enaction ofanti-LGBTQIA+ legislationcan be a contributing factor. Take the anti-LGBTQIA+ laws dictating what can be taught as part of the curriculum,

According to the CPTSD Foundation, 48% of gay and bisexual people and 42% of transgender and non-binary people have complex trauma.Meanwhile, Dr Haas says that over 50% of the patients in her residential trauma, complex trauma, and dissociative disorder program are in the LGBTQ+ community.

Impact of Complex Trauma on LGBTQIA+ Individuals

In contrast, LGBTQIA+ people might not always have that support at home, and may even experience the same sort of traumas at home, too, from their family. Many LGBTQIA+ people are used to simply not having any support, and never being heard. As Dr. Haas puts it, “When I think about treatment, the first thing is, what was home life actually like? Was there ever a moment of peace and respite, or was it kind of always hate and terror all the time? It may actually be very different than their peers.”

Keith Menhinick, PhDA common maxim in trauma studies is the slower you go, the faster you get there.

Keith Menhinick, PhD

A common maxim in trauma studies is the slower you go, the faster you get there.

The effects of trauma on LGBTQIA+ people can be similar to the effects of trauma on their cisgender and heterosexual counterparts. However, after a traumatic event, LGBTQIA+ people are more likely to progress to developing PTSD simply because they’re less likely to have the support of their family, or a community. So, LGBTQIA+ people can oftenfeel isolatedand lonely after experiencing trauma.

Of course, many LGBTQIA+ people find community online, and this can be helpful. However, it’s important to have support in your immediate surroundings, too, particularly when you’re going through or have been through trauma.

If you have complex trauma, you may find it hard to feel connected to other people. You may find keeping friends and romantic partners difficult, and you may also struggle to control your emotions. Feelings of worthlessness, shame, and guilt can also be common in people with complex trauma.

Understanding the Effects of Childhood Trauma

Trauma-Informed Care for the LGBTQIA+ Community

Getting help for complex trauma isn’t always easy for people in the LGBTQIA+ community. Treatment can be expensive, meaning that some people are priced out – and those who can afford it may still find that the financial burden causes more stress and anxiety. It’s important to remember, too, that when LGBTQIA+ young people do reach out, they’re met with higher rates of stigma and discrimination – and this can add to their stress, and further alienate them.

According toKeith Menhinick, PhD, visiting assistant professor of Spiritual Care and Pastoral Theology at Emory University, “A general rule of trauma-informed care, especially when working with LGBTQ+ people, is to treat everyone as if they have a history of trauma. However, we should be careful not to ask about someone’s trauma too quickly.”

He recommends asking people about their strengths, gifts, and wisdom to help build their trust, and asking questions like “Who or what is helping you the most right now?”

“Establishing environments of safety is always the top priority,” says Dr Menhinick. “In our work with others, especially those who have experienced trauma, we must move at the speed of trust. Building trust takes time and a commitment to keep showing up. A common maxim in trauma studies is the slower you go, the faster you get there.”

She explains that the LGBTQ+ people she works with will look at how their identity changes, how their identity affects trauma, trauma symptoms, and what affects their likelihood of developing trauma. “We have groups specifically for the LGBTQ+ community in the program to give them a safe space to talk about some of the things that are interwoven with their traumatic experiences but may not apply to the whole group,” she continues.

Something Dr Menhinick adds is that it’s important to remember that behavioral issues are often efforts to help someone cope withunresolved trauma. “Rather than punishing “bad” behavior, we can get curious about a person’s history and their current strategies and practices for coping with stress,” he says.

What Is Trauma-Informed Therapy?

Healing and Recovery for LGBTQIA+ Individuals With Complex Trauma

There are many things that LGBTQIA+ people with complex trauma can try to help with healing and recovery, too.

Among the treatments available for LGBTQIA+ people with complex trauma include psychotherapy,cognitive-behavioral therapy (CBT),dialectical behavior therapy (DBT),exposure therapy, andeye movement desensitization and reprocessing (EMDR).

Often, the same treatments used to help manage PTSD can be useful, but people with complex trauma can sometimes need more intensive treatment over a longer period of time. It can also be helpful to get support with other conditions you may have, like anxiety, depression, or dissociation.

Self-care can also be really beneficial when dealing with complex trauma. It helps to have friends and loved ones to speak to, while on your own you could try meditation or journaling. Consistency and sticking to a routine can help, too. This might involve going to bed and waking up at the same times each day, keeping track of your daily chores, or making sure you exercise, enjoying a nutritious diet with plenty of water, and staying on top of personal hygiene.

How to Heal From Trauma

Advocacy and Support for the LGBTQIA+ Community

The CPTSD Foundationworks with survivors of trauma worldwide and offers a lot of resources to support people with complex trauma. Meanwhile,Out of the Stormoffers a free and anonymous service to adults living with the symptoms of complex trauma.

Beauty After Bruiseshelps people who experienced trauma as children, while for teens and young adults, The Trevor Project’sTrevorSpaceis an online community and source of support.

Keep in Mind

Signs of Childhood Trauma in Adults

4 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.The National Child Traumatic Stress Network.Complex Trauma.Menhinick KA, Sanders CJ.LGBTQ+ stress, trauma, time, and care.Pastoral Psychol. 2023;72(3):367-384. doi:10.1007/s11089-023-01073-zKaratzias T, Cloitre M, Maercker A, et al.PTSD and complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania.European Journal of Psychotraumatology. 2017. doi:10.1080/20008198.2017.1418103The CPTSD Foundation.The LGBTQIA+ Community Complex Trauma, PTSD, and CPTSD.

4 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.The National Child Traumatic Stress Network.Complex Trauma.Menhinick KA, Sanders CJ.LGBTQ+ stress, trauma, time, and care.Pastoral Psychol. 2023;72(3):367-384. doi:10.1007/s11089-023-01073-zKaratzias T, Cloitre M, Maercker A, et al.PTSD and complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania.European Journal of Psychotraumatology. 2017. doi:10.1080/20008198.2017.1418103The CPTSD Foundation.The LGBTQIA+ Community Complex Trauma, PTSD, and CPTSD.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

The National Child Traumatic Stress Network.Complex Trauma.Menhinick KA, Sanders CJ.LGBTQ+ stress, trauma, time, and care.Pastoral Psychol. 2023;72(3):367-384. doi:10.1007/s11089-023-01073-zKaratzias T, Cloitre M, Maercker A, et al.PTSD and complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania.European Journal of Psychotraumatology. 2017. doi:10.1080/20008198.2017.1418103The CPTSD Foundation.The LGBTQIA+ Community Complex Trauma, PTSD, and CPTSD.

The National Child Traumatic Stress Network.Complex Trauma.

Menhinick KA, Sanders CJ.LGBTQ+ stress, trauma, time, and care.Pastoral Psychol. 2023;72(3):367-384. doi:10.1007/s11089-023-01073-z

Karatzias T, Cloitre M, Maercker A, et al.PTSD and complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania.European Journal of Psychotraumatology. 2017. doi:10.1080/20008198.2017.1418103

The CPTSD Foundation.The LGBTQIA+ Community Complex Trauma, PTSD, and CPTSD.

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