In the climate of hate, violence, and rampant misinformation surrounding queer and trans people and rights, it is now more important to hear the experiences behind the statistics and the stories behind the research directly from queer and trans people than ever before. The people facing the brunt of this harm are speaking out about their experiences, and as with every group facing hate and persecution, their voices, their accounts of their day-to-day reality, must take priority.
Over the course of two seminars, Mental Health America (MHA) hosted lectures featuring LGBTQ+ voices speaking about their journeys in finding healing, recovery, and self-love in spite of this social climate—and the role of the health care system in facilitating these positive outcomes. Speakers Ren Fernández-Kim (she/they), Casey Tanner (they/them), Patrick Custer (he/him) and Dr. LaNail R. Plummer (she/her) spoke on their experiences in a session titled “Pride in Myself,” and speaker Steven Haden presented in a session titled “The Importance of Providing Culturally Relevant and Affirming Care to Members of the LGBTQ+ Community.” Together, these seminars pair the voices and personal testimonies of the queer and trans people living the stories told by research, statistics, and modern best practices with that information.
Trauma for people in the LGBTQ+ community can take many forms. This may include, for example, acute trauma, chronic trauma, complex trauma, historical trauma, racial/oppressive trauma, and religious trauma. While all health professionals have a duty to provide the best care possible to their clients, which requires providing culturally-sensitive and trauma-informed care, for mental health professionals, understanding the trauma queer and trans people face is especially important. “In therapeutic contexts, the failure to adequately grasp the nature of trauma and its manifestations can lead to misdiagnosis, improper treatment, and unfavorable outcomes. Unrealistic objectives and interventions may be implemented as a result. Without a comprehensive understanding of trauma, clients may be pathologized, contributing to stigmatization,” Haden explained. As with any health-related profession, accurate information is necessary in order to avoid causing additional harm to the patient and to provide quality care.
Devoid of the context of personal testimony, the idea that something as abstract as an incomplete understanding of complex traumas and nuanced social conditions could lead to something as tangible as misdiagnosis can be hard to grasp. Tanner’s story offers a clear example of how a failure to understand trauma led directly to misdiagnosis, improper treatment, and unfavorable outcomes. “I think about the first time I ever went to therapy,” Tanner said. “I was 15. I was incredibly depressed because I was hopelessly in love with my best friend and had no idea what those feelings were. I went to therapy, and my therapist, within one single session of sitting with me, said, ‘This is a mother issue.’”
Due to a combination of the lack of information and representation available to Tanner for them to recognize their own identity and the social stigmas discouraging them and their therapist from taking the existence of queer identities into consideration, the real source of Tanner’s feelings went completely unacknowledged. With no other clear options, Tanner and their team of care providers tried to solve a problem that didn’t exist and ignored the problem that did.
“She was so off the mark about what was happening for me in regards to my friend, and so for another seven years, I didn’t talk about this again. I went through a severe eating disorder, my own suicidal ideation, suicide attempts, hospitalizations. I had at a certain point seven or eight different diagnoses, and nobody in any of these facilities was asking me questions about my sexual orientation. It just was not coming up,” Tanner said. Their experience is just one of many where a lack of queer trauma-informed care led to years of unresolved health conditions that worsened over time.
If the care providers had the information about queer and trans identities to care for them properly, they would be able to offer that same information to patients who may not be fully-informed about their own identities themselves. “For me, when it comes to embracing my identity and the journey of coming to love myself and accept who I am, especially within the mental health circle, has always come from a place of education,” said Fernández-Kim. As with Tanner, their most important step to reaching a more positive outcome for their mental health was learning more about and understanding queer and trans identities, allowing for the self-acceptance necessary for them to start healing.
It’s especially important for care providers to have that information so that even patients of theirs who may not lack that knowledge do not have to carry the burden of educating their own providers. “I don’t think we should ever feel like it’s our responsibility to educate other people on how not to be bigoted,” Custer said. “It’s their own work and their own education to do.” When care providers show that they have the knowledge and the context to speak with their patients about their identities in an educated way, the patients’ faith in and willingness to use those care resources is strengthened.
With a fuller understanding of queer and trans identities comes a kinder way of providing care as well. Queer and trans people have historically been pathologized by the medical community, turning their natural identities into diagnoses and furthering the idea that something is wrong with belonging to any group outside of the heterosexual cisgender standard. “The LGBTQ community has historically faced numerous challenges within the health care system, often encountering a lack of affirmation and acceptance,” Haden said. “Medical providers tend to pathologize LGBTQ identities, regarding them as a psychological disorder, or a form of deviance.
Within this framework, harmful approaches emerge, aiming to ‘cure’ individuals of their queer and trans identities. Perhaps you’ve come across the term ‘conversion therapy,’ which refers to practices that seek to alter sexual orientation or gender identity. While some jurisdictions have enacted laws prohibiting licensed mental health professionals from subjecting LGBTQ minors to these harmful conversion practices, approximately 30 states and four territories in the United States still lack protective measures.”
Protective measures, of course, are not education or information—only the prevention of weaponized misinformation. There are no laws in place to enforce medical providers’ ability to provide trauma-informed care, only to prevent them from causing more trauma, and then only to minors. It remains the individual duty of every provider to inform themselves and reach a sufficient level of education to perform their jobs appropriately. To learn more about culturally-sensitive and trauma-informed care, resources like Mental Health America (https://mhanational.org/) regularly provide informational webinars and other tools for education and training.
