Introduction
In June of 2019 the American Medical Association (AMA) labeled violence against African American and Latino Transgender (Trans) people in America an epidemic (Ennis, 2019). On May 27, 2020, just two days after George Floyd was killed at the hands police officers, Tony McDade, a Black transgender man from Tallahassee Florida, was also killed by police officers. Weeks later, two Black transgender women: Dominique Fells, a 27-year-old from Philadelphia, and Riah Milton, a 25-year-old from Ohio, were also violently murdered. Not surprisingly, the media only covered the death of Mr. Floyd, a heterosexual Black man. The goal of this paper is to call attention to some of the trauma and stressor-related disorders experienced by the Black and Brown trans population in America due to anti-trans violence; discuss the issue of their related intersectional collective trauma, and recommended evidenced-based mental health treatment interventions for Trans individuals and their community.
The Population at Risk
In 2021 the Human Rights Campaign (HRC) reported a record number of 50 Black or Brown transgender killings; the same report in 2022, asserted in June that at least 25 Black or Latinx transgender individuals had already been either shot dead, or otherwise violently killed. These HRC reports are part of a disturbing trend previously alluded to by the National Coalition of Anti-Violence Programs (2013) when they pointed out that compared to White cisgender people, transgender people of color were almost three times more likely to encounter police violence and, six times more likely to experience physical violence (Dinno, 2017). Unfortunately, crimes against Trans persons often go either misreported, underreported, or not reported at all. Trans stigmatization, anti-transgender violence, bias and discrimination often result in negative medical outcomes, and mental health and socioeconomic disparities, including: depression, acute stress disorder (ASD), posttraumatic stress disorder (PTSD), feelings of fear and helplessness, suicidal ideation, homelessness, joblessness, elevated rates of HIV infections, and substance use disorders (SUD). Consequently, Trans and gender nonconforming (TGNC) individuals have been recently designated as a “Health Disparity Population” by the American National Health Institutes (Valente et al., 2020; Nuttbrock et al., 2014).
Collective Cultural Trauma
Typically, when we speak about trauma it is often from the perspective of an individual or individualized trauma. Conversely, collective trauma refers to the impact of an adverse event on an entire group of people or community. For example, the recent police violence against Eric Garner in New York and George Floyd in Minneapolis, elicited collective Black community responses in urban cities across America, just like the horrific events of the Holocaust elicited a collective Jewish response in Jewish communities around the world. Whether it’s a mass shooting, act of terrorism, or systematic and historical oppression, collective trauma may be experienced indirectly when either a family member, loved one, or member of your particular race, religion, ethnicity or culture is threatened with imminent harm or killed (Aydin, 2017; Hirschberger, 2018). Experts agree that it is a common reaction for marginal communities, such as transgenders or members of the lesbian, gay, bisexual, queer, questioning, intersex or asexual (LGBTQQIA) communities to experience increased feelings of anxiety, anger, fear, or hypervigilance in response to directly or indirectly experiencing traumatic events (Assari et al., 2017).
In his research on collective trauma, Ciano Aydin (2017) emphasized a point made earlier by the German philosopher, Friedrich Nietzsche, that people are strange in that they exist outside of themselves. Which means that our individual identities are formed, based in large part, on our external collective identities. Although all of us are born separately, we were not born in a vacuum and our identity is developed within a home or community, in concert with others. We are born into a network; and for trans individuals that network is the group of non-binaries, gender nonconforming community. Consequently, the intersectionality of race and gender experienced by a trans person after the police killing of Tony McDade, a Trans person of color, or the mass shooting at the Orlando Pulse nightclub, is consistent with the culture related risks outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM – 5) for Trauma and Stressor-Related Disorders.
Treatment Interventions
A significant body of studies confirm that traumatic events lead to various negative mental health responses in individuals. In-order to mitigate the severity of trauma impacts, and to address early signs of dysfunction in survivors, psychological first aid (PFA) is critical in delivering immediate mental health interventions. One of the most culturally effective evidence-based PFA assessment treatment models, particularly for use with vulnerable groups, is John Hopkin’s Reflective Listening, Assessment, Prioritization, Intervention, and Disposition (RAPID), as suggested by Malik et al., (2021). The benefits of this early assessment method of PFA, have proven effective across all cultures, and with the time criticality of most trauma cases, RAPID offers survivors’ early access to effective mental coping skills which allow individuals to reclaim positive baseline life management (Malik et al., 2021). Hamblen and Mueser (2021) research study documents the value of early psychoeducation after a traumatic event. According to the empirical study data, psychoeducation provides trauma survivors with a better understanding of their own psychological condition and provides a good understanding of the challenges ahead, while teaching personal coping skills. Most significantly, it promotes awareness of individual strengths to better navigate difficulties and feel more in control.
In addressing the more severe trauma disorders in adults 18 years and above such as, ASD or PTSD, survivors can access treatment interventions that offer Trauma Focused Cognitive Behavioral Therapies (TF-CBT) or, the use of Eye-Movement Desensitization Reprocessing (EMDR) therapy, as the gold standard in effective treatment for PTSD (Wilson et al., 2018). The intersection of race and gender nonconformity adds extra layers of challenges for Trans people of color. Health disparities experienced by people of color, when combined with transgender identity create an extension of minority stressors (Lefevor et al., 2019). The core CBT-PD treatment model is delivered in eight to 12 one-hour sessions once a week, and is broken up into three main areas: education, resiliency skills, and cognitive restructuring. Similarly, although every individual may react differently to EMDR therapy, treatment is typically broken up into single one-hour sessions over a period of three to twelve sessions.
Conclusion
The stated goal of this paper is to call attention to the lived-experiences of trauma and stressor-related disorders present in the lives of the Black and Brown Trans population in America, and the challenges they face concerning the intersectionality of their race, culture and gender. By calling attention to these issues here, I appeal to the mainstream media to prioritize reporting on this epidemic of violence and do so with more accuracy with respect to victims’ chosen identity. The article is also a call upon city and state law enforcement to corporate with their federal counterparts in more systematically cataloging anti-trans violence. Finally, I join in solidarity with the AMA to advocate against transgender discrimination, and to call on mental health professionals to increase mental health interventions, and make it accessabble to this vulnerable population.
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