Risking It Anyway: An Adolescent Case Study of Trauma, Sexual and Gender Identities, and Relationality

Abstract

This article presents the case of a Chinese-American adolescent with a significant trauma history who was questioning her sexual and gender identities. The implications of the client's intersecting identities for case conceptualization and treatment are considered within the framework of affirmative practices for sexual and gender minority (SGM) clients. The impacts of stress and trauma on this client's experiences-and SGM clients more broadly-are also considered, particularly with respect to how this client understood and negotiated her experiences of relational trauma. This case is intended to illustrate some best practices with SGM clients within an intersectional framework which underscores the importance of multiple salient cultural identities.

“I knew that I wasn’t cis, I knew that, but I didn’t know exactly”: Gender identity development, expression and affirmation in youth who access gender affirming medical care

“…Recent literature has noted the growing diversity and prevalence of identities and labels espoused by youth who identify as something other than male/female or trans, including a range of non-binary and other identities (Cohen-Kettenis & Klink, 2015 ; McGuire et al, 2019 ; Twist & de Graaf, 2019 ). Though the experiences of both non-binary and gender-nonconforming youth and trans youth of color tended to be absent from earlier work, several recent papers have examined the gender identity development and affirmation of youth and young adults who concurrently navigate both these diverse sets of identities (Kuper et al, 2018 ; Kuper et al, 2014 ; McConnell, 2018 ; Nicolazzo, 2016 ).…”

Negotiation of Safety in Inter-cultural Trauma Therapy: A Meta-ethnography of Qualitative Studies

“…Cultural differences in the therapeutic alliance can have complex and context-specific impacts on the negotiation of safety in trauma therapy. Qualitative research showed that differences based on language, race, ethnicity, religion, nationality, and disability affected the experience of trust in trauma therapy (Anderson et al, 2017;Dinh et al, 2008;Heyer, 2016;McConnell, 2018;Mirdal et al, 2012). Sometimes the figure of the therapist as a cultural outsider fostered safety and confidentiality in the alliance ( Van de Water et al, 2018), while in other contexts it made the client feel disconnected because of cultural conflict (Gerassi et al, 2021).…”

“…Due to the high prevalence of traumatic exposure (Benjet et al, 2016), the rising interaction between different cultural groups (International Organization for Migration, 2019; United Nations Refugee Agency, 2020), and the complex role cultural difference can play in therapy (Anderson et al, 2017;Dinh et al, 2008;Heyer, 2016;McConnell, 2018;Mirdal et al, 2012), it is important to investigate how safety is negotiated in inter-cultural trauma therapy. Moreover, the published literature has over-represented the experiences of clients over service providers' (Buchholz & Abramowitz, 2020;Howard et al, 2021;Neelakantan et al, 2019;Noyce & Simpson, 2018).…”