______________________________________________________________ Understanding Domestic Violence
birthplace and current residence. If clarification is needed regarding a name, providers can politely inquire about the name under which the insurance is listed or if records might be under a different name. If a provider inadvertently uses an incorrect word or pronoun, they should promptly apologize for the mistake and continue with the interaction. However, it’s important for providers not to excessively apologize for such errors, as it can inadvertently convey discomfort and create an awkward dynamic where the patient feels compelled to reassure or comfort the provider (American Psychiatric Association, 2019). The outward appearance of a patient may not always accurately reflect their true gender identity or preferred gender expres- sion. Gender identity refers to an individual’s internal sense of their gender, while gender expression encompasses how they choose to present themselves to the world, including aspects like clothing, voice, and preferred names and pronouns. In some situations, transgender or gender nonconforming (TGNC) individuals may opt to interact with systems that align with the gender expression typically associated with their assigned sex at birth. This choice may be motivated by a desire to avoid potentially risky situations and unwanted disclosures of their transgender identity. If a transgender person initially presents with an expression that differs from their identity, it doesn’t indicate a lack of understanding of their identity but may instead serve as a protective measure for their safety and well-being (American Psychiatric Association, 2019). CREATE INCLUSIVE MATERIALS AND INCREASE VISIBILITY Providers may take following steps to make the physical loca- tions of their practice more inviting and affirming for LGBTQ people (American Psychiatric Association, 2019): • Adapt institutional pamphlets, posters, and other materials on IPV to incorporate LGBTQ+ persons. • When appropriate, incorporate inclusive materials into sessions with survivors, such as the Power and Control Wheel in Lesbian, Gay, Transgender and Bisexual Relationships. • Provide cultural sensitivity training to the staff interacting with LGBTQ+ patients. • Providers who are involved in developing clinical resources and practice guidelines surrounding IPV should revise their materials to reflect the impacts of violence in the LGBTQ+ community.
SUPPORT AND REFERRALS Many professionals can screen for IPV effectively, yet they may not know what to do when a patient screens positive. Have a plan for when a patient screens positive for IPV. Know local resources or a social work organization they can be referred to. You can even consider contacting the organization with the patient in the office. The Family Violence Prevention and Services Act (FVPSA) allocates funds for the continual operation of a nationwide, toll-free hotline available 24/7. This hotline serves as an urgent connection to crucial support for individuals in crisis. It offers guidance and aid to adult and youth victims of fam- ily violence, domestic abuse, or dating violence, as well as to family members, household residents, and various stakeholders such as domestic violence advocates, government officials, law enforcement agencies, and the wider public (U.S. Department of Health and Human Services, n.d.). The hotline can be accessed via the nationwide number 1−800−799−SAFE (7233) or TTY 1−800−787−3224 or (206) 518-9361 (Video Phone Only for Deaf Callers). The hotline provides service referrals to agencies in all 50 states, Puerto Rico, Guam, and the U.S. Virgin Islands. Persons can also contact the hotline through an email request from the hotline website (http://www.thehotline.org/) (U.S. Department of Health and Human Services, n.d.). Services are provided without regard to race, color, national origin, religion, gender, age, or disability (including deaf and hard of hearing). Assistance is available in English and Spanish with access to more than 170 languages through telephonic interpreter services. The hotline provides the following services: • Crisis intervention • Domestic violence education • Safety planning • Directly connecting callers to service providers such as local shelters • Referrals to agencies that provide legal, economic self- sufficiency, sexual assault, elder abuse, children’s, and other related service To find local support, The Salvation Army (n.d.) provides access through their website by entering a zip code to see available shelters and support in that area: https://www. salvationarmyusa.org/usn/stop-domestic-abuse/
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