Article

Intimate Partner Violence and Mental Health Among Transgender/Gender Nonconforming Adults

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

There is significant evidence to suggest that intimate partner violence (IPV) is associated with mental health problems including anxiety and depression. However, this research has almost exclusively been conducted through heteronormative and cisgender lenses. The current study is an exploratory, quantitative analysis of the relationship between experiences of IPV and mental health among transgender/gender nonconforming (TGNC) adults. A national sample of 78 TGNC individuals completed a survey online measuring participants' experiences with IPV and depression, anxiety, and satisfaction with life. Of the sample, 72% reported at least one form of IPV victimization in their lifetime: 32% reported experiencing sexual IPV, 71% psychological IPV, 42% physical IPV, and 29% IPV assault with injury. All four types of IPV were positively associated with anxiety, and all but physical abuse was significantly associated with depression. None of the four types of IPV was associated with satisfaction with life. In a canonical correlation, IPV victimization and mental health had 31% overlapping variance, a large-sized effect. Sexual IPV and anxiety were the highest loading variables, suggesting that TGNC individuals who have experienced sexual IPV specifically tended to have higher levels of anxiety. These findings support previous qualitative, small-sample studies suggesting that IPV is a pervasive problem in the TGNC community. TGNC individuals who have experienced IPV may be at increased risk for mental health problems, and therefore, IPV history may trigger appropriate mental health screenings and referrals for this population in health care settings.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... 4,9 Intersecting multilevel negative forces gravely impact individual-level outcomes, 10 yielding severe mental health issues (e.g., depression, psychological distress, suicidality), [11][12][13][14] internalized stigma (e.g., poor selfworth), 15,16 and negative behavioral consequences (e.g., substance use, avoidance of healthcare, sexual risk, and poor outcomes on the HIV continuum). 12,17 These represent socially determined explanatory factors behind the high morbidity and mortality recorded to date among diverse transgender groups, globally 3,10,[18][19][20][21] At the individual level, transgender persons experience striking health inequities in HIV, mental health, and drug and alcohol use compared to cisgender individuals. 12,18,[22][23][24][25] HIV and STI rates are highest among transgender women, especially of color. ...
... 12,18,[22][23][24][25] HIV and STI rates are highest among transgender women, especially of color. 3,[22][23][24][25][26][27][28][29] Psychosocial health inequities include drug use, 9,11,[30][31][32][33][34] often as a coping mechanism against and a consequence of stigma and discrimination, 10,31 depression, 13,14,35,36 anxiety, 13,37 attempted suicide 9,11,14,38,39 and violence, 5,11,14,20,40 including intimate partner violence, 10,19,29,40 and sexual assault. 9,11,14,41 Health inequities are driven at the institutional level by stigma in healthcare. ...
... High school/GED 2,189 (13) 1,661 (17) 339 (7) 180 (7) 1,437 (18) 330 (7) 415 (9) 1,648 (18) 495 (7) 37 (5) 1,064 (21) 227 (12) 869 ( (7) 1,316 (16) 419 (9) 374 (8) 1,518 (17) 538 (8) 47 (6) 964 (19) 255 (13) 872 ( ...
Article
Background Transgender individuals face severe stigma-driven health inequities structurally, institutionally and interpersonally, yielding poor individual-level outcomes. Gender affirmation, or being recognized based on one's gender identity, expression and/or role, may be considered a manifestation of resilience. Methods To provide intervention and policy guidelines, we examined latent constructs representative of gender affirmation (legal documentation changes, transition-related medical procedures, familial support) and discrimination (unequal treatment, harassment, and attacks), and tested their impact on mental, physical, and behavioral health outcomes among 17,188 binary-identified transgender participants in the 2015 US Transgender Survey. Results Confirmatory factor analyses revealed high standardized factor loadings for both latent variables, on which we regressed outcomes using structural equation modeling. Fit indices suggested good model fit. Affirmation was associated with lower odds of suicidal ideation (p < .001) and psychological distress (p < .001), and higher odds of substance use (p < .001), and past-year healthcare use and HIV-testing (p < .001). Discrimination was associated with higher odds of suicidal ideation (p < .001), psychological distress (p < .001), substance use (p < .001), and past-year HIV-testing (p < .001). Affirmation and discrimination interaction analyses showed lower odds of past-year suicidal ideation (p < .01), with affirmation having a significant moderating protective effect against discrimination. Conclusions Gender affirmation is paramount in upholding transgender health, and these findings carry global significance, beyond the US. Clarification of affirmation procedures, and increases in its accessibility, equitably across racial/ethnic groups, should become a priority, from policy to the family unit. The impact of discrimination demands continued advocacy via education and policy.
... 12,17 These represent socially determined explanatory factors behind the high morbidity and mortality recorded to date among diverse transgender groups, globally. 3,10,[18][19][20][21] At the individual level, transgender persons experience striking health inequities in HIV, mental health, and drug and alcohol use compared to cisgender individuals. 12,18,[22][23][24][25] HIV and STI rates are highest among transgender women, especially of color. ...
... 12,18,[22][23][24][25] HIV and STI rates are highest among transgender women, especially of color. 3,[22][23][24][25][26][27][28][29] Psychosocial health inequities include drug use, 9,11,[30][31][32][33][34] often as a coping mechanism against and a consequence of stigma and discrimination, 10,31 depression, 13,14,35,36 anxiety, 13,37 attempted suicide 9,11,14,38,39 and violence, 5,11,14,20,40 including intimate partner violence, 10,19,29,40 and sexual assault. 9,11,14,41 Health inequities are driven at the institutional level by stigma in healthcare. ...
... Trans women 9,238 (54) 5,206 (53) 2,616 (55) 1,383 (57) 4,412 (55) 2,283 (51) 2,529 (55) 4,273 (47) 4,322 (61) 551 (68) 2,380 (47) (4) 58 (1) 35 (1) 374 (5) 61 (1) 88 (2) 418 (5) 93 (1) 10 (1) 295 (6) 56 (3) 166 (2) (17) 339 (7) 180 (7) 1,437 (18) 330 (7) 415 (9) 1,648 (18) 495 (7) 37 (5) 1,064 (21) 227 (12) 869 (9) (15) 416 (9) 169 (7) 1,316 (16) 419 (9) 374 (8) 1,518 (17) 538 (8) 47 (6) 964 (19) 255 (13) 872 (9) (7) 892 (9) 230 (5) 124 (5) 750 (9) 235 (5) 261 (6) 793 (9) 399 (6) 54 (7) 535 (11) 113 (6) 588 (6) 999 (M ¼ 2.9, SD ¼ 1.86) ...
Article
Full-text available
Transgender individuals face severe stigma-driven health inequities structurally, institutionally, and interpersonally, yielding poor individual-level outcomes. Gender affirmation, or being recognized based on one’s gender identity, expression, and/or role, may be considered a manifestation of resilience. To provide intervention and policy guidelines, we examined latent constructs representative of gender affirmation (legal documentation changes, transition-related medical procedures, familial support) and discrimination (unequal treatment, harassment, and attacks), and tested their impact on mental, physical, and behavioral health outcomes among 17,188 binary-identified transgender participants in the 2015 US Transgender Survey. Confirmatory factor analyses revealed high standardized factor loadings for both latent variables, on which we regressed outcomes using structural equation modeling. Fit indices suggested good model fit. Affirmation was associated with lower odds of suicidal ideation and psychological distress, and higher odds of substance use, and past-year healthcare use and HIV-testing. Discrimination was associated with higher odds of suicidal ideation, psychological distress, substance use, and past-year HIV-testing. Affirmation and discrimination interaction analyses showed lower odds of past-year suicidal ideation, with affirmation having a significant moderating protective effect against discrimination. Gender affirmation is paramount in upholding transgender health. Clarification of affirmation procedures, and increases in its accessibility, equitably across racial/ethnic groups, should become a priority, from policy to the family unit. The impact of discrimination demands continued advocacy via education and policy.
... Obtaining a comprehensive understanding of the scope of IPV against TNB people is further complicated since TNB IPV victims are often misgendered and misnamed in media reports, furthering the erasure of TNB people within the IPV conversation (National Coalition of Anti-Violence Programs [NCAVP], 2017). Additionally, much extant IPV research with TNB participants captures lifetime IPV prevalence, not accounting for when the violence occurred and making it challenging to determine if TNB identities were associated with the violence (Henry, Perrin, Coston, & Calton, 2018). However, research is beginning to address this: in the 2015 United States Transgender Survey (USTS), participants were asked if their experiences of IPV were related to their gender identity (James et al., 2016). ...
... Though there is limited research on the IPV experiences of TNB people, lifetime prevalence is as high as 72% (Brown & Herman, 2015;Garthe et al., 2018;Henry et al., 2018;James et al., 2016), with research indicating TNB persons report a higher lifetime prevalence of IPV than cisgender peers (Langenderfer-Magruder, Whitfield, Walls, Kattari, & Ramos, 2016). ...
... In examining specific forms of violence, a national sample of 78 transgender/gender nonconforming adults found high prevalence for psychological IPV (71%), physical IPV (42%), sexual IPV (32%), and IPV assault with injury (29%; Henry et al., 2018). Notably, this pattern of descending prevalence-psychological, physical, and sexual IPV-mirrors that seen in broader IPV research (e.g., Coker, Smith, McKeown, & King, 2000). ...
... 42,43 Among the 71 unique studies that enrolled transgender individuals rather than service providers, AMAB individuals participated in 78% (n = 55/71), [6][7][8][9]11,15,22,23,26,[29][30][31][32][33][34][35][36][37][38]40,42, and AFAB individuals participated in 44% (n = 31/71) of studies. 6,9,15,22,23,26,29,31,35,37,38,40,42,[47][48][49][50][51][52]56,61,62,[65][66][67][71][72][73][74][75]78 While 28% (n = 20/71) of studies explicitly reported inclusion of nonbinary individuals, 6,9,15,26,35,38,40,47,[50][51][52]62,[65][66][67][71][72][73]75,78 this is likely an underestimate attributable to frequent lack of disaggregation of nonbinary participants. Authors from 30 of the 71 studies did not publish disaggregated IPV data for transgender participants or other information necessary for inclusion in the review, but they provided these data when contacted. ...
... 42,43 Among the 71 unique studies that enrolled transgender individuals rather than service providers, AMAB individuals participated in 78% (n = 55/71), [6][7][8][9]11,15,22,23,26,[29][30][31][32][33][34][35][36][37][38]40,42, and AFAB individuals participated in 44% (n = 31/71) of studies. 6,9,15,22,23,26,29,31,35,37,38,40,42,[47][48][49][50][51][52]56,61,62,[65][66][67][71][72][73][74][75]78 While 28% (n = 20/71) of studies explicitly reported inclusion of nonbinary individuals, 6,9,15,26,35,38,40,47,[50][51][52]62,[65][66][67][71][72][73]75,78 this is likely an underestimate attributable to frequent lack of disaggregation of nonbinary participants. Authors from 30 of the 71 studies did not publish disaggregated IPV data for transgender participants or other information necessary for inclusion in the review, but they provided these data when contacted. ...
... Authors from 30 of the 71 studies did not publish disaggregated IPV data for transgender participants or other information necessary for inclusion in the review, but they provided these data when contacted. 7,17,24,26,[29][30][31][33][34][35][36][37][38]42,43,47,48,61,62,66,70,72,74,76,77,[79][80][81][82][83] We excluded more than 40 articles representing more than 3000 transgender participants because, although they contained IPV data and recruited transgender participants, the authors were unresponsive to requests for disaggregated statistics for transgender participants. ...
Article
Background: Transgender individuals experience unique vulnerabilities to intimate partner violence (IPV) and may experience a disproportionate IPV burden compared with cisgender (nontransgender) individuals. Objectives: To systematically review the quantitative literature on prevalence and correlates of IPV in transgender populations. Search Methods: Authors searched research databases (PubMed, CINAHL), gray literature (Google), journal tables of contents, and conference abstracts, and consulted experts in the field. Authors were contacted with data requests in cases in which transgender participants were enrolled in a study, but no disaggregated statistics were provided for this population. Selection Criteria: We included all quantitative literature published before July 2019 on prevalence and correlates of IPV victimization, perpetration, or service utilization in transgender populations. There were no restrictions by sample size, year, or location. Data Collection and Analysis: Two independent reviewers conducted screening. One reviewer conducted extraction by using a structured database, and a second reviewer checked for mistakes or omissions. We used random-effects meta-analyses to calculate relative risks (RRs) comparing the prevalence of IPV in transgender individuals and cisgender individuals in studies in which both transgender and cisgender individuals were enrolled. We also used meta-analysis to compare IPV prevalence in assigned-female-sex-at-birth and assigned-male-sex-at-birth transgender individuals and to compare physical IPV prevalence between nonbinary and binary transgender individuals in studies that enrolled both groups. Main Results: We identified 85 articles from 74 unique data sets (n total = 49 966 transgender participants). Across studies reporting it, the median lifetime prevalence of physical IPV was 37.5%, lifetime sexual IPV was 25.0%, past-year physical IPV was 16.7%, and past-year sexual IPV was 10.8% among transgender individuals. Compared with cisgender individuals, transgender individuals were 1.7 times more likely to experience any IPV (RR = 1.66; 95% confidence interval [CI] = 1.36, 2.03), 2.2 times more likely to experience physical IPV (RR = 2.19; 95% CI = 1.66, 2.88), and 2.5 times more likely to experience sexual IPV (RR = 2.46; 95% CI = 1.64, 3.69). Disparities persisted when comparing to cisgender women specifically. There was no significant difference in any IPV, physical IPV, or sexual IPV prevalence between assigned-female-sex-at-birth and assigned-male-sex-at-birth individuals, nor in physical IPV prevalence between binary- and nonbinary-identified transgender individuals. IPV victimization was associated with sexual risk, substance use, and mental health burden in transgender populations. Authors’ Conclusions: Transgender individuals experience a dramatically higher prevalence of IPV victimization compared with cisgender individuals, regardless of sex assigned at birth. IPV prevalence estimates are comparably high for assigned-male-sex-at-birth and assigned-female-sex-at-birth transgender individuals, and for binary and nonbinary transgender individuals, though more research is needed. Public Health Implications: Evidence-based interventions are urgently needed to prevent and address IPV in this high-risk population with unique needs. Lack of legal protections against discrimination in employment, housing, and social services likely foster vulnerability to IPV. Transgender individuals should be explicitly included in US Preventive Services Task Force recommendations promoting IPV screening in primary care settings. Interventions at the policy level as well as the interpersonal and individual level are urgently needed to address epidemic levels of IPV in this marginalized, high-risk population. (Am J Public Health. Published online ahead of print July 16, 2020: e1–e14. doi:10.2105/AJPH.2020.305774)
... 12,17 These represent socially determined explanatory factors behind the high morbidity and mortality recorded to date among diverse transgender groups, globally. 3,10,[18][19][20][21] At the individual level, transgender persons experience striking health inequities in HIV, mental health, and drug and alcohol use compared to cisgender individuals. 12,18,[22][23][24][25] HIV and STI rates are highest among transgender women, especially of color. ...
... 12,18,[22][23][24][25] HIV and STI rates are highest among transgender women, especially of color. 3,[22][23][24][25][26][27][28][29] Psychosocial health inequities include drug use, 9,11,[30][31][32][33][34] often as a coping mechanism against and a consequence of stigma and discrimination, 10,31 depression, 13,14,35,36 anxiety, 13,37 attempted suicide 9,11,14,38,39 and violence, 5,11,14,20,40 including intimate partner violence, 10,19,29,40 and sexual assault. 9,11,14,41 Health inequities are driven at the institutional level by stigma in healthcare. ...
... Trans women 9,238 (54) 5,206 (53) 2,616 (55) 1,383 (57) 4,412 (55) 2,283 (51) 2,529 (55) 4,273 (47) 4,322 (61) 551 (68) 2,380 (47) (4) 58 (1) 35 (1) 374 (5) 61 (1) 88 (2) 418 (5) 93 (1) 10 (1) 295 (6) 56 (3) 166 (2) (17) 339 (7) 180 (7) 1,437 (18) 330 (7) 415 (9) 1,648 (18) 495 (7) 37 (5) 1,064 (21) 227 (12) 869 (9) (15) 416 (9) 169 (7) 1,316 (16) 419 (9) 374 (8) 1,518 (17) 538 (8) 47 (6) 964 (19) 255 (13) 872 (9) (7) 892 (9) 230 (5) 124 (5) 750 (9) 235 (5) 261 (6) 793 (9) 399 (6) 54 (7) 535 (11) 113 (6) 588 (6) 999 (M ¼ 2.9, SD ¼ 1.86) ...
Article
Full-text available
"A dissertation submitted to the Graduate Faculty in Psychology ... " Thesis (Ph. D.) -- City University of New York, 2007. Includes bibliographical references (leaves 375-385).
... Multiple studies have demonstrated a clear, consistent relationship between IPV and negative health outcomes in substance use, mental health, and general health among samples of predominantly cisgender adults aged 50 and older (Dong et al., 2009;Warmling et al., 2017) and transgender adults aged 18 and older (Henry et al., 2021;Peitzmeier et al., 2020). An examination of the relationship between IPV and health-related outcomes among these populations can be used to generate hypotheses about the relationship between IPV and health-related outcomes among transgender adults aged 50 and older. ...
... In addition to previously mentioned negative outcomes including increased hospitalization, disability, nursing home admissions, and a 300% increased risk of death (Dong et al., 2009), healthrelated outcomes associated with IPV among cisgender adults aged 50 and older include increased alcohol use and drug use, depression, and anxiety (Warmling et al., 2017). Negative health-related outcomes associated with IPV among transgender adults aged 18 and older include anxiety (Henry et al., 2021), binge drinking, drug use, depression, and posttraumatic stress disorder (PTSD; Peitzmeier et al., 2020). Consistent with the Gender Minority Stress Framework (Meyer, 2015;Testa et al., 2015), transgender adults aged 50 and older, when compared to young transgender adults, and LGB heterosexual and cisgender adults aged 50 and older, are expected to face additional, potentially synergistic stressors in relation to both their age and transgender identity, including unique, transgender-specific forms of IPV and worse health. ...
Article
Background and objectives: Intimate partner violence (IPV) has been linked with poor health among young transgender, and age 50+ cisgender LGB and heterosexual, adults. The objective was to examine lifetime prevalence of IPV, and its association with health, among age 50+ transgender adults. Consistent with the Gender Minority Stress Framework, any IPV was hypothesized to be associated with worse health. Research design and methods: Responses from 3,462, age 50+ transgender adults from the 2015 U.S. Transgender Survey (James et al., 2016) were assessed for lifetime IPV and type. Logistic regression analyses, adjusted for demographic characteristics, examined the association between any IPV and substance use, and mental and general health measures. Results: Fifty-seven percent of respondents reported any lifetime IPV, including transgender-specific (41%), physical (36%), psychological (29%), severe physical violence (24%), stalking (12%), and sexual (10%), abuse. Given any, compared to no, experience of IPV, the odds of having a disability (AOR=1.21, CI=1.00-1.46) and rating current health more negatively (AOR=1.17, CI=1.08-1.26); smoking (AOR=1.31, CI=1.08-1.58) and qualifying for screening for serious mental illness (AOR=1.32, CI=1.04-1.66) within the last month; and ever using drugs (AOR=1.42, CI=1.22-1.65) and attempting suicide (AOR=1.98, CI=1.66-2.46) were significantly higher; only binge drinking was unrelated to IPV. Discussion and implications: More than half of respondents experienced IPV, with trans-specific IPV reported most commonly. Lifetime prevalence of any IPV was significantly associated with worse health. Recommendations include health surveillance that recognizes gender identity, and longitudinal study and routine screening of IPV, including trans-specific abuse, among transgender adults age 50+.
... 32 To date, most research on the mental and physical health effects of IPV are focused on (assumed) heterosexual and cisgender survivors. 33 This discrepancy perhaps is due to the false belief that IPV in same-gender relationships is less severe than cisgender male-to-female perpetrated violence 11 or by categorizing bisexual individuals in different-gender relationships as being heterosexual. 26 LGBTQ1 survivors in both same-gender and different-gender partnerships, however, experience negative physical (eg, injury) and mental (eg, posttraumatic stress disorder [PTSD] and continued fearfulness) health outcomes that can result in needing health care. 1 Physical violence may result in injuries, such as bruises, cuts, scrapes, swelling, and burns, 34 and survivors may suffer from chronic pain. ...
... Harrowingly, 1 survey found that 76% of trans IPV victims experience mental health consequences following victimization. 11 Trans individuals are vulnerable to anxiety when they have experienced IPV, 33 and black trans women survivors, specifically, report high rates of depression. 45 The poor mental health outcomes that black trans women experience appear to be related to living in a culture of white supremacy, cis-heteropatriarchy, and trans misogynoir. ...
Article
Lesbian, gay, bisexual, transgender, queer, and other sexual and gender (LGBTQ+) minorities experience intimate partner violence (IPV) at higher rates than heterosexual and/or cisgender people. Providers often are less prepared to work with LGBTQ+ survivors, which can be the result of a reliance on stereotypes on what constitutes an IPV victim. This article provides recommendations for working with LGBTQ+ survivors, including screening for IPV regardless of sexual orientation or gender identity, participating in LGBTQ+-affirming trainings regarding IPV, and creating a welcoming and inclusive space that promotes LGBTQ+ survivors' comfort in disclosing IPV.
... 8 A recent study showed that 72% of transgender and gender nonconforming adults have experienced at least one incident of violence from an intimate partner in their lifetime (32% reporting sexual violence, 71% psychological violence, 42% physical violence, and 29% assault and injury). 9 Comparatively less is known about the experience of abuse and violence in younger trans populations, with most of the literature focused on the experience of bullying, harassment, and victimization in the school setting. For example, Grant et al. 10 found that 78% of transgender adults recalled harassment and 35% recalled physical assault during their school years. ...
... 23,24 Similar associations have been observed among transgender adults, such as between various types of intimate partner violence (sexual, physical, and psychological) and clinically significant anxiety and depression. 9 It is difficult to compare our sample with young same-sex attracted and gender-questioning (SSAGQ) young people because of incongruent measures of trauma. An Australian study found that 61% of SSAGQ young people had experienced verbal abuse due to their gender identity or sexuality; 18% had experienced physical abuse due to their gender identity or sexuality; and 24% had experienced verbal and physical abuse within their family. ...
Article
Purpose: Trans and gender diverse (TGD) young people have reported high levels of mental distress in research studies, specifically depression, anxiety, self-harming, and suicidal behaviors. Rates of abuse are also high in TGD populations, but little is known about how this relates to mental health in populations of TGD young people. This study sought to examine associations between experiences of abuse and mental health outcomes. Methods: A cross-sectional study design was used. An anonymous online questionnaire was conducted to determine rates of abuse among Australian TGD young people (N = 859) and the potential association with poor mental health. Primary outcomes of interest were self-reported psychiatric diagnoses, self-harm and suicidal behaviors, and current anxiety and depressive symptoms. Results: Exposures to six forms of abuse are reported in this article: extrafamilial physical abuse, familial physical abuse, extrafamilial sexual abuse, familial sexual abuse, abuse within an intimate relationship, and other familial abuse (including emotional or verbal abuse and neglect). All six forms of abuse measured were associated with poor mental health overall; risk estimates for some forms of abuse were much stronger than others. Conclusion: The current findings have wide-ranging implications for clinical practice. Those working in TGD health care need to be aware of the high prevalence of violence and abuse among TGD young people and the association with poor mental health outcomes. The findings also have implications for broader societal change and interventions targeting increasing parental support to reduce familial violence against TGD young people.
... It should be noted that these study findings varied depending on sex and/or sexual or gender minority subgroup. The high prevalence of physical health conditions among sexual and gender minority (SGM) individuals could be explained, in part, by their greater exposure to intercon-nected and mutually reinforcing psychosocial risks, including substance use, [12][13][14] sexual assault, 15,16 intimate partner violence, [16][17][18] depression, [19][20][21] and posttraumatic stress disorder (PTSD). 22,23 These types of synergistic psychosocial issues affecting SGM populations are referred to as a syndemic and compound overall risk for physical health conditions. ...
... [31][32][33] However, little is known about the associations between psychosocial syndemic risks and physical health conditions other than HIV. 5 In addition, despite the pervasiveness of trauma exposure and PTSD among SGM individuals, 22,23 scant research has examined PTSD as a psychosocial risk factor in relation to physical health conditions in this population. The importance of expanding the syndemics research to understand psychosocial determinants of physical health conditions among SGM individuals is underscored by evidence documenting that physical health conditions among SGM individuals are linked to increased rates of each of these psychosocial risks at least separately: violence (e.g., sexual assault and intimate partner violence), [15][16][17][18] health-risk behavior (e.g., substance use), [12][13][14] and psychological distress (e.g., depression and PTSD). [19][20][21][22][23] Methodologically, most syndemics research into physical health conditions has used an additive (i.e., dose response) approach with a count of syndemic conditions predicting health outcomes, without further assessing the possibility of a synergistic effect of syndemic conditions. ...
Article
Full-text available
Purpose: The high prevalence of physical health conditions among sexual and gender minority (SGM) individuals could be explained, in part, by SGM individuals' disparate exposure to interconnected psychosocial syndemic risks, including substance use, depression, posttraumatic stress disorder, intimate partner violence, and sexual assault. We utilized a syndemic framework to understand the overlapping and potentially synergistic association between psychosocial syndemic risks and physical health conditions among SGM adults. Methods: A sample of 298 self-identified SGM adults (M age = 28.03, SD = 9.86; 47.0% racial/ethnic minority, 41.6% transgender or gender nonconforming) completed an online survey from May 2016 through May 2017. Results: Three (1.0%) participants reported no syndemic risks, 19 (6.4%) reported one, 52 (17.4%) reported two, 85 (28.5%) reported three, 89 (29.9%) reported four, and 50 (16.8%) reported all five syndemic risks. The number of psychosocial syndemic risks was positively associated with the number of physical health conditions and synergistically (i.e., more than additively) increased the overall health burden on SGM individuals. Conclusion: We found evidence for psychosocial syndemic risks as predictors of SGM individuals' physical health. This study is novel in providing evidence for syndemics surrounding a comprehensive set of physical health outcomes among individuals identifying along a full spectrum of SGM identities. The study controlled for HIV to examine syndemic conditions surrounding physical health outcomes beyond this well-established syndemically determined condition. Comprehensive intervention and policy efforts that address co-occurring psychosocial risks for physical health conditions are needed to reduce health disparities affecting SGM populations.
... There was some inconsistency in the research related to anxiety. Two studies identified higher anxiety symptoms in individuals who experienced IPSV, 21,22 whereas one study showed that physical IPV severity but not IPSV severity predicted anxiety symptoms, 23 and two other studies found no differences in anxiety symptoms for those exposed to IPSV compared with other types of violence. 6,20 Of the studies that identified an association between anxiety and IPSV, one was a U.S. study that found that women and men with a high degree of shame proneness were at risk of developing IPSV-related anxiety symptoms in a moderation analysis (beta = 0.42, p < 0.001 for men; beta = 0.11, p < 0.01 for women), 21 and the other was a study of transgender/gender nonconforming individuals that found that sexual coercion and anxiety loaded most highly in a standardized canonical coefficient correlation analysis (-0.479 and -1.888 for IPSV and anxiety, respectively), suggesting that individuals with histories of IPSV experience higher anxiety 22 ; neither study reported proportions of individuals with IPSV who experienced anxiety symptoms in relation to other types of violence. ...
... Two studies identified higher anxiety symptoms in individuals who experienced IPSV, 21,22 whereas one study showed that physical IPV severity but not IPSV severity predicted anxiety symptoms, 23 and two other studies found no differences in anxiety symptoms for those exposed to IPSV compared with other types of violence. 6,20 Of the studies that identified an association between anxiety and IPSV, one was a U.S. study that found that women and men with a high degree of shame proneness were at risk of developing IPSV-related anxiety symptoms in a moderation analysis (beta = 0.42, p < 0.001 for men; beta = 0.11, p < 0.01 for women), 21 and the other was a study of transgender/gender nonconforming individuals that found that sexual coercion and anxiety loaded most highly in a standardized canonical coefficient correlation analysis (-0.479 and -1.888 for IPSV and anxiety, respectively), suggesting that individuals with histories of IPSV experience higher anxiety 22 ; neither study reported proportions of individuals with IPSV who experienced anxiety symptoms in relation to other types of violence. ...
Article
Background: Intimate partner sexual violence (IPSV) is a common but often overlooked form of intimate partner violence (IPV) that may have unique consequences for those who experience it. We aimed to explore how outcomes associated with IPSV differ from outcomes associated with other forms of intimate partner and sexual violence. Methods: We conducted a narrative review of the English-language literature, including original research studies and reports that focused on outcomes associated with IPSV. We aimed to quantify the risk for health outcomes associated with exposure to IPSV in comparison with exposure to other forms of interpersonal violence or nonexposure to interpersonal violence. Results: Twenty-eight publications were reviewed, most were small observational studies focused on women exposed to IPSV. Reported outcomes were related to mental health (n = 20 studies), physical and sexual health (n = 19 studies), and health of children with a parent exposed to IPSV (n = 1 study). Compared with other forms of interpersonal violence, exposure to IPSV was associated with greater risk for posttraumatic stress disorder and depressive symptoms, problematic substance use, suicidality, pain and other somatic symptoms, adverse sexual health problems, specific physical injuries including strangulation, and death by homicide. Children with an exposed parent were at higher risk for internalizing symptoms such as depression, anxiety, and somatization. Conclusions: Sexual violence in intimate partner relationships is common and has distinct consequences compared with other forms of interpersonal violence including elevated risks for suicidality and death by homicide. It should be given special consideration within the assessment and management of interpersonal violence.
... Transgender women of color are further disproportionately marginalized, experiencing heightened risks of discrimination, stigma, and violence due to their intersecting identities as women, racial/ethnic minorities, and sexual/ gender minorities. Data show significant disparities in substance use, mental health challenges, suicidal ideation, and mortality among transgender women of color compared with white transgender and cisgender women (Burnes et al., 2010;Henry et al., 2021;Lombardi, 2001;Peitzmeier et al., 2019;Testa et al., 2012;Wilson et al., 2013). While transgender women experience high rates of violence, they report seeking help at lower rates than cisgender women (Kattari et al., 2021). ...
Article
Within the United States, transgender women face a disproportionate burden of violence, experiencing increased rates of multiple forms of violence compared with cisgender women and other sexual/gender minority groups. Among transgender women, further racial/ethnic disparities in experiences of violence exist. Resilience has been shown to be protective against the adverse impacts of violence on mental and physical health outcomes, yet little is known about unique sources of resilience, coping, and strength among transgender women. Sixteen in-depth interviews were conducted with a racially diverse sample of transgender women between May and July, 2020 in Los Angeles. Participants were between the ages of 23 and 67 years. Four participants identified as African American/Black, four as Latina, four as White, two as Asian, and two as Native American. Participants were recruited from a local social service organization. Interview questions assessed social network characteristics, experiences of violence, coping mechanisms, and sources of resilience in response to violence. Deductive and inductive coding schemes were used to identify common themes, and data analysis focused upon experiences of violence and sources of resilience/coping. Violence was common among members of the sample, with every participant reporting a history of multiple forms of violence. Violence perpetration came from many sources, including cisgender male strangers, family members, intimate partners, and other transgender women. Women also reported multiple sources of strength and coping, including engaging in self-care and leisure activities, behavioral adaptations, mentorship/support from other transgender women, and striving to “pass” as cisgender. Despite having faced extensive violence, the participants in this sample were resilient, demonstrating many internal and external coping mechanisms and sources of strength. These findings can inform programs and services that target transgender women, providing participants with opportunities to build resilience and other coping mechanisms to buffer the harmful mental and physical health impacts of exposure to violence.
... Black women have unique and diverse experiences and needs, and those are best addressed through Black feminist frameworks, such as cultural betrayal trauma theory (e.g., Gómez, 2019aGómez, , 2019b, which center both ongoing societal oppression and within-group violence (e.g., Gómez & Gobin, 2020). These frameworks are beneficial when examining the various manifestations of structural intersectionality against diverse Black women, including the additional transphobia and heterosexism faced by Black transwomen (e.g., Bulkowski et al., 2019;Henry et al., 2021). This has implications for multiple societal systems and structures (Fraser et al., 2019), including healthcare (e.g., equity in access; reducing mistrust), labor (e.g., improved family/sick leave and working conditions; eliminating the pay gap) (Bloom, 2016;Moore & Ghilarducci, 2018), and housing (e.g., reducing barriers to relocation, increased affordable housing, tailored housing options for victims of violence) (Benfer et al., 2021). ...
Article
Due to systemic and structural inequities, the COVID‐19 pandemic disproportionately impacts the Black community, along with ongoing anti‐Black racism and violence. Violence against women in the home, particularly Black women, was prevalent during shelter in place, along with the additional family responsibilities of Black mothers. Crenshaw's theory of intersectionality (1991) provides a foundation for examining Black mothers’ experiences during shelter‐in‐place mandates. This mixed‐methods study aimed to quantitatively assess violence victimization, acknowledged racial inequities, depression and anxiety, while qualitatively examining Black mothers’ experiences in parenting during shelter‐in‐place orders. Participants (N = 127; Mage = 32.4 years) were mothers who self‐identify as Black or African American living in a Midwestern US city. Results showed that Black mothers who perceived greater COVID‐19 inequities in the Black community reported increased parental stress, decreased emotional support, greater exposure to physical or sexual violence, and higher symptoms of stress, anxiety, and depression. Qualitative results yielded numerous themes, including the integrative theme of two sides of the same coin, highlighting both positive parenting experiences and significant stressors for Black mothers. The implications point to the need for intersectional and feminist approaches to interventions and initiatives that support Black women as humans, mothers, souls, and spirits.
... The health impacts associated with IPV are profound, wide-ranging, and economically significant. IPV is associated with acute injuries stemming from physical trauma and chronic stress-related mental and physical health conditions that endure over the life course, leading to increased health care utilization and spending (Bidarra et al., 2016;Bonomi et al., 2006;Campbell, 2002;Henry et al., 2018;Jordan et al., 2010;McTavish et al., 2016;Peterson et al., 2018;Stewart & Vigod, 2017. Fortunately, research evidence suggests that timely, informed support from a health care provider can play an important role in mitigating both immediate and longer-term sequelae of IPV and gaining access to other supports (WHO, 2013). ...
Article
Full-text available
Resources addressing intimate partner violence (IPV) play a role in shaping how physicians conceptualize and perform their roles in caring for affected patients. This study combines environmental scanning with critical discourse analysis (CDA) to parse how roles of physicians were represented in 28 education materials and policy documents about IPV, taking the Canadian training milieu as an example. We developed a cyclical model of three core physician roles in addressing IPV—learning about IPV, identifying patients experiencing IPV, and responding to patients’ disclosures of IPV. The construction of these physician roles is suggestive of an ongoing process of medicalization of IPV.
... These respondents experienced high rates of homelessness, sex work, HIV, and suicide attempts compared to their peers who did not experience domestic violence (Grant et al., 2011). All four types of IPV (sexual, psychological, physical, and assault with injury) are positively associated with anxiety and some level of life dissatisfaction, and all but physical IPV are associated with depression (Henry et al., 2018). While many forms of IPV perpetrated against TGD people are like those reported by cisgender people, members of the TGD community also experience unique forms of IPV, including partner control of gender identity disclosure and transition, and psychological violence, such as a partner asserting, they are not a "real" man or woman (Wirtz et al., 2020). ...
Article
Transgender and gender diverse (TGD) people represent a small percent of the population and yet, they experience sexual violence at disproportionately high rates compared to their cisgender counterparts (Grant et al, 2011; James et al., 2016). The purpose of this interpretative phenomenological study is to gain a more nuanced understanding of the role that unwanted sexual experiences play in the lives of transgender and gender diverse people, particularly in relation to how they conceptualize their gender identity and the construct of posttraumatic growth (PTG). Semi-structured interviews were conducted with eight TGD participants who met the inclusion criteria. Two superordinate (i.e., negative impacts on self and factors that facilitated recovery) and ten subordinate (i.e., systemic oppression, mental health outcomes, gender dysphoria and transitioning, difficulties with disclosure, lack of resources, physical intimacy, advocacy, connection and support, strengths, personal growth, affirming resources, and hope) themes emerged from the data. Contextual factors were reported on. Limitations of the present study were also discussed. Implications for practice include the use of gender-affirming and culturally appropriate interventions, examination of power dynamics within the therapeutic relationship, understanding the potential interplay between gender dysphoria, oppression, and trauma, and exploration of strengths and avenues for growth. Implications for policy include the implementation of comprehensive policies that protect the human rights of TGD people, such as protections from being refused access to public places and insurance coverage of gender-affirming services. Future research should focus on diverse samples of TGD survivors, a more direct examination PTG within the TGD community, the impact of previous trauma on TGD survivors, and intimate partner violence (IPV) within the TGD community. Advisor: Michael Scheel
... Additionally, patients' average score was in the moderate range of depression at pretreatment and most of the patients reported no depressive symptoms or mild symptoms at posttreatment [59]. Thus, RISE provided in routine care helps reduce general psychological distress and feelings of overwhelm that are common among individuals experiencing IPV [72,73]. Reductions in distress may in turn enhance survivors' use of internal (e.g., self-care) and external resources (e.g., social support) to effectively cope with and recover from the far-reaching impacts of IPV and increase safety [74][75][76][77]. ...
Article
Full-text available
Intimate partner violence (IPV) is a common concern among military Veterans that negatively impacts health. The United States’ Veterans Health Administration (VHA) has launched a national IPV Assistance Program (IPVAP) to provide comprehensive services to Veterans, their families and caregivers, and VHA employees who use or experience IPV. Grounded in a holistic, Veteran-centered psychosocial rehabilitation framework that guides all facets of the program, the IPVAP initiated the pilot implementation of a novel intervention called Recovering from IPV through Strengths and Empowerment (RISE). This evidence-based, person-centered, trauma-informed, and empowerment-oriented brief counseling intervention is designed to support those who experience IPV and to improve their psychosocial wellbeing. This program evaluation study describes clinical outcomes from patients who participated in a pilot implementation of RISE in routine care. We examined changes in general self-efficacy, depression, and valued living, as well as treatment satisfaction among patients who received RISE and completed program evaluation measures at VHA facilities during the pilot. Results from 45 patients (84% women) indicate that RISE was associated with significant pretreatment to posttreatment improvements in self-efficacy, depression, and valued living (Cohen’s d s of 0.97, 1.09, and 0.51, respectively). Patients reported high satisfaction with treatment. Though preliminary results were similar across gender and IPV types, findings from the evaluation of the pilot implementation of RISE demonstrate the intervention’s feasibility, acceptability, and clinical utility in routine VHA care and inform the scalability of RISE. Additionally, findings provide preliminary support for the effectiveness and acceptability of RISE with men. Modification to RISE and its implementation are discussed, which may be useful to other settings implementing IPV interventions.
... There is a growing body of literature on the consequences of violence against transgender people. In addition to the obvious harm caused by the violence itself, compared to trans people who have not been assaulted, transgender people who have been assaulted are much more likely to subsequently experience mental health problems, engage in heavy drinking and drug use, and attempt suicide (Clements-Nolle et al., 2006;Henry et al., 2021;Nemoto, 2011;Testa et al., 2012). In their study of almost 6500 transgender and gender non-conforming participants, Grant et al. (2011) found that 61% of the respondents who had been physically assaulted had also attempted suicide. ...
Article
Full-text available
Violence against transgender people is a prevalent but understudied form of gender‐based violence. In recent years, this body of literature has expanded substantially. However, analysis of violence experienced by transgender people has been hampered by a shortage of good data. This article explores those data dilemmas and details what is and is not currently known about violence against transgender people in the United States. National surveys with sample sizes large enough to facilitate comparisons between transgender and cisgender respondents as well as attend to diversity with the category of transgender tend to not ask questions that count transgender respondents. Moreover, when they do, surveys often do not follow established best practices. Additionally, qualitative research on this topic is underfunded, resulting in small sample sizes with similar constraints. Therefore, although there is increased knowledge around rates of violence for transgender versus cisgender people, differences in risk related to gender and race, and intimate partner and sexual violence, this knowledge is flawed and does not cover the range of violence that transgender people experience. To better address this topic, data collection and analysis must be improved and scholars should attend to ways to prevent violence against transgender people.
... **p < 0.01; ***p < 0.001 transactional sexual partners was typically lower than stable and non-transactional casual partners. Consistent with previous studies [4,18,45], participants in the current study were exposed to high risk of violence victimization (59.1%) and suffered from high levels of depression (54.5% reported mild to severe depression compared with 4.1% in general population in China [46]). The high prevalence of violence, depression and CAI in TGW indicate urgent public health concern. ...
Article
Full-text available
Transgender women (TGW) worldwide report disproportionate violence victimization, depression and condomless anal intercourse (CAI), but the mechanism of the coexistence remains unclear. Using snowball sampling, we recruited 198 self-identified TGW in Shenyang, China between April 2017 and July 2017, and conducted confidential questionnaire survey among them. Positive HIV status was reported by 49 (24.7%) participants. 117 (59.1%) reported at least one type of lifetime violence victimization, with transactional sexual partners being the main violence perpetrators. 108 (54.5%) reported mild to severe depression. 105 (53.0%) reported having CAI with their sexual partners during the last 6 months. Path analysis showed that the association between participants' violence victimization and CAI was fully mediated by their depression (indirect effect: 0.083, p = 0.014; direct effect: 0.137, p = 0.121). We suggest to incorporate violence screening and prevention and mental health services into intervention strategies to prevent CAI among Chinese TGW.
... While no demographic group is immune to risk of trauma exposure, the nature, frequency, and severity of trauma exposure vary widely across groups. Epidemiological data suggests that individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) experience trauma, including violence and victimization, at higher rates than the general population [4][5][6][7]. Consequently, the estimated prevalence of PTSD tends to be higher among LGBTQ individuals, with rates ranging from 1.3 to 47.6% among LGB and 17.8 to 42% among transgender and gender diverse (TGD) individuals [8][9][10][11][12][13][14]. Thus, when treating LGBTQ patients, screening for trauma exposure and PTSD symptoms is essential (see Table 1). ...
Article
Full-text available
Purpose of review: Trauma exposure is widespread but is especially common among lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. LGBTQ individuals also experience higher rates of discrimination, victimization, and minority stress which can complicate posttraumatic stress disorder (PTSD) treatment but also represent independent intervention targets. In this review, we highlight existing evidence-based practices, current limitations, and provide recommendations for care in the absence of established guidelines for treatment PTSD among LGBTQ patients. Recent findings: Trauma-focused therapies (e.g., CPT, PE) and medications (e.g., SSRIs, SNRIs) have shown benefit for people with PTSD. However, evaluations of these interventions have failed to examine the role of LGBTQ identities in recovery from trauma, and existing PTSD treatments do not account for ongoing threat to safety or the pervasive minority stress experienced by LGBTQ patients. In addition, many LGBTQ patients report negative experiences with healthcare, necessitating increased education and cultural awareness on the part of clinicians to provide patient-centered care and, potentially, corrective mental health treatment experiences. Summary: Providers should routinely assess trauma exposure, PTSD, and minority stress among LGBTQ patients. We provide assessment and screening recommendations, outline current evidence-based treatments, and suggest strategies for integrating existing treatments to treat PTSD among LGBTQ patients.
... IPV against TW is often classified together with gender-based abuse, hate crimes, or general violence, without adequately differentiating the unique characteristics of intimate partner violence [8]. However, selected reports have documented a high frequency of partner-inflicted physical, verbal, and sexual violence against TW in diverse global settings [2,[9][10][11][12][13]. In a 2018 multi-site cohort study, the lifetime prevalence of IPV among TW in the United States was estimated as 52% [1]. ...
Article
Full-text available
Limited data exists on intimate partner violence (IPV) among transgender women (TW), though global trends suggest IPV is associated with HIV risk in this population. We describe the prevalence of verbal, physical, and/or sexual violence as well as participant- and partner-level correlates of IPV among TW in Lima, Peru. Among 389 respondents, 15.2% reported IPV with one or more of their last three sexual partners: 9.2% verbal, 8.2% physical, and 2.3% sexual violence. Physical and verbal violence were more common with stable partners (aPR 3.46, 95% CI 1.17–10.25, aPR 2.46, 95% CI 1.14–5.28, respectively). Physical violence was associated with condomless receptive anal intercourse (cRAI) (aPR 2.22, 95% CI 1.19–4.13) and partner alcohol use (aPR 4.38, 95% CI 1.56–12.33) while verbal violence correlated with participant inebriation (aPR 4.86, 95% CI 1.63–14.46). Our results link IPV with stable partnerships, alcohol use, and cRAI, suggesting TW in Peru may benefit from multidimensional IPV prevention strategies to foster supportive relationships and reduce HIV transmission.
... Gender has long been recognized as a variable of interest in the study of IPV, including a relatively recent focus on transgender survivors. Research on sex and gender differences in IPV victimization demonstrates that cisgender women and transgender individuals experience greater rates of IPV, more dangerous abuse types, and more severe consequences than cisgender men (Caldwell, Swan, & Woodbrown, 2012;Chan, 2011;Henry, Perrin, Coston, & Calton, 2018;James et al., 2016). Among college students, a recent study found that when compared to cisgender men, transgender students were twice as likely to experience emotional abuse, nearly three times as likely to experience physical abuse, and over six times as like to experience sexual abuse (Griner et al., 2017). ...
Article
Undergraduate students of all gender identities are at risk of experiencing intimate partner violence (IPV) victimization. It is known that IPV negatively affects academic performance, yet little is known about the role of health. This study examined if past-year IPV victimization was associated with an increase in students’ self-perception of health interfering with academic performance. Data were drawn from the 2011–2014 National College Health Assessment (N = 84,734). Structural equation modeling was used to examine the relationship between a latent variable of IPV and health impediments to academic performance. The model was a good fit for the data (RMSEA = .012, CFI = .994, TLI = .981). Undergraduate survivors of past-year IPV – and transgender students – were more likely to report impediments to their academic performance: physical assault (0.66, p < .001), sexual assault (0.57, p < .001), sexually transmitted infections (0.42, p < .001), pregnancy (0.38, p < .001), depression (0.38, p < .001), disordered eating (0.36, p < .001), financial problems (0.33, p < .001), anxiety (0.32, p < .001), sleep problems (0.32, p < .001), chronic health problems (0.29, p < .001), drug use (0.29, p < .001), injury (0.25, p < .001), and alcohol use (0.25, p < .001). This demonstrates that IPV has a spiral effect, such that IPV’s impact on health is perceived by students as detrimental to their academics.
... Nor is the abuse or violence primarily from the outside world. Many are subjected to intimate partner violence, which is associated with anxiety and depression (Henry, Perrin, Coston, & Calton, 2018). ...
Article
To support gender diversity in clinical practice, psychotherapists need to provide culturally competent, developmentally appropriate and trans‐affirmative care with trans and gender nonconforming people. This article explores the trans body, the trans identity, and the issues that arise in psychotherapy. It examines psychological wellbeing within the trans population and offers a rationale for body psychotherapy approaches to these issues, before exploring the politicisation of the trans body in our culture and the ethical issues that surround trans youth. The increased political focus on the topic has bought about legislation affecting trans rights. Psychotherapists need to be at the forefront of engagement with these changes and their implications for this population. To achieve this, this paper concludes that therapists today must build political and personal self‐awareness, taking care to examine their biases and avoid perpetuating unethical, harmful or limited perceptions of gender in the psychotherapy encounter.
... TGD individuals are more than twice as likely to receive threats of violence relative to cisgender sexual minority individuals (who are already at elevated risk relative to heterosexual counterparts; Landers & Gilsanz, 2009). This pattern of elevated risk is repeated across many forms of violence (Reisner, White, Bradford, & Mimiaga, 2014), including sexual violence (Langenderfer-Magruder, Whitfield, Walls, Kattari, & Ramos, 2016) and intimate partner violence (Dank, Lachman, Zweig, & Yahner, 2010;Henry, Perrin, Coston, & Calton, 2018;Langenderfer-Magruder et al., 2016;Valentine et al., 2017). Overall, lifetime rates of exposure to criterion A traumatic events are consistently between 90%-100% of TGD participants (Barr, 2018;Beckman, Shipherd, Simpson, & Lehavot, 2018;Shipherd, Green, & Abramovitz, 2010). ...
Article
Transgender and gender diverse (TGD) populations, including those that do not identify with gender binary constructs (man or woman) are increasingly presenting for treatment of posttrauma sequelae. Providers who offer services for trauma survivors including posttraumatic stress disorder (PTSD) treatment should be knowledgeable about evidence-based care and have some cultural familiarity with TGD experiences. Indeed, the Minority Stress Model suggests that the combination of distal and proximal minority stressors can combine to produce increased mental health symptoms as compared with cisgender peers, though this model has yet to be fully tested. Clients often present with a complicated picture of experiences, which include a variety of minority stressors, microaggressions, discrimination, and traumatic events that can all be related to their identity. However, conceptualizations of trauma treatment in the context of extensive minority stress are lacking. This paper summarizes the existing literature and offers guidance to mental health providers who are well positioned to address stigma, discrimination, violence, and related symptoms that arise from micro-, mezzo- and macro-level spheres of TGD individuals’ experience.
... Transgender and Gender-Nonconforming Populations It should also be noted that we believe our integrated theoretical framework discussed above, with some modification, could be extended to transgender and gender-nonconforming people. Indeed, rates of IPV (e.g., Henry et al. 2018) and alcohol use and problems (e.g., Tupler et al. 2017) are as high, if not higher, among transgender and gender-nonconforming people relative to cisgender people, and the minority stress model has been extended to transgender people (Hendricks and Testa 2012). However, given the differences between gender minorities and LGB+ populations, careful attention needs to be paid to the literature and the unique challenges that transgender and gender-nonconforming people face. ...
Article
Full-text available
Intimate partner violence (IPV) is a prevalent and serious public health problem. Alcohol use and misuse is one of the most well-known antecedents of IPV perpetration. However, minimal research examined whether alcohol use increases the risk for IPV perpetration among individuals who identify as a sexual minority (i.e., lesbian, gay, bisexual, or another non-heterosexual identity [LGB+]). This is particularly concerning given that rates of IPV and alcohol use are as high, if not higher, in LGB+ populations relative to their heterosexual peers. In this article we provide a brief review of existing alcohol-related IPV research among LGB+ populations, advance an integrated model of alcohol-related IPV perpetration among LGB+ populations, and discuss avenues for future research on this topic. Our review identified limited research on alcohol-related IPV perpetration among LGB+ populations, with no longitudinal or event level research on this topic. Incorporating tenets of minority stress models with models of alcohol-related IPV (i.e., I³ and Alcohol Myopia Theory), we propose an integrated theory of alcohol-related IPV perpetration among LGB+ populations. Based on the limited information available in the literature, our integrated theoretical model suggests several avenues for future research on alcohol-related IPV perpetration among LGB+ populations. We discuss these future areas for research and the importance of incorporating sexual minority stress frameworks into these investigations.
Article
Despite considerable research on the predictive accuracy of risk scales, there is limited research exploring other factors that influence perceptions of risk. We recruited participants ( N = 1,955) from Amazon's Mechanical Turk to read a vignette about a fictional intimate partner violence offender, varying risk level on a fictional scale (low or high), perpetrator gender (cis male, cis female, or transgender female), victim gender (cis male or cis female), and mental health diagnosis (none, schizophrenia, bipolar disorder, or anxiety disorder). The strongest effect was for the risk scale, with offenders perceived as highest risk when the scale reported “high risk” as opposed to “low risk.” The other main effects were also statistically significant. Cases were perceived as riskier when the perpetrator was cis male or the victim was cis female. Regarding mental health diagnosis, the highest risk ratings were provided in the schizophrenia condition. There was also a significant interaction among risk level, perpetrator gender, and diagnosis. The extent to which participants relied on gendered stereotypes about the relationship between mental illness and violence when providing risk judgments should be examined in future research. Overall, these findings enhance our understanding of characteristics that are secondary to risk level but are likely to influence case management decisions in cases of intimate partner violence.
Article
Although partner alcohol use and acceptance of intimate partner violence against women (IPVAW) are critical determinants of IPVAW, little is known about their interaction. We explored how partner alcohol use and attitudes toward IPVAW act independently and jointly at the individual and community levels to influence women's reports of experiencing IPVAW across low- and middle-income countries. We conducted secondary analyses using a pooled sample of reproductive-aged women (n = 166,621) from 19 Demographic and Health Survey datasets. We fit a series of a priori-defined mixed-effects logistic regression models of the total effects, within- and between-community effects, and contextual effects of past-year IPVAW on partner alcohol use, acceptance of IPVAW, and their multiplicative interaction. We then fit a series of models stratified by community alcohol use and acceptance of IPVAW. Partner alcohol use (odds ratio [OR] = 3.20; 95% confidence interval [CI]: [3.07, 3.33]) and women's acceptance of IPVAW (OR = 1.83; 95% CI: [1.76, 1.89]) were consistently associated with increased odds of experiencing IPVAW. Sub-multiplicative interactions were present for within-community effects (ratio of OR = 0.86; 95% CI: [0.79, 0.94]), whereas supra-multiplicative interactions were present for between-community effects (ratio of OR = 1.002; 95% CI: [1.0002, 1.005]) and contextual effects (ratio of OR = 1.003; 95% CI: [1.0007, 1.005]). The odds of IPVAW associated with partner alcohol use was greatet in communities with lower partner alcohol prevalence and lower acceptance of IPVAW. It is important to consider norms and attitudes toward IPVAW alongside alcohol use when understanding epidemiological patterns of IPVAW and potential opportunities for preventive programs and policymaking. Future studies should focus on the complex interactions, at multiple social levels, between interacting risk factors for IPVAW.
Article
The prevalence of experiencing sexual assault is alarmingly high among Transgender and Gender Diverse people (TGD; people whose gender identities and/or expressions are not traditionally associated with their sex assigned at birth) and is associated with various mental health sequalae. Perceived social support has been shown to abate the negative outcomes of sexual assault among cisgender individuals, yet little is known about this association among TGD people, especially which provider of support (i.e., family, friends, or significant others) may be most beneficial. To that end, 191 TGD adults were recruited through Amazon’s Mechanical Turk to examine perceived social support as a potential moderator of the association between sexual assault victimization and post-sexual assault trauma symptomology. Results showed an interaction trending toward significance between sexual assault and support from a significant other. Decomposition of this interaction demonstrated that sexual assault was associated with post-assault trauma symptoms when support from a significant other was low (ß = .25, p < .05) but not high (ß = .10, p = .089). The interaction between sexual assault and perceived social support was not significant for perceived support from friends ( p = .133) or family ( p = .954). Findings highlight the need for additional research on perceived social support as a potential buffering mechanism between sexual assault and post-assault symptomology in TGD people.
Article
Full-text available
Purpose: Sexual and gender minority (SGM) populations throughout Kenya as well as other sub-Saharan African countries face systemic discrimination and substantial human rights violations, yet scant literature documents the potentially harmful mental health effects of these experiences. This study sought to understand the relationship among experiences of violence, social support, and mental health among SGM adults in Kenya. Methods: Members of a local LGBT community-based organization collected survey data in Western Kenya from October 2017 to April 2018, recruiting 527 SGM participants through an array of community outreach methods. Respondents in this cross-sectional study completed a survey regarding their mental health and other psychosocial factors. Multiple linear regression analyses were conducted to assess associations between experiences of violence (SGM violence and intimate partner violence [IPV]) and mental health outcomes (depressive symptoms and post-traumatic stress symptoms [PTSSs]) and to examine the potential moderating effect of social support on these relationships. Results: Relative to those who had never faced violence, participants who experienced IPV and/or violence based on their sexual orientation, gender identity, or gender expression (SGM violence) reported significantly higher levels of depressive symptoms and PTSSs. Emotional support was associated with lower levels of PTSSs. Social support did not moderate the relationship between SGM violence and mental health symptoms. Conclusions: These findings suggest that there may be a relationship between experiences of violence and poor mental health among SGM Kenyans. More studies are needed to better understand SGM-specific risk factors for poor mental well-being among SGM people in Kenya and the types of interventions that may help mitigate these challenges.
Article
The legal granting of temporary and permanent protective orders prohibits a perpetrator from engaging in contact with the victim. Although protective orders reduce risk of re-abuse, very little research has explored factors that predict the likelihood that a victim is granted a protective order. Thus, we conducted an archival analysis on data previously collected from a Protection Order Assistance Office in a midwestern region of the United States, testing the influence of victim and perpetrator race on protective order allocations. Specifically, we coded data gathered from 490 petitioners (i.e., victims) seeking a protective order against a perpetrator of intimate partner violence, stalking, or sexual offending. Analyses revealed that racial minority victims were significantly less likely to receive a temporary protective order compared to White victims – effects that were exacerbated when the perpetrator was White (versus racial minority). These results are in line with existing research and theory regarding aversive racism. Implications for theory, policy, and practice are discussed.
Chapter
The victimization of transgender individuals is not always present in reported crime statistics. The victimizations experienced by this population are often invisible and suffered in isolation. There are many reasons why transgender people do not report their victimization, either to family members and friends or to the various institutions of society such as the police, the physical and/or mental health community, or to other social services providers. The authors explore what is currently known about the extent and nature of the victimization of transgender individuals. They explore the research associated with the role race/ethnicity plays in transgender victimizations, the nuances of victimizations that occur within intimate relationships, the response of the criminal justice system, and the impact of victimization on the transgender community. Possible solutions to the problems identified in the chapter are addressed, not the least of which is to dispel many of the myths associated with transgender individuals.
Article
Background Cognitive behavioral therapies for posttraumatic stress disorder (PTSD) are evidence-based and effective for many. However, the reach and impact of these interventions are limited. Physical interventions hold potential to bridge a gap in the unmet treatment of trauma and stressor-related disorders. Method This systematic review examined 84 studies from four decades of research on physical interventions for trauma and stressor-related disorders to: 1) describe the state of the field and 2) summarize the best available evidence. Reviewed studies were described in terms of measured sample characteristics and assessed outcomes. Treatment effect patterns were analyzed by intervention content and study design. Results The majority of studies (68.2%) reported statistically significant reductions in posttraumatic stress symptoms; 40% used a randomized controlled trial (RCT) design. Among RCTs, one performed rigorous, statistically powered analyses in an intention-to-treat sample. Limitations High variability in reporting strategies among reviewed studies precludes analysis of variables such as intervention length, frequency, and dropout. Conclusion Preliminary evidence for the efficacy of physical interventions for trauma and stressor-related disorders is promising. Larger scale RCTs powered and designed to identify mediators and moderators of these interventions are warranted.
Article
Violence is a known driver of HIV vulnerability among transgender (trans) women, who are disproportionately impacted by HIV globally. Violence is also a barrier to accessing HIV prevention, treatment, and support. Yet, little is known about the everyday experiences of violence faced by trans women living with HIV, who live at the intersection of a marginalized gender identity and physical health condition. To address this gap, this study draws on semi-structured, individual interviews conducted 2017–2018 with a purposive sample (selected based on diverse identities) of trans women living with HIV ( n = 11) participating in a large, community-based cohort study in three Canadian provinces. Framework analysis was used to identify key themes, patterns within themes between participants, and patterns across themes among participants. Findings showed that trans women living with HIV experience specific contexts of violence shaped at the intersection of stigma based on gender identity, gender expression, and HIV status, among other identities/experiences. Violence experienced in childhood (e.g., familial rejection, bullying) increased trans women’s likelihood of being exposed to a violent social context in young adulthood (e.g., state violence perpetuated by the police, interpersonal violence perpetuated by sexual partners, and community violence perpetuated by society-at-large/the general public), which increased trans women’s HIV vulnerability; once living with HIV trans women were subjected to discursive violence from healthcare providers. These multiple forms of violence have serious consequences for trans women living with HIV’s ongoing social, mental, and physical well-being. The findings suggest that interventions are urgently needed to reduce violence against trans women in childhood and young adulthood, in addition to reducing violence against trans women living with HIV perpetuated by healthcare providers in adulthood, to both proactively and responsively promote their safety, health, and well-being.
Chapter
Research on intimate partner violence (IPV) as a public and social health issue is extensive. Originally, it focused primarily on young, White, heterosexual cisgender women and was embedded within a feminist, gendered perspective that framed IPV as male violence against females that stemmed from patriarchal domination of men over women. It is only recently that researchers have begun to study IPV among LGBTQ individuals. The topic remains understudied, particularly for transgender and gender nonconforming (TGNC) people. Moreover, most of this research has not taken into account the intersection of sexual orientation and gender identity with other social identities. The purpose of this chapter is to explore current knowledge regarding the prevalence of IPV among LGBTQ individuals. In order to achieve this goal, we start with a brief history of the research on IPV both in heterosexual cisgender and sexual and gender minority individuals. We then compare ways in which IPV is experienced both similarly and differently in these populations. Next, we examine several methodological issues that create difficulties in determining the prevalence of IPV among LBGTQ populations. These methodological challenges include measurement issues, defining the LGBTQ population, and adequately sampling that population. Finally, we explore the prevalence of IPV in LGBTQ individuals through the intersectional lenses of sexual identity, gender identity, gender, age, and racial/ethnic identity. We conclude by noting that much remains to be accomplished not only in the areas noted above, but also through the incorporation of the role of other intersecting social identities, including social class, ableness, nationality, and citizenship status.
Chapter
The disparity of identification and response to incidents of intimate partner violence (IPV) within the LGBT+ community can be boiled down to discretion. From healthcare providers to social service professionals to police, the use of discretion is rampant and can lead to inconsistent and often detrimental services to the LGBT+ community. For instance, Healthcare workers decide whether to screen an individual for intimate partner violence. Social service professionals can choose whether to allow transgender victims stay in shelters based on their gender identity. Law enforcement officers and legal actors can decide whom to arrest or whether charges will be pressed against perpetrators or IPV victims. At each recommended step for help-seeking victims of IPV, professionals positioned to help this vulnerable community can lack the training, awareness, sensitivity, or policies to guide decision-making processes when assisting members of the LGBT+ community. Previous research has noted a consensus of equivalent, and sometimes higher, rates of IPV within the LGBT+ community compared to the heterosexual community. Thus, the disparity in service provider and criminal justice practices calls for reform designed to combat potential biases in order to better assist the LGBT+ community when they are most vulnerable. By eliminating ambiguity of policies and practices involving the LGBT+ community, requiring frequent training for law enforcement/health care professionals/social service providers, and creating comprehensive and generalizable screening tools to detect IPV within LGBT+ relationships, we can begin to properly treat victims and punish perpetrators of LGBT+ intimate partner violence.
Chapter
Research has demonstrated that intimate partner violence (IPV) is a severe and pervasive problem worldwide. Although most people tend to think of partner violence as women who are battered by their male partners, it is so much more than that. What has been repressed or hidden in plain sight are the sexual minority victims of IPV. Studies reveal there are differences and deficiencies in how sexual minority IPV victims are treated. Researchers, practitioners, and policymakers have yet to adapt their ideologies to accommodate these unseen victims. This can lead to negative consequences for victims and ultimately hinder our societal goals to recognize and eradicate IPV and provide equal justice for all. This book provides an evidence-based overview of the problem of IPV and sexual minorities. It offers a comprehensive review of the literature and suggestions that can pave the way to more inclusive research, ideologies, and practice designed to improve services and policies, thus leading us toward eradicating IPV and move toward a direction of inclusiveness and equality.
Article
Depression among Black transgender women (BTW) in the USA is an often understudied mental health concern with far-reaching consequences for overall physical and mental health at both the individual and community levels. Intimate partner violence (IPV) among BTW is also a frequently understudied and important social determinant of health in need of further exploration. This study sought to address the gap in research on the relationship between IPV and depression among BTW using a time- and location-based community sample of BTW from six US cities. In addition, it sought to explore the potential protective or suppressive effect of perceived social support on this relationship. Generalized structural equation models were used to assess conditional direct and indirect effects of IPV on depression via the suppression effect of perceived social support. Evidence was found of a statistically significant conditional direct effect of IPV on depression as well as a statistically significant suppression effect for perceived social support. Specifically, there was a 20% lower likelihood of increased depressive symptomatology for every 1-unit increase in perceived social support reported by participants. These findings indicated that perceived social support may be an important intervention point for helping to improve the mental health and well-being of BTW.
Article
While men’s sexual violence against women is unarguably a social and public health issue, both nationally representative data and smaller studies tell us that rates for lesbian, gay, bisexual, transgender, and queer+ (LGBTQ+) individuals are equally or significantly higher. Despite this, there remains little structural support for LGBTQ + survivors. This article highlights the voices of 38 queer and trans people of color (QTPOC)-identified U.S. Southerners who have experienced sexual violence and came together across three focus groups to detail their interactions with advocates and other professionals and explore posttraumatic needs. Nearly all survivors reported that the level of awareness regarding sexual violence in their communities was limited, with most reporting that they did not successfully access mainstream services, due to concerns about homophobia, transphobia, and racism. To address sexual violence in LGBTQ + communities, survivors pointed to the importance of friendship and community networks “outside the system,” knowledge sharing about LGBTQ+-specific violence tactics (e.g., threats of outing a partner), and holding batterers accountable for their behavior within LGBTQ + circles. Findings highlight the need to move beyond “culturally competent” health care by proactively engaging LGBTQ + communities in education, networking, resource sharing, and anti-violence outreach.
Preprint
A graduate-level final paper on Sam Levinson's 2018 film Assassination Nation analyzing the Foucauldian theory of sexuality as "incitement to discourse" in the digital media age.
Article
Full-text available
Since the mid-1970s, the field of Intimate Partner Violence (IPV) has debated over gender differences in the perpetration of physical partner violence. However, this classical controversy has ignored transgender people since their gender does not seemingly fit the binary categories (male and female) first used to conceptualize IPV. Furthermore, sustained attention on this ceaseless argument has contributed to transgender people remaining invisible to the field of IPV. In this article, we redefine IPV to extend beyond the gender binary and invite the field to shift its focus to transgender people. Research suggests that as many as one in two transgender individuals are victims of IPV, but that multiple barriers prevent this group from acquiring protection that is afforded to others. Therefore, we propose that researchers direct their attention to this topic, and thus, inform police officers, victim advocates, and medical professionals who work directly to combat IPV for all.
Article
Full-text available
Purpose: Theories explaining the impact of intimate partner violence (IPV) on mental health have focused on heterosexual relationships. It is unclear whether mental health disparities between heterosexual and sexual minority people are due to IPV or factors related to sexual orientation. The present study aimed to investigate pathways of how sexual orientation influenced quality of life and mental health. Methods: The present cross-sectional study was conducted in 1076 young adults in a university population (934 heterosexual and 142 sexual minority groups). Structural equation modelling was used to examine the pathways of sexual orientation, dating violence, sexual orientation concealment, quality of life and mental health (perceived stress, anxiety and depression). Results: After adjusting for sociodemographic factors, quality of life in sexual minority people was poorer [estimate -2.82, 95 % confidence interval (CI) -4.77 to -0.86, p = 0.005], and stress (estimate 2.77, 95 % CI 1.64-3.92, p < 0.0001), anxiety (estimate 1.84, 95 % CI 1.13-2.56, p < 0.0001) and depression levels (estimate 0.62, 95 % CI 0.05-1.2, p < 0.0001) were higher than in heterosexual people. Dating violence and sexual orientation concealment were mediators, with the models showing a good fit. Conclusion: Our study has progressed investigation of the link between sexual orientation and quality of life and mental health in the Chinese context. It has helped identify health disparities between heterosexual and sexual minority people and determined specific factors affecting their quality of life and mental health.
Article
Full-text available
Objectives: To provide lifetime estimates of intimate partner victimization among pregnant adolescents and examine associations between victimization and health risk behaviors identified by the Centers for Disease Control and Prevention as leading causes of adolescent morbidity and mortality. Methods: Participants (n = 1233) were predominantly Latina (58%) and non-Latina Black (34%) pregnant adolescents (aged 14-21 years) enrolled in a randomized controlled trial of group prenatal care in 14 clinical sites in New York City (2008-2012). They completed surveys to assess interpersonal victimization and risk behaviors: substance use, risky sexual behaviors, injuries or violence, unhealthy dietary behavior, and inadequate physical activity. Results: Fifty-two percent reported intimate partner victimization, which was associated with nearly all health risk behaviors. Conclusions: Pregnant adolescents who experienced intimate partner victimization were significantly more likely to engage in health risk behaviors, which can have adverse health consequences. Expanded prevention programs tailored to specific needs of pregnant adolescents are needed. Health care providers and others who work with pregnant adolescents should consistently screen for and intervene in intimate partner victimization. (Am J Public Health. Published online ahead of print June 16, 2016: e1-e3. doi:10.2105/AJPH.2016.303202).
Article
Full-text available
Objective: Intimate partner violence (IPV) is an important public health problem with high prevalence and serious costs. Although literature has largely focused on IPV among heterosexuals, studies have recently begun examining IPV in LGBT samples, with mounting evidence suggesting IPV may be more common among LGBT individuals than heterosexuals. Less research has examined the specific health consequences of IPV in this population, particularly across time and among young people, and it remains unclear whether experiences of IPV differ between subgroups within the LGBT population (e.g. race, gender identity, and sexual orientation). Method: An ethnically diverse sample of 172 LGBT young adults completed self-report measures of IPV, sexual behavior, mental health, and substance abuse at two time points (4- and 5-year follow-up) of an ongoing longitudinal study of LGBT youth. Results: IPV was experienced non-uniformly across demographic groups. Specifically, female, male-to-female transgender, and Black/African-American young adults were at higher risk compared to those who identified as male, female-to-male transgender, and other races. Being a victim of IPV was associated with concurrent sexual risk taking and prospective mental health outcomes but was not associated with substance abuse. Conclusions: Demographic differences in IPV found in heterosexuals were replicated in this LGBT sample, though additional research is needed to clarify why traditional risk factors found in heterosexual young people may not translate to LGBT individuals. Studies examining the impact of IPV on negative outcomes and revictimization over time may guide our understanding of the immediate and delayed consequences of IPV for LGBT young people.
Article
Full-text available
This qualitative study endeavored to examine the views and experiences of individuals who work with, and those who consider issues related to, transgender domestic violence in an effort to determine what (if anything) is known about this construct. Using a phenomenological approach, ten interviews were conducted with individuals who professionally confront transgender intimate partner violence. Overall, the study found that many individuals from different disciplines were in agreement concerning the paucity of resources for this population, and future research would benefit from quantitative research to understand more about transgender domestic abuse. Furthermore, criminal justice organizations should take active steps within their own agencies to appropriately address this problem for transgender victims of abuse. Finally, all of the participants stated their beliefs that transgender domestic abuse is a very serious problem and believed that more research should be done to better understand it before it can be addressed.
Article
Full-text available
Rationale Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. Objective This critical review aims to integrate the literature on stigma towards transgender people in the US. Results This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Conclusion Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. DOI: http://dx.doi.org/10.1016/j.socscimed.2015.11.010
Article
Full-text available
With a national sample of 552 transgender adults, the present study tested hypotheses drawn from minority stress theory and positive psychology research on stress-ameliorating processes. Specifically, the present study examined the relations of minority stressors (i.e., antitransgender discrimination, stigma awareness, and internalized transphobia) and individual- and group-level buffers (i.e., resilience and collective action) of minority stress. As expected, each minority stressor was positively correlated with psychological distress. In terms of buffers, resilience—though not collective action—was negatively correlated with psychological distress. Additionally, stigma awareness—but not internalized transphobia—mediated the relation of antitransgender discrimination with higher psychological distress. Moderation analyses indicated that resilience did not moderate any of the relations of the minority stressors with psychological distress. However, contrary to prediction, collective action strengthened the positive relation of internalized transphobia with psychological distress. Furthermore, at high levels of collective action, internalized transphobia became a significant mediator of the discrimination-distress relation. Strategies for developing individual (e.g., resilience building strategies) and group-level (e.g., engagement in collective action) interventions targeted toward transgender individuals who experience discrimination are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved)
Article
Full-text available
Researchers argue that partner violence (PV) is a multidimensional and heterogeneous phenomenon that needs to be measured in multiple ways to capture its range, extent, severity, and potential consequences. Several large scale, population-based studies show that about 40% to 50% of PV victims in a 1-year time period are men; this finding is consistent whether the study focuses on physical PV or a combination of several forms of PV. However, no one has investigated how the different forms of PV contribute to male victims' poor mental health, although research suggests that physical, psychological, and sexual PV contribute unique variance to female victims' poor health. The current study investigated how 6 forms of PV-physical, sexual, severe psychological, controlling, legal/administrative (LA), and injury- contributed to the poor health of 611 male victims of PV who sought help. We found that the combination of PV contributed significant unique variance to men's depression, posttraumatic stress disorder, physical health, and poor health symptoms, after controlling for demographic and other traumatic experiences. The common variance among the forms of PV victimization was the strongest contributor to victims' poor health; the types of PV that contributed the most unique variance were controlling behaviors, LA aggression, sexual aggression, and injury. Discussion focuses on the research and practice implications of these findings.
Article
Full-text available
Intimate partner violence (IPV) is a pervasive and devastating social problem that is estimated to occur in one of every four opposite-sex relationships and at least one of every five same-sex romantic relationships. These estimates may not represent violence against those who identify as transgender or genderqueer, and very little comprehensive research has been conducted on IPV within these populations. One statewide study on IPV found rates of IPV were as high as one of every two transgender individuals. In order to cope with the effects of abuse or leave an abusive partner, many lesbian, gay, bisexual, transgender, and genderqueer (LGBTQ) IPV survivors seek support from others. However, LGBTQ IPV survivors may experience unique difficulties related to their sexual orientation and gender identity when seeking assistance. This article reviews the literature on LGBTQ IPV and suggests three major barriers to help-seeking exist for LGBTQ IPV survivors: a limited understanding of the problem of LGBTQ IPV, stigma, and systemic inequities. The significance and consequences of each barrier are discussed, and suggestions for future research, policy, and practice are provided. © The Author(s) 2015.
Article
Full-text available
Objectives: We examined the independent demographic and psychosocial factors associated with psychological distress and resilience among transgender men and women. Methods: Our data came from an online survey involving a national Australian sample of 169 transgender men and women in 2011. Survey questions assessed demographics; sources of support; contact with lesbian, gay, bisexual, and transgender peers; and experiences of victimization. We assessed the outcomes with the Kessler Psychological Distress Scale and the Brief Resilience Scale. Results: In all, 46.0% of the sample reported high or very high levels of psychological distress. Multivariable regression analyses identified considerably different independent factors for psychological distress and resilience. Younger age, feeling unable to turn to family for support, and victimization experiences were associated with greater psychological distress, whereas higher income, identifying as heterosexual, and having frequent contact with lesbian, gay, bisexual, and transgender peers were associated with greater resilience. Conclusions: With different factors identified for psychological distress and resilience, these findings may help inform the development of tailored mental health interventions and resilience-building programs for this vulnerable population.
Article
Full-text available
Purpose: Lesbian, gay, bisexual, and transgender (LGBT) youth show increased risk for a number of negative mental health outcomes, which research has linked to minority stressors such as victimization. Further, social support promotes positive mental health outcomes for LGBT youth, and different sources of social support show differential relationships with mental health outcomes. However, little is known about how combinations of different sources of support impact mental health. Methods: In the present study, we identify clusters of family, peer, and significant other social support and then examine demographic and mental health differences by cluster in an analytic sample of 232 LGBT youth between the ages of 16 and 20 years. Results: Using k-means cluster analysis, three social support cluster types were identified: high support (44.0% of participants), low support (21.6%), and non-family support (34.5%). A series of chi-square tests were used to examine demographic differences between these clusters, which were found for socio-economic status (SES). Regression analyses indicated that, while controlling for victimization, individuals within the three clusters showed different relationships with multiple mental health outcomes: loneliness, hopelessness, depression, anxiety, somatization, general symptom severity, and symptoms of major depressive disorder (MDD). Conclusion: Findings suggest the combinations of sources of support LGBT youth receive are related to their mental health. Higher SES youth are more likely to receive support from family, peers, and significant others. For most mental health outcomes, family support appears to be an especially relevant and important source of support to target for LGBT youth.
Article
Full-text available
The present study is the first meta-analytic study about the prevalence of intimate partner violence (IPV) in self-identified lesbians in same-sex couples. It summarizes the scientific evidence from studies published from 1990 to 2013. First, 1,184 studies were identified, then 59 studies were pre-selected, and finally 14 studies were chosen that met the criteria for inclusion and methodological quality. The studies were conducted in the USA, using non-probabilistic sampling methods, and they were characterized by their high level of heterogeneity. The mean prevalence of victimization in IPV over the lifespan is 48 % (95 % CI, 44–52 %) and 15 % (95 % CI, 5–30 %) in the current/most recent relationship, with the difference being statistically significant between over the lifespan and current/most recent relationship IPV. The mean prevalence of victimization in physical violence over the lifespan is 18 % (95 % CI, 0–48 %), in sexual violence 14 % (95 % CI, 0–37 %), and in psychological/emotional violence 43 % (95 % CI, 14–73 %). The high prevalence suggests the need to implement IPV prevention programs among lesbians, as well as homophobia prevention programs. Moreover, the methodological quality of prevalence studies should be improved. The limited number of studies considered in each thematic block and the high heterogeneity of their results should be taken into account.
Article
Full-text available
National health initiatives emphasize the importance of eliminating health disparities among historically disadvantaged populations. Yet, few studies have examined the range of health outcomes among lesbian, gay, bisexual, and transgender (LGBT) people. To stimulate more inclusive research in the area, we present the Health Equity Promotion Model-a framework oriented toward LGBT people reaching their full mental and physical health potential that considers both positive and adverse health-related circumstances. The model highlights (a) heterogeneity and intersectionality within LGBT communities; (b) the influence of structural and environmental context; and (c) both health-promoting and adverse pathways that encompass behavioral, social, psychological, and biological processes. It also expands upon earlier conceptualizations of sexual minority health by integrating a life course development perspective within the health-promotion model. By explicating the important role of agency and resilience as well as the deleterious effect of social structures on health outcomes, it supports policy and social justice to advance health and well-being in these communities. Important directions for future research as well as implications for health-promotion interventions and policies are offered. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Article
Full-text available
Background: Intimate partner violence (IPV) has been known to adversely affect the mental health of victims. Research has tended to focus on the mental health impact of physical violence rather than considering other forms of violence. Objective: To systematically review the literature in order to identify the impact of all types of IPV victimisation on various mental health outcomes. Method: A systematic review of 11 electronic databases (2004-2014) was conducted. Fifty eight papers were identified and later described and reviewed in relation to the main objective. Results: Main findings suggest that IPV can have increasing adverse effects on the mental health of victims in comparison with those who have never experienced IPV or those experiencing other traumatic events. The most significant outcomes were associations between IPV experiences with depression, posttraumatic stress disorder, and anxiety. Findings confirm previous observations that the severity and extent of IPV exposure can increase mental health symptoms. The effect of psychological violence on mental health is more prominent than originally thought. Individual differences such as gender and childhood experience of violence also increase IPV risk and affect mental health outcomes in diverse ways. Conclusions: Psychological violence should be considered as a more serious form of IPV which can affect the mental health of victims. Experiencing more than one form of IPV can increase severity of outcomes. Researchers should look at IPV as a multi-dimensional experience. A uniformed definition and measure of IPV could help advance knowledge and understanding of this disparaging global issue.
Article
Full-text available
Religion may enhance successful aging by reducing stress, improving well-being, and augmenting social engagement. However, there is a paucity of research specific to religious affiliation in the elusive transgender-identified population. This exploratory study describes the demographic profile and religious affiliation of 289 transgender adults age 51 and older. Results indicate that the majority of transgender older adults (73.4%) are aging successfully, even though many are disabled or chronically ill. Transgender older adults affiliate with a wide range of religious and spiritual practices with a greater participation in lesbian, gay, bisexual, transgender-affirming religions than the normative sex and gender population.
Article
Full-text available
Intimate partner violence (IPV) among men who have sex with men (MSM) is a significant problem. Little is known about the association between IPV and health for MSM. We aimed to estimate the association between experience and perpetration of IPV, and various health conditions and sexual risk behaviours among MSM. We searched 13 electronic databases up to 23 October 2013 to identify research studies reporting the odds of health conditions or sexual risk behaviours for MSM experiencing or perpetrating IPV. Nineteen studies with 13,797 participants were included in the review. Random effects meta-analyses were performed to estimate pooled odds ratios (ORs). Exposure to IPV as a victim was associated with increased odds of substance use (OR = 1.88, 95% CIOR 1.59-2.22, I2 = 46.9%, 95% CII2 0%-78%), being HIV positive (OR = 1.46, 95% CIOR 1.26-1.69, I2 = 0.0%, 95% CII2 0%-62%), reporting depressive symptoms (OR = 1.52, 95% CIOR 1.24-1.86, I2 = 9.9%, 95% CII2 0%-91%), and engagement in unprotected anal sex (OR = 1.72, 95% CIOR 1.44-2.05, I2 = 0.0%, 95% CII2 0%-68%). Perpetration of IPV was associated with increased odds of substance use (OR = 1.99, 95% CIOR 1.33-2.99, I2 = 73.1%). These results should be interpreted with caution because of methodological weaknesses such as the lack of validated tools to measure IPV in this population and the diversity of recall periods and key outcomes in the identified studies. MSM who are victims of IPV are more likely to engage in substance use, suffer from depressive symptoms, be HIV positive, and engage in unprotected anal sex. MSM who perpetrate IPV are more likely to engage in substance use. Our results highlight the need for research into effective interventions to prevent IPV in MSM, as well as the importance of providing health care professionals with training in how to address issues of IPV among MSM and the need to raise awareness of local and national support services. Please see later in the article for the Editors' Summary.
Article
Full-text available
I review the current status of transgender people's access to health care in the United States and analyze federal policies regarding health care services for transgender people and the limitations thereof. I suggest a preliminary outline to enhance health care services and recommend the formulation of explicit federal policies regarding the provision of health care services to transgender people in accordance with recently issued medical care guidelines, allocation of research funding, education of health care workers, and implementation of existing nondiscrimination policies. Current policies denying medical coverage for sex reassignment surgery contradict standards of medical care and must be amended. (Am J Public Health. Published online ahead of print January 16, 2014: e1-e8. doi:10.2105/AJPH.2013.301789).
Article
Full-text available
The unique experiences of transgender persons subjected to abuse have not been the focus of legal scholarship; instead, the experiences of trans people are often subsumed in the broader discourse around domestic violence in the lesbian, gay, bisexual and transgender (LGBT) community. This dearth of legal scholarship is not surprising given how little research of any kind exists on how trans people experience intimate partner abuse. This is the first law review article to specifically concentrate on the intimate partner abuse of trans people. The article begins by discussing the difficulties of engaging in scholarship around this topic, noting the lack of a shared language or knowledge base for discussing intimate partner abuse in the trans community. The article then documents the barriers confronting trans people seeking relief from intimate partner abuse, situating those barriers in the broader context of the structural and institutional violence and discrimination that are so prevalent in the lives of trans people and looking particularly at the inadequacy of the legal system to address the needs of trans people subjected to abuse. This part of the article is informed by the observations and insights of legal professionals working with trans people subjected to intimate partner abuse, as well as the narratives of trans people who have engaged the legal system.The article then examines the gendered nature of intimate partner abuse against trans people, arguing that such abuse can be understood both through the lens of the patriarchal narrative of the battered women’s movement, but also as a means of policing gender norms and affirming gender identity. Recognizing that the legal system is the most developed and best funded response to domestic violence in the United States, the article questions whether the legal system can ever form the cornerstone of an effective response to intimate partner abuse for trans people. The article concludes that we cannot create effective systemic responses to intimate partner abuse without understanding the particular needs of discrete groups of individuals subjected to abuse — like trans people.
Article
Full-text available
Depression and suicide are responsible for a substantial burden of disease globally. Evidence suggests that intimate partner violence (IPV) experience is associated with increased risk of depression, but also that people with mental disorders are at increased risk of violence. We aimed to investigate the extent to which IPV experience is associated with incident depression and suicide attempts, and vice versa, in both women and men. We conducted a systematic review and meta-analysis of longitudinal studies published before February 1, 2013. More than 22,000 records from 20 databases were searched for studies examining physical and/or sexual intimate partner or dating violence and symptoms of depression, diagnosed major depressive disorder, dysthymia, mild depression, or suicide attempts. Random effects meta-analyses were used to generate pooled odds ratios (ORs). Sixteen studies with 36,163 participants met our inclusion criteria. All studies included female participants; four studies also included male participants. Few controlled for key potential confounders other than demographics. All but one depression study measured only depressive symptoms. For women, there was clear evidence of an association between IPV and incident depressive symptoms, with 12 of 13 studies showing a positive direction of association and 11 reaching statistical significance; pooled OR from six studies = 1.97 (95% CI 1.56-2.48, I (2) = 50.4%, p heterogeneity = 0.073). There was also evidence of an association in the reverse direction between depressive symptoms and incident IPV (pooled OR from four studies = 1.93, 95% CI 1.51-2.48, I (2) = 0%, p = 0.481). IPV was also associated with incident suicide attempts. For men, evidence suggested that IPV was associated with incident depressive symptoms, but there was no clear evidence of an association between IPV and suicide attempts or depression and incident IPV. In women, IPV was associated with incident depressive symptoms, and depressive symptoms with incident IPV. IPV was associated with incident suicide attempts. In men, few studies were conducted, but evidence suggested IPV was associated with incident depressive symptoms. There was no clear evidence of association with suicide attempts. Please see later in the article for the Editors' Summary.
Article
Full-text available
Intimate partner violence (IPV) is as prevalent in lesbian, gay, bisexual, and transgender (LGBT) relationships as it is in heterosexual ones; however, the issues, needs, and challenges associated with assisting or advocating on behalf of LGBT persons are poorly understood. Using community-based participatory approaches, we conducted a brief survey of professionals (e.g., shelter staff, domestic violence prevention and intervention programs, law enforcement) affiliated with one or more domestic violence prevention and/or intervention networks in Los Angeles, California. The sample, which included professionals (N = 54) from diverse programs/agencies, was obtained using purposive and snowball sampling. Participants self-administered a 33-item, online questionnaire. Analyses primarily involved descriptive statistics (frequencies, proportions). Most respondents had little or no training in LGBT IPV; nevertheless, nearly 50% of them reported having assisted LGBTs "sometimes" or "often" in the past year. Nearly all (92%) reported that their agencies/programs lack staff with dedicated responsibilities to LGBT IPV. The most frequent requests for assistance respondents reported receiving from LGBTs were for counseling, safe housing, legal assistance, and assistance navigating the medical system. The findings suggest that staff believe their agencies/programs inadequately address LGBT IPV but that many of the inadequacies (e.g., lack of staff training on LGBT IPV) are remediable.
Article
Full-text available
I woke up early that morning for an appointment with my primary care provider; I did not want to be late because I was a new patient and had waited a month for the appointment. Since I had moved across town to attend college, it was no longer feasible to go to my long-time primary care provider (PCP). Although seeing a new PCP made me slightly apprehensive, I had no idea that I would leave the physician’s office feeling ashamed. The office seemed like any other office—pamphlets about women’s health were displayed in a holder attached to the wall, there were comfortable chairs for waiting, and magazines were lying on a table ready for perusal. The receptionist at the front desk was friendly and welcoming. At check-in, I began to describe my medical history on a patient intake form that listed the typical medical questions that one would expect. Then I reached the section of the intake form that requested demographic information. One question asked for “Current relationship status” and the response options were: Single; Married; and Widowed. I didn’t fit any of those descriptions. I also noticed the omissions of questions concerning sexual orientation and gender identity. Thus, I checked the box for single despite my two-year long relationship with my partner. When the nurse led me to the exam room to assess my vital signs, she made small talk and we laughed a little, which made me slightly more comfortable. When the PCP came into the room, she introduced herself and shook my hand. We reviewed the information in my intake form together and everything seemed straightforward until she asked me if I was sexually active. I told her that I was, to which she replied, “Would you like birth control?” When I told her that I didn’t need it, she proceeded to tell me about unwanted pregnancy and the benefits of birth control, even though I did not request this information. She asked, “So, are you using protection to prevent pregnancy?” I simply said, “I don’t have sex with men.” That statement was met with a long pause as she just stared at me. The moment seemed to linger forever and I did not know which of us was more uncomfortable. “So, you’re a lesbian?” she asked, to which I quickly replied, “I’m gay.” I suddenly felt embarrassed. She sighed deeply as if to indicate that what I had just disclosed was deeply disturbing. She did not say anything else and stepped out of the room. I was left in the examining room wondering what would happen when she returned. At one point, I considered leaving. She returned with the nurse, who stood in the corner watching as the PCP conducted what seemed like an extremely superficial and rushed physical examination. At the end of my exam, I was given directions to a laboratory for some blood tests and a business card for the provider’s office so that I could make a follow-up appointment. I never did get the blood tests and I never returned to that provider. At the time, I did not suspect that many of my future experiences with health care providers would involve repetitive and awkward explanations about my relationship status, my sexual identity, and why I didn’t need birth control. Unfortunately, experiences like this are not rare for lesbian, gay, bisexual, and transgendered (LGBT) people seeking access to medical services; it seems that many LGBT people have negative experiences with their health care providers and the health care system. In addition to the lack of adequate, informed, and culturally sensitive provider and patient education, the LGBT communities face undue health disparities and inequities that should be addressed. (See below.) Health care professionals should be made aware of these disparities in order to improve quality and cultural sensitivity in care for this underserved population. On April 15th, 2011, President Obama signed a presidential memorandum regarding hospital visitation and health decision making for same-sex partners. It states that hospitals accepting Medicare and Medicaid must respect patients’ advance directives and “respect the rights of patients to designate visitors.” These hospitals...
Article
Full-text available
The medical community's efforts to address intimate partner violence (IPV) have often neglected members of the lesbian, gay, bisexual, and transgender (LGBT) population. Heterosexual women are primarily targeted for IPV screening and intervention despite the similar prevalence of IPV in LGBT individuals and its detrimental health effects. Here, we highlight the burden of IPV in LGBT relationships, discuss how LGBT and heterosexual IPV differ, and outline steps clinicians can take to address IPV in their LGBT patients.
Article
Full-text available
The current study examined the moderating role of shame proneness on the association between physical, psychological, and sexual intimate partner violence victimization and depressive and anxious symptoms among male and female college students (N = 967). Students completed self-report measures of dating violence, depression, anxiety, and shame proneness. Results showed that shame proneness moderated the association between all forms of victimization and mental health symptoms. A three-way interaction revealed that sexual victimization predicted symptoms of anxiety to a greater extent for men than for women at high levels of shame proneness. Furthermore, results showed that gender moderated the association between physical and psychological victimization and health outcomes, such that victimization was related to increased depressive and anxious symptoms for men but not for women. Interpretations of these findings are discussed in relation to violence interventions, including primary prevention, and men's health.
Article
Full-text available
For people who are transgender, transsexual, or transitioned (trans), access to primary, emergency, and transition-related health care is often problematic. Results from Phase I of the Trans PULSE Project, a community-based research project in Ontario, Canada, are presented. Based on qualitative data from focus groups with 85 trans community members, a theoretical framework describing how erasure functions to impact experiences interacting with the health care system was developed. Two key sites of erasure were identified: informational erasure and institutional erasure. How these processes work in a mutually reinforcing manner to erase trans individuals and communities and produce a system in which a trans patient or client is seen as an anomaly is shown. Thus, the impetus often falls on trans individuals to attempt to remedy systematic deficiencies. The concept of cisnormativity is introduced to aid in explaining the pervasiveness of trans erasure. Strategies for change are identified.
Article
This study explored patterns of intimate partner violence (IPV) victimization and perpetration in 150 sexual minority women (SMW): 25.3% had been sexually victimized, 34% physically victimized, 76% psychologically victimized, and 29.3% suffered an IPV-related injury. A latent class analysis found four behavioral patterns: (1) minor-only psychological perpetration and victimization; (2) no IPV; (3) minor–severe psychological, physical assault, and injury victimization, and minor-only psychological, physical, and injury perpetration; and (4) severe psychological, sexual, physical assault, and injury victimization and perpetration. Individuals who experienced and/or perpetrated all types experienced the greatest heterosexism at work, school, and in other contexts.
Article
Despite the fact that LGBT aging often is discussed, the unique needs of the transgenderidentified and gender non-conforming-identified (GNC) populations are still very much overlooked. This article examines some of the historical challenges faced by this population, and reviews their current status, and also discusses some of the important steps to support the well-being of these populations in the future.
Article
Among the crucial advancements in the study of intimate partner violence (IPV) is an understanding of the distinct help-seeking barriers that gay and lesbian victims face. Despite these additions to the literature, transgender IPV victimization remains under-researched. The current study utilized semi-structured interviews and open-ended questionnaires of 18 trans-identified survivors of IPV. Working through a modified grounded analytic approach, two major themes emerged in the help-seeking process: “walking the gender tightrope” in which participants first struggled with gendered notions of victimization that made it difficult to identify abuse, and second, the challenges of “navigating genderist resources.”
Article
Aims and objectives: The current study examined the coping styles used by sexual minority men who have experienced intimate partner violence (IPV), including sexual, emotional, and physical victimization, as well as physical injury. Background: While sexual minority men experience IPV at least as often as do heterosexuals, there is currently limited knowledge of IPV in this community or resources for sexual minority men who experience IPV. Design: Cross-sectional design. Method: Sexual minority men (N= 89) were recruited as part of a national online survey and completed questionnaires assessing lifetime experiences of IPV as well as various coping strategies. In terms of IPV, 34.8% of participants reported having been targets of sexual abuse, 38.2% targets of physical abuse, 69.7% targets of psychological abuse, and 28.1% had experienced an injury as a result of IPV during their lifetime. Results: Canonical correlation analyses found that IPV victimization explained 32.5% of the variance in adaptive and 31.4% of the variance in maladaptive coping behaviors. In the adaptive coping canonical correlation, standardized loadings suggested that sexual minority men who experienced IPV resulting in injury were more likely to use religious coping, but less likely to use planning coping. In the maladaptive coping canonical correlation, sexual minority men who had been targets of intimate partner sexual victimization and IPV resulting in injury tended to engage in increased behavioral disengagement coping. Conclusion: This study revealed several coping behaviors that are more or less likely as the severity of different forms of IPV increases. This article is protected by copyright. All rights reserved.
Article
In a number of cultures (e.g., Native American and Asian communities), the transgender experience has held positive, spiritual meanings - a value often denied to transgender people in today's Western society. We posit that gender dualism (male versus female, man versus woman, masculine versus feminine) has contributed to the social stigmatization of transgenderism, and that dualism in terms of the separation between science and religion (body versus spirit) has contributed to the medicalization (and pathologization) of transgenderism. A paradigm shift has been gradually occurring over the past decade, in which transgender individuals are affirming their identity and sexuality as distinct from both male and female identity and sexuality. This process can be described as a spiritual discernment or awakening, not only for the individual involved but also for family and community, including their community of faith. Attention to this coming-out process by mental health practitioners and spiritual counselors can help transgender individuals to transform stigma into pride and to integrate body and spirit. Case vignettes taken from the first author's clinical practice illustrate the spiritual aspects of the transgender coming-out process facilitated in psychotherapy.
Chapter
Heterosexism, an ideological system that refuses, derogates, and labels any nonheterosexual form of identity, behavior, relationship, or community, is one of the emerging issues associated with lesbianism, homosexuality, and heterosexuality whether at individual or cultural levels. This chapter intends to describe and explicate psychological heterosexism in the United States using empirical research and social science theory. Belief and attitudinal mechanisms of psychological heterosexism are explained in the first part of the chapter with particular attention given to motivational and cognitive activities. The second part tackles behavioral characteristics of psychological heterosexism which exhibits predominant manifestations of violence against lesbians and gay men while the third part discusses the outcomes of psychological heterosexism. The chapter ends with the implications of empirical research on the concept of heterosexism.
Article
Using a retrospective design, we examined verbal and physical child-to-parent violence (CPV) in terms of frequency and family correlates. Results from 365 university students revealed low frequencies of CPV, with higher means for child-to-mother violence. Regressions showed that ethnicity (African-Canadian and Middle Eastern) and, surprisingly, lower positive discipline were associated with less verbal CPV for both parents. Greater psychological aggression predicted greater mother-directed verbal violence, whereas more spanking, and the presence of child physical abuse and physical intimate partner violence were associated with mother-directed physical violence. Finally, verbal intimate partner violence between parents predicted children’s verbal violence towards mothers and fathers. Findings indicate that certain variables may place families at risk for CPV and, in this way, help inform interventions.
Article
Studies indicate that women victims of intimate partner violence are at increased risk for poor mental health. This research disentangled the effect of partner violence on new-onset depression and psychosis spectrum symptoms from effects of child maltreatment and other confounding factors, including substance abuse and antisocial personality. Participants were 1,052 mothers involved in the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative cohort of families followed prospectively. To test the directionality of associations between partner violence and depression, only women without a history of depression at the beginning of the study were considered (n = 978). Partner violence and mental health were assessed during face-to-face interviews with women across three time points. Four of 10 women reported being the victim of violence from their partner in a 10-year period. They represent 33% of our cohort and they account for 51% of new-onset depression. These women had a twofold increase in their risk of suffering from new-onset depression once the effect of childhood maltreatment, socioeconomic deprivation, antisocial personality, and young motherhood were controlled. Women who were abused both in childhood and adulthood were four to seven times more likely to suffer from depression than never-abused women. We observed similar associations with psychosis spectrum symptoms. Women victims of partner violence account for more than their share of depression. Findings strengthen existing evidence that partner violence independently contributes to women's poor mental health. Psychological difficulties among a considerable number of women could be reduced by stopping partner violence. © 2015 Wiley Periodicals, Inc.
Article
Applying a “power and control” lens to high-stakes conflicts involving a trans person and their intimate partner can both illuminate and distort the true picture of what is going on. This article discusses 6 ways in which discriminatory societal structures and/or cultural beliefs specific to trans people and their families can be wielded as power and control weapons by both trans people and their non-trans partners. These same “abuse tactics” may, however, simply be evidence of a lack of collaborative problem-solving beliefs and skills. The difference between the two is illustrated using common issues likely to be faced by a couple undergoing or contemplating a gender transition. This article ends with specific issues and concerns that should be addressed when safety planning with a trans person or their partner.
Article
Research indicates that lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at high risk of victimization by others and that transgender individuals may be at even higher risk than their cisgender LGBQ peers. In examining partner violence in particular, extant literature suggests that LGBTQ individuals are at equal or higher risk of partner violence victimization compared with their heterosexual peers. As opposed to sexual orientation, there is little research on gender identity and partner violence within the LGBTQ literature. In the current study, the authors investigated intimate partner violence (IPV) in a large sample of LGBTQ adults (N = 1,139) to determine lifetime prevalence and police reporting in both cisgender and transgender individuals. Results show that more than one fifth of all participants ever experienced partner violence, with transgender participants demonstrating significantly higher rates than their cisgender peers. Implications focus on the use of inclusive language as well as future research and practice with LGBTQ IPV victims.
Article
Executive Summary Increasing numbers of population-based surveys in the United States and across the world include questions that allow for an estimate of the size of the lesbian, gay, bisexual, and transgender (LGBT) population. This research brief discusses challenges associated with collecting better information about the LGBT community and reviews eleven recent US and international surveys that ask sexual orientation or gender identity questions. The brief concludes with estimates of the size of the LGBT population in the United States. Key findings from the research brief are as follows:  An estimated 3.5% of adults in the United States identify as lesbian, gay, or bisexual and an estimated 0.3% of adults are transgender.  This implies that there are approximately 9 million LGBT Americans, a figure roughly equivalent to the population of New Jersey.  Among adults who identify as LGB, bisexuals comprise a slight majority (1.8% compared to 1.7% who identify as lesbian or gay).  Women are substantially more likely than men to identify as bisexual. Bisexuals comprise more than half of the lesbian and bisexual population among women in eight of the nine surveys considered in the brief. Conversely, gay men comprise substantially more than half of gay and bisexual men in seven of the nine surveys.  Estimates of those who report any lifetime same-sex sexual behavior and any same-sex sexual attraction are substantially higher than estimates of those who identify as LGB. An estimated 19 million Americans (8.2%) report that they have engaged in same-sex sexual behavior and nearly 25.6 million Americans (11%) acknowledge at least some same-sex sexual attraction.  Understanding the size of the LGBT population is a critical first step to informing a host of public policy and research topics. The surveys highlighted in this report demonstrate the viability of sexual orientation and gender identity questions on large national population-based surveys. Adding these questions to more national, state, and local data sources is critical to developing research that enables a better understanding of the understudied LGBT community.
Article
The predictors of intimate partner violence (IPV) have received extensive attention in the literature, including a well-established link between exposure to violence in the family-of-origin and subsequent perpetration of IPV in adolescence and adulthood. However, a model that provides for potential mediating factors in this relationship would prove informative in understanding the processes involved in the development of IPV perpetration. The current study used a sample of college men (N = 228) to examine a model whereby violence in the family of origin is proposed to contribute to the development of hostile-dominant interpersonal problems (HDIP), which increase the likelihood of later IPV perpetration in adolescence and young adulthood. Path analytic results indicated that the proposed model was a good fit to the data. Specifically, sexual and psychological child abuse were significant predictors of HDIP, and HDIP significantly predicted all 3 types of IPV perpetration (i.e., physical, sexual, and psychological). In addition, childhood physical abuse was marginally related to HDIP and directly related to physical IPV perpetration in the path model. Although exposure to interparental violence did not predict HDIP or IPV perpetration in the path model, exposure to interparental violence was related to HDIP and physical IPV at the bivariate level. Future research suggestions are provided to aid in increasing the current knowledge regarding the developmental processes involved in the intergenerational transmission of violence. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
Article
A Monte Carlo study was run to check the stability of canonical correlations, canonical weights, and canonical variate-variable correlations. Eight data matrices were selected from the literature for the canonical analyses, with the number of variables ranging from 7 to 41. The results showed that the canonical correlations are very stable upon replication. The results also indicated that there is no solid evidence for concluding that the components are superior to the coefficients, a t least not in terms of being more reliable. However, the number of subjects per variable necessary to achieve re1i:tbility in detecting the most important variables, using components or coefficients, was quite large, ranging from 42/1 to 68/1.
Article
This article presents findings from an investigation of health needs, service utilization, and perceived barriers to services among male-to-female (MtF) transgender persons of color in San Francisco. Focus groups (n = 48) and survey interviews (n = 332) were conducted with convenience samples recruited from the community. Participants reported a range of health and social services needed during the previous year, with African-Americans and Latinas showing particularly strong service needs. Rates of utilizing services were high for basic health care but lower for social services, substance abuse treatment, psychological counseling, and gender transition-related medical services. No significant ethnic group differences in health service utilization were found. Qualitative findings evinced the call for transgender-specific programs and advanced provider training on transgender issues such as hormone use, gender transition, HIV/ AIDS care and prevention, substance abuse, and mental health problems.
Article
Lesbian, gay, bisexual, and transgender (LGBT) persons, while widely diverse in many ways, share health disparities related to the stigma and discrimination they experience, including disproportionate rates of psychiatric disorders, substance abuse, and suicide. Lesbians, gay men, bisexuals, and the transgender communities have additional health concerns and disparities unique to each population. This paper highlights the national recognition of these health issues and disparities and presents web-based information resources about them and their mitigation.
the role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established. a quantitative measure with items derived from prior qualitative work retrospectively assessed family accepting behaviors in response to LGBT adolescents' sexual orientation and gender expression and their relationship to mental health, substance abuse, and sexual risk in young adults (N= 245). family acceptance predicts greater self-esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors. family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities.
Article
This paper argues that, however useful the results of such interventions might be, the chosen measures of crime and violence underestimate certain types of violence, particularly non-economic violence, and key dimensions of violence, particularly gender and age. Complementary methodologies are therefore necessary for a more holistic understanding of the complexities of urban violence. The following section presents two conceptual tools for understanding violence manifestations and causality which provide a structure to the discussion of crime and violence measurement issues. Section III will provide a critical examination of crime and violence indicators, focusing on the ways that underreporting and misclassification contribute to a skewed picture of violence. Sections IV and V review quantitative and qualitative methodologies used in violence research, with lessons learned from research experiences in the Americas. The final section concludes with a discussion of the methodological implications for the development of "first round" crime and violence monitoring surveys and possible "second round" studies to assess the dynamics of violence characteristics, causality and intervention
Article
This study examines the role of coping as both a moderator and a mediator of the association between intimate partner violence and women's mental health. A sample of 298 women who had suffered physical aggression completed measures of physical and psychological abuse, coping responses, and symptoms of anxiety and depression. Tests of moderation consistently indicated that coping responses did not moderate the impact of intimate partner violence on symptoms of anxiety and depression, whereas tests of mediation demonstrated that disengagement coping mediated the impact of psychological abuse on distress. Thus, findings support the hypothesis that coping responses are influenced by violence itself and underline the dysfunctional nature of disengagement coping among victims.