Trauma and Internalized Shame | NAMI

Most people have heard of “Gay Pride” in reference to the LGBTQI community’s month of celebration, festivals and parades each June. However, many don’t know about the origins of the Pride movement as a protest, an act of community love in defiance of social and cultural standards that diminish the value of LGBTQI lives and contribute to stigma and shame. By loudly and proudly confronting discrimination with openness and positivity, the Pride movement offers many LGBTQI people a place to express themselves and a community to rely on when many can feel lost and alone.

Members of this community are often exposed to traumatic experiences in multiple areas of their lives including societal stigma, discrimination and repression, and rejection from family and community members. Unfortunately, these repeated exposures can lead to sustained levels of stress and internalized shame, and ultimately have serious impacts on the mental health of LGBTQI people.


Societal Stigma

Some of the current stigma associated with LGBTQI identities has origins in religious beliefs. Although each religion, sect and place of worship may vary in its beliefs around LGBTQI issues, and there are a growing number of LGBTQI-affirming denominations and congregations, there are still many religious individuals and communities that believe and promote the idea that being LGBTQI is unnatural, a sin or goes against God.

Some believe that sex should be reserved for the act of procreation, which is not an option for many LGBTQI people. Others may point out where their religious texts directly call homosexuality or being transgender a sin. Due to early education into shared family values, followers of such beliefs may have a harder time reconciling their sexual orientation or gender identity with those values. These conflicting beliefs can lead to inner turmoil and stress.

Conversion Therapy
Some people believe that a person can change their sexual orientation or gender identity through various interventions, such as talk therapy, physical aversion therapy, prayer or reconditioning. This concept is sometimes referred to as conversion therapy or sexual orientation/gender identity change efforts.

These practices have been discredited and deemed unethical by many mental health organizations. Conversion therapy has no scientific evidence of actually changing a person’s sexual orientation or gender identity and can cause long lasting mental health issues from the various types of trauma inflicted.

Don’t Ask, Don’t Tell
From 1993 to 2011, “Don’t Ask, Don’t Tell” was the official position of the U.S. military. Lesbian, gay and bisexual people were allowed to serve in the military but could not reveal their sexual orientation without risking dishonorable discharge. Today, similar practices are being utilized for transgender people. These practices force people to keep a core part of their identity hidden, unable to pursue romantic relationships or access gender-affirming health care. This internal division between sense of self and sense of duty is not only difficult to maintain, but can lead to further isolation and shame.

Rejection, or fear of rejection, from friends or family can reinforce the societal stigma of being LGBTQI. People may not disclose their identity for fear of being rejected and losing not only the love and respect of those they are close to, but also fear of losing housing, education and financial opportunities.


Discrimination, Harassment And Assault

Trauma can also come from discrimination, harassment or assault. Either a single event, such as getting assaulted for being gay or being fired by a transphobic employer, or the long-term effects of sustained stress due to discrimination, can lead to post-traumatic stress responses or PTSD.

majority of LGBTQI people have experienced harassment or discrimination based on their sexual orientation or gender identity. Harassment may include both verbal and physical harassment or physical assault. Being a victim of harassment can cause long-term mental health impacts such as anxiety, depression, lack of concentration and fatigue. Multiple instances of harassment or severe cases can cause PTSD. Any of these mental health issues can introduce more stress into a person’s life, compounding any existing issues and leading to more severe symptoms.

LGBTQI people also experience discrimination in employment, housing, public accommodations and while seeking health care. This discrimination can affect a person’s mental health whether it is blatant or merely implied — the fear of discrimination can be just as real as an obvious event. The burden of trying to hide or keep your identity a secret can lead to isolation, low self-esteem and other mental health issues. It may also make you less likely to seek help due to fear of discrimination from police, medical professionals and other social supports.



In order to avoid societal stigma or discrimination, an LGBTQI person may choose to not acknowledge their sexual orientation or gender identity. They may choose to seek out heterosexual relationships or to live as the gender they were assigned at birth despite knowing that these identities are not truly right for them.

Some people may choose celibacy in order to avoid awkward sexual encounters, or to only have sexual or romantic relationships in secret. Transgender people may live their day-to-day lives as the gender they were assigned at birth, but then dress or act their true identity in private. This ongoing discomfort and denial of the authentic self can negatively impact relationships with others and overall well-being, ultimately adding to any sense of stigma and shame you already feel.


Intersex Community

Individuals who are intersex often face trauma due to their identity, and, as a result, grapple with internalized shame. The specific types of trauma and shame, however, may differ from the LGBTQ portion of the community.

Stigma from the Medical Community
Starting in the early 1950s, the medical community began using the Hopkins model of treating intersex children. This model focused on making intersex children’s bodies as similar to their non-intersex peers as possible and raising the children as the genders that “matched” their bodies after a variety of medical procedures were complete.

This often involved cosmetic genital surgeries that were not medically necessary. Sometimes, doctors performed these surgeries without the parents’ consent — and they rarely, if ever, received the child’s consent. They also prescribed hormonal replacements to “normalize” patients’ bodies and conceal the fact that they were intersex.

Parents of young intersex children were often misled by doctors who concealed the patient’s intersex condition altogether or encouraged the parents to maintain secrecy. They were told that the medical professionals’ methods were, in fact, necessary for their children to live healthy and happy lives.

Judgments from the medical community about what a “normal” body looks like, how intersex bodies should be altered to meet arbitrary standards and the level of secrecy surrounding intersex conditions can cause unnecessary trauma and layers of shame for intersex individuals.

Societal Stigma
Trauma for intersex individuals also comes in the form of societal stigma. Frequently, intersex characters in popular culture either portray intersex people as monsters, manipulators or medical dilemmas to be solved. “Annabel,” the novel by Kathleen Winter, is one such example where intersex people are portrayed as monstrous. Meanwhile, the intersex manipulator-murderer plot twist trope can be found in television shows like, “Nip/Tuck,” “Passions” and “Janet King.” The medical dilemma trope has become particularly popular in Hollywood and can be is seen in shows like, “Children’s Hospital,” “Emily Owens, M.D.” and “House.”

While the inclusion of intersex people in media is important, inaccurate portrayals can create stigma surrounding what it means to be intersex. This impacts not only how society treats intersex individuals, but also damages intersex individuals’ self-perception.

Ultimately, this lack of understanding and the historical, systemic exclusion of (and discrimination against) of the intersex community can create a hostile environment fostering further trauma.

Social Isolation
While resources for intersex people have become more readily available in the last few decades, the hidden medical history, social stigma and other related factors contribute to social isolation for intersex people. This social isolation can also cause trauma as the individual may feel like they are alone in their identity with little to no support system.


How To Cope With Trauma And Shame

As a result of trauma, LGBTQI individuals may turn to negative coping strategies, such as:

  • Denying or trying to change their sexual orientation
  • Avoiding other LGBTQI people
  • Suppressing their emotions (especially romantic and sexual)
  • Having multiple or anonymous sex partners
  • Developing dependence on alcohol or drugs
  • Attempting suicide

While these coping strategies may provide temporary relief, they can also exacerbate problems with maintaining positive self-worth, personal relationships and overall mental health.

Instead of using negative coping strategies, LGBTQI individuals may consider more positive coping mechanisms such as:

  • Advocating for LGBTQI rights
    • Write a letter, email or call your representatives to support affirming legislation
    • Educate your community on LGBTQI issues
    • Participate in lobby days or days of action planned by LGBTQI organizations
  • Spending time with or building relationships with people who are openly accepting of LGBTQI people
    • Join a support group in your local area or online — there are many LGBTQI specific recovery groups and group therapy options
    • Spend time at LGBTQI-owned and LGBTQI-friendly businesses
    • Mentor LGBTQI young people
  • Engaging with LGBTQI organizations (e.g., arts organizations, sports leagues and book clubs)
  • Participating in an affirming place of prayer/worship

Allies to the LGBTQI community can also help support these positive coping strategies by openly and visibly supporting LGBTQI people and issues, advocating for inclusive policies and practices, and interrupting or speaking out against negative remarks and actions taken by other people.

LGBTQI people should not have to suffer from the impact of trauma and internalized shame. Seeking help from supportive friends, mental health professionals and LGBTQI organizations can be of great help to many people.

NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).