Trauma Informed Care for the LGBTQ Community Morris Home Clinical Team Kade Collins, MSW Laura Sorensen, MSW Andrew Spiers, MSS

Today’s Agenda Introductions Gender and Sexuality Review Microaggressions & Social Climate Rites of Passage Community Snapshot Minority Stress Model Trauma Informed Best Practices Morris Home Overview

Who are we? Who are You? Check In Name Pronouns What program are you from and what do you do there?

Some Sexuality Definitions Lesbian Gay Bisexual Queer Coming Out Same Gender Loving MSM So many others! What not to say!

Gender: Let’s unpack it Sex assigned at birth Male Female Intersex Gender Identity Gender Expression

Sex at birth Male Intersex Female Man GenderQueer Woman Gender Identity Masculine Androgynous Feminine Gender Expression Attracted to men Attracted to many or all genders Attracted to Women Emotionally Attracted Physically Attracted Attracted to men Attracted to many or all genders Attracted to Women

Transitioning Hormone Therapy Gender Confirmation Surgery Social Medical Coming out to family, friends, coworkers Gender expression may change to be congruent with gender identity Using new pronouns Legal Name Change Gender Marker Change on Legal Documents Hormone Therapy Gender Confirmation Surgery Laser Hair Removal Voice Training Mastectomy/Augmentation

Rites of Passage Activity What are rights of passage that everyone (or must everyone) goes through during the following stages of life: How might each answer be different if a person identifies as LGBT? Childhood Adolescence Adulthood

MicroAggressions

Why do we do these trainings Because we want to reduce Because they add up! Transphobia Homophobia Cissexism Heterosexism Internalized Oppression

Many LGBTQ students in Pennsylvania reported discriminatory policies or practices at their school. Most (58%) experienced at least one form of discrimination at school during the past year. Over 1 in 4 LGBTQ students in Pennsylvania were disciplined for public affection that does not result in similar action when it occurs between non-LGBTQ students (28%) Most LGBTQ students in Pennsylvania had been victimized at school. 53% never reported to school staff. Only 24% of students who reported said it resulted in effective staff intervention.

LGBT Youth Family Rejection Homelessness School to Prison Pipeline Increased substance use High risk behaviors Suicidality

National Transgender Discrimination Survey Income Transgender people are four times more likely to have a household income of less than $10,000/ year compared to the general population. School Those who expressed a transgender identity while in grades K-12 reported alarming rates of harassment (78%), physical assault (35%) and sexual violence (12%); harassment was so severe that it led almost one-sixth (15%) to leave school or college.  Employment Survey respondents experienced unemployment at twice the rate of the general population at the time of the survey, with rates for Black transgender people being four times the national rate, and other trans people of color at elevated rates. NCTE, NGLTF, 2011

Work Ninety percent (90%) of those surveyed reported experiencing harassment, mistreatment or discrimination on the job or took actions like hiding who they are to avoid it. Over one-quarter (26%) reported that they had lost a job due to being transgender or gender non-conforming and 50% were harassed. Sixteen percent (16%) said they had to work in the underground economy for income such as doing sex work or selling drugs. Housing and Homelessness One-fifth (19%) reported experiencing homelessness at some point in their lives because they were transgender The majority of those trying to access a homeless shelter were harassed by shelter staff or residents (55%), 29% were turned away altogether, and 22% were sexually assaulted by residents or staff. Suicide A staggering 41% of respondents reported attempting suicide, compared to 1.6% of the general population.

Trauma informed Best Practices Areas Best Practices Family Rejection Violence Incarceration Healthcare Barriers to accessing care Creating affirming environments Utilizing LGBT- sensitive clinical interventions Competency Advocacy

Affirming Physical Environments Environmental assessments Removing unnecessary sex segregated spaces Signage Materials displayed Capacity for individuals to personalize their spaces Cleanliness and Organization Creating Choice Privacy

Utilizing LGBT Sensitive clinical practices Inclusive curriculums and materials Acknowledging power dynamics between client and provider related to gender and sexuality Recognizing past traumatic experiences with service providers – and that fear of discrimination and harassment may have been a barrier to accessing services Client identity may not be central reason for seeking services Identifying and incorporating “chosen family” into treatment whenever possible Recognizing that physical manifestations of trauma are compounded by complicated relationships to bodies

Competency Staff training at all levels Facilitating discussions with all participants Confidentiality Building comfort with fluidity and ambiguity Self-identification Reflecting Client Language Comprehensive understanding of non-binary identities Self-education Understanding Intersectionality

Advocacy Trainings by LGBTQ providers for staff at all levels Addressing homophobia and transphobia in the workplace Awareness of current policies affecting LGBTQ communities Building a competent, affirming referral network Non-discrimination policies Hiring practices – making sure staff reflect the population being served Ensuring that your funders have an understanding of LGBTQ intersectionality and the impact of trauma on clients

LGBTQ Culture History Resilience Leadership and Organizing Community Chosen Families Creating our own spaces Pride

Morris Home Our Philosophy Trans Affirming Harm Reduction Staffing Training Advocacy Harm Reduction Lapse/Relapse Sex work Trauma informed Environmental Groups

What we offer Group psychotherapy Individual therapy Family Sessions Individualized Treatment Planning Life Skills Education Case Management Social/Recreation Psychiatric Care Access to medical care Mutual Aid opportunities (12 step) Job readiness Legal Support On-site HIV Testing