Keynote: “Consequences of Adverse Childhood Experiences in LGBT and Heterosexual Population”
In the last two decades, our understanding of psychological trauma and its sequelae has expanded considerably, and it is now recognized that a broader set of negative experiences can impact upon one’s functioning in more diversified ways. The seminal studies on the effects of Adverse Childhood Experiences (ACEs) have played a crucial role in advancing our conceptualization of the post-traumatic spectrum.
Specifically, research has shown that being a member of the LGB (Lesbian, Gay and Bisexual) population can expose an individual to a complex combination of long-standing stressors, including harassment, social exclusion, discrimination, stigma, physical, sexual and emotional abuse. Furthermore, in LGB individuals the effects of these experiences can interact with the challenges of coming out and socially negotiating their identities. Some sexual abuse survivals who identify as LGB may also struggle with differentiating their sexual orientation from the consequences of the abuse on their sexuality, such as when presenting with an Imprinted Arousal Pattern. All these aspects are complicated by a cultural context (heteronormativity) that devalues or actively punished non-heterosexual orientations. The minority stress model highlighted how this unique combination of vulnerabilities results in LGB people reporting poorer psychological, physical and socioeconomic outcomes compared to their heterosexual counterparts. Moving beyond the emphasis on internalized homophobia, recent developments have focused on the cumulative impact of homophobia-related traumas, as well as the risk associated with gender-nonconforming behaviors and presentations from an early age. Nonetheless, ACEs and their consequences have remained largely unexplored in the Italian LGB population. It is imperative for clinicians to further their understanding of these pathways of risk for LGB individuals, as well as barriers that prevent their access to mental health services, with a view of providing effective and affirmative care.
This presentation includes the findings of three empirical studies in an Italian sample, which were aimed at exploring: a) the prevalence of the three clusters of ACEs (Abuse, Neglect and Household Dysfunctions) in LGB versus heterosexual adults; b) the association between exposure to ACEs and level of gender-nonconformity in LGB versus heterosexual adults; and c) the relationship between exposure to ACEs and psychological treatment-seeking in LGB versus heterosexual adults.
Furthermore, the importance of a trauma-informed assessment phase with LGB patients will be discussed, with particular attention to recognizing the consequences of complex traumatic experiences beyond the traditional diagnosis of post-traumatic stress disorder. To follow, clinical implications will be explored, including by discussing how to apply and adapt evidence-based interventions from a cognitive-behavioral perspective, with the aim to successfully meet the specific needs of these patients group. Finally, strategies to overcome the barriers to seeking and accessing psychological help for LGB individuals will be considered.