The Impact of Minority Stress and Adverse Childhood Experiences on LGBTQ+ People

Although gains have been made in securing the rights of LGBTQ+ people, over the past few years, several state legislatures have attempted to remove some of these rights, contributing to increased stress due to discrimination and oppression of marginalized communities.

Todd Connaughty, MA, LPCC, LADC is the director of clinical services at the PRIDE Institute. He is passionate about his work with the LGBTQ+ community and has given presentations at the Cape Cod Symposium on Addictive Disorders, the Finding Freedom Symposium, West Coast Symposium, Minnesota Association of Resources for Recovery and Chemical Health (MARRCH), and the Minnesota Social Services Association (MSSA) among others.

Connaughty identifies as a pansexual white cisgender male and his pronouns are his and him.

In a recent webinar for Harmony Foundation, Connaughty presented data on minority stress as it applies to the intersectionality of identities of LGBTQ+ individuals. He examined minority stress, compounded with emerging research on adverse childhood experiences as it relates to the higher prevalence of substance use and mental health issues in the community.

First off, Connaughty presented a number of statistics that illustrate the stress and discrimination LGBTQ+ individuals are frequently exposed to:

  • 90% have been threatened or harassed at work
  • 60–70% have experienced physical or sexual harassment by law enforcement officers
  • 43+% report using substances to cope with stress and discrimination
  • 41% report suicide attempts (compared to 1.6% in the general population)
  • 10% higher rate of smoking than the general population
Connaughty then reviewed some of the guidelines of the American Psychological Association (APA) for working with LGBTQ+ clients:

  • Psychologists understand that gender is a nonbinary construct that allows for a range of gender identities and that a person’s gender identity may not align with the sex assigned at birth.
  • Psychologists understand that gender identity and sexual orientation are distinct but interrelated constructs.
  • Psychologists are aware of how their attitudes about and knowledge of gender identity and gender expression may affect the quality of care they provide to TGNC people and their families.
After reviewing some of the increasingly complex LGBTQ+ terminologies, Connaughty explained the elements of an LGBTQ+ affirming assessment, including the client’s coming out history, any internalized home/bi/trans/lesbo/queer negativity, and a complete adverse childhood experience (ACE) screening—childhood trauma such as experiencing violence, abuse, or neglect, witnessing violence in the home or community, or having a family member attempt or die by suicide. Research shows that 52 percent of LGBTQ+ individuals experience three or more such ACEs compared to 26 percent of straight adults.

“We’re looking to get a good picture of the client’s experience. We want to know what has been the impact of that minority stress,” he told the webinar audience. One way to reduce minority stress for LGBTQ+ people is using appropriate pronouns. “Asking and using the correct gender pronouns is the most basic way to show respect and has a significant impact on mental health outcomes,” said Connaughty.

He then went over the APA guidelines to counter stigma, discrimination, and barriers to care:

  • We recognize how stigma, prejudice, discrimination, and violence affect the health and well-being of TGNC (transgender and gender non-conforming) people.
  • We strive to recognize the influence of institutional barriers on the lives of TGNC people and to assist in developing TGNC-affirmative environments.
  • We understand the need to promote social change that reduces the adverse effects of stigma on the health and well-being of TGNC people.
As Connaughty explained, “minority stress theory suggests that sexual minorities, underrepresented gender identities, as well as queer and other sexual identities (LGBTQ+) commonly experience distinct and chronic stressors related to their sexual orientation and/or gender identity. Sexual minority health disparities can be explained in large part by stressors induced by a hostile, homophobic culture, which often results in a lifetime of harassment, maltreatment, discrimination, and victimization.”

The impact of stigma, discrimination, and harassment can lead to unhealthy coping strategies such as avoiding people, places, and services, misusing substances, and mental health issues, including self-harm.

Tools and strategies to help traumatized LGBTQ+ people include education on minority stress and trauma (many don’t realize that they have been traumatized). Therapy should help clients identify triggers, create safety plans, and provide support and resources.

At Harmony, we recognize the importance of providing culturally competent services to the LGBTQ+ community and understand that this community often faces a different set of challenges. Our LGBTQ+ specialty group offers a safe place for LGBTQ+ individuals to share experiences related to the intersection of their identities and substance use.

If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us at (970) 432-8075 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.