When Words Fail: Addressing Trauma in the LGBTQI Community

July 5, 2016


Jan Wrolstad, M.Div
Associate Director
Mid-America ATTC


Words fail in expressing sympathy for the friends and family members of those whose lives were lost in the horrific massacre in the Orlando night club nearly three weeks ago. Words also fail in conveying the fear now experienced by members of the LGBTQI community.


Fear has replaced what for many had been a growing sense of acceptance and affirmation.

In a recent workshop I facilitated,  "Using a Trauma-informed Care Approach in Working with the LGBTQI Population,"  these feelings of fear, triggering re-traumatization, were expressed by members of an LGBTQI panel. A middle-aged trans-woman, a thirty-something trans-man and a twenty-something lesbian woman gave the attendees at the standing-room-only workshop a personal glimpse of the trauma each had experienced through family rejection and aggressive acts of violence directed at them personally. Name calling, belittling, and rejection by parents, bullying at school, rape, beatings, workplace harassment, mistreatment by medical and behavioral health professionals along with internal confusion, depression, suicidal ideation and attempts were part of their stories. 

Members of the LGBTQI population also experience high rates of substance use disorders and mental illness. As the Center for American Progress stated in a 2012 issue brief Why the Gay and Transgender Population Experiences Higher Rates of Substance Abuse states:
Although data on the rates of substance abuse in gay and transgender populations are sparse, it is estimated that between 20 percent to 30 percent of gay and transgender people abuse substances, compared to about 9 percent of the general population.

"Using a Trauma-informed Care Approach in Working with the LGBTQI Population," was presented as part of the 13th Annual Midwest Conference on Problem Gambling and Substance Abuse, held June 22-24, 2016, in Kansas City, MO. Participating states included Iowa, Kansas, Missouri, Nebraska and Oklahoma. Mid-America ATTC , a SAMHSA-funded grant program, provides support for this annual conference. 

As a facilitator of this workshop for audiences of behavioral health specialists the past ten years, I have found that words can also fail to convey the many complex aspects of our human sexuality. To fall back on the binary system of the man/male-woman/female spectrum misses the mark (or perhaps better stated, misses many marks), but it is at least a place to start. The workshop began with a look at the terminology and language used in understanding this population, followed by how practicing trauma-informed care can be applied when serving someone who is LGBTQI. 

Assume trauma . . .

That’s a good place to start. If not diagnosable trauma, then at the very least there has been trauma that produces caution in social settings, fear in new settings, and a general mistrust of persons outside the LGBTQI community. This is quite obviously not the most positive springboard from which to launch into life. If fear wasn’t on the minds of persons who are LGBTQI before the June 12, 2016, nightclub shooting, it certainly must be there now. The young woman on the panel who is a lesbian said she has struggled in her life through a number of painful emotions and hurts and issues and problems because of her sexual orientation, but fear for her life hadn’t been part of her concerns . . . until now.

The panelists brought the workshop to life. Talking from their own perspectives, they each gave a face to what it means to be a member of the LGBTQI community.

What’s the take-away from my experience in facilitating this workshop? As the attendees asked questions and listened to stories, there was a sense that their own preconceptions and misconceptions were falling away. They were seeing these three panelists as authentic, unique and wonderful people.

While words often fail, personal stories can change hearts and minds. More opportunities for more people to hear more persons who are LGBTQI tell their stories just might turn the right heart at the right time.

The ATTC Network's YMSM+LGBT Center of Excellence: Building culturally responsive skills

For behavioral health professionals seeking ways to build their skills to address the unique needs of the LGBTQI population, the ATTC Network's YMSM + LGBT Center of Excellence (YMSM + CoE) offers an array of trainings and resources.  The Center is now accepting applications for a Training of Trainers event scheduled for September 21-23 in Mystic Lake, MN. Application deadline: July 18, 2016


For more information: 
The Substance Abuse and Mental Health Services Administration (SAMHSA) offers the following tools, resources and information:
Behavioral Health Equity: Lesbian, Gay, Bisexual, and Transgender
Responding to the Orlando Community Tragedy
Ending Conversion Therapy: Supporting and Affirming LGBTQI Youth
Top Health Issues for LGBTQI Populations: Information and Resource Kit

Jan Wrolstad, MDiv, is Associate Director of Mid-America ATTC. She received training on how to more effectively serve the LGBTQI population through a national training of trainers held by the ATTC Center of Excellence on Racial and Ethnic Minority Young Men Who Have Sex with Men and Other Lesbian, Gay, Bisexual, and Transgender Populations. Their curriculum, A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals has recently been updated to a second edition.

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