Many studies have helped demonstrate that LGBTI people, often faced with rejection and violence related to their sexuality or gender identity, are at greater risk of developing post-traumatic stress disorder. Indeed, as the disorder is defined, they are regularly confronted with different forms of violence that generate intense stress.
LGBTI people are at greater risk of having anxiety and depressive symptoms. In addition, several studies have looked at the prevalence of post-traumatic stress disorder among those affected. These studies have shown that people from the community are more likely to develop post-traumatic stress disorder (PTSD).
Indeed, it is observed among sexual minorities that the prevalence of developing the disorder is between 15% and 20% of all people combined with an explosion among transgender people with a prevalence between 35% and 47% of developing PTSD - the highest rate among all populations combined - thus, the prevalence of PTSD is lower among military personnel and veterans (William Peraud, 2024).
To explain this prevalence, we can first cite Meyer's theory which developed the term minority stress, which describes that minority people are more likely to develop PTSD. Minority Stress Theory (2003) suggests that sexual minority populations are more likely to experience negative mental health problems due to the stigma associated with sexual minority status. Individuals who identify with sexual minorities are therefore more likely to experience mental health difficulties and resort to inadequate coping mechanisms.
All forms of aggression that LGBTI people experience during their lives (physical, verbal and sexual violence, family and school rejection, employment discrimination, difficult access to care) create stress reactions for victims. Facing numerous aggressions, insults and violence, LGBTI people meet the definition of PTSD: being exposed (as a witness or victim) to violent acts generating extreme stress. When the victim finds themselves vulnerable and helpless, the usual defense mechanisms are overwhelmed. Being confronted with a state of stress will weaken the body, promoting the appearance of pathologies. Associated pathologies can be somatic: hypertension, atherosclerosis, cardiovascular diseases, constipation, colitis, gastroenteric disorders, diabetes, obesity, death and/or psychological: indifference, introversion, passivity, resignation, depression, anorexia nervosa and anxiety disorders. Socio-professional behavioral disorders can also develop: irritability, increased risk of accidents, inadequate response strategy or lack of response.
Other than the explanatory factors of stress, the factors related to PTSD symptoms that stand out the most for LGBTI people are exposure to potentially traumatic events such as hate crimes and violence, the perception of the event and individual vulnerability or gender transition. Indeed, we note that when transgender people transition (socially and/or medically) this exposes them to even more discrimination and violence, which generates an increase in PTSD symptoms. It is important to remember that it is not the transition itself that increases the risk of PTSD but the rejection and societal violence that transgender people face (William Peraud, 2024).
In its annual report on LGBT phobias, based on testimonies, SOS Homophobie warns of a spread of transphobic speech and an alarming increase in ambushes. Among the cases recorded in 2023, 500 acts are transphobic compared to 227 the previous year. "Since 2020, transphobia has been on the rise," says the association, which denounces a "wave".
Last year, SOS Homophobie warned of "an explosion of violence" against trans people. The association points out that these transphobic behaviors have harmful effects on the lives of trans people in France, that they make them precarious, and threaten their integrity and health. In addition to the prevalence of PTSD, there is also a prevalence of suicide among this community: 1 in 3 transgender people have already attempted suicide, this figure is the highest among all populations combined.
In addition to being socially confronted with hatred and discrimination, being exposed to barriers in accessing care (words, behavior, fear) is also a real issue in the community because it increases the risks of developing PTSD. This is reflected, for example, by not consulting a psychologist following an assault for fear of being discriminated against, which will increase the risk of acute stress symptoms developing into PTSD. Acute stress is a normal reaction to a stressful event, it lasts about 1 month, however if the physiological, behavioral and psychological reactions persist beyond four weeks, we then speak of PTSD.
Among the other risks that can increase the prevalence of PTSD, we find the fact of having come out and therefore being open about one's sexual orientation - this will expose one more to LGBTIphobic violence. And finally the political context also influences the factors of PTSD in LGBTI people, in fact, an unfavorable political environment in access to transitions as well as restrictive and homophobic laws will increase the risk of developing PTSD or even complex PTSD.
Chloé ROSATI,
Psychopractitioner
Bibliography:
Afp, L. M. A. (2024, 14 mai). La violence à l’encontre des personnes LGBT+ au plus haut en Europe. Le Monde.fr. https://www.lemonde.fr/societe/article/2024/05/14/la-violence-a-l-encontre-des-personnes-lgbt-au-plus-haut-en-europe_6233133_3224.html
Alfonsi, M., & Afp, A. (2024, 16 mai). SOS Homophobie alerte sur une « vague de transphobie » en France : « Les braises de la LGBTIphobie sont allumées ». Le HuffPost. https://www.huffingtonpost.fr/life/article/sos-homophobie-alerte-sur-une-vague-de-transphobie-en-france-les-braises-de-la-lgbtiphobie-sont-allumees_233969.html
David Bourguignon, Jacques Berent, Nada Negraoui (2018), Psychologie de la discrimination et des préjugés
William Peraud (2024). Webinaire : Les TSPT chez les personnes LGBTQIA+ - L'Association Française du Psychotraumatisme et de la Résilience (AFPR)
Rapport sur les LGBTIphobies, 2024. SOS homophobie. https://ressource.sos-homophobie.org/Rapports_annuels/Rapport_LGBTIphobies_2024.pdf
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