Affirmative Psychotherapy for Trauma-Exposed Sexual and Gender Minority Youth

Sexual and gender minority (SGM) youth are at increased risk for trauma-related psychopathology (e.g., posttraumatic stress disorder, depression, suicidality) relative to heterosexual and cisgender youth. These disparities have been documented across the globe and are due, in large part, to disproportionate exposure to adverse childhood experiences and other traumatic stressors as well as exposure to unique identity-related stressors. Despite the number of evidence-based interventions for trauma-exposed youth in general, very few have been tested in samples of SGM youth. The goal of this chapter is to provide clinicians with an overview of the literatures on SGM youth’s experiences of trauma and identity-related stressors, their impacts on trauma-related psychopathology, and the use of trauma-focused therapies with SGM youth. This chapter also provides recommendations for the assessment of trauma and minority stress among SGM youth, the inclusion of parents/guardians in the assessment and treatment process, and additional considerations to be mindful of when working with trauma-exposed SGM youth.