Skip to main content

Resilience Across the Life Span: Adulthood

  • Chapter
  • First Online:
Trauma, Resilience, and Health Promotion in LGBT Patients

Abstract

This chapter reviews the literature on resilience in lesbian, gay, bisexual, and transgender (LGBT) adults. Resilience as a result of LGBT minority stress is explored, followed by an overview of LGBT strengths identified in the context of positive psychology research. Specific areas of resilience are then explored. These include growth resulting from coming out, interpersonal factors implicated in resilience, and individual difference resilience factors. Individual difference factors reviewed include faith, religion, and spirituality; personality-related factors; and cultural factors. The specific topic of resilience against suicidality is addressed, followed by a review of emerging data including stress biomarkers and affirmative approaches to LGBT resilience promotion. The chapter ends with suggested strategies for promoting resilience in the context of patient/healthcare provider relationships and a case scenario highlighting resilience promotion among LGBT adults.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Note that “they” is used as a singular pronoun to avoid the false dichotomy of “he or she” that reinforces binary notions of sex and gender.

References

  1. Zautra AJ, Hall JS, Murray KE. Resilience: a new definition of health for people and communities. HandbAdult Resilience. 2010;1:3–34.

    Google Scholar 

  2. Meyer IH. Prejudice and discrimination as social stressors. In: The health of sexual minorities. Boston: Springer; 2007. p. 242–67.

    Chapter  Google Scholar 

  3. Vaughan MD, Miles J, Parent MC, Lee HS, Tilghman JD, Prokhorets S. A content analysis of LGBT-themed positive psychology articles. Psychol Sex Orientation Gend Divers. 2014;1(4):313–24.

    Article  Google Scholar 

  4. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.

    Google Scholar 

  5. Folkman S, Chesney M, McKusick L, Ironson G, Johnson D, Coates T. Translating coping theory into an intervention. In: Eckenrode J, editor. The social context of coping. New York: Plenum Press; 1991. p. 239–60.

    Chapter  Google Scholar 

  6. Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Washington, DC: National Academies Press; 2011.

    Google Scholar 

  7. Conger JJ. Proceedings of the American Psychological Association, incorporated, for the year 1974: minutes of the annual meeting of the Council of Representatives. Am Psychol. 1975;30:620–51.

    Article  Google Scholar 

  8. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Allport GW. The nature of prejudice. Reading: Addison- Wesley; 1954.

    Google Scholar 

  10. Hatzenbuehler ML. How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychol Bull. 2009;135(5):707–30.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Rostosky SS, Riggle ED, Gray BE, Hatton RL. Minority stress experiences in committed same-sex couple relationships. Prof Psychol Res Pract. 2007;38:392–400.

    Article  Google Scholar 

  12. Lehavot K. Coping strategies and health in a national sample of sexual minority women. Am J Orthopsychiatry. 2012;82(4):494–504.

    Article  PubMed  Google Scholar 

  13. Zea MC, Reisen CA, Poppen PJ. Psychological well-being among Latino lesbians and gay men. Cultur Divers Ethnic Minor Psychol. 1999;5(4):371–9.

    Article  Google Scholar 

  14. Park CL, Cohen LH, Murch RL. Assessment and prediction of stress-related growth. J Pers. 1996;64:71–106.

    Article  CAS  PubMed  Google Scholar 

  15. Vaughan MD, Rodriguez EM. LGBT strengths: incorporating positive psychology into theory, research, training, and practice. Psychol Sex Orientation Gend Divers. 2014;1(4):325–34.

    Article  Google Scholar 

  16. Seligman MEP, Csikszentmihalyi M. Positive psychology: an introduction. Am Psychol. 2000;55(1):5–14.

    Article  CAS  PubMed  Google Scholar 

  17. Riggle ED, Whitman JS, Olson A, Rostosky SS, Strong S. The positive aspects of being a lesbian or gay man. Prof Psychol Res Pract. 2008;39:210–7.

    Article  Google Scholar 

  18. Russell GM, Richards JA. Stressor and resilience factors for lesbians, gay men, and bisexuals confronting antigay politics. Am J Community Psychol. 2003;31(3–4):313–28.

    Article  PubMed  Google Scholar 

  19. Kwon P, Hugelshofer DS. The protective role of hope for lesbian, gay, and bisexual individuals facing a hostile workplace climate. J Gay Lesbian Ment Health. 2010;14(1):3–18.

    Article  Google Scholar 

  20. Kwon P. Resilience in lesbian, gay, and bisexual individuals. Personal Soc Psychol Rev. 2013;17(4):371–83.

    Article  Google Scholar 

  21. Riggle ED, Mohr JJ, Rostosky SS, Fingerhut AW, Balsam KF. A multifactor lesbian, gay, and bisexual positive identity measure (LGB-PIM). Psychol Sex Orientation Gend Divers. 2014;1(4):398–411.

    Article  Google Scholar 

  22. Hill CA, Gunderson CJ. Resilience of lesbian, gay, and bisexual individuals in relation to social environment, personal characteristics, and emotion regulation strategies. Psychol Sex Orientation Gend Divers. 2015;2(3):232–52.

    Article  Google Scholar 

  23. Berzon B. Positively gay. Millbrae: Celestial Arts; 1979.

    Google Scholar 

  24. Bonet L, Wells BE, Parsons JT. A positive look at a difficult time: a strength based examination of coming out for lesbian and bisexual women. J LBGT Health Res. 2007;3(1):7–14.

    Google Scholar 

  25. Vaughan MD, Waehler CA. Coming out growth: conceptualizing and measuring stress-related growth associated with coming out to others as a sexual minority. J Adult Dev. 2010;17(2):94–109.

    Article  Google Scholar 

  26. Bränström R, Hatzenbuehler ML, Pachankis JE. Sexual orientation disparities in physical health: age and gender effects in a population-based study. Soc Psychiatry Psychiatr Epidemiol. 2016;51(2):289–301.

    Google Scholar 

  27. Thomeer MB. Sexual minority status and self-rated health: the importance of socioeconomic status, age, and sex. Am J Public Health. 2013;103(5):881–8.

    Article  PubMed  PubMed Central  Google Scholar 

  28. McGarrity LA, Huebner DM. Is being out about sexual orientation uniformly healthy? The moderating role of socioeconomic status in a prospective study of gay and bisexual men. Ann Behav Med. 2014;47(1):28–38.

    Article  PubMed  Google Scholar 

  29. McGregor BA, Carver CS, Antoni MH, Weiss S, Yount SE, Ironson G. Distress and internalized homophobia among lesbian women treated for early stage breast cancer. Psychol Women Q. 2001;25(1):1–9.

    Article  Google Scholar 

  30. Pachankis JE, Cochran SD, Mays VM. The mental health of sexual minority adults in and out of the closet: a population-based study. J Consult Clin Psychol. 2015;83(5):890–901.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Waldo CR. Working in a majority context: a structural model of heterosexism as minority stress in the workplace. J Couns Psychol. 1999;46(2):218–32.

    Article  Google Scholar 

  32. Pachankis JE, Goldfried MR, Ramrattan ME. Extension of the rejection sensitivity construct to the interpersonal functioning of gay men. J Consult Clin Psychol. 2008;76(2):306–17.

    Article  PubMed  Google Scholar 

  33. Feinstein BA, Goldfried MR, Davila J. The relationship between experiences of discrimination and mental health among lesbians and gay men: an examination of internalized homonegativity and rejection sensitivity as potential mechanisms. J Consult Clin Psychol. 2012;80(5):917–27.

    Article  PubMed  Google Scholar 

  34. Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310–57.

    Article  CAS  PubMed  Google Scholar 

  35. Baumeister RF, Leary MR. The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol Bull. 1995;117(3):497–529.

    Article  CAS  PubMed  Google Scholar 

  36. Frost DM, Meyer IH. Measuring community connectedness among diverse sexual minority populations. J Sex Res. 2012;49(1):36–49.

    Article  PubMed  Google Scholar 

  37. Pflum SR, Testa RJ, Balsam KF, Goldblum PB, Bongar B. Social support, trans community connectedness, and mental health symptoms among transgender and gender nonconforming adults. Psychol Sex Orientation Gend Divers. 2015;2(3):281–6.

    Article  Google Scholar 

  38. Hanley S, McLaren S. Sense of belonging to layers of lesbian community weakens the link between body image dissatisfaction and depressive symptoms. Psychol Women Q. 2015;39(1):85–94.

    Article  Google Scholar 

  39. Ramirez-Valles J. The protective effects of community involvement for HIV risk behavior: a conceptual framework. Health Educ Res. 2002;17(4):389–403.

    Article  CAS  PubMed  Google Scholar 

  40. Weston K. Families we choose: Lesbians, gays, kinship. New York: Columbia University Press; 1991.

    Google Scholar 

  41. Patterson CJ. Lesbian and gay family issues in the context of changing legal and social policy environments. In: Bieschke KJ, Perez RM, DeBord KA, editors. Handbook of counseling and psychotherapy with lesbian, gay, bisexual, and transgender clients. 2nd ed. Washington, DC: American Psychological Association; 2007. p. 359–77.

    Google Scholar 

  42. Oswald RF. Resilience within the family networks of lesbians and gay men: intentionality and redefinition. J Marriage Fam. 2002;64(2):374–83.

    Article  Google Scholar 

  43. Levitt HM, Horne SG, Puckett J, Sweeney KK, Hampton ML. Gay families: challenging racial and sexual/gender minority stressors through social support. J GLBT Fam Stud. 2015;11(2):173–202.

    Article  Google Scholar 

  44. Arnold EA, Bailey MM. Constructing home and family: how the ballroom community supports African American GLBTQ youth in the face of HIV/AIDS. J Gay Lesbian Soc Serv. 2009;21(2–3):171–88.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Obergefell v. Hodges (2015).

    Google Scholar 

  46. United States v. Windsor (2013).

    Google Scholar 

  47. Perone AK. Health implications of the Supreme Court’s Obergefell vs. Hodges marriage equality decision. LGBT Health. 2015;2:196–9.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Patterson CJ. Family relationships of lesbians and gay men. J Marriage Fam. 2000;62(4):1052–69.

    Article  Google Scholar 

  49. Kurdek LA. Relationship outcomes and their predictors: longitudinal evidence from heterosexual married, gay cohabiting, and lesbian cohabiting couples. J Marriage Fam. 1998;60:553–68.

    Article  Google Scholar 

  50. Ontario consultants on religious tolerance. n.d. Available from: http://www.religioustolerance.org.

  51. Porter KE, Ronneberg CR, Witten TM. Religious affiliation and successful aging among transgender older adults: findings from the trans MetLife survey. J Religion Spirituality Aging. 2013;25(2):112–38.

    Article  Google Scholar 

  52. Schuck KD, Liddle BJ. Religious conflicts experienced by lesbian, gay, and bisexual individuals. J Gay Lesbian Psychother. 2001;5(2):63–82.

    Article  Google Scholar 

  53. Bowleg L, Huang J, Brooks K, Black A, Burkholder G. Triple jeopardy and beyond: multiple minority stress and resilience among black lesbians. J Lesbian Stud. 2003;7(4):87–108.

    Article  PubMed  Google Scholar 

  54. Walker JNJ, Longmire-Avital B. The impact of religious faith and internalized homonegativity on resiliency for black lesbian, gay, and bisexual emerging adults. Dev Psychol. 2013;49(9):1723–31.

    Article  PubMed  Google Scholar 

  55. Lease SH, Horne SG, Noffsinger-Frazier N. Affirming faith experiences and psychological health for caucasian lesbian, gay, and bisexual individuals. J Couns Psychol. 2005;52(3):378–88.

    Article  Google Scholar 

  56. Yarhouse MA, Carrs TL. MTF transgender Christians’ experiences: a qualitative study. J LGBT Issues Couns. 2012;6(1):18–33.

    Article  Google Scholar 

  57. Carter LW, Mollen D, Smith NG. Locus of control, minority stress, and psychological distress among lesbian, gay, and bisexual individuals. J Couns Psychol. 2014;61:169–75.

    Article  PubMed  Google Scholar 

  58. Moradi B, Wiseman MC, DeBlaere C, Goodman MB, Sarkees A, Brewster ME, et al. LGB of color and white individuals’ perceptions of heterosexist stigma, internalized homophobia, and outness: comparisons of levels and links. Couns Psychol. 2010;38(3):397–424.

    Article  Google Scholar 

  59. Balsam KF, Molina Y, Blayney JA, Dillworth T, Zimmerman L, Kaysen D. Racial/ethnic differences in identity and mental health outcomes among young sexual minority women. Cultur Divers Ethnic Minor Psychol. 2015;21(3):380–90.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Sung MR, Szymanski DM, Henrichs-Beck C. Challenges, coping, and benefits of being an Asian American lesbian or bisexual woman. Psychol Sex Orientation Gend Divers. 2015;2(1):52–64.

    Article  Google Scholar 

  61. Kleiman S, Spanierman LB, Smith NG. Translating oppression: understanding how sexual minority status is associated with white men’s racial attitudes. Psychol Men Masculinity. 2015;16:404–15.

    Article  Google Scholar 

  62. King M, Semlyen J, Tai SS, Killaspy H, Osborn D, Popelyuk D, et al. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry. 2008;8:70.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Meyer IH, Dietrich J, Schwartz S. Lifetime prevalence of mental disorders and suicide attempts in diverse lesbian, gay, and bisexual populations. Am J Public Health. 2008;98(6):1004–6.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Blosnich JR, Nasuti LJ, Mays VM, Cochran SD. Suicidality and sexual orientation: characteristics of symptom severity, disclosure, and timing across the life course. Am J Orthopsychiatry. 2016;86(1):69–78.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Mathy RM. Transgender identity and suicidality in a nonclinical sample: sexual orientation, psychiatric history, and compulsive behaviors. J Psychol Hum Sex. 2002;14:47–65.

    Article  Google Scholar 

  66. Nuttbrock L, Hwahng S, Bockting W, Rosenblum A, Mason M, Macri M, et al. Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. J Sex Res. 2010;47:12–23.

    Article  PubMed  Google Scholar 

  67. Clements-Nolle K, Marx R, Katz M. Attempted suicide among transgender persons: the influence of gender-based discrimination and victimization. J Homosex. 2006;51:53–69.

    Article  PubMed  Google Scholar 

  68. Grant JM, Mottet LA, Tanis J, Harrison J, Herman JL, Keisling M. Injustice at every turn: a report of the National Transgender Discrimination Survey. Washington, DC: National Center for Trans- gender Equality and National Gay and Lesbian Task Force; 2011.

    Google Scholar 

  69. Johnson J, Wood AM, Gooding P, Taylor PJ, Tarrier N. Resilience to suicidality: the buffering hypothesis. Clin Psychol Rev. 2011;31:563–91.

    Article  PubMed  Google Scholar 

  70. Osman A, Gutierrez PM, Muehlenkamp JJ, Dix-Richardson F, Barrios FX, Kopper BA. Suicide resilience inventory-25: development and preliminary psychometric properties. Psychol Rep. 2004;94:1349–60.

    PubMed  Google Scholar 

  71. Linehan MM, Goodstein JL, Nielsen SL, Chiles JA. Reasons for staying alive when you are thinking of killing yourself: the reasons for living inventory. J Consult Clin Psychol. 1983;51:276–86.

    Article  CAS  PubMed  Google Scholar 

  72. Moody C, Smith NG. Suicide protective factors among trans adults. Arch Sex Behav. 2013;42:739–52.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Moody C, Fuks N, Pelaez S, Smith NG. “Without this, I would for sure already be dead”: a qualitative inquiry regarding suicide protective factors among trans adults. Psychol Sex Orientation Gend Divers. 2015;2:266–80.

    Article  Google Scholar 

  74. Juster R-P, Hatzenbuehler ML, Mendrek A, Pfaus JG, Smith NG, Johnson PJ, et al. Sexual orientation modulates endocrine stress reactivity. Biol Psychiatry. 2015;77(7):668–76.

    Article  CAS  PubMed  Google Scholar 

  75. Juster R-P, Smith NG, Ouellet É, Sindi S, Lupien SJ. Sexual orientation and disclosure in relation to psychiatric symptoms, diurnal cortisol, and allostatic load. Psychosom Med. 2013;75(2):103–16.

    Article  PubMed  Google Scholar 

  76. Hatzenbuehler ML, McLaughlin KA. Structural stigma and hypothalamic–pituitary–adrenocortical axis reactivity in lesbian, gay, and bisexual young adults. Ann Behav Med. 2014;47(1):39–47.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Pachankis JE, Hatzenbuehler ML, Rendina HJ, Safren SA, Parsons JT. LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: a randomized controlled trial of a transdiagnostic minority stress approach. J Consult Clin Psychol. 2015;83:875–89.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Smith NG, Hart TA, Moody C, Willis AC, Andersen MF, Blais M, et al. Project PRIDE: a cognitive-behavioral group intervention to reduce HIV risk behaviors among HIV-negative young gay and bisexual men. Cogn Behav Pract. 2016;23:398–411.

    Google Scholar 

  79. Moody C, Smith NG, Hart T, Willis AC, Stratton NL, Blais M, et al. Project PRIDE (Promoting Resilience In Discriminatory Environments): results of a pilot test of an HIV-prevention intervention for gay and bisexual men. Counseling Psychology Conference; Atlanta, 2014.

    Google Scholar 

  80. Johnson SD. Gay affirmative psychotherapy with lesbian, gay, and bisexual individuals: implications for contemporary psychotherapy research. Am J Orthopsychiatry. 2012;82(4):516–22.

    Article  PubMed  Google Scholar 

  81. Eliason MJ, Schope R. Original research: does “don’t ask don’t tell” apply to health care? Lesbian, gay, and bisexual people’s disclosure to health care providers. J Gay Lesbian Med Assoc. 2001;5(4):125–34.

    Article  Google Scholar 

  82. Seaver MR, Freund KM, Wright LM, Tjia J, Frayne SM. Healthcare preferences among lesbians: a focus group analysis. J Womens Health. 2008;17(2):215–25.

    Article  Google Scholar 

  83. Bergeron S, Senn CY. Health care utilization in a sample of Canadian lesbian women: predictors of risk and resilience. Women Health. 2003;37(3):19–35.

    Article  PubMed  Google Scholar 

  84. American Psychological Association. Guidelines for psychological practice with lesbian, gay, and bisexual clients. Am Psychol. 2012;67(1):10–42.

    Article  Google Scholar 

  85. American Psychological Association. Guidelines for psychological practice with transgender and gender nonconforming people. Am Psychol. 2015;70(9):832–64.

    Article  Google Scholar 

  86. Hollenbach A, Eckstrand KL, Dreger AD. Implementing curricular and institutional climate changes to improve health care for individuals who are LGBT, gender nonconforming, or born with DSD: a resource for medical educators. Washington, DC: Association of American Medical Colleges; 2014. Available from: http://www.aamc.org/lgbtdsd.

  87. Gay, Lesbian, Bisexual and Transgender Health Access Project. Community standards of practice for the provision of quality health care services to lesbian, gay, bisexual, and transgender clients. Boston: Gay, Lesbian, Bisexual and Transgender Health Access Project. Available from: http://www.glbthealth.org/CommunityStandardsofPractice.htm.

  88. Gay and Lesbian Medical Association. Guidelines for care of lesbian, gay, bisexual and transgender patients. San Francisco: Gay and Lesbian Medical Association; 2006. Available from: http://glma.org/_data/n_0001/resources/live/GLMAguidelines 2006 FINAL.pdf.

  89. Meyer IH. Resilience in the study of minority stress and health of sexual and gender minorities. Psychol Sex Orientation Gend Divers. 2015;2(3):209–13.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nathan Grant Smith PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Smith, N.G. (2017). Resilience Across the Life Span: Adulthood. In: Eckstrand, K., Potter, J. (eds) Trauma, Resilience, and Health Promotion in LGBT Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-54509-7_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-54509-7_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54507-3

  • Online ISBN: 978-3-319-54509-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics