Kilpatrick DG, Resnick HS, Milanak ME, Miller MW, Keyes KM, Friedman MJ. National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. J Trauma Stress. 2013;26(5):537–47. https://doi.org/10.1002/jts.21848.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, (5th ed.). Washington; 2013.
Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(7):709. https://doi.org/10.1001/archpsyc.62.6.617.
Beckman K, Shipherd J, Simpson T, Lehavot K. Military sexual assault in transgender veterans: results from a nationwide survey. J Trauma Stress. 2018;31(2):181–90. https://doi.org/10.1002/jts.22280.Additional cultural context of added disparity.
Henry RS, Perrin PB, Coston BM, Calton JM. Intimate partner violence and mental health among transgender/gender nonconforming adults. J Interpers Violence 2018:1–26. Doi: https://doi.org/10.1177/0886260518775148.
Seelman KL, Woodford MR, Nicolazzo Z. Victimization and microaggressions targeting LGBTQ college students: gender identity as a moderator of psychological distress. J Ethn Cult Divers Soc Work. 2017;26(1–2):112–25. https://doi.org/10.1080/15313204.2016.1263816.
Fernández-Rouco N, Fernández-Fuertes AA, Carcedo RJ, Lázaro-Visa S, Gómez-Pérez E. Sexual violence history and welfare in transgender people. J Interpers Violence. 2017;32(19):2885–907. https://doi.org/10.1177/0886260516657911.
D’Augelli A, Grossman AH, Starks MT. Childhood gender atypicality, victimization, and PTSD among lesbian, gay, and bisexual youth. J Interpers Violence. 2006;21(11):1462–82. https://doi.org/10.1177/0886260506293482.
Gilman SE, Cochran SD, Mays VM, Hughes M, Ostrow D, Kessler RC. Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. Am J Public Health. 2001;91(6):933–9. https://doi.org/10.2105/ajph.91.6.933.
Roberts AL, Austin SB, Corliss HL, Vandermorris AK, Koenen KC. Pervasive trauma exposure among US sexual orientation minority adults and risk of posttraumatic stress disorder. Am J Public Health. 2010;100(12):2433–41. https://doi.org/10.2105/AJPH.2009.168971.
Roberts AL, Rosario M, Corliss HL, Koenen KC, Austin SB. Childhood gender nonconformity: a risk indicator for childhood abuse and posttraumatic stress in youth. Pediatrics. 2012;129(3):410–7. https://doi.org/10.1542/peds.2011-1804.
Shipherd JC, Maguen S, Skidmore WC, Abramovitz SM. Potentially traumatic events in a transgender sample: frequency and associated symptoms. Traumatology. 2011;17(2):56–67. https://doi.org/10.1177/1534765610395614.
Valera RJ, Sawyer RG, Schiraldi GR. Perceived health needs of inner-city street prostitutes: a preliminary study. Am J Health Behav. 2001;25(1):50–9. https://doi.org/10.5993/ajhb.25.1.6.
Whitbeck LB, Chen X, Hoyt DR, Tyler KA, Johnson KD. Mental disorder, subsistence strategies, and victimization among gay, lesbian, and bisexual homeless and runaway adolescents. J Sex Res. 2004;41(4):329–42. https://doi.org/10.1080/00224490409552240.
Fortin AH, Dwamena FC, Frankel RM. Smith's patient-centered interviewing: an evidence-based method. New York: McGraw-Hill Medical; 2012.
Martell CR, Williams ME. The social context of clinical practice with sexual minority clients: commentary on the special issue. Cogn Behav Pract. 2019;26(2):300–6. https://doi.org/10.1016/j.cbpra.2018.12.001.
•• Puckett J. An ecological approach to therapy with gender minorities. Cogn Behav Pract. 2019;26(4):647–55. https://doi.org/10.1016/j.cbpra.2019.08.002 Important review and commentary on addressing the healthcare needs of transgender and gender diverse (TGD) patients across micro, mezzo, and macro-level spheres, corresponding to the individual, local/community, and state or national policy levels, respectively.
Shipherd JC. Defining competence when working with sexual and gender minority populations: training models for professional development. Clin Psychol. 2015;22(2):101–4. https://doi.org/10.1111/cpsp.12100.
Ong LM, de Haes JC, Hoos AM, Lammes FB. Doctor-patient communication: a review of the literature. Soc Sci Med. 1995;40(7):903–18. https://doi.org/10.1016/0277-9536(94)00155-m.
Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97. https://doi.org/10.1037/0033-2909.129.5.674.
• O'Cleirigh C, Safren SA, Taylor SW, Goshe BM, Bedoya CA, Marquez SM, et al. Cognitive behavioral therapy for trauma and self-care (CBT-TSC) in men who have sex with men with a history of childhood sexual abuse: a randomized controlled trial. AIDS Behav. 2019;23(9):2421–31. https://doi.org/10.1007/s10461-019-02482-z First trauma-focused intervention designed for men who have sex with me.
Riggs DW, Treharne GJ. Decompensation: a novel approach to accounting for stress arising from the effects of ideology and social norms. J Homosex. 2017;64(5):592–605. https://doi.org/10.1080/00918369.2016.1194116.
Livingston NA, Flentje A, Heck NC, Szalda-Petree A, Cochran BN. Ecological momentary assessment of daily discrimination experiences and nicotine, alcohol, and drug use among sexual and gender minority individuals. J Consult Clin Psychol. 2017;85(12):1131–43. https://doi.org/10.1037/ccp0000252.
Pachankis JE. The psychological implications of concealing a stigma: a cognitive-affective-behavioral model. Psychol Bull. 2007;133(2):328–45. https://doi.org/10.1037/0033-2909.133.2.328.
Hatzenbuehler ML. How does sexual minority stigma "get under the skin"? A psychological mediation framework. Psychol Bull. 2009;135(5):707–30. https://doi.org/10.1037/a0016441.
Eldahan AI, Pachankis JE, Jonathon Rendina H, Ventuneac A, Grov C, Parsons JT. Daily minority stress and affect among gay and bisexual men: a 30-day diary study. J Affect Disord. 2016;190:828–35. https://doi.org/10.1016/j.jad.2015.10.066.
• Dworkin ER, Gilmore AK, Bedard-Gilligan M, Lehavot K, Guttmannova K, Kaysen D. Predicting PTSD severity from experiences of trauma and heterosexism in lesbian and bisexual women: a longitudinal study of cognitive mediators. J Couns Psychol. 2018;65(3):324–33. https://doi.org/10.1037/cou0000287 Longitudinal study of the effects of trauma and minority stressors (e.g., discrimination) on proximal stressors (e.g., shame, internalized heterosexism) and PTSD symptoms among sexual minority individuals.
Rood BA, Reisner SL, Surace FI, Puckett JA, Maroney MR, Pantalone DW. Expecting rejection: understanding the minority stress experiences of transgender and gender-nonconforming individuals. Transgend Health. 2016;1(1):151–64. https://doi.org/10.1089/trgh.2016.0012.
•• Livingston NA, Berke DS, Ruben MA, Matza AR, Shipherd JC. Experiences of trauma, discrimination, microaggressions, and minority stress among trauma-exposed LGBT veterans: unexpected findings and unresolved service gaps. Psychol Trauma. 2019;11(7):695–703. https://doi.org/10.1037/tra0000464 Qualitative account of LGBTQ veterans’ intersecting and overlapping experiences of trauma, discrimination, microaggressions, and related PTSD and other mental health symptom sequelae. The results of this study highlight the complex, overlapping, and intersectional nature of trauma and minority stress, as well as important cultural factors and treatment implications relevant to the care of LGBTQ veterans.
Berke DS, Maples-Keller JL, Richards P. LGBTQ perceptions of psychotherapy: a consensual qualitative analysis. Prof Psychol Res Pract. 2016;47(6):373–82. https://doi.org/10.1037/pro0000099.
Ruben MA, Fullerton M. Proportion of patients who disclose their sexual orientation to healthcare providers and its relationship to patient outcomes: a meta-analysis and review. Patient Educ Couns. 2018;101(9):1549–60. https://doi.org/10.1016/j.pec.2018.05.001.
Bolderston A, Ralph S. Improving the health care experiences of lesbian, gay, bisexual and transgender patients. Radiography. 2016;22(3):e207–11. https://doi.org/10.1016/j.radi.2016.04.011.
Ruben MA, Livingston NA, Berke DS, Matza AR, Shipherd JC. Lesbian, gay, bisexual, and transgender veterans' experiences of discrimination in health care and their relation to health outcomes: a pilot study examining the moderating role of provider communication. Health Equity. 2019;3(1):480–8. https://doi.org/10.1089/heq.2019.0069.
Heisler M, Bouknight RR, Hayward RA, Smith DM, Kerr EA. The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management. J Gen Intern Med. 2002;17(4):243–52. https://doi.org/10.1046/j.1525-1497.2002.10905.x.
Ruben MA, Blosnich JR, Dichter ME, Luscri L, Shipherd JC. Will veterans answer sexual orientation and gender identity questions? Med Care. 2017;55(Suppl 9 Suppl 2):S85–9. https://doi.org/10.1097/MLR.0000000000000744.
Shipherd J, Sloan C. The therapy room and beyond: necessary action when working with gender minority people. Cogn Behav Pract. 2019;26(4):589–91. https://doi.org/10.1016/j.cbpra.2019.07.011.
Sloan C, Shipherd J. An ethical imperative: effectively reducing SGM disparities utilizing a multi-level intervention approach. Cogn Behav Pract. 2019;26(2):239–42. https://doi.org/10.1016/j.cbpra.2019.02.001.
Weathers FW, Bovin MJ, Lee DJ, Sloan DM, Schnurr PP, Kaloupek DG, et al. The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): development and initial psychometric evaluation in military veterans. Psychol Assess. 2018;30(3):383–95. https://doi.org/10.1037/pas0000486.
Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD Checklist for DSM–5 (PCL-5). http://www.ptsd.va.gov. Published 2013. Accessed November 4, 2019.
Foa EB, Hembree EA, Rothbaum BO. Prolonged exposure therapy for PTSD. New York: Oxford University Press; 2007.
•• Resick PA, Monson CM, Chard KM. Cognitive processing therapy for PTSD. New York: Guilford Press Publications; 2017. Updated manual for Cognitive Processing Therapy which, along with Prolonged Exposure therapy, is a front-line trauma-focused therapy recommended by the American Psychological Association.
American Psychological Association. PTSD treatments. https://www.apa.org/ptsdguideline/treatments/index.aspx. Published 2017. Accessed November 4, 2019.Practice recommendations published to highlight which PTSD treatments currently have the best scientific evidence to support their effectiveness, and recommendations for which interventions to use when working with patients with PTSD.
National Center for PTSD. PTSD: National Center for PTSD. http://www.ptsd.va.gov. Published 2019. Accessed November 4, 2019.
Kelmendi B, Adams TG, Southwick S, Abdallah CG, Krystal JH. Posttraumatic stress disorder: an integrated overview of the neurobiological rationale for pharmacology. Clin Psychol. 2017;24(3):281–97. https://doi.org/10.1111/cpsp.12202.
Heck NC, Mirabito LA, LeMaire K, Livingston NA, Flentje A. Omitted data in randomized controlled trials for anxiety and depression: a systematic review of the inclusion of sexual orientation and gender identity. J Consult Clin Psychol. 2017;85(1):72–6. https://doi.org/10.1037/ccp0000123.
•• Shipherd J, Berke D, Livingston N. Trauma recovery in the transgender and gender diverse (TGD) community: extensions of the minority stress model for treatment planning. Cogn Behav Pract. 2019;26(4):629–46. https://doi.org/10.1016/j.cbpra.2019.06.001. Clinical review article focused on the treatment of minority stress, PTSD, and related mental health concerns (e.g., substance use, depression, sleep disturbance) among TGD individuals. Discussion revolves around current practices and future recommendations for prevention and intervention strategies spanning micro (e.g., individual therapy), mezzo (e.g., creating inclusive clinics), and macro spheres (e.g., improving legal protections for TGD individuals).
Steenkamp MM, Nash WP, Lebowitz L, Litz BT. How best to treat deployment-related guilt and shame: commentary on Smith, Duax, and Rauch. Cogn Behav Pract. 2013;20(4):471–5. https://doi.org/10.1016/j.cbpra.2013.05.002.
McEwen B. Allostasis and allostatic load: implications for neuropsychopharmacology. Neuropsychopharmacol. 2000;22:108–24. https://doi.org/10.1016/S0893-133X(99)00129-3.
Fredriksen-Goldsen KI, Kim H-J, Bryan AEB, Shiu C, Emlet CA. The cascading effects of marginalization and pathways of resilience in attaining good health among LGBT older adults. Gerontologist. 2017;57(Suppl 1):S72–83. https://doi.org/10.1093/geront/gnw170.
Livingston NA, Flentje A, Brennan J, Mereish E, Reed O, Cochran B. Real-time associations between discrimination and anxious and depressed mood among sexual and gender minorities: the moderating effects of lifetime victimization and identity concealment. Psychol Sex Orientat Gend Divers In press.
Stein JY, Wilmot DV, Solomon Z. Does one size fit all? Nosological, clinical, and scientific implications of variations in PTSD criterion A. J Anxiety Disord. 2016;43:106–17. https://doi.org/10.1016/j.janxdis.2016.07.001.
Ngamake ST, Walch SE, Raveepatarakul J. Discrimination and sexual minority mental health: mediation and moderation effects of coping. Psychol Sex Orientat Gend Divers. 2016;3(2):213–26. https://doi.org/10.1037/sgd0000163.
Foa EB, Kozak MJ. Emotional processing of fear: exposure to corrective information. Psychol Bull. 1986;99(1):20–35. https://doi.org/10.1037/0033-2909.99.1.20.
Wisco BE, Baker AS, Sloan DM. Mechanisms of change in written exposure treatment of posttraumatic stress disorder. Behav Ther. 2016;47(1):66–74. https://doi.org/10.1016/j.beth.2015.09.005.
Kaysen D, Lostutter TW, Goines MA. Cognitive processing therapy for acute stress disorder resulting from an anti-gay assault. Cogn Behav Pract. 2005;12(3):278–89. https://doi.org/10.1016/s1077-7229(05)80050-1.
Pachankis JE, Hatzenbuehler ML, Rendina HJ, Safren SA, Parsons JT. LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: a randomized controlled trial of a transdiagnostic minority stress approach. J Consult Clin Psychol. 2015;83(5):875–89. https://doi.org/10.1037/ccp0000037.
• Parsons JT, Rendina HJ, Moody RL, Gurung S, Starks TJ, Pachankis JE. Feasibility of an emotion regulation intervention to improve mental health and reduce HIV transmission risk behaviors for HIV-positive gay and bisexual men with sexual compulsivity. AIDS Behav. 2017;21(6):1540–9. https://doi.org/10.1007/s10461-016-1533-4 New cognitive-behavioral intervention designed to help gay and bisexual men manage emotions and reduce sexual risk and related risk-taking behaviors.
Barlow DH, Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Allen LB, et al. Unified protocol for transdiagnostic treatment of emotional disorders: therapist guide. New York: Oxford University Press; 2011.