Journal of the American College of Surgeons · 2026
Posttraumatic Stress Symptoms and Trauma Histories of LGBTQ+ Physical Injury Survivors.
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Ryan Paige M, Zatzick Douglas F, Engstrom Allison, Russo Joan, Conde Cristina, Wong Daisy, Huynh Mary, Moore Megan, Harner Vern, Bulger Eileen
Аннотация
BACKGROUND: The goal of the current study was to assess the trauma histories and posttraumatic stress disorder (PTSD) symptoms of hospitalized LGBTQ+ physical injury survivors.
STUDY DESIGN: Injury survivors aged 18 years and older were screened for PTSD symptoms and severe postinjury concerns; screen-positive patients were included in the study. The investigation developed a medical record review method to identify LGBTQ+ patients. The baseline surgical hospitalization PTSD symptom levels and preinjury trauma experiences of 45 chart review identified LGBTQ+ patients were compared with 169 patients who were both cisgender and heterosexual.
RESULTS: LGBTQ+ patients were significantly more likely to report rape trauma (chi-square (1) = 7.37, p < 0.01). Although other preinjury trauma history comparisons demonstrated greater frequency in the LGBTQ+ group relative to the cisgender heterosexual group, no other trauma history comparisons achieved statistical significance. Similarly, LGBTQ+ patients had a greater cumulative trauma burden as evidenced by 5 or more earlier traumatic events (71.1% LGBTQ+ [n = 45] vs 58.5% cisgender heterosexual [n = 159]); however, this comparison did not achieve statistical significance (chi-square (1) = 2.35, p = 0.17).
CONCLUSIONS: Approximately 10% of a cohort of physically injured patients with elevated PTSD symptom levels were identified as LGBTQ+. LGBTQ+ patients were significantly more likely to experience rape trauma before their inpatient admission compared with cisgender heterosexual patients. The finding of higher rates of rape trauma in LGBTQ+ physical injury survivors and trends toward a greater frequency of earlier traumatic events are important considerations in developing a trauma-informed care approach for LGBTQ+ populations in acute trauma care settings.
STUDY DESIGN: Injury survivors aged 18 years and older were screened for PTSD symptoms and severe postinjury concerns; screen-positive patients were included in the study. The investigation developed a medical record review method to identify LGBTQ+ patients. The baseline surgical hospitalization PTSD symptom levels and preinjury trauma experiences of 45 chart review identified LGBTQ+ patients were compared with 169 patients who were both cisgender and heterosexual.
RESULTS: LGBTQ+ patients were significantly more likely to report rape trauma (chi-square (1) = 7.37, p < 0.01). Although other preinjury trauma history comparisons demonstrated greater frequency in the LGBTQ+ group relative to the cisgender heterosexual group, no other trauma history comparisons achieved statistical significance. Similarly, LGBTQ+ patients had a greater cumulative trauma burden as evidenced by 5 or more earlier traumatic events (71.1% LGBTQ+ [n = 45] vs 58.5% cisgender heterosexual [n = 159]); however, this comparison did not achieve statistical significance (chi-square (1) = 2.35, p = 0.17).
CONCLUSIONS: Approximately 10% of a cohort of physically injured patients with elevated PTSD symptom levels were identified as LGBTQ+. LGBTQ+ patients were significantly more likely to experience rape trauma before their inpatient admission compared with cisgender heterosexual patients. The finding of higher rates of rape trauma in LGBTQ+ physical injury survivors and trends toward a greater frequency of earlier traumatic events are important considerations in developing a trauma-informed care approach for LGBTQ+ populations in acute trauma care settings.