Trauma, Resilience, and Health Promotion in LGBT Patients: What Every Healthcare Provider Should Know
Eckstrand, K.L., & Potter, J. (Eds.)
254 pp. $109
Review By Jared Boot, MA and Nadeen Majeed MA
“Trauma, Resilience, and Health Promotion in LGBT Patients: What Every Healthcare Provider Should Know” addresses the complex reality of how LGBT experience heterosexism and how that affects their health. Eckstrand and Potter (2017) present an exceptional text for clinicians such as mental health professionals, medical doctors, and nurses who work with trauma and the LGBT community; it aims to develop interdisciplinary teams of trauma-informed professionals. The layout of the textbook is easy to read and includes valuable pictures and tables that help the reader navigate and further recognize crucial concepts. The editors split the book into four sections, with chapters written by multiple authors. Trauma throughout the textbook is explained in a way that a reader from any discipline can comprehend. If a reader has not worked with trauma before, they could use this text as a guide to improving the overall health and well-being of LGBT patients. The well-being of clients is enhanced because the overall aim of the text is to normalize rather than pathologize the LGBT experience.
The first section of the book, “Overview of Trauma in LGBT Populations,” introduces the concept of trauma and how it relates to LGBT patients. The identity of a patient is a large part of who they are, and they experience situations that cause more stress — described through the minority stress model explained in the textbook. The authors do not assume that the reader is fully aware of everything about the minority stress model and the combination of internal and external stressors that places LGBT individuals at higher risk for health disparities. This clarity and the explicit definitions used helps make sure that everyone understands the experiences of LGBT patients in the book going forward. The biology of stress is also explained to demonstrate how the negative life experiences and resultant trauma faced by LGBT individuals cause physiological changes and trauma that make them more susceptible to mental health concerns. Due to the currently narrow definition of PTSD in the DSM-V, it could have been beneficial if the editors had reiterated throughout the text how the consequences of events the LGBT community lives through daily fall under the definition of trauma.
The second section, titled “Resilience Across the Lifespan,” addresses how resilience could influence patients throughout different phases of their lives and across generations. For example, youth in the LGBT community have different experiences than people of other ages. The text describes a broader sense of being able to reach out for social support using technology, and this helps LGBT youth recognize other individuals as similar to them. Importantly, the text points out how this experience contrasts with the experience of older adults in the LGBT community. When working with older patients, it is crucial to address their unique experiences of living through another era. The “Older Adults” section is an especially beneficial chapter for younger clinicians. Younger clinicians may be unaware of the isolating impact of the unique and forgotten experience that older LGBT adults lived.
The third section of the book titled “The Resilience of Specific Populations,” also addresses resilience; it outlined the resilience of sub demographics of LGBT people in the face of overwhelming adversity. It was great to see a focus on positive resilience attributes since, often, there is a tendency to focus exclusively on the negative consequences of adversity. This section of the text highlights the daunting statistics faced by transgender, gender nonconforming, LGBT people of color, LGBT migrants, LB women, and LGBT institutionalized and incarcerated populations. Nevertheless, from a feminist perspective, this section also highlights how healthcare providers can empower LGBT clients by helping them focus on their strengths that have helped them survive despite the odds. Additionally, from a positive psychology perspective, the focus on resilience can foster further post-traumatic growth for these populations.
The final section of the book was particularly useful. This section extensively focused on resources available to LGBT patients. The resources applied to every stage of life for the LGBT patient and all aspects of their lives (e.g., safe spiritual spaces, crisis hotlines). Also, the final chapter recommended a list of organizations for LGBT clinicians, such as the Society for the Psychological Study of Sexual Orientation and Gender Identity (Division 44). These resources are vital for LGBT clinicians considering their own experiences of prejudice and discrimination (i.e., trauma). The resources are especially significant, given that they may help mitigate compassion fatigue.
Jared Boot, MA, TLLP is a second-year PsyD student at the Michigan School of Psychology (MSP), studying clinical psychology. On-campus, Jared has served as a student ambassador, has held multiple board positions through the Inclusion, Diversity, and Equity Alliance (IDEA), and is the current treasurer of Psi Chi. Jared’s research interests are scale development to assess stigma among emerging gender and sexual minorities and the development of cultural competency training for rural clinicians that work with transgender and gender nonconforming clients. In addition to his student affiliate status through the APA, he is the vice-chair of the World Professionals Association for Transgender Health (WPATH) Student Initiative. Jared also serves on the Health Professionals Advancing LGBTQ Equality (GLMA) Health Professionals in Training Curricular Reform Committee.
Nadeen Majeed, MA, TLLP, is a second-year PsyD student studying clinical psychology at the Michigan School of Psychology (MSP). Nadeen served as student ambassador at MSP, is a member of the Inclusion, Diversity, and Equity Alliance (IDEA), Chair of the Psi Chi Research Symposium, and a member of the Psi Chi Philanthropy Committee. Nadeen’s research interest include trauma stewardship and children’s health psychology. Nadeen is passionate about working with refugees and minimizing health disparities of minority groups. She is a student affiliate of the APA and the Trauma Psychology Division 56.