Sexual and Gender Minority Status Predicts Additional Variance in Posttraumatic Stress Disorder After Accounting for Conventional Trauma Exposure

Sexual and gender minority (SGM) populations have substantially higher rates of most psychopathologies. Several theoretical models have been proposed, attributing the disparities to either (a) additional stressors related to their minoritized status (i.e., minority stress) or (b) that stressors interact with a pre-existing vulnerability. A parallel body of research posits minority stress as a form of trauma and connects discrimination to posttraumatic stress disorder (PTSD). The present study attempts to bridge these two areas of literature by testing if SGM status-a proxy for minority stress-predicts additional variance in PTSD symptoms after accounting for conventional trauma (i.e., childhood maltreatment, actual or threatened death/bodily harm, sexual violence, and other stressful life events) or if SGM status interacts with conventional trauma to nonlinearly increase PTSD symptoms. First, the validity of using SGM status as a proxy for minority stress was examined in a subsample of participants. Then, to test our primary hypotheses, a post hoc analysis of a study investigating common psychobiological adaptations to trauma was completed. Results supported the use of SGM status as a proxy and the additive, as opposed to interactive, model. After accounting for conventional trauma, SGM status predicted additional variance in PTSD symptoms and diagnosis. Although tentative, these findings suggest that minority stress may be additive to trauma symptomatology in SGM individuals and therefore be an important factor to consider when assessing for and treating PTSD in this population. Future research that directly measures minority stress should be conducted to validate these findings.