Navigating Trauma Caused by Healthcare — and Why LGBTQ+ Folks Are Impacted More Often

What do you do when the system that's supposed to heal you, hurts you?

Kelli Dunham

Published: October 29, 2025 | Last Updated: October 30, 2025

I was a nurse with more than 20 years of clinical experience when I developed a raging infection after a knee replacement. Let's just say the words "20 cc of frothy brown fluid" and "emergency surgery" now live rent-free in my amygdala. I'd seen a lot of scary things in hospitals, but this time I was the one lying on the table.

Afterwards, every time I smelled alcohol wipes or heard a monitor beep, my body went straight into fight-flight-freeze. My care group made up of friends (and an ex or two, of course) essentially staged an intervention.

"You need therapy," they said, and they were right. Because even as a nurse, I was avoiding follow-up appointments, convincing myself I could manage infection symptoms at home. Turns out, even knowing how the system works doesn't protect you from being hurt by it.

For queer and trans people in Michigan, that fear isn't hypothetical. This is lived, daily reality.

When medical care becomes trauma

Dr. Shanna Kattari, associate professor at the University of Michigan School of Social Work, studies how iatrogenic post-traumatic stress disorder (PTSD) — trauma that comes directly from medical care — affects LGBTQ+ communities. It can show up when someone sees an alert from MyChart or gets a call from their provider's office. "It might look like delaying or avoiding care, minimizing medical issues, dissociating from their body or even discouraging others from getting healthcare for fear of the same things happening," they explained.

The cost of avoidance is staggering. In Michigan research on transgender health, 46 percent of respondents reported delaying needed care — not preventative care, but needed care — due to fear of discrimination.

"By the time something is beyond urgent, they are rolling into the emergency department with multiple chronic and acute issues," Kattari said. "They then feel let down and betrayed once again by the system that harmed them previously."

And the experiences that cause that fear? Kattari didn't mince words. While smaller interactions like misgendering and using dead names can stack up, there are far more egregious experiences that are too common: refusing to touch patients because they're queer or trans, or conversely, touching them more aggressively and painfully. Blaming all health issues on someone's gender or sexuality. Not believing their reported pain levels. Using queerphobic and transphobic language, laughing at or about patients and flat-out denying care.

The intersectionality of marginalized identities compounds these barriers. "Racialized people, disabled people, lower income people, fat people, non-native English speakers are all already less likely to be believed by healthcare providers, more likely to be accused of faking it and/or drug seeking," Kattari noted. Many of these groups already have less access to providers due to systemic barriers like transportation, language access or insurance limitations.

The body keeps score

Daniel Horrigan, LMSW. Courtesy photo

Daniel Horrigan, social worker and founder of Your Story Counseling in Metro Detroit, sees the ripple effects daily. "A lot of people are afraid to seek care even before experiencing medical trauma. This can be due to shame and then the experience of medical and healthcare trauma adds to that." The outcomes include increased infection rates, hormonal and physical changes and increased anxiety, depression and isolation.

As a clinician using eye movement desensitization and reprocessing (EMDR), Horrigan works to address layered trauma. "Often we find prior traumas that we might target first to cultivate strength and resilience," he said. "EMDR is a very somatic practice and I'm really trying to care for people's bodies, including [with] this work." He refers clients to culturally competent providers including Corktown Health, Ruth Ellis Center, Planned Parenthood, Matrix and Be Well Medical Center in Berkley.

For some, the trauma lives so deeply in the body that walking into a clinic becomes a trigger.

Take Jordan Reyes, a nonbinary musician from Detroit who has turned appointment avoidance into an art form. "My doctor's office calls? Straight to voicemail," Jordan told me. They've experienced everything from invasive curiosity about their transition to being laughed at during a pelvic exam. "The last time, I made it all the way to the parking lot and then sat there crying until I drove home."

Jordan now brings a friend to every appointment — someone who can witness, intervene or just hold their hand. "It's not just about moral support," they noted. "It's about safety."

That approach is something Kattari actively recommends. They practice what they calls"yes...AND" — acknowledging fears while encouraging care. "Your feelings are real and valid, and I really think you need to get this looked at."

Partners and loved ones can help by taking on the labor of finding explicitly queer and trans affirming providers, attending appointments to reduce new trauma while helping hold space for any PTSD activation and establishing post-care rituals, which can include anything from getting ice cream to sitting in a dark room with calming music. "Additionally, not shaming them when they do cancel appointments is huge," Kattari added. "It might take several rounds to be able to actually make it through the door."

A path forward: the HEAL model

As a nurse who's also been a patient, I sometimes feel like I'm living in the in-between space: the medical system both broke and built me. I believe in science and medicine, but I also believe that we can't heal what we won't name. And especially for queer and trans people, trauma courtesy of the healthcare system is something we have to name, treat, and prevent.

So where do we start? The HEAL model:

Hold space. For yourself and others. Your fear, anger, and mistrust are valid.
Educate yourself. Find out your rights as a patient. Learn to spot signs of affirming care (inclusive intake forms, pronoun fields, visible nondiscrimination policies).
Advocate and ask. Bring a friend. Ask to record the appointment. Always have a notebook with you; taking notes can keep you grounded and providers behave better when they know you're writing everything down.
Laugh (and let go). Because sometimes, the absurdity of a "we don't do that kind of care here" conversation can only be met with gallows humor.

Trauma doesn't disappear because we will it away. Healing, especially from medical harm, is slow and nonlinear. But every time we name it, talk about it or make a plan to get through the next appointment, we reclaim a little bit of power the system tried to take.

Reyes put it best: "I still get scared every time I go to the doctor. But I go. I show up with my friend and my playlist. That's what healing looks like right now."

Same, Jordan. Same. We may never stop flinching when the MyChart alert pings, but we're learning to open it anyway.