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

2. 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

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

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

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

8. 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

9. 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

10. 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

11. MicroAggressions

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

13. 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.

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

15. 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

16. 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.

18. 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

19. 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

20. 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

21. 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

22. 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

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

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

25. 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