Marginalized groups such as sexual and gender minorities are disproportionately affected by trauma, and health care staff and systems can inadvertently cause harm by re-traumatizing a patient – for instance, by misgendering a patient or through unnecessary or poorly handled body exposure or questioning. Being a trauma-informed agency does not mean treating the trauma, it means being mindful of how trauma affects individuals, and taking measures to reduce the risk of traumatizing or re-traumatizing those being served. A program, organization, or system that is trauma-informed contains these elements: Realizes the widespread impact of trauma and understands potential paths for recovery; Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; Responds by fully integrating knowledge about trauma into policies, procedures, and practices; Seeks to actively resist re-traumatization. Five guiding principles of trauma-informed-care include: safety, choice, collaboration, trustworthiness, and empowerment.