Professional Documents
Culture Documents
Trauma and Sexual Orientation
Trauma and Sexual Orientation
Overview
It has been barely more than a century since Western science and psy-
chology have come to conceive of persons having a fixed nonheterosexual
orientation and then to define such an orientation as normative for a nu-
merical minority of the population. That century has not sufficed to reduce
bias against and stigma associated with nonheterosexual status. Lesbian, gay,
and bisexual (LGB) people constitute a target group with a unique status
based solely on sexual orientation; unlike many other target groups in the
United States, they continue to be subject to legal discrimination and in
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some arenas increased legal discrimination. This social context lends a unique
experience to the intersection of sexual orientation with trauma. For LGB
people, having a minority sexual orientation leads to endemic exposure to
insidious trauma, frequent exposure to active discrimination and maltreat-
ment, and some risk of hate crimes. Although many discussions of the topic
of LGB people include transgender people in discussions of sexual orienta-
tion, I have opted to include transgendered people in chapter 6 in the discus-
sion of gender. Transgendered people can be heterosexual, gay, lesbian, or
bisexual, and thus issues of sexual orientation will be a component of iden-
tity as they are for nontransgendered individuals.
Usually LGB people, unlike members of target ethnic and cultural
groups and like people with disabilities, do not share target group status
with their immediate family members. Many LGB people thus develop their
sexual orientation identities in a vacuum informed by myth, misinforma-
tion, and negativity (Garnets & Kimmel, 2002). Although this picture is
beginning to change as openly LGB people are becoming more visible in
the public sphere, having openly lesbian comic and talk show host Ellen
DeGeneres cheerfully appearing on one's television screen daily does not
make up for the absence of direct and emotionally intimate paradigms for
becoming LGB nor does it counteract the ubiquitous presence of anti-LGB
sentiment in dominant culture in which pejorative terms for gay men and
lesbians are common epithets. Because bias against LGB people continues
to have potentially life-threatening consequences and discrimination against
LGB people is active and legal in the United States, I argue here that
for most LGB people the social environment has regular potentials to be
traumatizing.
Families are sometimes the source of trauma for LGB people as well;
even in a family in which no other abuse has occurred, an LGB person grow-
ing up may encounter continuous biased commentary and experience the
threat of loss of relationship with family simply because of sexuality. As a
result of persistent mythologies, some promulgated by mental health profes-
sionals, that LGB orientations are chosen freely and thus can be unchosen as
well, LGB people frequently receive the message that they are to blame for
their own victimization and in control of whether they are targets. Most
LGB people are affected by systemic forms of bias, including homophobia,
which is an anti-LGB sentiment, and heterosexism, which privileges hetero-
sexual lives and relationships although does not necessarily stigmatize in the
manner of homophobia. Like racism and sexism, homophobia and
heterosexism can be systemic, institutional, and also individual. Like other
forms of bias, homophobia and heterosexism can, and frequently do, become
internalized and a source of emotional distress; in fact the bulk of the litera-
ture on psychotherapy with LGB people speaks to the importance of address-
ing internalized homophobia, heterosexism, and biphobia as a core compo-
nent of affirmative psychotherapies.
When LGB people make their sexual orientation known to their fami-
lies of origin there can be very negative consequences. Even nondisclosure
can have negative outcomes arising from the strategies of distancing and
disengagement from families used by many LGB people in attempts to con-
ceal their sexual orientation from family, something Pharr (1988) referred to
as "internal exile." Higher rates of suicidality and homelessness among LGB
youth are attributed in part to extreme negative responses by families to learn-
ing of a child's sexual orientation (Hershberger & D'Augelli, 2000). Being
kicked out of a family, told that you are no longer their son or daughter, and
denied access to younger siblings because you are now seen as a child mo-
lester are all varieties of traumatic experience that have been repeatedly re-
ported by LGB people. Some data also document physical or sexual assaults
by family members on LGB people when their sexual orientation became
known to the family (Garnets, Herek, & Levy, 1993). These events do not
occur in a vacuum; these are families in which LGB people have often first
been exposed to the insidious trauma of overt verbal expressions of homopho-
bia by family members or cultural systems of authority such as religion that
are embraced by the family of origin.
When LGB persons are members of target ethnic and cultural groups
they often find themselves facing the racism of the Euro-American LGB
communities and the heterosexism and homophobia of their cultures and
communities of origin. Kanuha (1990) and Greene (1990, 1992) have each
referred to lesbians of color as experiencing "triple jeopardy" psychologically
because of risks associated with sexist, racist, and heterosexist oppressions,
although Greene (2007) also commented on the special resiliencies inher-
ent in having to successfully navigate the daily challenges of multiple and
intersecting oppressions. Espin (2005) and Gock (2007) have each spoken
eloquently of the creative synthesis of identities arising from their social lo-
cations as lesbian or gay members of ethnic cultures of color and engaged
members of often-homophobic communities of faith. Frequently, LGB people
of color violate gender-role norms of their target ethnic cultures of origin
and may experience exclusion or violence in those cultures due to their trans-
gressive identities. For those ethnic cultures strongly associated with particu-
lar faith traditions that are overtly rejecting or stigmatizing of nonheterosexual
orientations, the experience of betrayal by those closest to the LGB person is
not uncommon and can be traumatic.
Cultural competence with a survivor of trauma who blends these mul-
tiple identities will lead a psychotherapist to explore the meaning of the
trauma not for each identity alone but for the place of intersection that is the
Religion and spirituality, which are sources of comfort for many people,
are frequently not for LGB people. Some faith traditions are actively anti-
LGB, including the one in which Ted Haggard was a pastor and national
leader; these traditions single out the sin of homosexuality from among other
behaviors that are Biblically proscribed and focus on its eradication as a nec-
essary condition for entrance into the community of believers. Haldeman
(2002) has documented the emotional harms, some of them traumalike, ex-
perienced by LGB people who, in the context of such faith traditions, have
attempted to change their sexual orientations through so-called reparative
therapies. Many LGB people in these faith traditions, which include many of
the fundamentalist or orthodox versions of several faiths, struggle with the
untenable choice of faith versus intimacy and partnership and may in the
process experience traumas of betrayal and insidious traumatization.
Hate Crimes
The sergeant forcibly raped Colleen repeatedly and gave her bad fitness re-
ports. Depressed and despondent, she went to the commanding officer and
outed herself as a lesbian, which began the process of her being discharged.
She also finally reported the sergeant but was told, "It's your word against his,
When oppression and homophobia are not themselves the direct cause
of a trauma exposure for an LGB person, heterosexism may compound or
aggravate the experience of a trauma and its aftermath. After the terror at-
tacks of September 11, 2001, a number of lesbian and gay widows and widow-
ers found themselves excluded from pensions, awards of damages, and other
benefits available to legal family members of partners who had died that day;
this sort of legal exclusion resulting from heterosexist failures to include LGB
partners in inheritance structures is common but was an aggravation of trau-
matic loss in those instances, similar to what happened in Aaron's story ear-
lier in this chapter. An LGB trauma survivor may also have difficulty access-
ing resources available to trauma survivors because of a real or perceived
sense of unwelcome to LGB people by that resource. In a time when federal
funding to support social services is increasingly going to faith-based agen-
cies, which are legally allowed to discriminate against LGB people on the
basis of theological principles, the risk that an LGB person may feel unsafe
seeking assistance after a trauma has grown.
Aside from these sources of exclusion, an LGB person may, like other
members of target groups, be both more vulnerable and more or differently
resilient in the face of current trauma exposure because of a history of insidi-
ous traumatization. Data indicate that LGB people are the target group most
likely to seek therapy of any; as many as 80% of White lesbians and gay men
studied in nonclinical samples indicated having sought the services of a psy-
chotherapist at some juncture (Perez, DeBord, & Bieschke, 1999). Other
data suggest that the high rates of depression, anxiety disorders, and sub-
stance abuse in LGB populations in the United States are persistent conse-
quences of stigma and discrimination (Cochran, Sullivan, & Mays, 2003),
an interpretation of the data that would be supported by Russell's (2004a,
2004b, Russell & Richards, 2003) findings of the specific negative impacts
on LGB mental health of antigay political discourses. I have previously ar-
gued (Brown, 2003) that trauma, particularly insidious and betrayal trauma,
is a normative component of identity development for many LGB people
and thus should be considered endemic in the LGB population.
Consequently, culturally competent practice with LGB survivors will
involve a psychotherapist in considering these various factors as they play
into, aggravate, or ameliorate trauma exposure. The effects of internalized
homophobia and heterosexism within an LGB person's psyche and the im-
pacts of oppression in the client's immediate and historical social milieus
must all be weighed as contributing factors in response to trauma. The inter-
actions between sexual orientation and all other aspects of identity will cre-
ate powerful possibilities for healing as well as increased risks for pain, both
of which a psychotherapist must consider in comprehending the distress ex-
perienced by an LGB trauma survivor.
Although the discourse about sexual orientation and risks for trauma
has historically focused on the experiences of LGB individuals, the risks of
heterosexuality, particularly for women in relationships with men, need to
also be addressed. Heterosexual women are at risk of being physically and
sexually abused by male partners. Whitaker-Clark (2005), in an extensive
critical review of the literature on abuse in intimate partner relationships,
found that for adolescents in heterosexual relationships an average of around
30% of girls reported abuse from their dating partners, and adult women in
heterosexual relationships reported abuse approximately 25% of the time at
the hands of their male partners (with lesbians reporting about one half that
rate from female partners). Heterosexuality appears to be a protective factor
for men because heterosexual men report less abuse from female partners
than do gay men at the hands of their same-sex partners (suggesting that sex
of partner is a stronger predictor for risk of partner violence than sexual ori-
entation per se). The mediating effect of sexual orientation on the sex of
one's partner thus places heterosexual women at risk of intimate violence
arising from their sexual orientation as well as their sex.