Redefining Inclusive Care: How Identity-Related Stress Compounds the Impact of Trauma For LGBTQ+ Individuals

When it comes to providing care to someone who has experienced trauma, a person’s identity is more than just something to take into consideration; it can color their entire experience with healing. An accepting, informed response from their care team can do a world of good, while an invalidating response can be detrimental and, in many cases, further traumatizing to a person.

Enter Dr. Jillian Scheer, a licensed psychologist, the director of the Minority Stress & Trauma Lab and an assistant professor of clinical psychology at the University of Rhode Island. Scheer is leading the research for Project QueST: Queer Survivors of Trauma to discover more about the relationship between identity-related stress and trauma, and how that interaction affects healing.

“My research program is focused on understanding and addressing trauma, stigma and poor health outcomes (e.g., substance use disorders, chronic pain, traumatic stress symptoms) among LGBTQ+ communities and other minoritized groups like cis and trans women living with HIV and those with lived experience of sexual violence, with a particular emphasis on how social and structural stressors shape health,” Scheer says.

It’s a topic that Scheer is passionate about championing.

“I was drawn to this work through both clinical and research experiences,” they say.  “Repeatedly, I saw that LGBTQ+ individuals were not only more likely to experience trauma, but also faced ongoing identity-related stress, like discrimination, stigma or lack of affirming care, that shaped how that trauma affected them over time.”

Through thoughtful research, Scheer has found that the facets of a person’s identity do not operate independently from their lived experiences; identity-related stress is not separate from past trauma, in fact, it often interacts with it in a way that intensifies distress and creates barriers to healing.

“One key finding [of Project QueST] is that identity-related stress, such as discrimination, anticipated rejection or lack of access to affirming care, can amplify the impact of past trauma,” they state.

In other words, not only is non-affirming healthcare not helpful in the journey of healing from past trauma, it is actively harmful to recipients.

Of course, conducting this crucial research was an extremely vulnerable, sensitive matter, and Scheer’s team made certain that participants in the study felt safe the whole time.

“We placed a strong emphasis on ethical, trauma-informed research practices,” they say. “That included giving participants control over what they shared, ensuring confidentiality and creating a respectful, affirming environment.”

To collect their data from study participants, Scheer’s team used a mixed-methods approach, combining surveys with in-depth interviews, to capture both broader patterns between individuals and the individuals’ unique lived experiences.

Their research aims to make a positive impact on people’s lives and is already making immense progress. One way the team is helping to create this positive change is through RISE (Recovery through Inhibitory learning, Self-Efficacy building, problem-solving and community building), a trauma-informed, five-week telehealth intervention for LGBTQ+ people who are experiencing both traumatic stress and unhealthy alcohol use, developed through the research gleaned from Project QueST.

“What makes RISE unique is that it is specifically adapted to reflect the experiences of LGBTQ+ individuals, including identity-related stress and barriers to care. It is also designed to be low-threshold and accessible and delivered remotely, with an emphasis on flexibility and safety,” Scheer says. “The goal is to provide tools for managing distress, reducing potentially unhelpful coping behaviors, and supporting healing in a way that feels affirming and relevant.”

By validating patients’ identities, healthcare workers will be better equipped to guide queer individuals on their paths to healing from past trauma.

“Affirming care can be transformative, while invalidating experiences can have lasting negative effects and discourage future help-seeking,” Scheer explains. “Overall, the research reinforces that we need approaches that are not only trauma-informed, but also structurally and culturally responsive.”

Scheer’s research is intended to help queer people live healthier, happier, safer lives. Put simply, your identity is valid, special and deserves to be not only acknowledged, but celebrated.

“If you are navigating identity-related stress or past trauma, it’s important to know that your reactions make sense in the context of what you’ve experienced,” they say. “You are not alone, and your responses are not a reflection of personal weakness as they are adaptive responses to very real stressors … Healing is possible, and it doesn’t require you to separate your identity from your care; your full self deserves to be supported.”

Queer healing, after all, is just as vital as queer resilience.