Abstract
<p>Background: Sexual and gender minorities (SGMs) face a higher risk of mental health disorders due to stigma associated with their identities. Research demonstrates that minority stress (e.g., discrimination, microaggressions, and internalized stigma) negatively affects mental health outcomes among SGMs, including trauma-related symptoms. However, no studies have explicitly examined the relationship between minority stress, trauma-related symptoms, and dissociation using a mixed-methods approach.Methods: Forty SGM participants with diverse intersecting identities participated in the study. Using a convergent parallel mixed-methods design, we conducted semi-structured qualitative interviews to examine experiences with minority stressors and administered clinical assessments and quantitative measures of minority stress, trauma symptoms, and dissociation. Qualitative themes pertaining to trauma-related symptoms were extracted and converged with scores from our quantitative minority stress measure, allowing us to investigate differential thematic presentations based on minority stress severity. A mediation analysis examined whether dissociation may be a trauma-related response to minority stress.Results: Our study revealed four qualitative themes pertaining to minority stress-based trauma symptoms among SGMs: hypervigilance, negative sense-of-self, emotion dysregulation, and dissociation. These themes differentially presented depending on minority stress severity. Quantitative analyses revealed that trauma symptoms mediate the relationship between minority stress and dissociation symptoms, suggesting that dissociation may be a trauma-related response to minority stress.Conclusions: This study is among the first to employ a mixed-methods approach to examine the relationship between minority stress, trauma symptoms, and dissociation among SGMs. Findings suggest that dissociation may represent a trauma-related response to minority stress and provide support for adapting existing frameworks, such as the 4-Dimensional Model of the Traumatized Self, to better understand trauma-related mental health disparities associated with minority stress. Collectively, these findings provide a foundation for developing interventions aimed at addressing the psychological consequences of minority stress among SGMs.</p>