Reducing The Impact of Chronic Stress Among LGBTQ+ Youth

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) adolescents experience disproportionately high levels of childhood trauma and have more negative experiences in healthcare due to stigma, discrimination, and a lack of healthcare provider expertise. Ongoing political debates about LGBTQ+ youth magnify these concerns by undermining their sense of safety and belonging in the community. These factors have a significant negative impact on health across the lifespan. Many pediatric providers are seeking training opportunities to respond by providing competent and affirming care.  

In September 2023, Ryan Combs, PhD, Associate Professor, Health Promotion and Behavioral Sciences, and several UofL School of Medicine colleagues began addressing this education gap with the help of a two-year, $250,000 grant from the Jewish Heritage Fund. The team will plan and implement an evidence-based, trauma and resilience education curriculum for healthcare providers and trainees to improve health outcomes for LGBTQ+ adolescents.

The project’s aim is to reduce the risk of trauma, chronic stress and acquired disability among LGBTQ+ youth by training pediatric primary care healthcare providers in Louisville, along with UofL Pediatrics residents and UofL School of Medicine students. The curriculum will employ a variety of educational strategies, such as small group discussion, case-based learning, and standardized patient encounters, to teach learners how to identify and treat trauma in LGBTQ+ youth.

Dr. Combs anticipates that the project will lead to greater awareness of link between trauma, chronic stress, and acquired disability in LGBTQ+ youth, as well as more inclusive healthcare environments that incorporate strategies to bolster their resilience. He said, “LGBTQ+ youth deserve safety and opportunities to heal from the trauma they too often experience. We are employing the best available evidence to develop this training so that healthcare providers can quickly identify and respond to chronic stress in this population.”

Dr. Combs’ project is in collaboration with Amber Pendleton, MD, Professor and Associate Division Chief of General Pediatrics; Emily Noonan, PhD, MA, Assistant Professor, Undergraduate Medical Education; and Carrie Bohnert, MPA, CHSE, Director of UofL’s Standardized Patient Program.