Post-traumatic stress disorder among LGBTQ people: a systematic review and meta-analysis

Abstract

Aims Lesbian, gay, bisexual, transgender and queer people (LGBTQ) are at increased risk of traumatization. This systematic review aimed to summarize data regarding the risk of post-traumatic stress disorder (PTSD) for LGBTQ people and their subgroups. Methods Medline, Scopus, PsycINFO and EMBASE were searched until September 2022. Studies reporting a comparative estimation of PTSD among LGBTQ population and the general population (i.e., heterosexual/cisgender), without restrictions on participants’ age and setting for the enrolment, were identified. Meta-analyses were based on odds ratio (OR and 95% confidence intervals [CI]), estimated through inverse variance models with random effects. Results The review process led to the selection of 27 studies, involving a total of 31,903 LGBTQ people and 273,842 controls, which were included in the quantitative synthesis. Overall, LGBTQ people showed an increased risk of PTSD (OR: 2.20 [95% CI: 1.85; 2.60]), although there was evidence of marked heterogeneity in the estimate (I2 = 91%). Among LGBTQ subgroups, transgender people showed the highest risk of PTSD (OR: 2.52 [95% CI: 2.22; 2.87]) followed by bisexual people (OR: 2.44 [95% CI: 1.05; 5.66]), although these comparisons are limited by the lack of data for other sexual and gender minorities, such as intersex people. Interestingly, the risk of PTSD for bisexual people was confirmed also considering lesbian and gay as control group (OR: 1.44 [95% CI: 1.07; 1.93]). The quality of the evidence was low. Conclusions LGBTQ people are at higher risk of PTSD compared with their cisgender/heterosexual peers. This evidence may contribute to the public awareness on LGBTQ mental health needs and suggest supportive strategies as well as preventive interventions (e.g., supportive programs, counselling, and destigmatizing efforts) as parts of a tailored health-care planning aimed to reduce psychiatric morbidity in this at-risk population.

The Assessment and Treatment of Post-traumatic Stress Disorder in Autistic People: A Systematic Review

“…This is particularly important to the study of PTSD, which in the general population is more common amongst women (Olff, 2017). Additionally, research shows that transgender people are at the high risk of PTSD (Marchi et al, 2023;Reisner et al, 2016). A large population study showed higher numbers of transgender and gender diverse people are autistic when compared to cisgender people (Warrier et al, 2020).…”

Sex and gender differences in risk factors for posttraumatic stress disorder: A systematic review and meta-analysis of prospective studies.

“…Likewise, masculine gender role stress (Neilson et al, 2020) or hormonal changes related to androgen deprivation therapy in the context of prostate cancer (Donovan et al, 2015) might be interesting targets to increase knowledge on men-specific risk factors. Moreover, a nonbinary perspective on sex and gender can help to address existing data gaps and improve care for currently underserved high-risk communities (Marchi et al, 2023).…”

Types of childhood maltreatment as predictors of posttraumatic stress disorder severity and complex posttraumatic stress disorder in patients with substance use disorders

“…Interestingly, many studies found the prevalence of both PTSD and CPTSD to be about twice as high in women as in men (Cloitre et al, 2019 ; Driessen et al, 2008 ; Hyland, Murphy, et al, 2017 ; Tolin & Foa, 2006 ). The risk of developing PTSD among LGBTQ people is even higher, especially for transgender people, since due to transphobia/homophobia individuals within sexual minority groups continue to face a heightened risk of experiencing trauma including childhood abuse (Marchi et al, 2023 ; Roberts et al, 2012 ). Nevertheless, there are conflicting findings in studies; some report a sex-specific risk for PTSD but not for CPTSD (Hyland, Shevlin, et al, 2017 ; McGinty et al, 2021 ), while others found this neither for PTSD nor for CPTSD (Cloitre et al, 2013 ; Wolf et al, 2015 ).…”