Compounded Stigma in LGBTQ plus People: A Framework for Understanding the Relationship Between Substance Use Disorders Mental Illness, Trauma, and Sexual Minority Status

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) people are sexual minorities and have higher rates of substance use disorders, mental illness, and trauma, which translates into compounded stigma for them. Compounded stigma is the additive and cumulative impact of belonging to one, or several, marginalized groups (eg, racial/ethnic minority, LGBTQ+) and also suffering from addiction, mental illness, and/ or trauma. There are important interactions among these comorbidities, trauma, and sexual minority status that affect patient behavior, treatment planning, and treatment outcomes. This article presents a Venn diagram as a helpful clinical tool to visually illustrate the complex interactions of mental illness, addictions, trauma, and LGBTQ+ minority status for both health care providers and patients. Having an awareness and understanding of these important interactions can enhance patient rapport and treatment experience as well as treatment planning.