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PTSD & Transgender Individuals Short for Posttraumatic stress disorder, PTSD is a mental illness/disorder caused by trauma. It can occur after an individual witnesses, or experiences, a traumatic event. Symptoms include intrusive recollections of trauma, avoidant/numbing of emotions, hyperarousal (extreme alertness)

Self-Directed Violence Self-care should be explored. Medications, interventions, cognative therapies might also be explored. Clinicians need to provide a safe space, devoid of triggering stimulai. Self affirmation is important. Helping an individual susceptable to self-directed violence means getting this person to care, understand, and appreciate their own thoughts and actions.. Journaling, exercise, and empowering stories about transgender people, are useful.

PTSD was thought of being triggered by one traumatic event, but “Complex PTSD” is when it manifests because a person has experienced prolonged violence. This applies to transgendered people, because of the ongoing, chronic stress of being part of a stigmatized group. Symptoms of “Complex” PTSD - Problems with personal identity -Cannot have stable relationships -Does not have or consider boundaries, does not maintain personal safety -Somatization (bodily issues related to psychiatric conditions, like anxiety, stress) -Cannot control emotional states -Altered state of consciousness, dissociation (detachment from surroundings, physical/emotional experiences) It is possible to have both PTSD and “Complex PTSD” at the same time.

Frameworks for violence

Interpersonal Violence

Violence can be organized into three different definitions:

Social networks are important. It is suggested that transgender surivors of interpersonal violence find someone in their social circle to validate their experiences with violence. This can be done through support groups, LGBT positive clubs, communities, the internet, etc.

-Interpersonal (between two or more people) -Self-directed (self destructive) -Collective (larger groups/organizations)

Public health workers and therapists should facilitate this, as well talk about and acknowledge them.

Microaggressions Considered an insidious (“subtle”) trauma, a microaggression is a ongoing exposure to oppresion. Examples of this: Being refered to with wrong pronouns, overhearing common perjorative slang words, assumptions based on gender identity, class, race; etc. Some individuals do no realize exposure to insidious trauma or consider certian microaggressions problamatic. It should be noted that bringing to light microaggressions and “translating” certain events as microaggressions (thereby raising these individuals awareness), might decrease the likelyhood of a more “intense” PTSD developing. When looking at or discussing violence and trauma, it is critical that one doesn’t establish transphobia as the sole reason behind violence/violent events in a person’s life. It is extremely important to consider different oppressions, and that violent acts are influenced by sexuality, race, class, et al.

Therapists should be prepared to help individuals with healthcare providers and if possible/wanted/viable, gender transition. Doctor/patient rollplay is helpful for educational purposes and reducing possible traumatic triggers. Language used should always be inclusive.

Collective Violence Advocate for policies and legislation related to transgendered people. Make prevention of trauma a priority. Be trans-positive.

References Richmond, K.A., Burnes, T. & Carroll, K. (2012). Lost in Trans-lation: Interpreting systems of trauma for transgender clients. Traumatology, 45 (18). Kenagy, G. P. (2005). Transgender health: Findings from two needs assessment studies in Philadelphia. Health and Social Work, 30. Brown, L.S., Pantalone, F. (2011). Lesbian, Gay, Bisexual, and Transgender Issues in Trauma Pscyhology: A topic comes out of the closet. Traumatology, 17(1) National Center for PTSD (U.S.) (2010). Understanding PTSD. http://permanent.