Interpersonal Trauma, Marginalization, and Low-Resource Settings: Understanding Sexual and Gender Minority People's...

Sexual and gender minority (SGM) people disproportionately experience interpersonal trauma and face significant barriers to affirmative support. This mixed-methods study explored help-seeking and care utilization among 55 SGM people who experienced sexual assault, intimate partner violence, or childhood maltreatment and lived in low-resource areas across New York State (M_age=30.47; SD=9.83; 70.9% cisgender women; 27.3% people of color; 29.1% annual income ≤$9,999). Participants completed an online needs assessment survey with quantitative and open-ended questions. Descriptive statistics described sample characteristics, help-seeking, and care utilization experiences. Conventional content analysis was employed to examine contexts surrounding experiences seeking support and utilizing services. In the past year, 38.2% sought interpersonal trauma-related mental health treatment; nearly a third lacked confidence in finding SGM-affirmative providers and experienced poor provider treatment and 18.2% experienced SGM conversion efforts in their lifetime. Qualitative data revealed five interrelated themes describing social and structural contexts that shaped help-seeking and care engagement, including (1) anticipated stigma and self-protective avoidance as barriers to help-seeking; (2) family and relational responses shape safety, disclosure, and avoidance; (3) provider validation versus invalidation shapes trust and engagement in care; (4) geographic isolation undermines safety, anonymity, and care access; and, (5) structural inequities and policy barriers reinforce mistrust and limit options. The current study's findings offer a novel socioecological perspective on interpersonal trauma - related help-seeking among SGM people in low-resource settings, demonstrating how stigma, trust, provider interactions, geographic isolation, and structural inequities shape care-seeking pathways.