risk, and a person’s help-seeking behavior or willingness to disclose abuse must be considered in the context of his or her experiences and perception (Hulley et al., 2022) . Federal laws allow victims to self-petition for lawful permanent resident status or obtain a temporary visa (i.e., a “U” or “T” visa) and later apply for permanent residence, depending on the specific situation. The first step in establishing eligibility for these programs is to consult with an immigration lawyer who works specifically
with victims of IPV. A local domestic violence service agency can provide referrals to an immigration lawyer in the area. Unfortunately, recent changes to immigration law have made it more challenging for some survivors of IPV to access these remedies, and it is important to understand what a survivor’s options may be. The National Domestic Violence Hotline (1-800-799-SAFE) can help with determining what the current regulations are and how a particular survivor may be affected. there is something wrong with the victim that may have led to the assault—even if inadvertent, this is a form of victim blaming and must be avoided. Culturally appropriate behavior may encompass more than recognition of beliefs and expectations of cultures outside the United States. Even within the United States, regional or group differences should be considered in providing care. For example, some survivors may feel uncomfortable having photos taken of their bodies. Some may be reluctant to recount the history of their assault to someone of a different gender. To support a victim through what may be the most difficult experience of his or her life, it is crucial that providers approach any possible cultural issues with understanding, sensitivity, and flexibility. In such cases, the victim may be viewed as failing to follow social rules that dictate where and how people can keep themselves safe and therefore are at fault. The problem with this perspective is easily illustrated by considering that a victim may have been in a place thought to be safe, dressed in a way that is considered appropriate, and behaving in a way that is considered polite or appropriate and still be victimized. In order to avoid perpetuating structurally violent effects on victims of IPV and/or SA, it is thus crucial that providers examine their own internal biases and avoid allowing them to influence practice. Failure to do so risks retraumatization of the victim as well as liability for inappropriate practice (Portnoy, Relyea, et al., 2020) . a female victim and a male assailant, forms and other documents may be structured with this presumption; thus, it may be habit for the provider to use a male pronoun when referring to the assailant. Recognizing that both victims and assailants may have any gender or sexual orientation is the first step toward creating a culturally safe care environment inclusive of LGBTQIA2S+ health (Mukerjee et al., 2022) . Developing protocols with gender-neutral language, asking specifically who the assailant was, and making it clear that discrimination is not tolerated in the organization are also elements of such an environment. Safety planning for members of the LGBTQIA2S+ community and other sexual and gender minority individuals may require different strategies than those used with other populations. Individuals who identify with these categories are often part of a social community that is also thus identified, and this community may include the assailant (Burton et al., 2019) . Rather than seeking to avoid all contact with the assailant, the victim may need to develop strategies for encountering the assailant socially, coping with retaliatory behavior from their social community, and altering social routines to reduce risk. It is also important to remember that LGBTQIA2S+ may have histories of violence or discrimination related to their minority status, and an experience of IPV or SA can bring back these experiences as well (Burton et al., 2019; Orphanidys et al., 2022) .
Cultural Safety and Competence in Clinical Care for Intimate Partner Violence/Sexual Assault In addition to protecting immigrants who are victims of IPV and/or SA from deportation or loss of family, providers should strive to provide culturally appropriate care to all victims of IPV and/or SA. Cultural safety and cultural distress have been discussed earlier in this course. Cultural distress is a biobehavioral model that describes the psychological and physiological consequences of receiving care that does not account for cultural mores or requirements, which can create a stress state in addition to the stress of the care- necessitating incident (DeWilde & Burton, 2016).
In the case of IPV and/or SA, violation of cultural norms in the process of a forensic examination can retraumatize the victim in multiple ways. If perceived as violating the victim’s values, the provider many inadvertently be implying that Structural Violence One important construct that informs the cultural distress paradigm is structural violence. Structural violence refers to the deleterious impact of social systems that value some characteristics over others and privilege those with the valued characteristics while disempowering those without them (Burton, Gilpin, & Draughon Moret, 2020) . Structural violence may manifest as experiences of racial, class, sex/ gender, or other prejudice, all of which may be embedded in systems – including educational, governmental, economic and healthcare systems – that individuals need to access in their daily lives (Burton & Guidry, 2021) . For example, structural violence occurs when victims of IPV or SA are blamed because of where they were at the time of the assault, what they were wearing, or how they were acting. of IPV and/or SA are processed or disclosed. Survivors may fear that they will be ridiculed or shamed for their sexuality or gender identity, or they may anticipate being misgendered or “outed” for their identity (Callan et al., 2020) . Unfortunately, these fears can prevent survivors from reporting an assault or seeking needed care—and it is clear that such underreporting does occur. One study of LGBTQ- identified young adults found that although nearly a third of the sample ( N =354) had experienced IPV, less than half of these sought any type of IPV-related care or services (Scheer & Baams, 2019) . When treating a member of the LGBTQIA2S+ community or other sexual or gender minority who is the victim of IPV and/or SA, providers must recognize the many ways in which sexuality and gender norms are embedded in both culture and language. For example, it may be considered polite to refer to an individual as “miss” or “mister,” but for transgender or nonbinary identified individuals, these honorifics may not apply or may even be offensive (Mukerjee et al., 2022; Orphanidys et al., 2022) . In addition, because so many reported incidents of IPV and SA involve
Intimate Partner Violence and Sexual Assault in the LGBTQIA+ Population Sexual and gender minority individuals are those who self- identify as members of the LGBTQIA2S+ community or who have any nonheterosexual or nonspecific gender identity (Suen et al., 2020) . For these individuals, both structural violence and cultural norms may influence how experiences
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Book Code: SWFL1825
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