Trauma-Focused Therapy in Sexual and Gender Minority Individuals: A Scoping Review of Therapeutic Interventions Contributing to Accessibility and Outcomes.

Rates of trauma exposure and post-traumatic stress disorder (PTSD) are much higher in sexual and gender minorities (SGMs). However, negative psychotherapy experiences are frequently reported in this population. There is limited existing literature on outcomes for SGMs in trauma-focused therapies (TFTs). This scoping review aimed to synthesize quantitative and qualitative outcomes for TFTs in patients from SGMs, as well as examine TFT accessibility barriers and facilitators in these minority groups. A scoping review methodology was used and a systematic search across MEDLINE, EMBASE, PsycInfo, and CINAHL databases was conducted on May 26, 2025. Included studies were mapped by location, design, and programme characteristics, then narratively synthesized. The initial search yielded 5,580 articles of which ten met inclusion criteria (e.g., peer-reviewed studies examining TFT outcomes for youth and adult SGMs), comprising quantitative (n = 8) and qualitative (n = 2) designs. Seeking Safety, Dialectical Behavioural Therapy-Prolonged Exposure, Narrative Exposure Therapy, Trauma-Focused Psychodynamic Psychotherapy, and Cognitive-Behaviour Therapy for Trauma and Self-Care were found to reduce post-traumatic stress disorder symptoms and risk-taking behaviours in SGMs, with varying effect sizes and attrition rates. Barriers to accessing TFTs were concerns around discrimination, and facilitators to TFTs included SGM-inclusive practices and a strong therapeutic alliance with the provider. Several TFTs appear to have potential efficacy for SGMs, with best outcomes and retention demonstrated in protocols that were designed or adapted for SGMs, with high levels of clinician SGM sensitivity. Registration on Open Science Framework: 10.17605/OSF.IO/EQXY5.