Understanding Domestic Violence ______________________________________________________________
Exploring the historical context of stigma and prejudice against the LGBTQ+ community can offer valuable insights into the distinctive challenges of IPV in LGBTQ+ relationships. This understanding can illuminate the complex and often conflict- ing choices faced by survivors when navigating support options from both general and LGBTQ+-specific service providers. Due to stigma and prejudice, LGBTQ+ IPV survivors may be hesitant to seek treatment because of: • Fear that it would further negative stereotypes or perceptions of LGBTQ+ people. • Fear of disclosing the abuse to family members or friends who are resistant to the LGBTQ+ relationship but not rejecting of the LGBTQ+ person themselves. • Fear that disclosure of the abuse may result in a dismissive or negative response to their identity or potential future partners. • Fear of health care professionals/institutions not fully accepting of LGBTQ+ people or viewing LGBTQ+ relationships as inferior to straight and/or cisgender relationships. Self-Assessment Question 6. Which group of high school-aged students reports the highest prevalence of forced sexual activity? A) Cisgender heterosexual students B) Transgender students C) Lesbian, gay, and bisexual students D) Cisgender heterosexual students and transgender students report similar rates SCREENING AND RISK ASSESSMENT When working with an LGBTQ+-identified survivor of IPV, it’s crucial for providers to avoid assuming that the support systems available to them are identical to those accessible to straight and/or cisgender survivors. While there have been advance- ments in the accessibility of courts and support services, it’s important to recognize that depending on the survivor’s geographic and social context, these systems may inadvertently expose them to greater risks of harm or violence—either from their abusive partner or from the institutions themselves (American Psychiatric Association, 2019). PRIMARY AGGRESSOR ASSESSMENTS Heteronormative perceptions of intimate partner violence (IPV) can pose significant challenges for LGBTQ+ survivors seeking support services. Providers must recognize the wide- spread misconception that IPV primarily involves a masculine- presenting individual victimizing a feminine-presenting indi- vidual. This misconception can hinder access to assistance for survivors who do not fit within traditional gender norms or who present themselves in a manner that deviates from the conventional narrative of male-on-female abuse, regardless of their sexual orientation or gender identity (American Psychi- atric Association, 2019).
Effective methods for identifying IPV within relationships should prioritize a comprehensive assessment of empathy, agency, and entitlement, rather than focusing solely on the sex, gender identity, or gender expression of individuals involved. It is essential to recognize that individual actions within a relationship may reflect broader patterns of power and control exerted by one partner over the other. Therefore, assessments of primary aggressors should consider detailed information about the entire relationship, rather than focusing narrowly on isolated incidents. Providers are advised to (American Psychiatric Association, 2019): 1. Inquire about the presenting individual’s emotions or responses to specific incidents. 2. Explore the decision-making dynamics within the relationship. 3. Evaluate whether the individual’s access to support, power, and self-determination has changed over time. Only by understanding the broader context of the relationship—including power dynamics, control over resources, the impact of fear or intimidation, and the ability to make basic decisions—can one accurately assess the presence of IPV dynamics. Healthcare Consideration Healthcare providers should sensitively inquire about sexual behavior and desire as part of the clinical history- taking process for all patients without judgment. Research indicates that gay and bisexual men experiencing IPV are at increased risk of substance misuse and engaging in unsafe sexual practices, such as unprotected intercourse. As such, providers should assess IPV survivors for substance misuse,
HIV, and other sexually transmitted infections. USE INCLUSIVE AND NONJUDGMENTAL LANGUAGE
To ensure respectful communication, providers should inquire about each patient’s preferred name, pronouns, and terminol- ogy. Instead of assuming gendered terms like husband/wife or brother/sister, providers should use neutral language such as spouse, partner, or siblings. For instance, if a patient identify- ing as a cisgender man expresses attraction to other cisgender men, the provider should refrain from labeling them and their attraction as “gay” without clarification. It’s essential to ask the patient about their self-identification and use the language they prefer (American Psychiatric Association, 2019). While it’s appropriate to seek clarification from patients when necessary for understanding their experiences, providers should refrain from delving into personal aspects of a patient’s life out of mere curiosity. During initial encounters, providers should not presume that the name or gender indicated on a patient’s identification aligns with their identity. Some patients may be in the pro- cess of transitioning, resulting in conflicting information on their paperwork. Furthermore, legal name and gender marker changes are subject to varying rules and regulations based on
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