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Intimate Partner Violence and Mental Health Among Transgender and Gender Diverse Young Adults

Authors:
Christopher Stults at Baruch College
Christopher Stults
Siyan Gao at University of Wisconsin–Madison
Siyan Gao
Stephan A Brandt at Stony Brook University
Stephan A Brandt
Jamie L. Taber
Jamie L. Taber
Jamie L. Taber
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Abstract

PurposeResearch indicates that multiple forms of intimate partner violence (IPV) may be prevalent among transgender and gender diverse (TGD) people, including general forms of IPV (psychological, physical, sexual), as well as identity-specific forms (transgender-related IPV (T-IPV), identity abuse (IA)). Studies also suggest that IPV is associated with negative mental health outcomes in TGD populations, including depression, anxiety, and posttraumatic stress disorder (PTSD). However, little is known about IPV and its association with mental health among TGD young adults. This is noteworthy, as this is a key developmental period for many TGD individuals.Methods Thus, the present study sought (1) to estimate the lifetime and past-year prevalence of several forms of general and identity-specific IPV among a sample of (N = 200) TGD young adults in New York City and (2) to assess the associations between IPV with recent symptoms of depression, anxiety, and PTSD. To address the study aims, a cross-sectional quantitative survey was conducted between July 2019 and March 2020.ResultsRegarding lifetime IPV, IA was most prevalent (57.0%), followed by sexual (40.0%), physical (38.5%), T-IPV (35.5%), and psychological IPV (32.5%). Regarding past-year IPV, psychological IPV was most common (29.0%), followed by IA (27.5%), physical (20.0%), T-IPV (14.0%), and sexual IPV (12.5%). Results of hierarchical regression models indicate that lifetime IA was related to depression, anxiety, and PTSD, while past-year T-IPV was only associated with depression.Conclusions Taken together, these findings suggest that IPV is highly prevalent among TGD young adults and that IPV – especially identity-specific forms – warrants additional attention from researchers, healthcare professionals, and policymakers, as it may place this population at risk for negative mental health outcomes.
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ORIGINAL ARTICLE
Journal of Family Violence
https://doi.org/10.1007/s10896-023-00579-7
have been linked to several adverse mental health outcomes,
including symptoms of depression, anxiety, and posttrau-
matic stress disorder (PTSD; Lagdon et al., 2014). These
ndings have led IPV to be recognized as a signicant, com-
mon health issue in the general population; however, less
attention has been paid to the experiences and consequences
of IPV among transgender and gender diverse (TGD) people
(i.e., those whose gender identity and/or expression diers
from their sex assigned at birth; American Psychological
Association 2015; Peitzmeier et al., 2020).
Nevertheless, a growing body of research suggests that
multiple forms of IPV victimization may be prevalent
among TGD individuals. Specically, a recent systematic
review of IPV prevalence among TGD people (Peitzmeier
et al., 2020) found that the rates of any lifetime IPV victim-
ization ranged from 6.3 to 83.3%, with a median of 37.5%
Intimate partner violence (IPV) refers to physical, psycho-
logical, and/or sexual abuse or aggression by or toward an
intimate partner (e.g., spouse, boyfriend/girlfriend, romantic
or sexual partner; Breiding et al., 2015). These experiences
Christopher B. Stults
christopher.stults@baruch.cuny.edu
1 Department of Psychology, Baruch College, City University
of New York, 55 Lexington Ave, New York, NY 10010, USA
2 Department of Psychology, Stony Brook University, New
York, USA
3 Department of Psychology, The Graduate Center, City
University of New York, New York, USA
4 Department of Urban-Global Public Health, School of Public
Health, Rutgers University, Newark, USA
Abstract
Purpose Research indicates that multiple forms of intimate partner violence (IPV) may be prevalent among transgender and
gender diverse (TGD) people, including general forms of IPV (psychological, physical, sexual), as well as identity-specic
forms (transgender-related IPV (T-IPV), identity abuse (IA)). Studies also suggest that IPV is associated with negative men-
tal health outcomes in TGD populations, including depression, anxiety, and posttraumatic stress disorder (PTSD). However,
little is known about IPV and its association with mental health among TGD young adults. This is noteworthy, as this is a
key developmental period for many TGD individuals.
Methods Thus, the present study sought (1) to estimate the lifetime and past-year prevalence of several forms of general and
identity-specic IPV among a sample of (N = 200) TGD young adults in New York City and (2) to assess the associations
between IPV with recent symptoms of depression, anxiety, and PTSD. To address the study aims, a cross-sectional quantita-
tive survey was conducted between July 2019 and March 2020.
Results Regarding lifetime IPV, IA was most prevalent (57.0%), followed by sexual (40.0%), physical (38.5%), T-IPV
(35.5%), and psychological IPV (32.5%). Regarding past-year IPV, psychological IPV was most common (29.0%), followed
by IA (27.5%), physical (20.0%), T-IPV (14.0%), and sexual IPV (12.5%). Results of hierarchical regression models indicate
that lifetime IA was related to depression, anxiety, and PTSD, while past-year T-IPV was only associated with depression.
Conclusions Taken together, these ndings suggest that IPV is highly prevalent among TGD young adults and that IPV –
especially identity-specic forms – warrants additional attention from researchers, healthcare professionals, and policymak-
ers, as it may place this population at risk for negative mental health outcomes.
Keywords Intimate partner violence · Depression · Anxiety · PTSD · Transgender
Accepted: 18 May 2023
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023
Intimate Partner Violence and Mental Health Among Transgender and
Gender Diverse Young Adults
Christopher B.Stults1,3 · StanGao1· Stephan A.Brandt2· Jamie L.Taber1,3· Savannah G.Lynn1· WalterKaczetow3·
GabinLee1· AndrewCruise1· Kristen D.Krause4
1 3
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... This violence encompasses a broad spectrum of aggressive behaviors, such as physical violence, sexual violence, stalking, financial exploitation, and psychological abuse (i.e., intense criticism, coercive control, and verbal harassment; CDC, 2021). Additionally, sexual and gender minority (SGM) individuals experience unique IPV tactics such as identity-specific abuse (i.e., abuse related to an individual's sexual and/or gender minority identity (Scheer et al., 2019;Stults et al., 2023). 1 Extensive research has illuminated the impact of IPV victimization on millions of individuals annually, transcending demographic categories such as age, gender, race, ethnicity, socioeconomic status, sexual orientation, and nationality (Devries et al., 2013). However, scant attention has been given to understanding the adverse consequences of IPV victimization among individuals with SGM identities. ...
... among lesbian, gay, bisexual, transgender, and queer individuals. Stults et al. (2023) further illustrated that in the second step of a hierarchical linear regression model, the 2 The Medical Subject Headings (MeSH) thesaurus is a controlled and hierarchically organized vocabulary produced by the National Library of Medicine. It is used for indexing, cataloging, and searching of biomedical and health-related information. ...
... Yu et al. (2023) also found that MSM living with HIV who had experienced any type of IPV were more likely to report depressive symptoms (aOR = 3.83; 95% CI: 2.09-7.02). Finally, Stults et al. (2023) noted that lifetime IPV significantly increased the variance explained in depression scores among transgender and gender-diverse young adults (ΔR 2 = 0.15, F(5, 155) = 7.10, p < 0.001), with both lifetime identity abuse and past-year T-IPV showing significant associations (B = 3.37, p = 0.012; B = 5.66, p = 0.010). Similarly, Peng et al. (2020) found a significant positive correlation between experiences of various forms of IPV and depression in MSM (r = 0.206, p < 0.01). ...
The Impact of Intimate Partner Violence on the Mental and Physical Health of Sexual and Gender Minorities: A Comprehensive Review of Quantitative Research
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Full-text available
The aim of this review was to investigate the mental and physical health outcomes of intimate partner violence (IPV) victimization among sexual and gender minority (SGM) individuals. This study addressed an existing gap in research concerning IPV outcomes among SGM populations. A systematic review was conducted through PubMed, APA PsycInfo, APA PsycNet, and manual searches on Google Scholar using specific keywords. Inclusion criteria included peer-reviewed publications and quantitative studies specifically assessing the impacts of IPV among SGM individuals. A total of 35 studies meeting these criteria were included in the review. Our review showed significant associations between IPV victimization and adverse mental and physical health outcomes, including posttraumatic stress disorder, depression, anxiety, suicidal ideation and attempts, substance use, and risky sexual behaviors among SGM individuals. IPV victimization poses mental and physical health risks for SGM populations. Our findings highlight the need for comprehensive, tailored intervention and prevention efforts that consider the diverse needs of individuals with multiple minoritized identities in the context of IPV victimization.
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... Stults and colleagues (2023) found that trans people commonly faced IPV related to their identity (e.g., identity abuse). Abusive partners may threaten to "out" trans victims to people unaware they are trans, hide gender-affirming resources, and deadname them to cause harm (Bermea et al., 2021;Stults et al., 2023). Abusers may also use transphobic slurs against their victims, ask them to act in stereotypically gendered ways, or target specific body parts (e.g., chest) with physical abuse (Quinn, 2020). ...
... On the surface, our findings show that most respondents employ a trans-neutral approach to Katrina's service provision due to lack of education or personal bias toward trans clients, which exhibits one of Bonilla-Silva's (2006) frames of abstract liberalism and the perpetuation of equal opportunity to services. This practice can expose Katrina to discrimination and negatively impact her safety in temporary housing which aligns with prior research indicating that trans IPV survivors report experiencing transphobic discrimination from abusers and social services (Kurdyla, 2023;Stults et al., 2023). Therefore, Katrina's identity as a trans woman must be central to her care, or service providers are at risk of reproducing the unsafe circumstances she is trying to flee. ...
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Article
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  • Mar 2024
  • Crit Criminol
Trans women have distinct dynamics in abusive relationships that cisgender women may not experience (e.g., purposeful misgendering). Therefore, it is important that IPV service providers recognize the unique needs of trans women to provide appropriate care. We draw on data from a larger study employing an online open-ended survey with a hypothetical vignette depicting a trans woman experiencing IPV (Merken et al., 2023). Responses from 75 IPV service providers in the USA and Canada indicate that many respondents aim to “treat everyone equally” regardless of gender identity, but may do so based on the constraints of their organization. Drawing on colorblind racial ideology, we discuss the harms of generalized IPV service provision, or what we term trans-neutrality. We argue this perspective has harmful consequences for trans women seeking assistance and call for more structural support for service providers to implement sustained trans-inclusive IPV provision. Implications for IPV policy and practice are discussed.
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... Τα πολυεπίπεδα εμπόδια που αντιμετωπίζουν τα ΛΟΑΤΚΙ+ θύματα συντροφικής βίας στην αναζήτηση βοήθειας, σε συνδυασμό με τις επιπτώσεις της βίας σε σωματικό και ψυχικό επίπεδο, αυξάνουν τους παράγοντες επικινδυνότητας. Ειδικότερα, τα ΛΟΑΤΚΙ+ θύματα βιώνουν υψηλά επίπεδα κατάθλιψης, άγχους και μετατραυματικού στρες (Stults et al., 2023). Συνεπώς, οι δυσμενείς ψυχοκοινωνικές επιπτώσεις της βίας σε συνδυασμό με τα εμπόδια στην αναζήτηση βοήθειας αναδεικνύουν την επιτακτική ανάγκη εστίασης στο φαινόμενο αυτό και την ανάπτυξη στοχευμένων παρεμβάσεων διαχείρισης και αντιμετώπισης περιστατικών συντροφικής βίας από τους επαγγελματίες που εργάζονται στην πρώτη γραμμή στο πεδίο της ενδοοικογενειακής/ενδοσυντροφικής βίας. ...
Μια συγκριτική προσέγγιση της συντροφικής βίας στις ΛΟΑΤΚΙ+ και ετερόφυλες σχέσεις: Ο ρόλος της Κοινωνικής Εργασίας A comparative approach to intimate partner violence in LGBTQI+ and heterosexual relationships: The role of Social Work
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Η παρούσα βιβλιοανασκοπική μελέτη εστιάζει στο φαινόμενο της συντροφικής βίας στις ΛΟΑΤΚΙ+ σχέσεις σε σύγκριση με τις ετερόφυλες σχέσεις.Η ΛΟΑΤΚΙ+ κοινότητα αποτελεί μια έντονα στιγματισμένη, καταπιεσμένη και περιθωριοποιημένη πληθυσμιακή ομάδα. Ως εκ τούτου,επιδιώχθηκε η διερεύνηση των επιπέδων βίας μεταξύ τωνΛΟΑΤΚΙ+ και των ετερόφυλων σχέσεων, των διαφοροποιήσεων που υφίστανται στις μορφές βίας, των εμποδίων στην αναζήτηση βοήθειας, καθώς και των υφιστάμενων παρεμβάσεων της Κοινωνικής Εργασίας. Για την επίτευξη αυτού του σκοπού, πραγματοποιήθηκε δευτερογενής έρευνα σε τρεις βάσεις δεδομένων (PubMed,Scopusκαι GoogleScholar). Επίσης συλλέχτηκαν δεδομέναπου ήταν καταχωρημένα στις εκδόσειςSpringerLink, SagePub, JSTOR. Αρχικά εντοπίστηκαν 214εγγραφές, εκ των οποίων τελικά συμπεριλήφθηκαν στη μελέτη οι 43, έπειτα από την αξιολόγηση των μελετών βάσει των κριτηρίων επιλογής και απόρριψης. Σύμφωνα με τα ευρήματα της ανασκόπησης, τα επίπεδα βίας στις ΛΟΑΤΚΙ+ σχέσεις είναι υψηλότερα συγκριτικά με τις ετερόφυλες σχέσεις. Οι μορφές βίας παραμένουν ίδιες, αλλά ηδιαφοροποίηση έγκεινται στην άσκηση της βίας, η οποία είναι ειδικά εστιασμένη στη ταυτότητα του φύλου και την σεξουαλικότητα του θύματος. Τα συστημικά εμπόδια στην αναζήτηση βοήθειας, συμπεριλαμβανομένου των διακρίσεων, τηςέλλειψηςσυμπεριληπτικών υπηρεσιών και τουκοινωνικούστίγματος, θέτουν σε αορατότητα την συντροφική βία στις ΛΟΑΤΚΙ+ σχέσεις. Αναφορικά με τον ρόλο και τις παρεμβάσεις των κοινωνικών λειτουργών,η βιβλιογραφία είναι αρκετά περιορισμένη σε διεθνές και εθνικό επίπεδο. Υφίσταται έντονη ανάγκη για μελλοντικέςπρωτογενείς έρευνεςστο πεδίο της συντροφικής βίας, λαμβάνοντας υπόψη όλους τους σεξουαλικούς προσανατολισμούς και τις ταυτότητες του φύλου, προκειμένου να αναπτυχθούν στοχευμένες παρεμβάσεις στο πεδίο της Κοινωνικής Εργασίας για την αντιμετώπιση του φαινομένου.
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... These experiences were not unique, as a growing number of studies also documented the physical and verbal harm experienced by TGD individuals both at home and in the outside world (Domínguez-Martínez & Robles, 2019). At the same time, there was a strong association between the stressors and emotional burden (Stults et al., 2023;Verbeek et al., 2020), connecting stressors with gender dysphoria and mental distress as described in domain 4. Our research showed that psychological elements (e.g. gender dysphoria and distress) created further barriers to using GAHT properly. ...
Factors influencing overdose and misuse of gender-affirming medication in Chinese transgender and gender diverse individuals: a qualitative study of experience and perspectives
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  • Feb 2024
Background: The overdose and misuse (ODM) of gender-affirming hormone treatment (GAHT) medications is common among the Chinese transgender and gender diverse (TGD) population due to a unique sociocultural and healthcare basis. However, there is no existing publication providing descriptions and interpretations of this situation among Chinese TGD people. Aims: To investigate related factors, probable triggers, and causes of GAHT ODM among Chinese TGD people on a qualitative basis, and develop a corresponding framework for further studies. Methods: We used an expert panel to draw up the criteria of ODM and semi-structured interviews to collect data. TGD people from mainland China were recruited online for interviews. An inductive thematic analysis was conducted using a framework method. A working analytical framework was developed based on the coding of nine randomly selected transcripts and the researchers’ discussion and experience. The framework was continuously refined and applied to code and chart all transcripts into the framework matrix. We examined all potential experiences and perspectives of participants on GAHT ODM. Results: Twenty-one Chinese TGD youths (mean age 21.6, SD 3.65) with GAHT experience in the past 12 months completed eligible interviews, of whom eight were trans women, eight were trans men and five identified themselves as genderqueer or non-binary. Ten of them reported ODM according to the criteria derived from an expert panel. We extracted five domains consisting of 14 topics related to their GAHT medication behaviors, i.e. accessibility of healthcare resources, gender minority stress, online TGD communities and drug sellers, gender dysphoria and mental distress, and knowledge deficit. Conclusion: This study firstly used qualitative methods to investigate GAHT ODM among Chinese TGD people, providing a framework to identify probable causes and triggers for further studies. Practitioners or psychologists can take this framework as a reference when evaluating TGD clients in order to better understand their behaviors. [FULL TEXT available at https://doi.org/10.1080/26895269.2024.2316693]
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Article
  • Oct 2021
Study/research objective To develop and validate a brief intimate partner violence (IPV) scale that screens for controlling behaviors and psychological abuse tactics directed toward transgender individuals. Rationale Transgender individuals are at elevated risk of physical and sexual IPV compared to cisgender individuals. IPV often takes on unique dimensions against transgender individuals, such as when an abusive partner threatens to “out” the transgender person, or use other tactics that weaponize transphobia within the relationship. Standard IPV screeners do not assess this type of transgender-specific IPV (T-IPV). Methods Between March 2018 and October 2019, a T-IPV scale was tested in two samples (in-person and online) of transfeminine adults (i.e. assigned a male sex at birth and identify with femininity) from the eastern and southern U.S. Exploratory factor analysis (EFA) was conducted with the in-person sample (N = 661) to assess construct validity. Confirmatory factor analysis (CFA) was then used in an independent online sample (N = 481). Using the combined sample (N = 1137), convergent validity was assessed using correlations with other forms of victimization. Multivariable regression models were fit to estimate the relationship between T-IPV and health outcomes. Results Factor analyses yielded an 8-item unidimensional scale with moderate to good fit. Nearly half the sample (48.7%) experienced at least one scale item. Internal consistency reliability was strong (KR-20 = 0.827). Significant correlations with other forms of victimization indicated convergent validity. Lifetime T-IPV was significantly associated with psychological distress (adjusted prevalence ratio [aPR] = 1.32, 95% CI = 1.13, 1.53), PTSD (aPR = 1.50, 95%CI = 1.31, 1.72), alcohol abuse (aPR = 1.21, 95%CI = 1.01, 1.44), and drug use disorder (aPR = 1.30, 95%CI = 1.06, 2.59). Conclusions This T-IPV scale is a reliable and unidimensional measure with strong construct validity. T-IPV is independently associated with mental health burden and substance use. Service providers working with transgender clients should screen for T-IPV to avoid missing cases of IPV, and refer to violence response services.
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Intimate Partner Violence in Transgender Populations: Systematic Review and Meta-analysis of Prevalence and Correlates
Article
  • Jul 2020
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)
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LGBTQ+ based discrimination is associated with PTSD symptoms, dissociation, emotion dysregulation, and attachment insecurity among LGBTQ+ adults who have experienced trauma
Article
  • Oct 2019
Objectives: LGBTQ+ based discrimination is a form of insidious trauma and minority stress, and is associated with poor mental health. However, there is a dearth of research on the impact of discrimination on the psychological functioning of LGBTQ+ individuals who have experienced trauma. The current study seeks to remedy this gap. It was hypothesized that: (1) LGBTQ+ adults who perceived their experience of trauma as related to LGBTQ+ based discrimination would have greater attachment insecurity, emotion dysregulation, PTSD symptoms, and dissociative symptoms; (2) experiences of LGBTQ+ based discrimination would be associated with greater attachment insecurity, emotion dysregulation, PTSD symptoms, and dissociative symptoms; (3) transgender congruence (i.e., the extent to which one feels authentic and comfortable with their gender identity and appearance) would be negatively associated with attachment insecurity, emotion dysregulation, PTSD symptoms, and dissociative symptoms. Methods: Participants were 157 LGBTQ+ adults who had experienced trauma, and who completed questionnaires on discrimination and psychological functioning. Results: Compared to participants who did not experience their trauma as related to discrimination, those who did were higher in attachment anxiety, attachment avoidance, emotion dysregulation, PTSD, and dissociative symptoms. Biphobia was positively associated with attachment anxiety, emotion dysregulation, PTSD, and dissociative symptoms. Homophobia was positively associated with emotion dysregulation, PTSD, and dissociative symptoms. Transphobia was positively associated with PTSD and dissociative symptoms. Appearance congruence was negatively associated with emotion dysregulation, PTSD, and dissociative symptoms. Conclusions: When working with LGBTQ+ clients who have experienced trauma, clinicians should be mindful of the effects of discrimination on wellbeing.
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