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Intersecting Trauma & Minority Stress Burden on LGBTQ+ Individuals: Theory, Assessment, & Treatment

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Learning objectives: 1. Describe the prevalence and impacts of interlocking trauma and minority stress among LGBTQ+ people2. Describe patient centered screening and assessment strategies for LGBTQ+ people3. Outline considerations when working with LGBTQ+ clients, including recommended intervention targets and modifications to existing evidence-based protocols Nicholas A. Livingston, PhD, [he/him] is an Assistant Professor of Psychiatry at Boston University Chobanian & Avedisian School of Medicine; and a Lecturer at Harvard University. For over 15 years he has studied the effects of trauma and minority stress on health among LGBTQ+ individuals. Primary clinical expertise includes evidence-based SUD and PTSD treatment and patient centered adaptations for LGBTQ+ people. Citations:<a name="_Hlk71099641" id="_Hlk71099641">Ayhan, C. H. B., Bilgin, H., Uluman, O. T., Sukut, O., Yilmaz, S., & Buzlu, S. (2020). A systematic review of the discrimination against sexual and gender minority in health care settings. International Journal of Health Services, 50(1), 44-61. doi:</a><a href="https://doi.org/10.1177/0020731419885093">10.1177/0020731419885093</a><a name="_Hlk108514441" id="_Hlk108514441"></a>Baca, S. A., Crawford, J. N., & Allard, C. B. (2023). PTSD, depression, and suicidality among survivors of childhood sexual trauma (CST), military sexual trauma (MST), and sexual revictimization (CST + MST). Psychological Trauma: Theory, Research, Practice and Policy, 15(8), 1271–1279. https://doi.org/10.1037/tra0001149<a name="_Hlk98527768" id="_Hlk98527768"></a>Hinds, Z., Herbitter, C., Bryant, W. T., Newberger, N. G., & Livingston, N. A. (2022). Hazardous substance use among sexual and gender minority adults: A deeper look into distal minority stressors. Psychology of Sexual Orientation and Gender Diversity. Psychology of Sexual Orientation and Gender Diversity, 11(1), 105–112. https://doi.org/10.1037/sgd0000583<a name="_Hlk108511276" id="_Hlk108511276"></a>Livingston, N.A., Berke, D., Scholl, J., Ruben, M., & Shipherd, J. (2020). Addressing diversity in PTSD treatment: Clinical considerations and guidance for the treatment of PTSD in LGBTQ populations. Current Treatment Options in Psychiatry, 7(2), 53-69. doi: 10.1007/s40501-020-00204-0Pachankis, J. E. (2018). The scientific pursuit of sexual and gender minority mental health treatments: Toward evidence-based affirmative practice. American Psychologist, 73(9), 1207-1219. https://doi.org/10.1037/amp0000357<a name="_Hlk98528847" id="_Hlk98528847"></a>Pachankis, J. E., Harkness, A., Maciejewski, K. R., Behari, K., Clark, K. A., McConocha, E., Winston, R., Adeyinka, O., Reynolds, J., Bränström, R., Esserman, D. A., Hatzenbuehler, M. L., & Safren, S. A. (2022). LGBQ-affirmative cognitive-behavioral therapy for young gay and bisexual men’s mental and sexual health: A three-arm randomized controlled trial. Journal of Consulting and Clinical Psychology, 90(6), 459–477. <a href="https://doi.org/10.1037/ccp0000724">https://doi.org/10.1037/ccp0000724</a>Shipherd, J. C., Lynch, K., Gatsby, E., Hinds, Z., DuVall, S. L., & Livingston, N. A. (2021). Estimating prevalence of PTSD among veterans with minoritized sexual orientations using electronic health record data. Journal of Consulting and Clinical Psychology, 89(10), 856–868. https://doi.org/10.1037/ccp0000691