Cumulative Trauma and Intersecting Stigma Among LGBTQ+ Individuals with Psychiatric Diagnoses

LGBTQ+ individuals with psychiatric diagnoses often encounter intersecting stigmas related to identity and mental health, increasing their vulnerability to trauma, marginalization, and exclusion from supportive services. Despite well-documented mental health disparities, less is known about how LGBTQ+ individuals with psychiatric diagnoses subjectively experience, interpret, and cope with psychologically traumatic experiences and their enduring consequences. This study examined the experiences of trauma among 24 LGBTQ+ adults in Israel who participated in two therapeutic groups. Reflexive thematic analysis identified three themes: (1) Multiple and Intersecting Traumatic Experiences, including sexual violence, family rejection, and social exclusion; (2) The Enduring Impact of Past Trauma on Present Experiences, encompassing emotional, behavioral, somatic, and relational consequences; and (3) Coping Strategies with Trauma: Between Survival and Processing. Importantly, responses such as dissociation, avoidance, appeasement, and substance use emerged not merely as manifestations of psychopathology but also as context-dependent survival strategies for managing overwhelming distress and ongoing marginalization, despite their potential long-term costs. Participants described therapeutic groups as spaces of belonging, normalization, and mutual recognition. Findings conceptualize trauma as a cumulative process shaped by intersecting forms of stigma and highlight the importance of trauma-informed, identity-affirming approaches that recognize both the protective functions and potential costs of coping responses.