Trauma Experiences of LGBTQ+ Victims: Victimization, Discrimination, and Other Stressful Experiences

Introduction

Research suggests lesbian, gay, bisexual, transgender, and queer individuals and individuals belonging to other diverse sexual minority groups (LGBTQ+) have high rates of trauma, including victimization, discrimination, and other stressful experiences. A recent study of victimization and help-seeking among Illinois residents found individuals who identified as LGBTQ+^[1] were more likely to report having been victimized at some point in their lifetime than non-LGBTQ+ individuals.^[2] A U.S. survey of 27,715 transgender individuals found that nearly half of participants had experienced sexual assault in their lifetimes and one-tenth reported being the victim of sexual assault within the prior year.^[3] In addition, LGBTQ+ communities in the United States are likely to experience hate crimes at rates higher than expected based on their representation in the general population.^[4]

People who are LGBTQ+ have reported experiencing harassment, mistreatment, and/or discrimination in varied settings. Forty-two percent of LGB individuals participating in a nationally representative study of the U.S. population reported at least one form of workplace discrimination (e.g., harassment at work, lost a job) during their lifetime and 27% had experienced workplace discrimination within the prior five years.^[5] The U.S. Transgender Survey of 2015 revealed that 14% of participants experienced unequal treatment or services in public spaces, such as retail stores, busses, trains, taxis, and rape crisis centers, within the prior year because of their transgender identity or expression.^[6]

Furthermore, research has found that LGBTQ+ individuals had high rates of many of other types of stressful, and potentially traumatic, experiences, including bullying, the loss of a loved one, and homelessness. A national school climate survey of LGBTQ+ youth found 74% of LGBT youth had been a victim of verbal harassment within the prior year.^[7] One study found that being victimized may to lead to a higher incidence of suicidality among LGBTQ+ youth.^[8] Studies also suggest that 20% to 45% of homeless youth are LGBTQ, a percentage that is two to four times higher than the total number of estimated LGBTQ youth.^[9]

While there is robust literature on the prevalence of traumatic experiences among LGBTQ+ individuals, this study provides much needed information on the prevalence of victimization, discrimination, and other stressful life experiences of LGBTQ+ victims in Illinois. Study findings can demonstrate this population’s need for services and supports, including those that are trauma-informed and/or help victims heal from trauma.

Method

Procedure

We employed convenience sampling to recruit survey participants. Recruitment methods included emailing LGBTQ+ and allied service providers, distributing study flyers, and posting study information on social media and Craigslist. Participants were screened by phone or online via Qualtrics, an online survey platform. Eligible participants were Illinois residents aged 18 years or older who identified as LGBTQ+ and had experienced physical and/or sexual harm in their lifetimes. Surveys were administered online using Qualtrics or via paper copy, which was mailed to them. Respondents were offered a gift card for participation.

Measures

The present study analyzed data across four domains: victimization, hate-motivated victimization, discrimination, and other stressful experiences.

Victimization

We asked participants to report whether they had experienced any of 15 different victimization types at various points in their lifetimes or life stages. This included experiences with community, sexual, and domestic, and other types of violence, such as arson or injury resulting from impaired driving. For each item, a description of a victimization experience was given (e.g., Physical force was used against me in a robbery or mugging) and participants were asked to report at what age the experience occurred: as a child under 12 years old; youth, aged 12-20; adult, aged 21-59; and/or older adult at 60 years or older.

Have-Motivated Victimization

To assess whether participants’ victimization experiences were motived by hate, we asked participants if, for each type reported, they suspected the victimization was a hate crime or a crime of prejudice or bigotry. In addition, participants were asked to indicate whether they were targeted because of their race, religion, ethnic or national origin, disability, gender identity, gender expression, and/or sexual orientation.

Discrimination

We asked participants to indicate whether they had experienced any of five forms of discrimination in their lifetimes, including unfair discipline at work or school; unfair employment practices; unfair medical treatment; unfair treatment by realtors, landlords, or neighbors; and unfair treatment by law enforcement. Participants were also asked to indicate whether they thought their race, religion, ethnic or national origin, disability, gender identity, gender expression, and/or sexual orientation was the main reason(s) for each experience.

Other Stressful Experiences

We asked participants to report occurrences of any of 11 different stressful experiences in their lifetimes, including bullying, loss of a close friend or family due to suicide, and financial crime. They were also asked to describe any other extremely distressing experiences that had not been reported elsewhere in the survey.

Sample

We had a final sample of 212 survey responses. The average age of participants was 31 years old. Most participants resided in Cook County (58.0%), identified as White (67.9%), and had received postsecondary education and training, and reported a household income of less than $50,000 (58.6%).

Participants represented different gender identities (Table 1) and sexual orientation. For sexual orientation, participants were asked to select only one response option. They identified as gay or lesbian (45.8%), bisexual (40.6%), or heterosexual or straight (1.9%). Twenty-five participants did not report their sexual orientations.

Table 1

Number and Percentage of LGBTQ+ Participants’ Self-Reported Gender Identity (N = 212)

Analytic Strategy

We analyzed the dataset using IBM SPSS Statistics, Version 19.0. Frequencies were calculated for nominal variables (e.g., robbery, housing discrimination, bullying) and percentages reported for participants who endorsed a given traumatic experience. Bivariate analyses (i.e., chi-square and independent sample t-tests) were conducted to test if there were differences in participants’ reporting of trauma types by LGBTQ+ identity (i.e., cisgender compared to transgender/gender non-conforming and gay/lesbian compared to bisexual participants).

Limitations

There were some limitations to the findings of this study. The study was conducted with a non-representative sample of LGBTQ+ victims in Illinois and may have been limited by self-report bias and memory recall issues. Despite being consistent with best practices for capturing sexual orientation,^[10] responses provided for this item did not capture the nuanced sexual orientation options. We also made changes to the participation methods due to survey fraud which may have inadvertently discouraged some from participating. Finally, we may have removed some valid survey responses from the dataset because we suspected fraud and/or were unable to confirm participation, but this was necessary to ensure the validity of responses included in the analysis.

Findings

Victimization

Participants reported experiencing an average of six victimization types, ranging from one to 14, in their lifetimes (SD = 3.03). The most common types of victimizations they had experienced during their lifetimes were sexual abuse, family verbal abuse, stalking, verbal intimate partner violence, and sexual assault (Figure 1). Far fewer reported robbery, being injured as a result of impaired driving, kidnapping, human trafficking, or arson. They were most likely to report experiencing victimization as a youth than at any other life stage (88.2%). More participants reported experiencing family verbal abuse as children and youth than other forms of victimization at 48.6% and 54.7%, respectively. Stalking was the most common victimization type participants experienced as an adult (43.2%).

Figure 1

Percentages of LGBTQ+ Participants’ Self-Reported Victimization, by Victimization Type TYPE (N = 212)

Victimization Motivated by Hate

Two-thirds of participants (66.5%) reported experiencing a victimization motivated by hate during their lifetime due to disability, LGBTQ+ identity, race/ethnicity, and/or religion. Participants were most likely to report family verbal abuse motivated by hate (31.1%) than any other hate-motivated victimization type. A majority of participants reported experiencing a hate-motivated victimization resulting from their LGBTQ+ identity (63.2%). Of participants who had experienced a hate-motivated victimization, 95% reported the victimization was motivated by their LGBTQ+ identity. Regardless of the victimization type, participants were most likely to attribute the hate-motivated victimization to their LGBTQ+ identity than to any other motivating factor. Across all types of hate-motivated victimization participants reported as being motivated by LGBTQ+ identity, more endorsed family verbal abuse (24.5%) than any other victimization type.

Discrimination

More than half of survey participants reported experiencing at least one of five forms of discrimination in their lifetimes (57.1%) and about half reported experiencing discrimination because of their LGBTQ+ identity (Figure 2). Unfair discipline at work or school was the most common form of discrimination reported (36.3%). More participants reported that each form of discrimination was due to their LGBTQ+ identity than to any other motivating factor. An analysis of differences by gender identity found that more than three times as many transgender or gender non-conforming participants reported unfair medical treatment as cisgender participants at 38.2% and 10.7%, respectively.

Figure 2

Percentages of LGBTQ+ Participants Who Self-Reported Discrimination, by Motivating Factor (N = 212)

Other Stressful Experiences

Participants reported experiencing an average of three stressful experiences, ranging from zero to 10, in their lifetimes (SD = 2.13). Being bullied at school, at work, or electronically was the most commonly experienced stressful experience, followed by someone threatening to tell others about participants’ LGBTQ+ identity without permission (Figure 3). About one in five participants (21.2%) described other experiences they found to be extremely distressing, including medical and faith-related trauma and distress due to a parent or close friend’s mental health disorder. Analyses of differences by sexual orientation and gender identity revealed gay and lesbian participants were more likely to report that someone had threatened to tell others about their LGBTQ+ identity without permission (57.8%) and to have experienced homelessness (35.7%), an eviction (36.5%), or “couch surfing” (i.e., living with others when homeless) (22.1%) than bisexual participants. In addition, transgender and gender non-conforming participants were more likely to indicate that a close family member, intimate partner, or friend died from suicide (45.9%) than cisgender participants (25.4%).

Figure 3

Percentages of LGBTQ+ Participants Who Self-Reported Other Stressful Experiences (N = 212)

Discussion and Recommendations for Policy and Future Research

Provide Trauma-Informed Services and Supports to LGBTQ+ Youth

In the present study, we found that LGBTQ+ victims were most vulnerable to victimization as youth aged 12 to 20. Due to the high prevalence of trauma among LGBTQ+ youth, the National Resource Center for Mental Health Promotion and Youth Violence Prevention recommends that schools and community-based agencies serving this population adopt a trauma-informed approach and offers guidance for doing so.^[11] To better support youth victims, service providers can offer school-based services to reduce barriers to access and teen-focused programs or interventions.^[12] Examples of approaches that may be well received by youth include teen-staffed hotlines and opportunities to express their experiences through journaling, drama, and art. Victim service agencies can better serve LGBTQ+ youth by expanding their partnerships and/or referral networks to include both LGBTQ+ and youth organizations.

Train Law Enforcement to Appropriately Respond to Sexual and Hate-Motivated Victimization of LGBTQ+ Individuals

Study participants reported experiencing high rates of sexual violence, most reported experiencing an LGBTQ+ hate-motivated victimization during their lifetime, and nearly all who had experienced a hate-motivated victimization were targeted due to their LGBTQ+ identity. However, the present study sampled only LGBTQ+ victims, which could explain why participants reported more LGBTQ+ hate-motivated than racially or ethnically hate-motivated victimization. Nationally representative studies of victimization estimate that 33.9% to 41% of sexual violence victims report to law enforcement^[13] and that 40% of hate crimes are reported to law enforcement,^[14] suggesting law enforcement may be likely to encounter LGBTQ+ victims who have experienced these victimization types.

Law enforcement training on LGBTQ+ topics can better prepare officers to respond to LGBTQ+ victims. The National Resource Center for Reaching Victims and FORGE, an organization committed to providing services to transgender/non-binary and training resources, have outlined topics for inclusion in law enforcement training.^[15] All officers should receive training^[16] and, when possible, training should be co-developed and co-facilitated by law enforcement and LGBTQ+ subject matter experts from the community.^[17]

Prevent LGBTQ+ Hate-Motivated Discrimination in Work and School Settings

About half of participants reported experiencing several forms of discrimination because of their LGBTQ+ identities and were most likely to have experienced discrimination in a work or school setting. To help prevent LGBTQ+ hate-motivated discrimination, employers and educators should develop and implement policies that protect employees and students from discriminatory practices regardless of their sexual orientation or gender identity and assess impacts of any existing or new policies and practices. Employers can review discrimination and harassment policies to confirm they include protections for LGBTQ+ employees.^[18] Schools can examine their policies and procedures to ensure supports are in place for LGBTQ+ students, including involving educators who are LGBTQ+ allies, building in curriculum that incorporates LGBTQ+ history,^[19] and identifying ways to bolster efforts.

Adopt Gender Affirming and Trauma-Informed Practices in Healthcare Services

In the present study, transgender and gender non-conforming participants were more likely than cisgender participants to experience unfair medical treatment. Healthcare providers should take steps toward providing equitable care for all regardless of gender identity and integrate trauma-informed practices to effectively respond to the experiences and needs of transgender and gender non-conforming clients. This may include creating safe and gender-affirming environments by asking clients preferred names and gender pronouns, using less gendered terms to refer to human anatomy or terms used by client,^[20] and updating forms and bathroom signage to be gender inclusive.^[21] Providers should also solicit feedback from transgender and gender non-conforming clients on how to adapt their practices to be more responsive^[22] and acknowledge when care falls short of being gender inclusive.

Conduct Additional Research on Trauma Among LGBTQ+ Victims

Over two-thirds of participants reported bullying. Past research has shown that past victimization or trauma can put individuals at increased risk of future victimization^[23] and that those who have experienced different victimization types are more likely to have experienced a serious victimization and to have more trauma symptoms.^[24] Future research is needed on direct and indirect relationships between bullying and victimization. Research on LGBTQ+ victims’ experiences with self-described medical trauma, faith-based trauma, or extreme distress due to a loved one’s mental health disorder is scarce and more studies are needed to better understand these extreme stressors, their impacts, and relationship to other trauma.

Conclusion

Participants reported experiencing multiple forms of victimization and other trauma, including discrimination and other stressful experiences. We found some differences by LGBTQ+ identity, including that transgender and gender non-conforming participants were more likely to report unfair medical treatment than cisgender participants. LGBTQ+ victims require culturally sensitive support from institutions, systems, social and victim service agencies, and informal support sources as they work towards meaningful recovery from trauma. Direct service providers, funders, researchers, and others can collaborate to help LGBTQ+ victims heal.