Intimate Partner Violence and the LGBT+ Community: Understanding Power Dynamics [1st ed.] 9783030447618, 9783030447625

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Brenda Russell   Editor

Intimate Partner Violence and the LGBT+ Community Understanding Power Dynamics

Intimate Partner Violence and the LGBT+ Community

Brenda Russell Editor

Intimate Partner Violence and the LGBT+ Community Understanding Power Dynamics

123

Editor Brenda Russell The Pennsylvania State University, Berks Reading, PA, USA

ISBN 978-3-030-44761-8 ISBN 978-3-030-44762-5 https://doi.org/10.1007/978-3-030-44762-5

(eBook)

© Springer Nature Switzerland AG 2020 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Foreword

When I began studying intimate partner violence (IPV) in lesbian relationships in the late 1980s, I often felt quite isolated. There were few other scholars researching the topic, let alone examining the IPV experiences of anyone in a relationship that was not heterosexual and cisgender. I had one trans woman participate in my study, but I was warned against using her responses since, after all, a sample of one is hardly sufficient for drawing reliable and valid conclusions about pretty much anything. I also had to respond to a lot of pushback from various quarters. For one thing, colleagues questioned my focus on such a “narrow” topic; as one asked me publicly following a conference presentation, “Why are you spending time on this? There just isn’t much to study.” Some members of the LGBTQ community also raised concerns about how the research might negatively impact them by possibly reinforcing homophobic and heterosexist stereotypes of LGBTQ relationships as unhealthy. And their concerns were not unfounded, given that the coverage the research received in popular media frequently had undertones of condemnation (of the relationships, not the violence) or voyeurism. I was nevertheless motivated to continue the work because of the encouragement I received from research participants who desperately wanted their stories told and attention brought to the problem, and from the support group for lesbian victims who partnered with me as co-researchers. The publication of the present volume, therefore, cannot help but make me smile and feel optimistic, despite the serious dimensions of the problem of LGBTQ relationship violence the contributors discuss. Although it is clear that we still have a great deal to learn about and do to address the problem, the publication of Gender and Sexual Orientation: Understanding Power Dynamics in Intimate Partner Violence stands as evidence of how much the knowledge base has grown. Gender and Sexual Orientation forces us to consider not only IPV in lesbian and gay relationships, but also to break out of the dominant, binary construction of sex and gender so as to recognize the fluidity of both and how that fluidity might uniquely influence experiences of IPV victimization and perpetration. As many of the contributors point out, intimate violence is similar across all types of intimate relationships, but there are also aspects of the problem in terms of risk and protective factors, barriers to help-seeking, and resilience and recovery that produce v

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experiences specific to non-straight and non-cisgender individuals. The researchers whose work is collected in this volume are on the frontlines of identifying and explaining these unique dynamics as well as developing clinical and social structural ways to address and ameliorate them. The contributors recognize the need for more effective responses to individual victims and perpetrators, but they also emphasize the need to move beyond (not abandon) individual and relational explanations and solutions to understand community-level and structural factors, such as transphobia, trans discrimination, and heteronormativity, that are embedded in the major institutions of our society. Another strength of this volume is the contributors’ intersectional approach to the problem, demonstrating how inequalities of gender identity and sexual orientation are intertwined with racism, xenophobia, ageism, ableism, and other inequalities to amplify and more deeply entrench disadvantage and the harms that emanate from it. Gender and Sexual Orientation casts a bright light on the gaps in our understanding of and responses to intimate partner violence in LQBTQ relationships. Yet, it behooves us to see this bright light also as a beacon, giving those of us concerned about IPV—researchers, activists, practitioners, policymakers, and LGBTQ individuals and allies—guidance on what we need to do to more effectively respond to and, even more importantly, prevent this problem. I am grateful to Brenda Russell and all of the contributors for their courage and resolve to lead the way. Claire M. Renzetti University of Kentucky Lexington, KY, US

Preface

I’ve spent most of my academic life researching intimate partner violence (IPV) and other forms of violence often concerning layperson’s or police officers’ perceptions of victims and perpetrators of IPV and concerning legal decision making. At the beginning of my career, I focused on women as the primary victims of intimate partner violence. This is not surprising as IPV has historically been considered a heterosexual phenomenon with women as the primary victims of heterosexual men. Yet, for over 35 years, research that has consistently found IPV is also a serious issue among sexual minorities and heterosexual men. As my knowledge in IPV progressed, it was clear that IPV is a human problem, and until we address this issue as a human crisis, little can be done to address the problem. Research and theory have helped us to understand power dynamics about heterosexual IPV, but very little attention has been provided to help us recognize the unique issues and power dynamics of IPV in sexual minority populations. The intersectionality of sexual orientation and gender identity continues to be neglected under the shroud of our own gendered biases which affect the way we respond to victims and perpetrators of IPV. In my own experience testifying in homicide trials, I have personally witnessed how our gendered bias, lack of understanding, communication, intervention, and general breakdown of services can lead to barriers to help-seeking and ultimately lead to tragedy in many IPV cases. These experiences have led me and the contributors to this book to provide an in-depth look at gender and sexual orientation in IPV. Each chapter of this book provides incredible insight about the scope of the problem, history and theoretical frameworks associated with gendered biases and how these biases lead to barriers to help-seeking, the (un)availability of appropriate intervention and prevention services, criminal justice response and provide evidence-based ideas for research, policy, outreach, and advocacy for sexual minorities. There are many people to thank for their contributions to this book. First, I especially grateful for the authors in this book who dedicated their time and expertise to each topic and made this book possible. Their work helped to provide multi-disciplinary, evidence-based perspectives that can be helpful to researchers, scholars, practitioners, legal actors, educators, and laypersons who aim to vii

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understand theory, etiology, and empirical research regarding IPV in sexual minority populations. I’d like to thank Dr. Claire Renzetti for contributing the forward to this book and each author who provided original works in the area of sexual minorities and IPV. This book would not have been possible without the contributions of Claire Etaugh, Clare Cannon, Sarah Jane Brubaker, Betsi Little, Veanne Anderson, Sarah Head, Jillian Scheer, Alexa Martin-Storey, Laura Baams, Katie Edwards, Ryan Shorey, Kalei Glozier, John Hamel, Susan Turell, Jennifer Hillman, Celia Torres, and Toby Miles-Johnson. I would also like to thank my incredible assistant, Celia Torres for her tireless work, assistance and a keen eye for detail on content, references, and APA format and Savanna Brown and Ivana Davis for their assistance with references. I am thankful to have worked with such wonderful student assistants. Lastly, I am also thankful to my family who inspires and continues to support me through the process. Brenda Russell Penn State University, Berks Reading, PA, USA

Contents

Part I

The Scope of the Problem: Methodological and Theoretical Perspectives 3

1

Introduction: A Call to Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . Brenda Russell

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Prevalence of Intimate Partner Violence in LGBTQ Individuals: An Intersectional Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Claire Etaugh

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On the Importance of Feminist Theories: Gender, Race, Sexuality and IPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Clare Cannon

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Identifying Influences on Interpersonal Violence in LGBTQ Relationships Through an Ecological Framework: A Synthesis of the Literature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sarah Jane Brubaker Who’s the Victim Here? The Role of Gender, Social Norms, and Heteronormativity in the IPV Gender Symmetry Debate . . . . . Betsi Little

Part II 6

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A Broader Understanding of Partner Violence and Barriers to Help-Seeking

Trans Prejudice and Its Potential Links to IPV Among Trans People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Veanne N. Anderson

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Understanding Power Dynamics in Bisexual Intimate Partner Violence: Looking in the Gap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Sarah Head

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Help-Seeking Barriers Among Sexual and Gender Minority Individuals Who Experience Intimate Partner Violence Victimization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Jillian R. Scheer, Alexa Martin-Storey, and Laura Baams

Part III 9

Intervention and Prevention of IPV Among Sexual Minorities

Primary Prevention of Intimate Partner Violence Among Sexual and Gender Minorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 Katie M. Edwards, Ryan C. Shorey, and Kalei Glozier

10 Learning What You Need: Modifying Treatment Programs for LGBTQ Perpetrators of IPV . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 Clare Cannon 11 Beyond Gender: Finding Common Ground in Evidence-Based Batterer Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 John Hamel Part IV

Outreach and Advocacy

12 Lessons Learned: One Researcher’s Same-Sex IPV Journey . . . . . 227 Susan Turell 13 Intimate Partner Violence Among Older LGBT Adults: Unique Risk Factors, Issues in Reporting and Treatment, and Recommendations for Research, Practice, and Policy . . . . . . . . . . . 237 Jennifer Hillman Part V

Criminal Justice Response

14 Identifying and Responding to LGBT+ Intimate Partner Violence from a Criminal Justice Perspective . . . . . . . . . . . . . . . . . . . . . . . . 257 Brenda Russell and Celia Torres 15 Policing Transgender People and Intimate Partner Violence (IPV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281 Toby Miles-Johnson Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305

Editor and Contributors

About the Editor Dr. Brenda Russell is a Professor of Psychology at The Pennsylvania State University, Berks. Her scholarly interests include psychology and law, perceptions of victims and perpetrators of domestic violence, homicide defendants, and the social psychological and cognitive aspects of jury decision making. She is particularly interested in how gender and sexual orientation play a role in evaluating and responding to perpetrators and victims in cases of intimate partner violence, rape, sexual coercion, and sexual harassment. She is a fellow at the Midwestern Psychological Association and received the Eisenhower Award for distinguished teaching at Penn State University. She also provides expert testimony in homicide cases and serves as consultant and program evaluator for various federal and state educational, law enforcement, justice, and treatment programs.

Contributors Veanne N. Anderson Indiana State University, Terre Haute, USA Laura Baams Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, The Netherlands Sarah Jane Brubaker Virginia Commonwealth University, Richmond, VA, USA Clare Cannon Department of Human Ecology, University of California, Davis, CA, USA; Department of Social Work, University of the Free State, Bloemfontein, South Africa

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Katie M. Edwards University of Nebraska Lincoln, 160 Prem S. Paul Research Center at Whittier School, Lincoln, NE, USA Claire Etaugh Bradley University, Peoria, IL, USA Kalei Glozier Department of Psychology, University of Wisconsin Milwaukee, Milwaukee, WI, USA John Hamel Private Practice, San Francisco, CA, USA Sarah Head Twickenham, UK Jennifer Hillman The Pennsylvania State University, Berks College, Reading, PA, USA Betsi Little Palomar College, San Marcos, USA Alexa Martin-Storey Department of Psychoéducation, Université de Sherbrooke, Sherbrooke, QC, Canada Toby Miles-Johnson Queensland University of Technology (QUT), Brisbane, QLD, Australia Brenda Russell The Pennsylvania State University, Berks, Reading, PA, USA Jillian R. Scheer Center for Interdisciplinary Research on AIDS, Yale School of Public Health, Yale University, New Haven, CT, USA Ryan C. Shorey Department of Psychology, University of Wisconsin Milwaukee, Milwaukee, WI, USA Celia Torres The Pennsylvania State University, Berks, PA, USA Susan Turell Marywood University, Marywood University Academic Affairs, Scranton, PA, USA

Part I

The Scope of the Problem: Methodological and Theoretical Perspectives

Chapter 1

Introduction: A Call to Action Brenda Russell

Intimate partner violence (IPV) is a serious social problem affecting millions in the United States and worldwide (Black 2011). The Centers for Disease Control and Prevention (Breiding et al. 2015) defines IPV as “abuse or aggression that occurs in a close relationship.” This can include physical and/or sexual violence, stalking, and psychological aggression that can occur with a current or former intimate partner. Historically, IPV has primarily been thought of as violence enacted by a male aggressor to a female victim. This image continues to dictate our public perceptions of IPV today. Yet, what is lesser known is the increasing rates of female-to-male IPV and IPV within the LGBT+ community. For example, The U.S. Centers for Disease Control conducts an annual survey called the National Intimate Partner and Sexual Violence Survey (NISVS). The telephone survey asks Americans about their experience with domestic violence. The results of these surveys over the years have revealed similarities in perpetration between men and women in rates of IPV. For instance, a recent survey (Smith et al. 2015) found 36.4% of women and 33.4% of men experienced lifetime rates of sexual or physical violence or stalking by an intimate partner. It should be noted that as rates of IPV among men and women appear to look almost equivalent, women do seem to endure more severe physical violence (Smith et al. 2015). As you will see throughout this book, rates of intimate partner violence (IPV) within the LGBT+ community tend to vary in the extant literature. While researchers may not agree on exact numbers, there is a general consensus that the prevalence of IPV within the LGBT+ community is equivalent or greater to rates seen in the heterosexual community (Messinger 2011; Romero et al. 2019; Turell 2000; Walters et al. 2013). According to Walters et al. (2013), the prevalence of rape, physical B. Russell (B) The Pennsylvania State University, Berks, Reading, PA, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_1

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violence, and/or stalking for lesbians was 43.8%, bisexual women: 61.1%, and heterosexual women: 35.0% as reported in the authors’ 2010 study. Additionally, gay men experienced these methods at a reported rate of 26.0%, bisexual men: 37.3%, and heterosexual men: 29.0%. Moreover, when considering incidents of severe violence—for example, kicking, hitting with an object, or use of weapons—rates for lesbians were 29.4%, bisexual women were 49.3%, and heterosexual women experienced these at a rate of 23.6%. Such numbers are consistent with the National Coalition of Anti-Violence Programs’ (NCAVP 2016) report that the most common types of IPV experienced by survivors were physical violence, verbal harassment, threats, intimidation, isolation, stalking, and sexual/financial/economic violence. When comparing bisexual IPV to IPV within the gay and lesbian communities, prevalence rates have shown to be higher for bisexual individuals as opposed to other groups (Barrett and St. Pierre 2013; Messinger 2011; Romero et al. 2019; Walters et al. 2013). Barrett and St. Pierre (2013) found 46.8% of bisexual-identified individuals in their analysis reported experiencing IPV compared to 26.6% of gay or lesbian individuals. Further, 28.8% of bisexual respondents reported physical injuries resulting from the violence, whereas 15.5% of gay or lesbian respondents reported physical injuries. In Walters et al.’s (2013) report, bisexual women (and sometimes bisexual men) reported higher lifetime prevalence rates of rape, sexual violence, physical violence, and stalking compare to gay, lesbian, heterosexual men, and heterosexual women. In the scant research examining the transgender and gender nonconforming community, Henry et al. (2018) found in their sample 56 out of 78 participants reported experiencing some form of IPV with psychological abuse being the most common followed by physical and sexual abuse. Langenderfer-Magruder et al. (2016) also reported transgender participants in their sample had higher prevalence rates of IPV than cisgender participants. Another study (NCAVP 2016) found in their sample of 1,976 LGBTQ survivors of IPV that six of the 13 reported homicides in the sample involved transgender women. Additionally, transgender survivors were three times more likely to be stalked and experience sexual and financial violence compared to cisgender survivors. Interestingly, Turell (2000) cautiously noted of the seven transidentified participants in their study, transgender people were more likely to have their children used against them as a means of control compared to gay or lesbian participants and were just as likely as lesbians to be threatened. Thus, while data on transgender and IPV remains sparse, what research exists strongly suggests that transgender-identified individuals experience much higher rates of IPV than other members of the LGBT+ community. While these reports of IPV are substantial, the actual prevalence rates may be even higher because sexual minorities are less likely to report the violence. This book reviews many of the unique barriers associated with help-seeking (Calton et al. 2016) including physical and mental health services, access to shelters, and a general mistrust of law enforcement that leads to a reticence to report IPV incidents. Understanding the true prevalence of IPV and a victim’s reluctance to report is difficult because not only is IPV a phenomenon that is deeply rooted in heteronormative

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beliefs, but public discussion of IPV in the LGBT+ community may be used to stigmatize the community, therefore building greater minority stress and social oppression. Further, more needs to be accomplished in terms of identifying and addressing community readiness to become more inclusive. Cultural ideologies about gender roles and femininity/masculinity often discourage victims from reporting. A victim’s perceived stigma reinforces their stereotype that homosexual men are more feminine than heterosexual men, and lesbians are more masculine than heterosexual women (Blashill and Powlishta 2009), or that IPV among two males or two women is less serious (Brown 2004). The feminist community relies upon power and control to explain abuse against women in a patriarchal society. Power and control play a significant role in all relationships. Yet, our society attributes masculine and feminine characteristics toward perpetrators and victims of IPV. Researchers (Russell and Kraus 2016) found despite gender and sexual orientation, masculine perpetrators (despite gender) were more likely to be perceived as having threatened bodily injury and initiating an assault compared to feminine perpetrators. Therefore, power and control are intimately related to these gendered features. Our gender binary way of thinking is woven into the fabric of our culture. This way of thinking hinders our ability to see gender and sexuality as a fluid entity and therefore neglects the intricate differences in recognizing, intervening, and responding to IPV incidents among sexual minorities. The chapters in this book explain the correlates, causes, and effects of this binary reality and provide novel ideas and solutions to improve our societal response and better serve all victims of IPV. The authors in this book provide new ways of thinking and challenge researchers, practitioners and policymakers to consider possible solutions to improve our current status. While there has been significant progress in the rights and recognition of sexual minorities over the past years, there is still much to do be done before LGBT+ individuals are treated equally. In the relatively short period that scholars have studied sexual minorities in general, and specifically concerning IPV, research has shown noticeable differences in the way sexual minorities are treated in health, social and legal services, policy, and protections for IPV. Though much of these differences have demonstrated deleterious consequences for many victims, there is so much more we need to learn about what works and what is beneficial in our elusive search for equality. All these areas of service have been remiss in keeping up with empirical research findings. This book provides an insightful collection of contributions made by scholars and practitioners to aid in our understanding of how heteronormativity influences reporting and responding to partner violence. The authors will examine the scope of the problem, theories and barriers to help-seeking, psychological effects of abuse, intervention and prevention services, outreach and advocacy, criminal justice response and policy implications.

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The Purpose of This Book The overarching theme of this book is to offer readers current perspectives on the topic of IPV and sexual minorities from evidence-based research and experts in their respective fields as practitioners and scholars studying gender, sexual orientation, and social inequality. This serves three important goals: (1) to emphasize a call for action in policy, practice, and research to consider the intersections of gender, gender identity, and sexual orientation in this understudied phenomenon; (2) provide readers with a broader understanding of the similarities between abuse in LGBT+ and heterosexual relationships and those that are unique to sexual minorities; and (3) identify discrepancies in response to IPV in sexual minority populations and provide theoretical and empirical evidence to explain and better respond to these discrepancies. Authors will also address some of the ways in which our society perpetuates differences through sex-role socialization and how gendered ideologies influence service provision, criminal justice response, and public policy. After examining the methodological, empirical, and theoretical foundations associated with IPV and sexual minorities, resulting conclusions invite readers to a call for action to question their perceptions, practices, and whether equality is within our grasp.

Organization of the Book The content of this book includes some important contemporary views on IPV and sexual minorities. Part 1 sets the stage by providing information about the scope of the problem in terms of research methodologies and theory. For example, what is IPV? How do researchers study and define this concept in sexual minority populations? Etaugh (see Chap. 2) examines the prevalence of IPV in LGBTQ individuals and stresses the importance of recognizing the intersection of sexual orientation, gender identity, and other social identities. She identifies methodological problems in studying this population and provides suggestions to researchers as we move toward the future of researching this understudied issue. Part 1 also provides a general understanding of the theoretical foundations surrounding IPV and how these relate to our personal biases. For instance, Cannon (see Chap. 3) traces feminist theories from the second wave to intersectionality, black feminist thought, queer theory, and how it continues to influence our understanding of IPV. Brubaker (see Chap. 4) synthesizes important empirical findings and theoretical insights using an ecological framework to examine how factors such as power, disempowerment, minority stress, homophobia, gender affirmation, and social resources affect people at an individual, interpersonal, community, and societal level. Finally, Little (see Chap. 5) concludes this section by comparing feminist theory with other theories that purport IPV is bilateral (both partners act as perpetrator and victim) to describe our perceptions of relationships, partner and gender roles, and social norms about IPV.

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Part 2 provides a broader understanding of some of the unique factors sexual minority populations face which often leads to barriers to help-seeking. In Chap. 6, Anderson examines the roots of trans prejudice and potential links to IPV among transgender people to provide a better understanding of how the origins of prejudice relate to victimization. Head (see Chap. 7) provides an overview of the largely invisible bisexual experience of IPV. This chapter notes that while there are similarities among LGBT and heterosexual IPV, there are distinct differences in the bisexual, LGBT, and heterosexual experiences and the author provides information to inform education, screening, and support for bisexual victims of IPV. Lastly, in this section, authors (Scheer et al. see Chap. 8) examine some of the unique interpersonal and systemic barriers to obtaining support services to recover from IPV. The authors review the literature on help-seeking patterns and barriers among sexual minorities in the context of minority stress, as well as examine the consequences of IPV victimization and suggest intervention and prevention strategies. Part 3 focuses on the intervention and prevention of IPV among sexual minorities. Edwards and her colleagues (see Chap. 9) provide an overview of how to prevent IPV among sexual minorities. The authors examine prevention programs designed for LGBTQ+ adolescents and young adults and examine the effectiveness of these programs. They also discuss ideas for programs and policy initiatives to reduce minority stress and ultimately reduce IPV. In Chap. 10, Cannon provides ideas for modifying treatment programs for LGBTQ+ perpetrators of IPV. Cannon addresses how batterer intervention programs (BIPs), in their current form, may not be appropriate for LGBTQ+ perpetrators and identifies some necessary modifications to be utilized in treatment programs. Similarly, Hamel (see Chap. 11) heralds the importance of finding common ground in evidence-based batterer intervention programs. Hamel provides a comprehensive overview of research on IPV and batterer intervention groups and offers a new framework designed for evidence-based treatments to improve outcomes. Part 4 of the book captures ideas for outreach and advocacy. Turell (see Chap. 12) reflects on the lessons she has learned over the years as a researcher and clinician working with sexual minorities and IPV. Turell asserts that there is a heterogeneity of influences among each LGBTQ+ community and efforts should be made to identify the impact of intersecting identities within and among LGBT+ people. We can no longer continue to research LGBTQ communities homogeneously, as it can impede the progress of research and practice while doing a disservice to each community and the heterogeneity within each community. In Chap. 13, Hillman brings attention to another largely ignored group—that of older LGBT+ adults. IPV in older adults is associated with greater mental and physical health problems, higher rates of nursing home and hospital admissions, and mortality. Hillman examines the available research to review the prevalence, risk factors, and the unique challenges faced within this population and provides ideas of policy and practice. Lastly, Part 5 centers on criminal justice response to IPV in LGBT+ populations. Russell and Torres (see Chap. 14) review the literature and note the disparity and response to IPV within the LGBT+ populations from healthcare and social service professionals to law enforcement and criminal justice response. The authors argue

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that the use of discretion and lack of clear policy and procedure involving the LGBT+ community is detrimental to combatting potential biases and assisting the LGBT + community when they are most vulnerable. Chapter 15 (Miles-Johnson) explores the understudied topic of policing transgender people and IPV. Transgender individuals are often uncomfortable seeking help from police. As perhaps one of the most hidden groups of IPV survivors, transgender victims face unique obstacles in IPV incidents relating to gender identity, and police need to be aware of the transgender experience with IPV when responding. Miles-Johnson offers a general review of the literature and concludes with suggestions for police training and practice. Overall, this book provides an exceptional overview of the problem of IPV and sexual minorities. It is written from various perspectives who tend to agree upon the notion that this is a largely neglected and understudied phenomenon in need of further investigation and social consideration. The current state of research presented in this book provides a foundation from which we can learn and subsequently utilize by developing tools to improve research, policy, and practice to move toward eradicating this dangerous social problem and begin to grow toward inclusiveness and equality. It should be noted however that research in this field remains in its infancy and evidence supporting or refuting some of the recommendations made by scholars have yet to be tested. While there are limitations and issues this book may not address, it does serve to provide direction for those searching for ways in which to better serve sexual minorities who experience IPV. Though it may take some time to incorporate such inclusive thinking, policy, and practice that can lead to change, we hope this book serves as a catalyst to increase communication, research, and theory that can lead to ideological and comprehensive improvement over time.

References Barrett, B. J., & St. Pierre, M. (2013). Intimate partner violence reported by lesbian-, gay-, and bisexual-identified individuals living in Canada: An exploration of within-group variations. Journal of Gay & Lesbian Social Services, 25(1), 1–23. https://doi.org/10.1080/10538720.2013. 751887. Black, M. C. (2011). Intimate partner violence and adverse health consequences: Implications for clinicians. American Journal of Lifestyle Medicine, 5, 428–439. https://doi.org/10.1177/ 1559827611410265. Blashill, A. J., & Powlishta, K. K. (2009). Gay stereotypes: The use of sexual orientation as a cue for gender-related attributes. Sex Roles, 61(11–12), 783–793. https://doi.org/10.1007/s11199009-9684-7. Breiding, M. J., Basile, K. C., Smith, S. G., Black, M. C., & Mahendra, R. (2015). Intimate partner violence surveillance uniform definitions and recommended data elements. Version 2.0. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Brown, G. A. (2004). Gender as a factor in response to law-enforcement system to violence against partners. Sexuality and Culture, 8, 3–139. https://doi.org/10.1007/s12119-004-1000-7. Calton, J. M., Cattaneo, L. B., & Gebhard, K. T. (2016). Barriers to help seeking for lesbian, gay, bisexual, transgender, and queer survivors of intimate partner violence. Trauma, Violence, & Abuse, 17(5), 585–600. https://doi.org/10.1177/1524838015585318.

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Henry, R. S., Perrin, P. B., Coston, B. M., & Calton, J. M. (2018). Intimate partner violence and mental health among transgender/gender nonconforming adults. Journal of Interpersonal Violence, 1–26. https://doi.org/10.1177/0886260518775148. Langenderfer-Magruder, L., Whitfield, D. L., Walls, N. E., Kattari, S. K., & Ramos, D. (2016). Experiences of intimate partner violence and subsequent police reporting among lesbian, gay, bisexual, transgender, and queer adults in Colorado: Comparing rates of cisgender and transgender victimization. Journal of Interpersonal Violence, 31, 855–871. https://doi.org/10.1177/ 0886260514556767. Messinger, A. (2011). Invisible victims: Same-sex IPV in the National Violence Against Women Survey. Journal of Interpersonal Violence, 26, 2228–2243. https://doi.org/10.1177/ 0886260510383023. National Coalition of Anti-Violence Programs (NCAVP). (2016). Lesbian, gay, bisexual, transgender, queer, and HIV-affected intimate partner violence in 2015. New York, NY: Emily Waters. Romero, A. P., Shaw, A. M., & Conron, K. J. (2019). Gun violence against sexual and gender minorities in the United States: A review of research findings and needs. Los Angeles, CA: The Williams Institute. Russell, B., & Kraus, S. (2016). Perceptions of partner violence: How aggressor gender, masculinity/femininity, and victim gender influence criminal justice decisions. Deviant Behavior, 37, 679–691. https://doi.org/10.1080/01639625.2015.1060815. Smith, S. G., Zhang, X., Basile, K. C., Merrick, M. T., Wang, J., Kresnow, M., & Chen, J. (2015). The National Intimate Partner and Sexual Violence Survey (NISVS): 2015 Data brief–updated release. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Turell, S. C. (2000). A descriptive analysis of same-sex relationship violence for a diverse sample. Journal of Family Violence, 15(3), 281–293. https://doi.org/10.1023/A:1007505619577. Walters, M. L., Chen J., & Breiding, M. J. (2013). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 findings on victimization by sexual orientation. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

Dr. Brenda Russell is a Professor of Psychology at The Pennsylvania State University, Berks. Her scholarly interests include psychology and law, perceptions of victims and perpetrators of domestic violence, homicide defendants, and the social psychological and cognitive aspects of jury decision making. She is particularly interested in how gender and sexual orientation play a role in evaluating and responding to perpetrators and victims in cases of intimate partner violence, rape, sexual coercion, and sexual harassment. She is a fellow at the Midwestern Psychological Association and received the Eisenhower Award for distinguished teaching at Penn State University. Dr. Russell also provides expert testimony in homicide cases and serves as consultant and program evaluator for various federal and state educational, law enforcement, justice, and treatment programs.

Chapter 2

Prevalence of Intimate Partner Violence in LGBTQ Individuals: An Intersectional Approach Claire Etaugh

Introduction What Is IPV? Intimate partner violence (IPV) is defined as physical violence, sexual violence, stalking, and/or psychological aggression by a current or former intimate partner (e.g., a current or former spouse, girlfriend or boyfriend, sexual partner or dating partner) (Centers for Disease Control and Prevention [CDC] 2017). Research investigating IPV as a public and social health issue within the general population began over 50 years ago and is extensive (Kubicek 2018). Violence by an intimate partner affects women around the world, with estimates ranging from 16.3% in East Asia to 65.6% in sub-Saharan Africa (Devries et al. 2013; Walters et al. 2013; World Health Organization 2013).

Prevalence of IPV in the United States The National Intimate Partner and Sexual Violence Survey (NISVS) (Breiding et al. 2014; Walters et al. 2013) contains perhaps the most accurate estimates of intimate partner violence in the United States, because of its large (over 16,500 participants), probability-based, nationally representative sample. According to this survey, 1 in 3 women (32.9%) and more than 1 in 4 men (28.1%) in the general population of the United States report that they have experienced some type of physical violence from their close romantic or sexual partner at least once in their lifetime (Walters et al. 2013). Such violence includes being slapped, kicked, burned, or harmed with a knife C. Etaugh (B) Bradley University, Peoria, IL, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_2

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or gun. In addition, 15.9% of women and 8.0% of men reported ever experiencing sexual violence (other than rape) from an intimate partner.

Study of IPV in LGBTQ Individuals The study of IPV in lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) couples did not begin until the end of the 1980s and the beginning of the 1990s (Badenes-Ribera et al. 2015). Prior to this time, research on IPV focused primarily on the experiences of young, white, cisgender, heterosexual women. This research was embedded within a feminist, gendered perspective that framed IPV as male violence against females, stemming from patriarchal and misogynistic domination of men over women (Armstrong et al. 2018; Baker et al. 2013; Laskey and Bolam 2019). Such a dichotomous and hierarchical view could not account for same-sex partner IPV, men’s victimhood, and women’s perpetration (Armstrong et al. 2018), although some theorists proposed that the perpetrator, regardless of biological sex or gender identity, was performing hegemonic masculinity i.e., socially accepted norms regarding how males are supposed to think and behave) (Messinger 2017). Research on IPV in sexual minority individuals has increased during the past few decades, initially focusing on lesbian and (to a lesser extent) gay male relationships. More recently, the experiences of bisexual and transgender/gender nonconforming IPV survivors have been examined (Donovan and Barnes 2017). Nonetheless, IPV among sexual and gender minorities remains understudied compared with IPV in cisgender heterosexual individuals (Brown and Herman 2015; Bucik 2016; Rollè et al. 2018; Scheer et al. 2019). Data are especially scarce on IPV among transgender/gender nonconforming individuals (Laskey et al. 2019; Messinger 2017). In addition, little of the existing research on IPV among LGBTQ individuals has employed a nuanced approach that takes into account the intersection of sexual orientation, gender identity, and other social identities that could have an influence on both victimization and perpetration of IPV (Whitfield et al. 2018). This chapter explores the prevalence of IPV among LGBTQ individuals through the intersectional lenses of sexual orientation, gender identity, gender, age, and race/ethnicity. We begin with a general comparison of IPV in LGBTQ and heterosexual cisgender individuals. We then examine methodological issues in studying IPV in LGBTQ populations. After looking at the overall prevalence of IPV in the U.S. population, we use an intersectional approach to discuss what is known about the prevalence of IPV in the LGBTQ population. We look first at the role of gender, then turn to age, and finally, examine racial/ethnic identity.

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Is IPV the Same in LGBTQ and Heterosexual Cisgender Populations? In many respects, IPV is similar in both heterosexual cisgender individuals and LGBTQ people (Decker et al. 2018; Miller-Perrin et al. 2017). However, sexual and gender minorities experience higher rates of IPV (Dank et al. 2014; Edwards et al. 2015a; Martin-Storey and Fromme 2016). They also experience more serious outcomes—a topic that will be discussed in detail later in this volume. Certain risk factors heighten the vulnerabilities of the LGBTQ community to IPV as compared to the heterosexual cisgender population. These factors are rooted in social, political, and economic conditions that devalue sexual minorities (Jordan et al. 2019; Patterson 2016). One key way in which IPV in the LGBTQ community differs from that found among cisgender heterosexual individuals is the use of an abusive tactic known as identity abuse. This form of violence refers to the ways in which IPV perpetrators may employ heterosexist, homophobic, biphobic, and transphobic societal discrimination against their sexual and gender minority partners, thus undermining and devaluing their already marginalized gender or sexual identity (Brown 2011; Bucik 2016; Guadalupe-Diaz and Anthony 2017; Guadalupe-Diaz 2019; Jordan et al. 2019; Scheer and Baams 2019; Scheer et al. 2019; Woulfe and Goodman 2018). Perpetrators may threaten to disclose a partner’s identity, attack or deny the partner’s identity, use derogatory terms to refer to the partner’s identity, or isolate them from the LGBTQ community (Scheer et al. 2019). A related tactic involves the manipulation of gender presentation. As an example, some perpetrators of IPV control the way their partner dresses to minimize the chances that the couple is identified as a sex/gender minority pair (Bermea 2019). Within the transgender community, identity abuse may take the form of withholding or controlling access to gender-affirming medical treatment (Jordan et al. 2019). Discrimination based on one’s sexual orientation and/or gender identity, in combination with the internalized homophobia experienced by many in the LGBTQ community, can lead to minority stress, which in turn increases the risk of being both a perpetrator and a survivor of IPV (Decker et al. 2018; Kimmes et al. 2017; Lewis et al. 2017; Longobardi and Badenes-Ribera 2017; Miller-Perrin et al. 2017; Miltz et al. 2019; Stephenson and Finneran 2017; Suarez et al. 2018). Indeed, as seen later in the volume, minority stress is the theoretical concept most frequently used to account for the increased incidence of various mental health issues among LGBTQ individuals (Fabbre et al. 2019). Minority stress has been studied much less in bisexual individuals than among gay and lesbian people, possibly mirroring the frequent assumption that bisexuals are shielded from social stigmatization because of their ability to “pass” as heterosexuals (Diamond and Blair 2018). But in fact bisexuals often are subject to considerable stigmatization (known as binegativity) from both the heterosexual and gay/lesbian communities, who criticize bisexual individuals as being sexually promiscuous, confused about their sexuality, indecisive, or immature (Doan Van et al. 2019; Dyar

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et al. 2019a; Etaugh and Bridges 2018). One recent study of bisexual couples (Turell et al. 2018), for example, found that the level of experienced IPV victimization was strongly related to the partner’s binegativity, especially among male couples.

Methodological Problems in Studying IPV Among LGBTQ Populations Pinpointing the precise prevalence of IPV among sexual and gender minority individuals is a daunting task. Three major methodological challenges are: (1) measuring IPV; (2) defining the LGBTQ population; and (3) sampling the population (Messinger and Roark 2019a).

Measuring IPV One challenge in measuring IPV is that researchers do not always separate data according to whether the perpetrator of violence was an intimate partner (e.g., World Health Organization 2013), making it difficult to disentangle these abusive experiences (McKay et al. 2017). In addition, IPV must be clearly differentiated from other similar types of abuse, such as peer victimization, as well as from similar-looking but nonviolent behavior such as play fighting. Moreover, specific forms of IPV need to be clearly delineated in contrast to the practice of some studies that only measure overall IPV, perhaps employing just a single item to assess it (Messinger 2017). When researchers do examine different forms of IPV victimization, they need to clearly specify the type since some studies do not differentiate among the broad range of behaviors that constitute, for example, psychological or emotional abuse (e.g., Longares et al. 2018). Such behaviors can include verbal abuse (e.g., name-calling, publicly humiliating and degrading the partner), social abuse (e.g., social isolation), monitoring, and stalking (Messinger 2017; Woodyat and Stephenson 2016). In addition, many who study psychological or emotional abuse exclude certain forms of it such as coercive control, and financial and legal abuse (Laskey et al. 2019). Another measurement issue is a clear specification of the time frame involved. Researchers need to frame survey questions in a way that asks whether a particular form of IPV has been experienced in a certain time frame such as in a current relationship, in the last month, in the past year, or in one’s lifetime. Because the most frequently used time frames are “past year” and “lifetime”, employing these allows for greater comparability across studies (Messinger 2017). Another issue in the measurement of IPV in LGBTQ individuals is that many of the instruments are heterocentric in nature, assuming a male perpetrator and a female victim. In addition, heterocentric instruments usually do not assess minority-stress related fears such as fears about being outed by one’s partner, even though, as noted

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above, one type of psychologically abusive control in same-sex or transgender relationships involves threats to reveal the partner’s identity (Counselman-Carpenter and Redcay 2018). The two most widely used measures of IPV in both cisgender heterosexual and sexual and gender minority individuals are the Conflict Tactics Scale (CTS) and its revised version (CTS2) (Messinger 2017). When using these measures to study IPV in LGBTQ people, researchers typically adjust the language to be gender neutral. However, these and similar measures are rarely evaluated psychometrically with LGBTQ samples, leading to concerns about the reliability and validity of these instruments with sexual and gender minority populations. In addition, as noted above, these instruments typically fail to capture the abusive tactics that are unique to LGBTQ relationships (Laskey et al. 2019; Messinger and Roark 2019a), nor do they assess the occurrence of minority-stress oriented fears, such as “Are you afraid of being outed by your partner?” (Counselman-Carpenter and Redcay 2018). In recent years, a handful of measurements that help to address these issues have been developed for use specifically with various subgroups of the LGBTQ community, such as the Lesbian Partner Abuse Revised Scale (see Counselman-Carpenter and Redcay 2018) and the IPV-GBM (gay and bisexual men) Scale (Stephenson and Finneran 2013). Along these same lines, Dyar et al. (2019b) recently developed and validated three culturally appropriate measures of IPV for sexual and gender minorities assigned female at birth (SGM-AFB). These instruments are an adapted version of the CTS2, an adapted measure of coercive control, and a newly developed SGM-Specific IPV Tactics Scale that is designed to assess the unique types of IPV that may be experienced by SGM-AFB individuals. Another recent measure of IPV among transgender individuals has been developed by Peitzmeier and colleagues (Peitzmeier et al. 2019). This 4-item instrument, which has been administered to female-to-male transgender individuals, continues to undergo refinement. While the instruments described above address many of the methodological concerns about the measurement of IPV in LGBTQ samples, one disadvantage is that their very specificity makes them less well-suited to compare the prevalence of IPV across groups that vary in sexual orientation and gender identity. Still another challenge in measuring IPV is the fact that it is bidirectional. In other words, the same individual may be both a survivor and a perpetrator of IPV (Lewis et al. 2015; Messinger 2018; Pepper and Sand 2015). The study of directionality of IPV in LGBTQ individuals is quite limited. As of 2017, directionality research had not been carried out at all on transgender or gender nonconforming persons, and such research on sexual minorities had not been done outside North America (Messinger 2017). The studies that have been done indicate that among sexual minorities who have ever been in a relationship involving IPV, 12–78% have both received and perpetrated some type of IPV in their lifetime (Lewis et al. 2015; Messinger 2017; Whitton et al. 2019b).

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Defining the LGBTQ Population Historically, studies of IPV in sexual and gender minority individuals focused on those in same-sex relationships (i.e., relationships between self-identified lesbians or between gay men), thus excluding individuals identifying as bisexual, transgender, queer, or “other.” Moreover, the assumption was often made that those identifying as lesbian or gay had relationships only or primarily with members of their own sex, and that heterosexuals had only other-sex relationships — neither of which is accurate (Messinger 2017). Even when researchers have included various subgroups of sexual or gender minorities, the different patterns of IPV experienced by these subgroups have often been masked by lumping two or more of them together under a single LGBTQ umbrella (see Bacchus et al. 2017; Langenderfer-Magruder et al. 2016a; Miltz et al. 2019; National Coalition of Anti-Violence Programs [NCAVP] 2017; Rothman et al. 2011; Sheridan et al. 2019; Sutter et al. 2019).

Sampling the Population A third methodological problem is the difficulty of securing representative samples of sexual and gender minority individuals (Fredriksen-Goldsen and Kim 2017; Gehring and Vaske 2017; Stiles-Shields and Carroll 2015; Messinger 2017). The proportion of LGBTQ individuals in the population is relatively small, making it difficult (as well as expensive) to recruit sexual and gender minority research participants using probability sampling, which provides the most representative sample (FredriksenGoldsen and Kim 2017). As a result, most research uses small convenience samples of LGBTQ survivors of IPV such as individuals attending public events for sexual and gender minorities (e.g., gay pride parades, musical events), or help-seeking populations such as those using shelters, HIV clinics, and various community support services (Badenes-Ribera et al. 2019; Calton et al. 2016; Laskey et al. 2019; Smith et al. 2018). These samples not only are small, they are geographically limited to a relatively small area. Such limitations in sample characteristics can yield biased results that are not generalizable to the larger population (Fredriksen-Goldsen and Kim 2017). Still another problem in trying to determine accurate estimates of the incidence of IPV in LGBTQ individuals is the possible underreporting of the abuse (CounselmanCarpenter and Redcay 2018). For one thing, members of the LGBTQ community maybe less likely to perceive abuse by a partner as IPV. In addition, sexual and gender minority survivors of IPV may be less willing to report their mistreatment because they may be concerned about stigmatization and further mistreatment on the part of family, friends, and/or medical and law enforcement personnel if they reveal their abuse and their sexual orientation/gender identity (Bucik 2016; Laskey and Bolam 2019; Miller and Irvin 2017; Scheer and Poteat 2018).

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Intersecting Roles of Gender, Sexual Orientation, Gender Identity, Age, and Racial/Ethnic Identity In the remainder of the chapter, we employ an intersectional approach to examine how the prevalence of IPV in the LGBTQ community differs as a function of one’s gender, sexual orientation, gender identity, age, and racial/ethnic identity. We first look at sexual orientation, starting with cisgender women who identify as lesbian or bisexual, or others who have sex with women regardless of their self-identified sexual orientation, including heterosexual women. We then turn to cisgender men who identify as gay or bisexual, or others who have sex with men regardless of their self-identified sexual orientation, including heterosexual men.

Prevalence in Cisgender Lesbians, Bisexual Women and Other Women Having Sex with Women As noted earlier, existing research on IPV has relied heavily on heterosexual assumptions of male violence committed against women. These gender-based assumptions for IPV focus on larger systems of patriarchy and misogyny, thus ignoring same-sex IPV (Steele et al. 2017). Therefore, lesbian perpetrators of IPV challenge the cultural assumption that women are inherently non-violent (Campo and Tayton 2015; Smith 2011). Additionally, to acknowledge that one’s female partner has committed abuse might be perceived as betraying the “feminist sisterhood” (Durish 2011). Sexual-minority women experience higher levels of IPV than heterosexual women. For example, lesbian women are more likely than heterosexual women to experience and/or perpetrate IPV (Bucik 2016), including that which results in physical injury (Graham et al. 2019). Among sexual-minority women, bisexual women are victimized at higher rates than lesbian women (Bermea et al. 2018). The NISVS survey (Breiding et al. 2014) discussed earlier revealed that an alarming 76.2% of bisexual women had experienced psychological IPV at least once in their lifetimes compared to 63.0% for lesbian women and 47.5% for heterosexual women. Similarly, bisexual women reported a higher rate of lifetime physical IPV, rape, or stalking (61.1%) than either lesbian women (43.8%) or heterosexual women (35.0%). Several other recent studies that have directly compared the prevalence of IPV in lesbian and bisexual women (Bostwick et al. 2019, 2015; Fredriksen-Goldsen et al. 2010; Puckett et al. 2016; Schwab-Reese et al. 2018) also found higher rates of IPV among bisexual women than among lesbian women. However, bisexuals are not the only group who have partners of more than one sex/gender. Some individuals who label themselves as heterosexual, as lesbian/gay, or who use no label, also report having dating, romantic or sexual relationships with people of multiple sexes/identities. That is, they are behaviorally bisexual, but do not identify as such. Coston (2017) used the NISVS data set to identity over 400 such individuals, whom she called “non-monosexuals”. The author compared the

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rate of IPV for the women in this group with both the self-identified bisexual women in the study, and the study’s female “monosexuals” (i.e., heterosexual and lesbian women who have had partners of only one sex/gender). She found that bisexual and non-monosexual women were more likely than monosexual women to experience sexual, emotional, and psychological/controlling/stalking IPV, but to have equivalent rates of experiencing physical violence. Moreover, all of these forms of violence were more prevalent at the hands of a male than a female partner. Interestingly, non-monosexual women were 1.5–2 times less likely than those who identified as bisexual to experience sexual violence, psychological violence and stalking, thus suggesting that an explicit bisexual identity has a greater influence on IPV victimization than does behaving bisexually, but without the explicit label (Coston 2017). Other research, however, has yielded different findings. Luo et al. (2014) examined data from over 62,800 youth in major U.S. cities who participated in the Youth Risk Behavior surveys in 2001–2011. They found that youth who identified as bisexual had the same incidence of physical teen dating violence (TDV) as gay and lesbian youth, while those who had sex with both sexes, but did not identify as bisexual, reported experiencing more physical TDV than lesbian and gay youth. Along the same lines, a 3-year longitudinal study of more than 1900 U.S. college students (Martin-Storey and Fromme 2016) found that those who had sexual partners of both sexes had higher levels of physical dating violence throughout the study than those who reported only same-sex or only other-sex partners.

Prevalence in Cisgender Gay Men, Bisexual Men, and Other Men Having Sex with Men In the same way that lesbian perpetrators of IPV challenge the assumption that women are inherently non-violent (see above), stereotypes that gay men are not “masculine” can lead to the perception that they are not likely to be abusive (Campo and Tayton 2015; Calton et al. 2016; Russell 2018; Russell et al. 2019). Nonetheless, prevalence estimates of IPV in men who have sex with men range anywhere from 10 to 87%, depending on numerous factors. These include the type of abuse, whether one is the victim or perpetrator, the measurement of violence, and the sampling techniques employed (Bacchus et al. 2017; Barrientos et al. 2018; Buller et al. 2014; Finneran and Stephenson 2013; Gabbay and Lafontaine 2017; Goldberg and Meyer 2013; Nowinski and Bowen 2012; Stanley et al. 2006: Suarez et al. 2018). As was the case with women, according to the NISVS data, bisexual men reported the highest rate of physical IPV (53.0%) (Breiding et al. 2014; Walters et al. 2013). Unlike the pattern for women, however, heterosexual men were next highest (28.7%), with gay men reporting the lowest rate (25.2%). Again, unlike women, it was gay men who experienced the highest rate of psychological IPV (59.6%), followed by bisexual men (53.0%), and heterosexual men (49.3%). Some recent research on IPV among gay, bisexual, and other men who have sex with men has been carried out in the UK

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and other countries (Bacchus et al. 2017; Finneran and Stephenson 2013; Miltz et al. 2019). The prevalence of IPV victimization among the sexual minority men in the UK was high compared to the overall rate for UK men (Miltz et al. 2019). Unfortunately, the researchers of these three studies did not analyze their data separately for men in the various sexual minority categories. A recent study (Dickerson-Amaya and Coston 2019) further mined the NISVS data to examine the incidence of three subtypes of psychological IPV victimization— emotional, control, and stalking—among gay, bisexual, and heterosexual men. Gay men (71.1%) were most likely to have experienced emotional abuse, followed by heterosexual men (61.6%) and bisexual men (57.4%). Controlling IPV was reported by approximately equivalent percentages in the three groups: heterosexual men (81.5%), bisexual men (79.6%), and gay men (74.7%). Being stalked was more common among gay men (66.3%) and bisexual men (60.4%) than among heterosexual men (46.5%).

Gender as an Intersecting Variable One of the most comprehensive studies of gender as an intersecting variable in IPV occurrence is the NISVS survey, which compared female and male participants in each of three sexual orientation categories: lesbian/gay, bisexual, and heterosexual. The study found that women in each sexual orientation group, compared to their male counterparts, experienced a higher prevalence of IPV in all three physical IPV categories and in two of three psychological IPV categories. Specifically, with respect to physical IPV, bisexual women (56.9%) had a much higher incidence than bisexual men (37.3%), lesbian women (40.4%) reported a higher rate than gay men (25.2%), and heterosexual women (32.3%) were victimized more than heterosexual men (28.7%). Psychological IPV showed a similar pattern for the two sexual minority groups: bisexual women (76.2%) showed a greater prevalence than bisexual men (53.0%), and more lesbian women (63.0%) were victimized than gay men (59.6%). Among heterosexuals, however, men (49.3%) were somewhat more likely than women (47.5%) to experience psychological IPV. Another comprehensive research project that reports data on risky health-related behaviors by gender is the Youth Risk Behavior Surveillance (YRBS) initiative. Results from this biennial survey, conducted by the CDC, are presented in greater detail in the section on IPV in LGBTQ youth. In the present section on gender as a variable, it is sufficient to note that, in line with the NISVS results, the YRBS findings show that female lesbian, bisexual, heterosexual, and “not sure” high school students experience more physical and sexual violence than their male counterparts (Kann et al. 2016, 2018). Other studies similarly have found that women, regardless of their sexual orientation or gender identity, experience more physical and sexual violence than do men (Coston 2017; Harland et al. 2018; Martin-Storey and Fromme 2016; Reuter et al. 2017; Reuter and Whitton 2018; Valentine et al. 2017), and that men have greater acceptance of IPV

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than women (Jacobson et al. 2015). Along similar lines, a nationwide study of Australian LGBTQ individuals found that females who identified as lesbian, bisexual, or transgender reported more sexual IPV (but less physical IPV) than corresponding males who identified as gay, bisexual, or transgender (Campo and Tayton 2015). One exception to this pattern of females reporting more IPV than males occurred in a recent online study of bisexual people which found that men reported significantly more total abuse victimization than women (Turell et al. 2018).

Prevalence in Transgender Individuals: Gender Identity as an Intersecting Variable In research on IPV, transgender people, as a discrete group, are often overlooked or (if included) are grouped with lesbian, gay, bisexual, and queer individuals under the larger LGBTQ umbrella (Barrett and Sheridan 2017; Edwards et al. 2015b; Jordan et al. 2019; Martin-Storey and Fromme 2017; Swan et al. 2019; Wirtz et al. 2018). In their review of research, Brown and Herman (2015) located only seven prior studies that dealt with the topic of IPV among transgender individuals, and in four of these studies, transgender individuals were not examined separately (see Yerke and DeFeo 2016). Even the much-lauded NISVS survey (Walters et al. 2013) mentioned above does not assess gender identity as a variable related to IPV. A relatively small number of studies since the review by Brown and Herman (2015) have looked at IPV specifically among transgender individuals. In some cases, the term “gender nonconforming” (GNC) has been used along with “transgender” as a self- identifying term (Henry et al. 2018). In one study of IPV in a sample of 150 trans men in the Boston area, more than two-thirds of the participants had experienced IPV in their lifetime (McDowell et al. 2019). Of those currently in a relationship, 49.5% had experienced IPV in their lifetime, and 9.5% had been a victim of IPV in the past 12 months. Another study of 204 young transgender women in Boston and Chicago found a similarly high lifetime prevalence rate—42%–of IPV (Garthe et al. 2018). In still another sample of 131 transgender and gender nonconforming (TGNC) youth from four U.S. cities, 45% reported lifetime experiences of physical or sexual IPV (Goldenberg et al. 2018). Similarly, in a recent national online survey of 78 TGNC young adults, 72% reported at least one form of IPV victimization in their lifetimes (Henry et al. 2018). The most common type was psychological abuse (71%), followed by physical abuse (42%), sexual abuse (32%), and assault with injury (29%). The largest national sample of transgender and gender nonconforming adults in the United States to date, with nearly 28,000 respondents, is the 2015 U.S. Trans Survey (USTS) (James et al. 2016). Over half (54%) of the respondents had experienced IPV in their lifetime, with 24% stating that the IPV was severe. Transgender men were somewhat more likely than transgender women to have experienced IPV, and transgender women reported more IPV than those who identified as nonbinary. On the

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other hand, Reuter et al. (2017) reported in a study of LGBT young adults that trans women were more likely than trans men to experience verbal or physical IPV. One recent study used the 2015 U.S. Trans Survey data to look more closely at the types of IPV reported by the participants (King et al. 2019). Psychological IPV was the most frequently reported (42.0%), followed by physical IPV (39.9%), trans-related IPV (30.4%), forced sex (21.5%), and stalking (18.0%). While the handful of studies mentioned above have examined the prevalence of IPV among transgender individuals, relatively few have investigated the incidence of IPV in transgender individuals relative to cisgender heterosexual and/or cisgender sexual minority people. One of the first studies to do this explored dating violence experiences of over 3,700 adolescents in schools in New York, New Jersey, and Pennsylvania (Dank et al. 2014). Transgender youth reported both higher victimization and higher perpetration rates of physical, psychological, cyber, and sexual dating violence than cisgender youth. Similar results were found in an AAU survey of over 150,000 college students attending 27 U.S. universities (Cantor et al. 2015). Transgender and gender nonconforming undergraduate students reported experiencing IPV nearly twice as often as the next highest group of undergraduates: cisgender females (22.8% vs. 12.8%). In a study of nearly 1,200 LGBT individuals in Colorado, 31% of transgender participants had experienced intimate partner violence, compared to only 20% of their cisgender peers (Langenderfer-Magruder et al. 2016b). Similarly, a longitudinal study of LGBT youth found that transgender college students were more likely to experience physical, sexual, and emotional IPV than their cisgender male and cisgender female peers, summing across all sexual orientations (Griner et al. 2017). A Canadian survey likewise reported that transgender participants were almost twice as likely as cisgender participants to ever experience IPV (Bucik 2016). No comparisons according to sexual orientation were made in the five studies just cited. One recent online study (N = 354) that specifically compared TGNC youth to cisgender gay and lesbian youth found significantly higher rates of identity abuse victimization among the TGNC individuals (Scheer and Baams 2019). A more extensive set of such comparisons were made in a study of over 7,500 routine primary care patients at an urban health center (Valentine et al. 2017). All groups of transgender and gender nonconforming individuals reported elevated levels of IPV victimization compared to both cisgender heterosexual and cisgender sexual minority women and men. Specifically, rates of reported sexual or physical IPV were reported, in descending order, by transgender women (12.1%), TGNC persons who did not report their gender identity (9.1%), gender nonbinary individuals (8.2%), transgender men (6.6%), cisgender bisexual women (3.9%), cisgender bisexual men (2.6%), cisgender lesbian women (1.7%), and cisgender gay men (1.3%). The most comprehensive and systematic review to date of IPV among transgender individuals across nations has been carried out by Kattari et al. (2019) and Peitzmeier et al. (under review). They located 48 articles from 42 unique datasets involving over 41,000 transgender individuals in eight different countries: The United States, Canada, Mexico; Brazil, Scotland, Spain, India, and Japan. The aggregated prevalence of lifetime physical IPV was 30.6%, and that of sexual IPV was 17.5%. Transgender individuals, compared to their cisgender counterparts, were more than

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twice as likely to experience physical IPV and nearly three times more likely to experience sexual IPV. Prevalence of IPV did not differ between trans women and trans men.

Age as an Intersecting Variable The research on IPV among sexual and gender minority individuals discussed above has focused almost exclusively on young and middle-aged adults, with youth being the second-most studied age group (Cook-Daniels 2017; Westwood 2019). We turn now to what is known about the prevalence of IPV at both the younger and older ends of the age continuum.

Prevalence in LGBTQ Adolescents Data on the perpetration of IPV among sexual minority youth (sometimes referred to as teen dating violence, or TDV) are fairly limited and still emerging (Plichta 2018). Similar to the findings for LGBTQ adults discussed above, research shows that sexual minority and gender minority adolescents are significantly more vulnerable to dating violence than their heterosexual peers, with respect to both victimization and perpetration (Dank et al. 2014; Kann et al. 2016, 2018; Meyer and Frost 2019; Reuter and Whitton 2018; Wong et al. 2017). Rates range from 12 to 43.5%, with variations largely due to differences in the definition of TDV (Plichta 2018). Further blurring the accuracy of prevalence estimates is that TDV is often bidirectional in both heterosexual youth (Renner and Whitney 2012) and sexual minority youth (Messinger 2018; Messinger et al. 2018), with perpetrators also reporting concurrent victimization. A very limited amount of research suggests that TDV perpetration rates remain relatively stable from adolescence to emerging adulthood (Shorey et al. 2018) and that TDV physical victimization rates stay stable over time for racial/ethnic minorities but decline for White youth (Whitton et al. 2019a). The small number of studies of IPV in LGBTQ youth carried out in the early years of the twenty-first century were limited by small sample size, restricted generalizability of the sample, and/or the measures of IPV employed (see Olsen et al. 2017). More recent studies have used larger, more representative, school-based samples to assess the incidence of TDV among sexual and gender minority youth. Several of these studies have analyzed data from recent years of the Youth Risk Behavior Surveys (YRBS). The YRBS is part of a multi-decade project of the Centers for Disease Control and Prevention (CDC) that monitors health-risk behaviors of adolescents (Edwards 2018). The YRBS project findings reveal that LGBQ youth often experience elevated levels of TPV when compared to non-LGBQ peers. For example, in the Massachusetts Youth Risk Behavior Survey (MA-YRBS) (2005), the incidence

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of TDV victimization was over four times higher in LGB youth than in their heterosexual peers (35% vs. 8%) (Espelage et al. 2018). Martin-Storey (2015) expanded upon this research by using pooled data (N of nearly 10,500) from four years of the MA-YRBS (2003, 2005, 2007, and 2009). The author found that girls who identified as lesbian or bisexual were nearly three times more likely to experience TDV than their heterosexual counterparts (42% and 42% vs. 16%). The disparity for boys was even greater: 36% for questioning boys, 32% for gay-identified boys, and 20% for bisexual males, compared to only 6% for heterosexual males. For most sexual minority youth, these associations were significant even when controlling for mediating and demographic variables. Similarly, Edwards (2018) analyzed data for over 25,000 participants in the 2013 New Hampshire YRBS and found elevated rates of physical and sexual TDV among LGBQ youth compared to heterosexual youth, especially heterosexual males. There was little difference in rates of TDV victimization between LGBQ girls and boys, with the exception that questioning boys reported a higher incidence of physical and sexual TDV than other LGBQ sub-groups. This finding of enhanced vulnerability for questioning boys is in line with Martin-Story’s (2015) results mentioned above. The CDC, which coordinates the YRBS project, issues reports every other year on health risk factors for U.S. youth. The most recent study (Kann et al. 2018) found higher rates of physical and sexual TDV for both female and male lesbian/gay, bisexual, and “not sure” youth than their heterosexual counterparts. Similarly, those who had partners of the same sex or of both sexes (regardless of their self-labeled sexual orientation) were at increased risk compared to those with only other-sex partners. Encouragingly, the incidence of TDV in all groups had declined since the comparable study carried out two years earlier (Kann et al. 2016).

Prevalence in Older LGBTQ Individuals Studies of elder abuse, both in domestic and wider contexts, have become more numerous in recent years, but their focus has been almost exclusively on sexual and gender majority populations (see Feltner et al. 2018; Gerino et al. 2018; Pillemer et al. 2016; Van Den Bruele et al. 2019; Yon et al. 2017). Moreover, these literature reviews did not even mention the absence of, or the need to, study elder abuse in LGBTQ people (Westwood 2019). In addition, a recent review of 66 articles published between 2009 and 2016 that did focus on older LGBTQ adults (FredriksenGoldsen et al. 2019) yielded not a single article that examined IPV in this population. Even the largest and most representative national study of LGBTQ older adults, the National Health Aging, and Sexuality/Gender (NHAS) study (Fredriksen-Golden 2017), does not address IPV. Older LGBTQ individuals have experienced a lifetime of various types of discriminatory abuse stemming from their sexualities and/or their gender identities. As they age, they may be less likely to cope with such abuse while at the same time they are more likely to be in care situations that increase their exposure to it. Thus, older

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LGBTQ individuals not only are at risk of the elder abuse experienced by any older person but are also at risk of LGBTQ-specific abuse (Westwood 2019). Put another way, older LGBTQ people who have experienced IPV based on their marginalized sexual or gender minority status must now confront the additional marginalizing factor of ageism (Bishop and Westwood 2019; Messinger and Roark 2019b). To compound the situation, many LGBTQ elders speak of the long-lasting effects of violence experienced years earlier, including the sudden re-emergence in later life of trauma thought to have been dealt with previously (Cook-Daniels 2016). In addition, certain barriers may interfere with older LGBTQ individuals acknowledging or recognizing that they have been victims of IPV. For one thing, the virtual absence of any information on the topic may lead one to question whether IPV even occurs among late-life sexual and gender minority individuals. In addition, older generations of LGBTQ individuals may have learned to be more private and self-sufficient (Forge 2017). These generations grew up at a time when society was ignorant of the many ways in which IPV could be inflicted. Even the most violent forms were often considered to be a legitimate aspect of power and control in a relationship, to be endured by the victim. Thus, victims may have been unaware that the way they were being treated was abusive (Altman 2017).

Racial/Ethnic Identity as an Intersecting Variable Relatively little is known about how IPV is experienced and perpetrated by individuals at the intersection of sexual orientation and/or gender minority status with racial/ethnic identity status (Bates et al. 2019). The handful of published studies indicate that, while heterosexual racial/ethnic minorities experience increased rates of IPV than their White counterparts, LGBTQ racial and ethnic minorities are at an even higher risk of experiencing IPV (Charak et al. 2019). These findings suggest that interactions exist between intimate partner violence and multiple forms of societal marginalization (Miller and McCaw 2019). Unfortunately, some of the research on this topic does not differentiate either among the various types of racial and ethnic diversity (see Turell 2000) or among subgroups within the LGBTQ population (see Reuter et al. 2017), therefore making it difficult to draw nuanced conclusions about IPV prevalence in individuals who identify both as sexual/gender identity minorities and as racial/ethnic minorities.

Prevalence of IPV in LGBTQ Individuals Varying in Racial/Ethnic Identity The few studies that have included indigenous LGBTQ individuals find that this group has experienced very high levels of IPV, exceeding that of other racial/ethnic

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groups. For example, Turell (2000) found higher rates of physical IPV among Native American LGB individuals (92%) than among LBG individuals who identified as Latinx (50%), White (50%), African American (44%), bi/multiethnic (39%), and Asian American (33%). Coercion also was highest among Native American sexual minorities (92%), followed by those identifying as bi/multiethnic (67%), African American (53%), White (51%), Asian American (3%), and Latinx (25%). Turell et al. (2018) later replicated the high incidence of total IPV abuse victimization of Native Americans among a group of bisexual individuals. Native Americans reported IPV at a rate that was more than twice that of Black/African Americans, more than three times that of bi/multiracial and Asian American participants, and over five times that of White and Latinx individuals. The U.S. Trans Survey reported above (James et al. 2016; King et al. 2019) similarly found Native trans individuals to have higher rates of IPV victimization than other racial/ethnic groups, with almost threefourths (73%) of American Indian and Alaska Native respondents experiencing some form of IPV. This included experiencing more physical violence and more acts of coercive control related to their transgender status (e.g., threat of being outed). Along the same lines, the most recent report from the National Coalition of Anti-Violence programs (NCAVP) reported that Native LGBTQ survivors of IPV were more than twice as likely to experience violence than survivors of other races or ethnicities (Tillery et al. 2018). Similarly, in the one published study on IPV violence in the Canadian Indigenous Two-Spirit LGBTQ population, Ristock et al. (2017) found an extremely high rate of experienced partner violence: 80% among the one sample in which partner violence was differentiated from other forms of domestic violence. The limited data available suggest that after Native people, Black/African American sexual and gender minorities are the racial/ethnic group second most likely to be survivors of IPV, closely followed or equaled by their Latinx counterparts. Turell et al. (2018) found this pattern in their bisexual sample. Similarly, in two studies of sexual and gender minority youth and young adults (Reuter et al. 2017; Whitton et al. 2019b), Black participants were anywhere between two-to-six times more likely than White participants to be survivors of severe and minor psychological, physical, and sexual IPV, as well as coercive control victimization. Results were similar but not as strong for Latinx individuals. Along the same lines, the U.S Trans Survey (James et al. 2016) found that Blacks experienced less IPV than Native peoples, and slightly more than Latinx participants. Interestingly, the incidence of physical IPV reported by Black transgender women and transgender men (44%) is virtually identical to the incidence reported by Black transgender women in six U.S. cities (44.7%) in a recent study (Bukowski et al. 2019). In some research, rates of IPV victimization are equally likely among Black and Latinx sexual minorities. One example is a study by Bostwick and her colleagues (Bostwick et al. 2019) who examined data from the Chicago Health and Life Experiences of Women (CHLEW): an 18-year, community-based, longitudinal study of sexual minority women. They found higher rates of lifetime IPV victimization among Black bisexual (44.3%) and lesbian women (39.0) and Latinx bisexual (45.0%) and lesbian women (39.0%) than among White bisexual (17.3%) and lesbian women (18.0). Rates for Black and Latinx participants were essentially the same. When

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Steele et al. (2017) analyzed data from the most recent wave of the CHLEW study, they similarly found that Black and Latinx lesbian and bisexual women reported comparable rates of experienced total IPV and of severe IPV, and that both groups had higher rates than their White counterparts. Asian-American sexual and gender minority individuals tend to have the lowest, or one of the lowest, reported rates of IPV victimization (James et al. 2016; Turell 2000; Turell et al. 2018; Whitfield et al. 2018). That said, a caveat is in order here. Although most researchers use broad categories to represent particular racial/ethnic groups, every major category encompasses a diversity of ethnic subtypes, each often representing a different national or tribal entity with its own unique cultural contexts, attitudes, and behaviors. To illustrate the point, let us examine the findings of the U.S Trans Survey for the respondents in the category entitled “Asian and Native Hawaiian/Pacific Islander” which is a standard category used by the US Census Bureau. Native Hawaiian/Pacific Islander respondents experienced a higher incidence of IPV than did Asian participants. This was true for overall IPV (50% compared to 43%), physical IPV (44% compared to 29%), and coercive control related to transgender status (28% vs. 20%). Such differences are masked when the subgroups are subsumed under a single racial/ethnic classification.

Conclusion This chapter examined the current state of knowledge of the prevalence of intimate partner violence in LGBTQ individuals. It was noted that IPV research focused initially on young, White, cisgender, heterosexual women and was embedded within a feminist, gendered framework that conceptualized IPV as male violence against females. This view stemmed from the patriarchal view of men’s domination over women. More recently, studies of IPV among the LGBTQ community have appeared, although the topic remains understudied. This is particularly true for transgender and gender nonconforming people. A number of methodological difficulties were shown to contribute to the challenges of determining the prevalence of IPV in the LGBTQ community. These challenges include measurement issues, defining the LGBTQ population, and sampling that population. Another major issue is that much of the research has not examined the intersection of sexual orientation, gender, gender identity, and other social identities. Finally, the existing research on the prevalence of IPV in LGBTQ individuals was viewed through the intersectional lenses of sexual orientation, gender, gender identity, age, and racial/ethnic identity. The upswing in research on the prevalence of IPV among LGBTQ individuals is encouraging. However, much remains to be accomplished in terms of more nuanced examinations of the roles of intersecting social identities such as gender, age, and racial/ethnic identity, not to mention other social identities that have scarcely, if ever, been examined in the context of research on IPV in LGBTQ individuals. These include variables such as social class, ableness, nationality, and immigrant status (among others). Researchers need to seek creative solutions to our understanding of

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IPV, a major public and social health issue, in those among us who have long remained invisible, or barely visible at best. It is worrisome when the groundbreaking NISVS study on IPV in the US in 2010 (Breiding et al. 2014), which included IPV data for individuals by sexual orientation, is followed up by a 2015 update (Smith et al. 2018) that omits any mention of sexual orientation. Still, the rapid and positive overall changes in societal attitudes and behaviors towards LGBTQ individuals, one of the most rapid societal shifts in recent memory (Etaugh 2019; Etaugh et al. 2019) is heartening. Undoubtedly, research on many aspects of LGBTQ lives will continue to burgeon, helping to inform areas of policy and practice that are discussed by others in this volume.

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Claire Etaugh Ph.D. received her bachelor’s degree from Barnard College and her Ph. D. in developmental psychology from the University of Minnesota. She is Emerita Distinguished Professor of Psychology and Caterpillar Professor of Psychology at Bradley University, where she has taught Psychology of Women courses since 1979. She is a Fellow of the Psychology of Women

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and the Developmental Psychology divisions of the American Psychological Association and a charter member and Fellow of the Association for Psychological Science. Her work focuses on issues related to girls, women and gender. She has published more than 100 articles in such journals as The Psychology of Women Quarterly, Sex Roles, Child Development, as well as several chapters in edited books. She is lead author of The Psychology of Women: A Lifespan Perspectives (two editions), and Women’s Lives: A Psychological Perspective (four editions, with a fifth in preparation).

Chapter 3

On the Importance of Feminist Theories: Gender, Race, Sexuality and IPV Clare Cannon

Feminist Theories and IPV Advances in feminist theories have been instrumental in developing legislation to criminalize partner abuse, creating policy to direct treatment interventions, and inform treatment programs to more acutely address motivations of partner abuse. Applying feminist theories and approaches to intimate partner violence (IPV) emphasizes the meanings, context, and impacts of violence to better identify responses needed to address such abuse. To this end, this chapter traces a history of feminist theory in the U.S. from the second wave through black feminist thought and intersectionality to poststructuralist feminist and queer theories. Each theory is explicated through a discussion of its constructions of identity and power. Following this treatment of the theory, each theory is applied to IPV to demonstrate advances in our understanding of IPV, policy implications, and developments in treatment interventions. Feminist theories advance our understanding of IPV, which in turn informs policy and aims to improve treatment interventions.

Second Wave Feminisms Although demarcations of second wave feminisms have been debated by scholars, these are heuristic devices used to understand similarities and differences across theorists and theories, and ultimately show the trajectory of feminist thought across the 20th and into the 21st century. There have been many critiques to this sort of C. Cannon (B) Department of Human Ecology, University of California, Davis, CA, USA e-mail: [email protected] URL: https://clarecannon.ucdavis.edu/ Department of Social Work, University of the Free State, Bloemfontein, South Africa © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_3

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approach (see Guy-Sheftall 1995), however it is useful for tracing conceptualizations of identity and power across feminist thought. Furthermore, the wave metaphor does not refer to temporality as much as it does the shift in ideas and practices as feminist thought changes in the 20th and 21st centuries (Mann and Huffman 2005). Although there are many strands of second wave feminist thought, such as Marxist (e.g., Salzinger 2003), liberal (e.g., Nussbaum 1999), and radical (e.g., Daly 1978), second wave feminisms generally rely on a Marxist model of power (Schippers and Sapp 2012). Though utilizing a Marxist model of power, only those who put capitalism as the major driver of sex oppression fall in the Marxist feminist school of thought (e.g., Salzinger 2003). The point here is that second wave feminisms, in general, conceptualize identity and power, as well as apply these concepts to intimate partner violence in the U.S. context. Applying Marx’s insights into structural power in which those who own the means of production (i.e., the bourgeoisie) wield power over those who do not (i.e., the proletariat), second wave feminists utilize a Marxist framework to explain patriarchal power over women in a capitalist society (Schippers and Sapp 2012). Power operates from the top of social structure to the bottom. Second wave feminists use Marx’s theory of oppression/domination and method of historical material analysis to analyze gender relations (e.g. Davis 1983; Hartsock 2003; Merchant 1980; Wittig 1993). Additionally, second wave feminists also incorporated insights garnered from psychoanalysis and structuralism. For the most part, second wave feminisms conceptualize identity as a fairly fixed category. When identifying a woman, or a man for that matter, theorists assume we imagine the same kind of woman: white, middle-class, heterosexual, female-bodied (today, cis-gendered) experiences. Identity is also a function of social location, or where one falls in the societal pecking order. For instance, Rubin (1975) writes that females are a raw material that the social apparatus, specifically the “sex/gender system,” turns into women, a domesticated product. Moreover, in this Marxist-inspired analysis, second wave feminists were more concerned with the commonalities of women, eliding differences among women, to form a class of women, which they believed was necessary to overthrow the system of sex-oppression (or patriarchy) (Hartsock 2003; Wittig 1993). This sense of identity is important in that it is the grounding for feminist standpoint, in which women’s position in society provides a unique and critical perspective for understanding societal dynamics generally, and gendered oppression specifically. Second wave feminists, using the analytical tools accessible to them (most notably from Marx who developed a critical, historical analysis to explain economic class oppression), created a critical epistemology of feminist standpoint which took women’s experiences and point of view as their position with which to describe and critique society (e.g., Hartsock 2003). This maneuver not only valued women’s humanity and lived experiences in systematic ways previously ignored, but also generated insights into the ways sex oppression operates structurally. Feminist standpoint, although rooted in Marx, is influenced by the U.S. Civil Rights movement in its drive to organize a movement around common experiences to being women in a sexist society. Such an epistemology allowed second wave feminists to challenge the

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binaries (i.e., man/woman, heterosexual/homosexual, white/black, rich/poor, etc.) that structured woman’s oppression, laying the foundations for upending these binaries because of their deep insights into identity and power. The feminist standpoint is an important departure from earlier epistemologies in that it not only valued women’s experiences, but it argued that women’s experiences are sources for production of knowledge. In this formulation, the identity category of gender is the primary focus, with race and sexuality being secondary. Identity is understood as a binary: white or black, woman or man, heterosexual or homosexual etc. Although many second wave feminists explicitly stated that such dualisms sprang from male-centered thought (e.g., Hartsock 2003, p. 297), questioned their validity and wrote on their social constructionist nature, feminists implicitly felt the limitations of the binary framework. However, using a Marxist model of power, that is power over as Collins (2000) puts it, limited their approach to this binary framework. In their understanding of power and how it is structured and operated, second wave feminists, for the most part, understood power to be a binary: dominators and subordinates, the oppressed and the oppressor. Second wave feminisms are rightly credited with advocating for the criminalization of spousal abuse and leading the charge for the landmark passage of the Violence Against Women Act of 1994 (VAWA) by the U.S. Congress. VAWA was a legislative win for second wave feminists in the recognition that abuse of women by men was unlawful and the appropriations of expenditures for both prosecution and support for victim services was imperative. VAWA has been reauthorized three times since then and although it passed the Democratically-controlled house in April 2019, the bill is currently being ignored in the Republican-controlled Senate. Having been critiqued since its passage alternatively for not protecting enough minority classes (such as same-sex couples, transgender individuals) and protecting too many minority classes, the reauthorization of VAWA has historically overcome the blue-red divides that have led to much stagnation across the U.S. federal policy. In fact, the paradigm that drives much U.S. policy and treatment for IPV perpetrators is the feminist paradigm. The feminist paradigm argues that men use violence against women as an extension of patriarchy and as an expression of power to control women (Dobash et al. 1992). The feminist paradigm, as such, has become the pervasive treatment paradigm even when applied to different kinds of perpetrators—female perpetrators and LGBT perpetrators (see Cannon et al. 2016). As scholars recognize the limitations of the feminist paradigm for a diverse group of perpetrators, their research increasingly calls for culturally relevant curricula for perpetrator treatment programs in order to better identify and understand causes and consequences of IPV. As such, IPV scholars’ work is increasingly informed by advances in feminist theory, namely black feminist thought and intersectionality. These theories help inform IPV policy and treatment programs to better understand dynamics with respect to IPV in minority populations. Although important for advancing equality between genders, there are two major lines of critique to second wave feminisms that have led to advances in feminist theory. The first advancement comes from the black feminist theorists’ critique of

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second wave feminisms’ lack of confronting experiences of race and racism. The second critique to second wave feminisms comes from advances in poststructuralist thought that changed the ways in which we think of identity categories themselves. Black feminist thought. Second wave feminists argued that women were similarly oppressed by men in a patriarchy as the proletariat is by the bourgeoisie in a capitalist society. Specifically, they argued that in a patriarchal and capitalist society, women are doubly oppressed by men and capital. Second wave feminists elevated their cause for the equality of women while maintaining the position that as subjugated subordinates they held an important and unique vantage point to understand the inner-workings of society. From such a vantage point, for instance, they argued for increased protection from partner abuse and increased regulation and enforcement of abusers. However, much of second wave feminist scholarship itself was produced by white, middle-class women who universalized their experiences for all women, and thus (according to the critique leveled by Black feminist scholars) neglected to account for experiences of race (e.g., Alexander 2010; Collins 2000; Combahee River Collective 1995; Crenshaw 1991; Davis 1983; Harris-Perry 2011; Hooks 1981, 1984; Lorde 1984; Moraga and Anzaldúa 1983). Black feminist thought ultimately sought to account for the particularities of the lived lives of black women (Cho et al. 2013). Black feminists critiqued second wave feminists, who tended to be white and middle-class because, by defining women in terms of their own experiences, they were unable to account for differences in race and class and the implications of these differences (Collins 2000; Lorde 1984). Maintaining difference is a central contribution of Black feminist theory. Whereas, Black feminists sought to make visible and uphold difference through their theories and politics based in identity categories, third wave and queer theorists sought to use difference to deconstruct identity categories. As Lorde (1984) writes, maintaining differences (e.g., race, class, sexuality) is an act of rebellion against the form of social control in which only differences between men and women are granted legitimacy. Similar to Hartsock’s (2003) argument that women, as subjugated people have an important and unique standpoint with which to expose the mechanisms of domination by men and capital, Collins (1986) argues that a Black feminist standpoint provides an important vantage point to understand the mechanisms of domination based on race, gender, and class. Black feminist thought generally, and intersectionality specifically, focuses on the interlocking systems of oppression women face, adding another dimension to the analysis of second wave feminists who investigated the intersection of class and gender systems of oppression. Similar to second wave feminists, identity is understood as a Cartesian subject. Identity is therefore varied, complex, and informed by all aspects of a person’s lived experiences. Hooks (1984) and Collins (1986) go further in arguing binaries are the building blocks for maintaining systems of domination and denying Black women their subjectivity and agency. They argue such logic of either/or must be replaced with both/and; such that women experience and respond both to sex oppression and race oppression. Black feminist theorists argue Black women cannot choose between their identity as a woman and as a Black person. In fact, the multiple categories of identity can be thought of as coalitions

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of identities. In conceiving identity as categories that are always already pervaded with each other, and by understanding that power always informs these categories, Black feminist thought contributes to the ways power is understood relationally and identity is understood to be intersectional. The major critique to second wave feminists’ constructions of power is that it is limited to power over; power over oppressed peoples to determine their life chances and the opportunities available to them (e.g., Cho et al. 2013; Collins 2000; Schippers and Sapp 2012). Hooks (1984) writes that many in the feminist movement believed since they were women, they would exercise power differently; yet they repeated oppressive social structures within their own movement. Importantly, Hooks (1984) further unpacks why this misconception occurred. Although a woman is assigned different societal roles based on sex, she is not taught a different value system. Acceptance of this value system, delivered by culture, leads her to passively accept sexism (given the value system is sexist, among other things). Since she does not have the power of the ruling group, she does not conceptualize power differently. Given the prevailing ideology of culture, most women are taught, like most men, “domination and control are the basic expressions of power” (Hooks 1984, p. 87). Therefore, Hooks (1984) argues that if feminists had conceptualized power differently, they would not have recapitulated the class and race hierarchies of larger society. However, like many Black feminists, Hooks (1984) reconceptualizes power by arguing that women have power to refuse definition of oneself offered by the powerful, and that sexism has not rendered us powerless. Put simply, every woman has the authority to define her own reality, and to do so is an act of resistance and strength. Furthermore, future survival depends on our ability to identify and create new conceptualizations of power and new ways of relating to one another across our differences—not in spite of them (Lorde 1984). Black feminist thought, then, understood oppression to be relational, binary, and structural (Mann and Huffman 2005). Black feminist thought has informed researchers’ understanding of IPV. The focus on experiences of race and gender, as well as the intersections of race and gender have contributed to a greater understanding of the dynamics and systems at work on intimate relationships from calls to police, arrests, and treatment interventions. For instance, research shows that African American women are at an elevated risk for intimate partner violence and that there are multiple dimensions that make this population particularly vulnerable (West 2012, 2019). Importantly, more research is necessary to focus on the intersection of multiple forms of oppression that shape Black women’s experiences of violence as well as survivors’ resilience and advocacy (West 2004). Given the overlapping systems of oppression faced by African Americans, and particularly African American women, a Black feminist standpoint provides important insights into factors that influence both specific patterns of abuse as well as specific forms of resilience. This knowledge is important and necessary to create more effective, culturally relevant treatment options for this population. Intersectionality. Intersectionality has emerged as a dominant touchstone for public consciousness around intersecting systems of oppression along axes of race, class, gender, sexuality, disability, immigration status, and religious identity. Specifically,

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intersectionality, as this strand of feminist theory is called, seeks to identify and critique the ways various systems of power oppress specific kinds of people and how oppressed peoples can enact their own forms of power (e.g., Carasthathis 2013; Carbado 2013; Cho et al. 2013; Choo and Ferree 2010; Collins 1986, 2000; Crenshaw 1989, 1991, 2016). Intersectionality is always concerned with intersecting axes of power and inequality, who has it, why, and how it is sustained (Cho et al. 2013). One of the landmark pieces that formed this theory is Crenshaw’s (1991) article on violence against women of color. Black feminist theorists focused on criteria of exclusion and inclusion, who is marginalized, how, and why (e.g. Hooks 1984; Verloo 2013). Moreover, Black feminist thought sought to go beyond demands for inclusion and addressed ideological structures that framed subjects and their experiences (Cho et al. 2013). In this way, Black feminist theorists are concerned with both structural contributors to inequality and identity categories, or how inequality plays out in real lives. By naming the interlocking systems of domination—the very social condition of people’s lives— Black feminist theorists seek to impart to their communities a language for naming and revealing these forms of domination (Collins 2000, pp. 269–271). The goal of Black feminist thought was not equality with the ruling class of white men, but to build a coalition of oppressed peoples based on identity categories that would create a movement to gain rights and liberation from oppression. Although the roots of intersectionality grew out of an intersectional understanding of the violence experienced by women of color (Crenshaw 1991), little IPV research since has utilized theoretical framings and methods of intersectionality with a few notable exceptions (e.g., Cramer and Plummer 2009; Kelly 2011; Nixon and Humphreys 2010; Sandberg 2013; Sokoloff and Dupont 2005). For a review of research on the subject, see West (2012). Increased use of intersectionality to understand and analyze IPV may help provide greater insight to policymakers and help begin to legislate policies and programs that get at not only the multiple identity categories (e.g., same-sex couples, transgender individuals), but also the intersections of these categories (e.g., black same-sex couples, Southeast Asian transgender individuals). Doing so will ensure protections of those who are the most vulnerable to violence in U.S. society and to increase effectiveness of resources available to abusers to reduce abuse and to survivors to increase their life chances and quality of life. Moreover, intersectionality as a holistic, multi-dimensional framework may prove useful for scholars and practitioners alike interested in creating holistic, culturally relevant treatment programs.

Post-Structuralist Feminist Theories The two overlapping strands of post-structuralist feminist and queer theories (e.g., Butler 1990; Mohanty 1988; Sedgwick 1990; Spivak 1987) provide a second critique to radical second wave feminism. This critique is marked by a shift from a Marxist model of power to a Foucauldian model of power (Schippers and Sapp 2012).

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Discursive power is central in Foucault’s (1977, 1978) formation of power because he argues discourses produce identities. Notably, many scholars produce both poststructuralist feminist theory and queer theory (e.g., Butler 1990; Schippers 2007; Sedgwick 1990). Advances in feminist theory along with post-structuralist and post-modernist thought sought to deconstruct the notion of identity as cohesive, binary, and static (e.g. Butler 1988; Derrida 1976; Foucault 1978). Contrary to intersectionality scholars who uphold identity categories in order to build political coalitions (e.g., Crenshaw 1991), post-structuralist feminist theorists seek to deconstruct identity categories because they understand these categories to be restrictive, regulatory, and disciplinary (e.g., Butler 1990; Sedgwick 1990). Since identity categories are understood to be restrictive, post-structuralist feminist theorists deconstruct these categories. Deconstruction is a method that (1) identifies ways in which binaries are operating; and (2) analyzes the effects of how these binaries operate. The method of deconstruction reveals these binaries (e.g., heterosexual/homosexual, white/black, man/woman, etc.) to be inherently unstable because of the subjugation of the second term in order to define the first. Deconstructing identity categories is necessary not to reproduce or sustain dominant discourses and disciplinary power (Foucault 1978). For example, Butler (1988, 1990) deconstructs the gender binary of man/woman by arguing that gender is embodied, multiple, fluid, discursive, relational, and performative. Based on gender performance, people belong to different groups (e.g. men, women, nonbinary, etc.). Such deconstruction of the gender binary is necessary to reveal the fiction that the gender binary is necessary and natural. The reality of gender is real only in so far as it is performed, not whether there is an essentialized gender to which the performance refers (Butler 1988, p. 527). Gender-identity-asperformative is important for precisely this reason: there is no essential sex from which one’s gender expression comes; rather, since gender is socially performed, it cannot be false. Butler (1988, 1990) argues that much of feminist theory, in which the personal is political, situates individual acts and practices within political and cultural structures, and that these acts of the individual reproduce the gender binary. Butler (1988) argues that embedded in said feminist theory, gender (although understood as socially constructed) reproduces the gender binary. Butler’s (1988, 1990) deconstruction of the gender binary and argument that gender is performative challenges the notion that gender stems from some structure or essence, whether natural or cultural. While acknowledging the effectiveness of feminist theory at elevating the visibility of women’s oppression, Butler suggests rendering such a category of women as a universal category of a gender binary fails to accurately and adequately represent women’s lived experiences (Butler 1988, p. 523). Thus, one effect of the gender binary is its failure to account for women’s lived experiences. Another effect is that the gender binary serves to reproduce and conceal a system of compulsory heterosexuality through its portrayal of heterosexual desire as natural. This understanding of identity and subsequent deconstruction of the Cartesian subject is girded by a Foucauldian framework of power.

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According to Foucault’s understanding of power (1977; 1978), power operates in a field of relations—people—based on their social location and use of tactics and strategies available to them to negotiate dynamics of power. Groups consist of identities (e.g., men/women, heterosexual/homosexual). Since identity is formed within and by discourses, a Foucauldian model of power provides a framework to understand how identities are produced and how they use particular strategies and tactics available to them, based on their social location, to enact resistant deployments of power to dominant deployments of power. Persons and groups can enact resistant forms of power. This is a key difference from a Marxist model of power in which the dominant group holds all power and the subordinated group does not. Foucault (1977, 1978) argues that Marx was not wrong about power, but that Marx’s articulation of how power operates is one of several ways in which power operates. Considering this one arrangement of power suggests we may miss other arrangements of power, namely discursive forms of power. To identify and disrupt discursive forms of power, discourse analysis is a key method of deconstructing discourses. For example, Butler’s (1988, 1990) analysis of the gender binary is important because of how power is framed. By taking the gender binary as given, subversive gender performances are not read as enacting power against cultural forces that oppress people based on their gender and/or sexuality. Through Butler’s deconstruction of the gender binary, the author reveals that gender is neither fixed nor essential. This distinction is important because it means that those who portray non-conforming gender performances enact power that subverts social constructs of normativity. Normativity is socially constructed acts and practices legitimated as normal from which all other expressions of identity are considered deviant (e.g., the construct of the manly man, such as Clint Eastwood, as normal; and, the construct of the feminine beauty, such as Marilyn Monroe, as normal; and, the construct of a transvestite, such as Eddie Izzard, as deviant). Similar to Butler’s (1988, 1990) critique of the gender binary and deconstruction of gender as an identity category, Mohanty (1988) suggests that taking the discursively constructed category of women as always already socially constituted by a sense of shared oppression risks overlooking women as material subjects with their own histories and experiences. For Mohanty (1988), the dangers of such a subjective erasure have consequences for understanding how power works. The author argues that feminist discourses in describing, without histories or particularities, the always already constituted group of women as powerless defines this category (women) by its very subordination. Doing so defines power as a binary: men, the oppressors, have it, and women, the oppressed, do not. Such delineations, Mohanty (1988) argues, limits strategies to resist oppressions and reinforces the gender binary between men and women. Put concisely, framing women as an already constituted coherent group regardless of race, class, or national contexts buttresses binary structures of men and women, in which men dominate women. As Butler (1988, 1990) has shown by using a post-structuralist feminist approach, identity is a form of representation; it is the effect, not reality, of representational codes of ideology and power. Deconstructing identity categories complicates the assumption that identity is a natural property of any individual and challenges notions

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that subjectivity is stable and coherent (Butler 1988, 1990). Through such deconstruction of binaries, subjects are understood as unstable, fragmented, contingent, and emergent, and are not ontologically fixed. Deconstructing binaries (e.g. man/woman, Western Feminist/Third-World Woman) reveals the ways power operates discursively. As Mohanty (1988) has argued, such binary identity categories reproduce binary structures of power in which the dominant term (e.g., men, the first world) have power over the subordinated term (e.g., women, the third world). These binary structures of power limit the ability to create and utilize strategies and tactics to combat oppressions since either one belongs to a group with power or one belongs to the powerless. By identifying how binaries operate, the effects of these binaries, and by deconstructing binary categories to reveal how power operates, both Butler (1988, 1990) and Mohanty (1988) employed a post-structuralist feminist approach. Although several scholars, most notably Johnson’s typology of IPV (2005), have addressed a range of motivations for the use of violence in intimate partnerships, post-structuralist theory offers a novel approach to understanding the use and experiences of violence. A post-structuralist feminist approach is particularly useful in addressing deployments and arrangements of power within experiences of IPV and institutional responses (e.g., agencies, police, courts, policy) (Cannon et al. 2015). Insights from a post-structuralist feminist approach can inform treatment programs in assisting providers in framing different uses of power to mediate relationships. For instance, Cannon et al. (2015) argues the post-structuralist feminist approach helps us to understand the tactics and strategies available to both perpetrators and victims based on their social location in using violence or experiencing violence to mediate intimate relationships. Recent scholarship has incorporated insights from these theories to increase our understanding of the use of violence in LGBTQ relationships (e.g., Cannon and Buttell 2015, 2016; Cor and Chan 2017; Hust et al. 2017; Sanger and Lynch 2018).

Queer Theor(ies) Queer theor(ies), similar to post-structuralist feminist theories, conceive of identity as fluid, performative, and multiple as well as uses a Foucauldian model of power to understand dynamics of power, with a focus on discursive forms of power (e.g., Ahmed 2006; Berlant and Freeman 1993; Butler 1990, 2004; Halberstam 1998, 2011; Halperin 1990; Jagose 1997; Pfeffer 2014; Puar 2007; Sedgwick 1990; Seidman 1996; Warner 1993). As second wave feminists convincingly argued that gender is a central category of individual, interactional, and institutional living necessary for understanding oppression, so too is sexuality since heterosexism and homophobia are deeply embedded in every institution (Sedgwick 1990; Warner 1993; Weeks 1977). Furthermore, queer theorists argue that sexuality—like gender, race, and class—is contingent: that the context in which it is performed and negotiated matters. The theoretical evolution of queer theory can be traced through queer’s inheritance from the homophile movement, gay liberation, and lesbian feminism movements

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(Jagose 1997). The homophile movement codifies into identity politics—a political coalition built on socio-demographic characteristics—and revolutionizes ideals of gay liberationists and lesbian feminists, however queer theories are interested in the limitations of identity, and subsequently identity politics. As Jagose (1997) convincingly argues, the homo-inspired movements used the tools and social constructions of its time similar to feminists at the time (e.g., the gay liberationists use a liberation model, lesbian feminists use a feminist model of separation, queer theory uses post-modernist influenced notions of subjectivity). Queer theory emerges in reaction to the limitations of identity politics. Specifically, queer theories argue that identity politics reify binary identity constructions, which reproduce binary constructions of power (Puar 2007). Following such sexuality scholars as Rubin (1992) and employing a poststructuralist framework, queer theories seek to articulate identity binary constructions with a central focus on those relating to sexuality and their effects. A major and distinct insight of queer theory is not to focus on part of the binary with hierarchical power (i.e., hetero), which relies on the subjugated term for its definition (i.e., homo), but to analyze, critique, and reveal normativity itself (Sedgwick 1990; Warner 1993). To accomplish this, queer theorists use deconstruction as an analytic move to reveal the inherent instability of the relationship between binary oppositions since one term relies on the subjugation of the other (i.e., hetero/homo) (Sedgwick 1990). In arguing that heterosexuality depends on queer bodies (the excluded subject)— which is to say that heterosexuality is defined over and against queer subjectivity— then the object of analysis for queer theories is normativity itself. For example, queer theories focus on heteronormativity instead of the binary heterosexual/homosexual. Heteronormativity refers to the practices associated with heterosexuality, which are discursively constructed as the norm or referent. Those who self-present or whose practices are different from what is socially recognizable as heterosexual are discursively constructed as deviant. In this way, queer theories focus on that which is normed rather than on the identity binary construction of heterosexual/homosexual (e.g., Puar 2007; Warner 1993). Exposing that which is defined as normal, revealing the power dynamics and inequalities that enable it as such, and to bare the differences that matter, these are the tasks of queer theory. In this way, queer theories seek to rethink the social and in doing so reveal logics of the social order (Warner 1993). Queer theory asks in what ways do queers’ political interests as queers connect to wider demands for justice and freedom given that, as Warner (1993, p. xiii) puts it: Every person who comes to a queer self-understanding knows in one way or another that her stigmatization is connected with gender, the family, notions of individual freedom, the state, public speech, consumption and desire, nature and culture, maturation, reproductive politics, racial and national fantasy, class identity, truth and trust, censorship, intimate life and social display, terror and violence, health care, and deep cultural norms about the bearing of the body.

In this way, queer bodies, and the theory that aims to transform social order, is a space of holding all of these tensions, simultaneously, all of the time. Such a condition is illuminative of all the various aspects that go into creating and maintaining social order of which queers have intimate knowledge. This perspective provides us with

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a spacious framework with which to analyze dynamics ranging from nationalism (e.g., Berlant and Freeman 1993), to transnational capitalism (e.g., Alexander 2006), to class identity (e.g., Feinberg 1993). Through the lived experience and awareness such experiences engender of the internal dynamics of social life for queers, queer people are uniquely situated to theorize and critique seemingly disparate constructs in order to generate more just and free forms of life. Such theorizing renders possible the practices of queer politics, which seeks not the toleration and representation of a minority constituency in a liberalist and pluralist society but seeks to reject the logic of normalcy itself. Queer theories aim to disrupt heterosexual ideology, embedded in all forms of life, which frames heterosexuality as “natural” while emphasizing that humanity and heterosexual mean the same thing (Warner 1993). To undermine this form of heteronormativity that exists deep in our social structures, categorizations, and assumptions, it is necessary to assert a queer understanding of the world. Unlike framings of identity in second wave feminisms and intersectionality theories, queer people cannot be thought of as a class of people or as having a status since an identity of gay or lesbian “is ambiguously given and chosen, in some ways ascribed and in other ways the product of performative act of coming out—itself a political strategy without precedent or parallel” (Warner 1993, p. xxv). Since queer theories conceptualize identity as performative, fluid, and relational, then one’s queer identity is performed and performed differently depending on context. Queer theor(ies), with its roots in post-structuralism and gay and lesbian liberation movements, furthers this post-structuralist critique and broadens its focus to constructions of sexuality and difference (Jagose 1997). In the wake of Black feminist critiques of second wave feminist theory, queer theorists expand their focus from so-called biologically determined women to queer people. Queer theories seek to render visible that which has been rendered invisible by current forms of domination in order to resist (using adaptive strategies and tactics) dominant deployments of power (Jagose 1997). Unlike a Marxist model of power in which the dominant group has power and the subordinated group does not, queer theories identify particular strategies and tactics available to resist dominant deployments of power; thus recognizing multiple different forms of resistance exist (e.g., Butler 1990; Halberstam 2011; Haraway 1988; Puar 2007; Warner 1993). There are two major critiques to post-structuralist feminist and queer theories. First, given the emphasis on subjectivity, some argue that these approaches miss macrostructural effects (e.g., Nussbaum 1999). Secondly, the timing of these theoretical shifts, in not focusing on obtaining rights, may have undermined the coalition building of identities at a crucial juncture: when second wave feminists and black feminists alike have so much left, they endeavor to accomplish, namely liberation from oppression. Although there is an uptake of the use of queer theory to frame and understand the use and experiences of IPV, researchers are increasingly investigating IPV in bisexual, lesbian, gay, transgender, genderqueer, and queer relationships (for overview see Calton et al. 2016; Langhinrichsen-Rohling et al. 2012). Research suggests that prevalence rates of IPV are comparable, if not greater, for relationships of those

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in these communities (Breiding et al. 2014). More research is necessary to understand both motivations of perpetrators and protective factors of survivors in order to better support these marginalized communities through advancements in policy and treatment options. For instance, in Cannon’s (2019) study of batterer intervention programs (BIPs) across the U.S., they found that more LGBTQ-identified facilitators and greater outreach to the LGBTQ community are two important steps needed to increase awareness of resources to combat IPV. Queer theories provide an exciting opportunity for scholars to rethink IPV as it occurs in both queer and heterosexual relationships. For instance, using queer theory in developing curricula for BIPs will enable providers and clients the ability to recognize heteronormativity and how it may negatively affect one’s ability to navigate their relationship without violence.

Theory and IPV: Implications for Policy and Treatment In this chapter I have argued that feminist theories have advanced our understanding of intimate partner violence, thus informing policy and treatment interventions. As Black feminist thought (particularly intersectionality), post-structuralist, and queer theories continue to be incorporated into mainstream discourses, we can expect to see more of an increase in research into IPV. Each of the feminist theories described in-depth here provides a unique framework with which to understand IPV, especially for those belonging to racial/ethnic minorities and sexual and gender minorities. In using these theories to advance research into IPV, there are likely to be developments in policy to reflect our increased understanding of IPV and better support those who have historically been marginalized when it comes to support for combatting IPV as a pernicious social problem. For instance, both Washington state and Iowa require culturally sensitive training of perpetrator providers to address sexism, racism, and homophobia and address how these ideologies of oppression relate to partner abuse (Cannon et al. 2016). Just as research using second wave feminist theory led to the criminalization of domestic abuse and the subsequent passage of the Violence Against Women Act, so the theories presented here can aid in the next generation of IPV research. To do so, first, scholars must be trained in these theoretical models to use them to frame and empirically test research questions and evaluate and inform treatment interventions. Second, policymakers must use this evidence-based research to better inform policy that protects and supports all those affected by IPV. For instance, most state standards emphasize adherence to a “power and control” model of treatment informed by socio-political theories of patriarchy (Cannon et al. 2016; Maiuro and Eberle 2008). Although other treatment models, such as cognitive-behavioral therapy, have proven efficacious at treating perpetrators of IPV (Maiuro and Eberle 2008), there has yet to be a widescale adoption in policy across states promoting these evidence-based practices. As research continues to utilize the theoretical models described here, and as such research diffuses across the policy and treatment landscapes, we will find new ground in our progress towards ending partner abuse.

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Langhinrichsen-Rohling, J., Misra, T. A., Selwyn, C., & Rohling, M. L. (2012). Rates of bidirectional versus unidirectional intimate partner violence across samples, sexual orientations, and race/ethnicities: A comprehensive review. Partner Abuse, 3(2), 199–230. https://doi.org/10. 1891/1946-6560.3.2.199. Lorde, A. (1984). Sister outsider: Essays and speeches. New York, NY: Ten Speed Press. Mann, S. A., & Huffman, D. J. (2005). The decentering of second wave feminism and the rise of the third wave. Science & Society, 69(1), 56–91. https://doi.org/10.1521/siso.69.1.56.56799. Maiuro, R. D., & Eberle, J. A. (2008). State standards for domestic violence perpetrator treatment: Current status, trends, and recommendations. Violence and Victims, 23(2), 133–155. https://doi. org/10.1891/0886-6708.23.2.133. Merchant, C. (1980). The death of nature: Women, ecology, and the scientific revolution. New York, NY: HarperCollins Publishers. Mohanty, C. T. (1988). Under western eyes. Feminist scholarship and colonial discourses. Feminist Review, 30(1), 61–88. doi: 10.1057/fr.1989.1. Moraga, C., & Anzaldúa, G. (Eds.). (1983). This bridge called my back: Writings by radical women of color (2nd ed.). Latham, New York: Kitchen Table/Women of Color Press. Nixon, J., & Humphreys, C. (2010). Marshalling the evidence: Using intersectionality in the domestic violence frame. Social Politics, 17(2), 137–158. https://doi.org/10.1093/sp/jxq003. Nussbaum, M. C. (1999). Sex and social justice. Oxford, UK: Oxford University Press. Pfeffer, C. A. (2014). I don’t like passing as a straight woman: Queer negotiations of identity and social group membership. American Journal of Sociology, 120(1), 1–44. https://doi.org/10.1086/ 677197. Puar, J. K. (2007). Terrorist assemblages: Homonationalism in queer times. Durham, NC: Duke University Press. Rubin, G. (1975). The traffic in women: Notes on the “political economy” of sex. In R. R. Recter (Ed.), Toward an anthropology of women (pp. 157–209). New York, NY: Monthly Review Press. Rubin, G. (1992). Thinking sex: Notes for a radical theory of the politics of sexuality. In C. S. Vance (Ed.), Pleasure and danger: Exploring female sexuality (pp. 267–293). London, UK: Pandora Press. Salzinger, L. (2003). Genders in production: Making workers in Mexico’s global factories. Berkeley, CA: University of California Press. Sandberg, L. (2013). Backward, dumb, and violent hillbillies? Rural geographies and intersectional studies on intimate partner violence. Affilia, 28, 350–365. https://doi.org/10.1177/ 0886109913504153. Sanger, N., & Lynch, I. (2018). You have to bow right here: Heteronormative scripts and intimate partner violence in women’s same-sex relationships. Culture, Health & Sexuality, 20(2), 201–217. https://doi.org/10.1080/13691058.2017.1338755. Schippers, M. (2007). Recovering the feminine other: Masculinity, femininity, and gender hegemony. Theory and Society, 36(1), 85–102. https://doi.org/10.1007/s11186-007-9022-4. Schippers, M., & Sapp, E. G. (2012). Reading Pulp Fiction: Embodied femininity and power second and third wave feminist theory. Feminist Theory, 13(1), 27–42. https://doi.org/10.1177/ 1464700111429900. Sedgwick, E. K. (1990). Epistemology of the closet. Berkeley, CA: University of California Press. Seidman, S. (Ed.). (1996). Queer theory/sociology. New York, NY: Blackwell. Sokoloff, N. J., & Dupont, I. (2005). Domestic violence at the intersections of race, class, and gender: Challenges and contributions to understanding violence against marginalized women in diverse communities. Violence Against Women, 11(1), 38–64. https://doi.org/10.1177/ 1077801204271476. Spivak, G. C. (1987). In other worlds: Essays in cultural politics. London, UK: Methuen. Verloo, M. (2013). Intersectional and cross-movement politics and policies: Reflections on current practices and debates. Signs, 38, 893–915. https://doi.org/10.1086/669572. Violence Against Women Act of 1994, 42 U.S.C. § 13701-14040.

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Warner, M. (Ed.). (1993). Fear of a queer planet: Queer politics and social theory. Minneapolis, MN: University of Minnesota Press. Weeks, J. (1977). Coming out: Homosexual politics in Britain from the nineteenth century to the present. London, UK: Quartet Books. West, C. M. (2004). Black women and intimate partner violence: New directions for research. Journal of Interpersonal Violence, 19, 1487–1493. https://doi.org/10.1177/0886260504269700. West, C. M. (2012). Partner abuse in ethnic minority and gay, lesbian, bisexual, and transgender populations. Partner Abuse, 3(3), 336–357. https://doi.org/10.1891/1946-6560.3.3.336. West, C. M. (2019). Toward an ecological model of violence among African Americans. In W. S. DeKeseredy, C. M. Rennison, & A. K. Hall-Sanchez (Eds.), The Routledge international handbook of violence studies (pp. 190–209). New York, NY: Routledge. Wittig, M. (1993). One is not born a woman. In H. Abelove, M. A. Barale, & D. M. Halperin (Eds.), The lesbian and gay studies reader (pp. 103–109). New York, NY: Routledge.

Clare Cannon Ph.D. As Assistant Professor in the Department of Human Ecology at the University of California, Davis, Dr. Clare Cannon is excited to continue her research into social inequality and health disparities, with an emphasis on feminist theories and methods. Her research areas include intimate partner violence, sex and gender minorities, gender and society, socioenvironmental inequality, and climate change and natural hazards. Dr. Cannon has two main research lines: (1) investigating environmental inequality and health; and, (2) analyzing policies and interventions to treat personal-based violence. Dr. Cannon’s research continues to evolve in studying social vulnerability due to climate change related disasters and socio-environmental health in environmental justice communities. Dr. Cannon received her doctorate from the interdisciplinary City, Culture + Community program at Tulane University. She received a B.A. in American Studies with a minor in Gender and Women’s Studies from Scripps College of the Claremont Colleges Consortium. She earned a M.A. in Social Ethics and Depth Psychology and Religion from Union Theological Seminary, Columbia University in New York City.

Chapter 4

Identifying Influences on Interpersonal Violence in LGBTQ Relationships Through an Ecological Framework: A Synthesis of the Literature Sarah Jane Brubaker

Introduction We have learned from feminist theory, intersectionality, critical race theory, and queer theory that membership within a socially marginalized and stigmatized group can influence one’s vulnerability to intimate partner violence (IPV). Where feminist theory initially focused on women as a marginalized group vulnerable to victimization, subsequent theories have illuminated ways that marginalization can also lead members of various groups to engage in and perpetrate violence in response to stress, lack of access to “legitimate” sources of power, and internalization of social stigma and hatred. Social inequality based on group membership operates at multiple levels and can affect interpersonal violence at each of these levels. Social-ecological models identify multiple levels of influence on human behavior and the interconnections across them. Particularly popular among public health and human service researchers, social-ecological frameworks have been applied to various forms of interpersonal violence in multiple ways, both in empirical research and in policy and practice. Although these models are typically viewed as “objective” and apolitical, scholars have often combined them with approaches that bring power to the center of the analysis as discussed further below. In this chapter, I use a social-ecological framework to synthesize theoretical and empirical insights into factors influencing interpersonal violence in LQBTQ relationships. Currently, the literature on IPV in LGBTQ relationships focuses on minority stress theory, which has helped expand our understanding of violence beyond traditional feminist theory by prioritizing individual and relational level factors and identifying factors unique to sexual minorities. Although this has been a major contribution, attention to and understanding of other levels of the social-ecological model largely remain to be examined. S. J. Brubaker (B) Virginia Commonwealth University, Richmond, VA 23284, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_4

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First, I provide an overview of the social-ecological model and a summary of each level, discussing how each applies to IPV. I conceptualize IPV as any form of violence, such as physical, emotional, or sexual, that occurs in the context of an intimate relationship. I then identify important theoretical frameworks and concepts that have enhanced our understanding of IPV in LGBTQ relationships associated with each level. I then synthesize insights from empirical studies regarding factors that influence violence within these relationships. I discuss how both the concepts and empirical findings align with the ecological framework and I identify levels that need more attention to provide a more comprehensive understanding of the complexities of IPV within all relationships. I end with recommendations for future theoretical development and empirical research.

Social-Ecological Frameworks Social-ecological frameworks are illustrated as concentric circles representing levels of influence on behavior, beginning with the individual in the middle, and moving outward toward the societal level. In this section, I identify and describe these levels.

Ontogenic This level is represented by the smallest, innermost circle and refers to individuallevel factors such as psychological, developmental, personal, and family history characteristics including stress, anxiety, depression, attachment, substance abuse, eating disorders, resiliency, and abuse (Banyard 2011; DeKeseredy and Schwartz 2011; Heise 1998). Psychological theories, such as attachment theory, often focus primarily on this level of influence.

Microsystem Moving outward, the next level focuses on an individual’s particular relationships, or what Heise (1998) refers to as “situational factors.” This level is critical to studying IPV because it focuses on relationship dynamics and behaviors, such as the use of power and control tactics and partners’ relative power and resources. Much work has been done to conceptualize and study relationship dynamics that are abusive and controlling. Johnson’s typology has been instrumental in identifying common types of violent relationships based on the presence or absence of coercive control (Johnson 2006, 2008). We generally know more about how the quality and type of relationship are related to IPV than we know about what creates those dynamics.

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Exosystem The next circle refers to networks that connect individuals to the larger, macrosystem (DeKeseredy and Schwartz 2011). This is important in demonstrating how structural level resources within social institutions are accessible to some, but not all, individuals. Marginalized groups are denied access to social institutions both because of discriminatory policies and laws, as well as through discriminatory behaviors of individuals who are gatekeepers to those institutions. Members of marginalized groups also may lack knowledge about how to access institutions, as well as connections to other individuals who can provide access. Not only do marginalized groups lack access to specific institutions, they often experience cumulative effects of neglect when systems are interconnected. For example, lack of access to higher education can lead to economic instability as well as a lack of access to health care.

Macrosystem The outermost circle represents sociocultural factors such as social institutions and laws, as well as cultural ideologies, expectations and shared beliefs (Heise 1998). This level includes sources of structural oppression that deny marginalized groups access to major social institutions and the protections and supports they provide. Lack of access renders marginalized groups more vulnerable to risks related to health, financial security, housing, and a host of social supports that others take for granted. The stress from such vulnerability can increase the potential for violence, and the absence of structural supports exacerbates its impact when it does occur.

Mesosystem Rather than represented by one of the circles, this concept refers to connections and interactions across systems and levels in the model (Bronfenbrenner 1977; Heise 1998). As I discuss further below, this aspect of the model is helpful in considering how discrimination and oppression at the sociocultural level can be internalized at the individual level, as well as how it can shape interpersonal dynamics such as power and control tactics that connect individual and group identities with cultural and structural dimensions. Many of the concepts used to understand IPV in LGBTQ relationships address these interconnections, whether explicitly or implicitly. Clearly, factors at each of these levels can play a role in contributing to IPV, but it is often difficult for any single theory, or single empirical study, to address them all. In the next section, I provide a brief overview of feminist theory and intersectionality— both of which have been used to better understand IPV in LGBTQ relationships—and I situate their approaches within the social-ecological model.

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Feminist Theory’s Successes and Limitations Feminist theory provided an early and dominant frame for studying and responding to intimate partner violence. Its strengths were in defining IPV as a political and public concern rather than a private matter, and in demonstrating how violence is used to maintain power and control. Feminist theory’s focus on men’s power in social institutions, patriarchy, and male supremacy at the sociocultural level has been effective in challenging individualistic views of perpetrators as deviant or mentally ill. Feminist theory has demonstrated how traditional hegemonic masculinity is socially constructed using violence and the objectification and marginalization of women (Price 2005). Two major criticisms of early feminist work in this area prompted subsequent theoretical approaches that attempted to expand feminist theory. One criticism was that those who were leading feminist efforts were almost exclusively white, middleclass heterosexual women whose experiences did not include or reflect those of women marginalized by race, ethnicity, class or sexual identity. Intersectionality, in particular, responded to this limitation by emphasizing the need to examine the unique experiences and concerns of women of color, poor women, and lesbian and bisexual women (Bograd 2005; Coker 2004; Crenshaw 1989). The second criticism of feminist theory has been its focus on structural level influences on IPV that could not explain why all men were not violent, why some women are violent, or why violence took different forms in different contexts. Recent advances in theory and research addressing IPV in LGBTQ relationships have shifted the focus to individual and relational factors that influence violence.

Empirical Research on IPV Within LGBTQ Relationships In this section, I synthesize several empirical studies of IPV in LGBTQ relationships and discuss their fit within the social-ecological model. Although not all studies clearly apply a particular theoretical framework to their analysis, their research designs, questions, and analysis incorporate assumptions and focus on factors that are consistent with more integrative approaches such as intersectionality and queer theory. In addition, my focus within this body of research is less on prevalence and barriers to reporting and help-seeking, and more on research that begins to identify factors that influence IPV by identifying risk factors for both victimization and perpetration. Most of the focus of the literature reviewed here is on ontogenic/individual and microsystem/relational level risk factors. Many of these factors are similar to those identified in heterosexual and cisgender relationships, but some are unique and specific to LGBTQ contexts (Messinger 2017). One complex concept, minority stress, which includes both internal aspects such as internalized homophobia and external

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factors, such as sexual minority-based discrimination, is a powerful example of the ecological frameworks’ mesosystem, as discussed further below.

Overview of Literature There are many methodological challenges to identifying causes of intimate partner violence. Most importantly, most studies utilize a cross-sectional design, collecting data at one point in time, rather than a longitudinal design that allows us to see change over time and to determine which factors happened first. Some studies have been able to identify correlational factors, i.e. those that seem to relate to IPV perpetration or victimization, and they are discussed as factors placing individuals at risk for, rather than causes of, violence. The second general characteristic of this research is that there are more studies of victimization than perpetration. This is likely because individuals are more likely to self-report victimization than to acknowledge or admit that they are perpetrators, and it is generally easier to gain access to victims through service providers. Studies of IPV in sexual minority populations rarely include comparisons with heterosexual couples (Edwards et al. 2015), which makes it difficult to identify factors unique to each group. Studies also focus on a wide range of forms of intimate partner violence, including physical, sexual, and emotional/psychological. Another challenge to synthesizing and comparing studies is that they often use different measures of risk factors as well as different definitions and measures of IPV. For example, some studies provide definitions of IPV and some allow respondents to self-define (see Badenes-Ribera et al. 2016). Some, but not all, researchers use a version of the Conflict Tactics Scale to measure IPV (e.g. see Graham et al. 2019). In addition, some researchers also assess the levels of violence severity and how they vary depending on other factors (Badenes-Ribera et al. 2016).

Ontogenic Research has shown that certain individual-level factors increase the likelihood that someone will experience intimate partner violence victimization as well as perpetration. At the ontogenic level, there are several factors that increase one’s risk for IPV that are common across all contexts and types of relationships, those that Messinger (2017) refers to as non-LGBTQ-specific predictors. Most studies of IPV, for example, examine various demographic factors operating at the ontogenic level. They might include age, race, ethnicity, educational achievement, relationship, and income. Graham et al. (2019), for example, discuss how younger age and associated developmental factors can make one more vulnerable to IPV. Other individual factors include having a family history of interpersonal violence, i.e. witnessing or experiencing violence growing up, which increases one’s

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likelihood of perpetrating and experiencing IPV (Badenes-Ribera et al. 2016). Certain health-related individual characteristics are associated with IPV as well, such as substance abuse (Badenes-Ribera et al. 2016; Edwards et al. 2015; Kelly et al. 2014). Langenderfer-Magruder et al. (2016), for example, found that LGBTQ youth were more likely to have experienced partner violence if they binge-drank in the past month, had a history of family violence, or had experienced homelessness. Several personality characteristics, such as low self-esteem and need to control (Miller et al. 2001) and jealousy (Telesco 2003), have been associated with various forms of IPV. For example, Pepper and Sand (2015), in a study of young adult women’s same-sex relationships, found that hostility/aggression was associated with perpetrating psychological aggression as well as perpetrating and receiving physical assault. Participants with a negative worldview were also more likely to perpetrate physical psychological aggression and sexual coercion, and emotional instability was associated with perpetrating psychological aggression and physical assault, as well as receiving physical assault. Relatedly, attachment theory suggests that individuals with insecure attachments to others are more vulnerable to IPV victimization (e.g. see Gover et al. 2018). In addition to demographic, health-related, family and personality characteristics that are associated with IPV in general, research has suggested that there are several factors at the ontogenic level correlated with IPV victimization and perpetration that are specific to LGBTQ individuals. These factors typically result from systemic homophobia and cissexism that marginalize one’s identity and are experienced and responded to at the individual level. Gender and sexual identity. One important factor is gender identity, which can be conceptualized in many ways. Early feminist theory and research provided evidence that women were much more likely to be victims, and men much more likely to be perpetrators, of intimate partner violence. Later these findings were challenged by researchers, largely from the family violence field, who claimed that IPV reflected “gender symmetry,” with women and men participating equally in its perpetration (e.g. see Dutton 2012; Johnson 2006; Mennicke and Kulkarni 2016; Rosen 2006). This debate is beyond the scope of this chapter, but Johnson’s typology (2008) has helped respond to and clarify the issue by demonstrating that different types of IPV involve different motives and contexts and that different sampling approaches yield different empirical findings. Specifically, some IPV involves coercive control, where one partner uses violence or the threat of violence to control the other. This type is more prominent in clinical samples, in which the victims are seeking support services or perpetrators are seeking treatment. Another prominent type of IPV is situational couple violence (also known as common couple violence), where there is an absence of coercive control and violence is used to manage conflict. Men and women are equally likely to engage in this type of IPV, and it is the type most prevalent in the general population (Johnson 2008). More recently, researchers have challenged the gender binary and heterosexual bias in early feminist research, arguing for the need to examine IPV in samesex couples, as well as violence experienced by transgender and gender nonconforming/genderqueer individuals (e.g. see Yerke and DeFeo 2016). This requires

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that researchers include all possible gender identities and sexual identities in data collection instruments. Capturing these data allow us to better assess the extent to which gender and sexual identity, as individual-level factors, are risk factors for IPV. An empirical example of how sexual identity can serve as a risk factor for IPV is Coston’s (2017) study, which utilized the National Intimate Partner and Sexual Violence Survey, to address interpersonal violence against monosexual (i.e., only having dating, romantic, and sexual partners of one sex/gender) and non-monosexual (i.e., having dating, romantic, and sexual partners of multiple sexes/genders) women. Coston found that non-monosexual women were more likely than women who identify as heterosexual or lesbian to experience sexual, emotional, and psychological/control violence, as well as intimate stalking, but were at equal risk of experiencing physical violence. Importantly, Coston’s analysis distinguished between sexual identity, i.e. self-identifying as “bisexual” and sexual behavior. This distinction is not always made in the literature but is an individual-level factor that should be explored further. Similar to Coston’s study, Edwards et al. in a 2015 critical review of the literature, found that bisexual men and women were more likely to be victimized by an other-sex intimate partner. In a review of studies of IPV in lesbian relationships, Badenes-Ribera et al. (2016) also showed that studies with probabilistic samples found that lesbian had experienced more violence than heterosexual women, but less than bisexual women. In their study of lifetime sexual assault and rape, Canan et al. (2019) found a similar pattern, where 63% of bisexuals, 49% of lesbian, and 35% of heterosexual women reported these experiences. Edwards et al. (2015) found significantly higher victimization rates of physical dating violence, sexual violence, and stalking among all sexual-minority students than among all non-sexual-minority students. They also found more physical dating violence victimization among female sexual-minority students than among female non-sexual-minority students. Another study of students, comparing those in mixedsex and same-sex couples (Graham et al. 2019) found that perpetration of all types of IPV resulting in injury was higher among same-sex than mixed-sex couples and that victimization resulting in injury was highest among female-female couples and perpetration resulting in injury highest among male-male couples. Jacobson et al. (2015) incorporated an additional measure of gender, “gender expression,” in their study of IPV. They found that masculine-identifying college students reported higher levels of perpetration, victimization, and acceptance of violence. The authors suggest that researchers should measure assigned sex, sexual orientation, and gender expression separately, as distinctive aspects of gender and sexual identity. These examples reflect the complexity of conceptualizing, defining and measuring gender and sexual identity. They also suggest that these individual-level factors matter in terms of how IPV occurs in patterned ways. Minority stress theory: Interiorized stress factors. Longobardi and BadenesRibera (2017) define minority stress as “a series of stressful psychosocial events that derive from being a member of a minority group that is stigmatized and marginalized” (p. 2040). They describe this as unique to those with stigmatized identities, chronic, and socially based. One aspect of minority stress theory focuses on how structural and cultural aspects of homophobia and cissexism can be internalized by sexual and

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gender minorities, increasing their risk for IPV. Researchers use a variety of concepts to capture this process, and one of the most common is internalized homophobia (Balsam and Szymanksi 2005). This concept has been measured by researchers using an outness inventory, internalized homophobia scale, and stigma consciousness questionnaire (see, for example, Carvalho et al. 2011). In addition, Szymanksi and Chung (2001) developed the Lesbian Internalized Homophobia Scale (LIHS). Edwards and Sylaska (2013) studied LGBTQ college students and found significant and positive correlations between internal homonegativity and both physical and sexual IPV perpetration, between sexual identity concealment and physical IPV perpetration, and between previous sexual orientation victimization and psychological IPV perpetration. Similarly, Balsam and Szymanski (2005) studied domestic violence within a sample of 272 predominantly European American lesbian and bisexual women and found that internalized homophobia and discrimination were associated with lower relationship quality and both domestic violence perpetration and victimization. Pepper and Sand (2015), however, studied violence in women’s same-sex relationships and found only one outcome to be related to internalized homophobia, the perpetration of sexual coercion. Kelley et al. (2014) studied men’s same-sex partner violence and found that both higher levels of internalized homophobia and less “outness” (disclosures of sexual orientation) were positively correlated with IPV perpetration. An additional factor is stigma consciousness, a measure of the extent to which an individual expects to be stereotyped by others (Carvalho et al. 2011; Edwards and Sylaska 2013). Carvalho et al. (2011) found that higher degrees of stigma consciousness were associated with lifetime same-sex victimization and perpetration of IPV. Another ontogenic factor related to minority stress is disempowerment, a theory tested by McKenry et al. (2006) which posits that those who feel inadequate or lacking self-efficiency are at risk of using unconventional means of power assertion, including violence (Archer 1994) [and that] these individuals overcompensate by controlling persons they perceive threatening or who expose their insecurities (Gondolf et al. 1988, p. 233) This theory helps explain why members of marginalized groups may use or perpetrate violence in their relationships (see also Edwards and Sylaska 2013). The findings from McKenry et al.’s (2006) study of lesbian and gay individuals supported some aspects of disempowerment theory in that individuals who scored higher on individual factors, including insecure attachments and relationship stress, were more likely to perpetrate relationship violence. While examining these individual factors is important in terms of knowing who is at greater risk for experiencing IPV, on their own, they do not explain why they increase risk. We need to examine additional factors at other levels to understand what additional contexts and features create those risks. Also, Longobardi and Badenes-Ribera (2017) found that in studies reviewed from the previous ten years, correlations were found between minority stress factors and victimization/perpetration of IPV, but that the findings were not consistent. They suggest further that these correlations can be mediated by the quality of the relationship (see also Balsam and Syzmanski 2005). This observation moves our

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discussion from the ontogenic level to the microsystem/relational level, where we examine interpersonal characteristics that contribute to interpersonal violence.

Microsystem/Relational Some studies have examined the ways that interactions between individuals in a relationship can contribute to IPV. A major area of focus at this level is on power dynamics within an intimate relationship. Resource theory, for example, assesses the aggregate power of each partner and how each uses their power to meet their needs (Coston 2017). Traditionally, feminist theory has emphasized men’s greater societal power over women, and the ways that their perpetration of IPV helps them to retain power. More recently, researchers have argued that there are other sources of power that influence the power dynamics within a relationship. For instance, Coston (2017) found that having a great deal of relative social power (i.e. individual aggregate power based on age, race, ethnicity, education, income, immigration status, and/or indigeneity) was associated with higher rates of IPV experience. This conceptualization of factors often identified as demographic characteristics relates identities to membership in social groups that are positioned hierarchically with respect to power, illustrating the mesosystem of the ecological model. Johnson’s typology assesses the use of violence within relationships and the extent to which it is used coercively to maintain control (Johnson 2008). His analysis does not explicitly correlate the use of coercive control with access to particular sources of social power, but it does demonstrate how violence can be used to wield power. Based on a review of the literature, Longobardi and Badenes-Ribera (2017) suggest that bi-directional violence, referred to as situational couple violence by Johnson (2008), may be a common IPV pattern among LGBTQ given that both partners are subject to homophobia and heterosexism in the culture at large. Badenes-Ribera et al. (2016), in a systematic review of the literature on IPV among self-identified lesbians, described a (2001) study by Miller et al. that examined relationship quality through the concept of fusion, which refers to the extent to which partners spend time together, share recreational and social activities, share money, clothing and professional services, and feel the need for independent time with friends. The only study among the 14 they reviewed to focus on the relational level of the ecological model, it found a significant and positive correlation between relationship fusion and IPV. Like ontogenic factors, microsystem factors include many that are unique to LGBTQ individuals and relationships. For example, Sevelius (2013) introduces an additional concept operating at the microsystem/relational level that can be viewed as a risk factor for interpersonal violence for transgender individuals. Gender affirmation refers to an interpersonal, interactive process whereby a person receives social recognition and support for their gender identity and expression … [and] can include everything from family, friends, and strangers using the correct name and pronoun to “being treated like a lady” [for women who are transgender] to being accepted in all of one’s various expressions of gender, depending on the context (Sevelius 2013, p. 676). While conceptualized as a positive aspect of one’s gender identity, Sevelius

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found that its absence—or others’ refusal to accept one’s gender—can a source of both discrimination and partner abuse, as well as a general stressor. The minority stress framework includes microsystem/relational, in addition to ontogenic, components. For example, sexual minority discrimination (Balsam and Szymanksi 2005) can operate at the interpersonal level and include microaggressions as well as various forms of hate-motivated violence. Balsam and Szymanski (2005), found that when internalized homophobia and actual discrimination were considered simultaneously, discrimination was a stronger predictor of partner violence. The relationship between internalized homophobia and IPV experienced in the past year was mediated by relationship quality, a general characteristic of all intimate partner relationships. The extent to which it can serve as a mediator of violence when other risk factors are present should be examined further. Researchers also describe how power resources or deficits of partners within a relationship can influence abuse tactics as well as relationship dynamics (Miller et al. 2016). In a same-sex relationship, such tactics could include the threat of outing and isolation. For instance, Cook-Daniels (2015) identified several tactics specific to members of the transgender community including threatening safety through outing and violating boundaries. Next, we turn to the exosystem of the ecological model.

Exosystem A level of the model more difficult to conceptualize and measure is the exosystem, which refers to networks that connect individuals to the larger macrosystem. One concept that illustrates this connection is sanctuary harm, which Miller et al. (2016) define as a range of factors [that] cause well-meaning social services systems to harm members of marginalized communities, including sexual minorities. Forms of oppression such as racism, colonialism, ableism, heterosexism, sexism, and transphobia that are often implicit in our helping systems can render these systems traumatogenic, especially when these oppressive dynamics are not acknowledged (Buzawa and Buzawa 2003; Dirks 2004; Herman 2003; Walters et al. 2002). The kind of harm done by institutions designed to provide support has been termed “sanctuary harm” (Bloom 2010, 2013) (p. 16).

In a previous publication, I provided examples of sanctuary harm: Examples of sanctuary harm include, in health care, for example, refused care, being blamed for health problems, verbal assaults, refusal to touch patients or taking extra precautions with them, and physically rough treatment (Miller et al. 2016, p. 16). Other examples include police arresting both the abuser and the victim, shelters denying entry, physical violence from police, denial of protective orders, and heterosexist language in program materials (Miller et al. 2016, p. 17; Brubaker 2019, p. 82).

Although sanctuary harm is enacted at the mesosystem level of interpersonal interactions, it connects individual experiences of victimization to larger oppressive systems at the macrosystem, which we examine next.

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Macrosystem The final, outer layer of the ecological system is the macrosystem. This is the level most attended to by traditional feminist theory that first named the problem of intimate partner violence. The focus was on patriarchal systems that privileged men in economic, political, family and criminal justice social institutions in ways that allowed them to use violence against women to maintain their power. Although it was the level that received the most attention from feminists early in the anti-violence movement, it could be argued that it currently receives less attention—relative to ontogenic and microsystem factors—from scholars examining IPV in LGBTQ relationships. At the macrosystem level, we focus on structural oppression and violence in general, which can affect members of various marginalized groups such as people of color, poor people, people with disabilities, in addition to women. When considering LGBTQ individuals, structural violence refers to harm caused by formal social institutions such as legal or medical (Jauk 2013) institutions. This is a form of systematic oppression on the basis of sexual or gender identity—including homophobia, heteronormativity, cisgenderism, cissexism (the idea that cisgender bodies and experiences are normal and preferred), genderism (a general cultural discomfort with gender as a continuum), transphobia (negative emotional reactions to transgender individuals), binegativity, and biphobia—that can affect access to resources including health care, shelters, and other services, protections (and lack thereof) from laws, employment opportunities, and so on (Brubaker 2019, p. 82). In addition, Cook-Daniels (2015) describes macro-level factors as structural challenges faced by transgender individuals that leave them vulnerable to IPV, including limited access to employment and other financial resources, restrictive gender roles and general transphobia. Structural oppression makes individuals vulnerable to various stressors and other risk factors and can exacerbate barriers to reporting and seeking support.

Mesosystem The mesosystem of the ecological model addresses connections and interactions across all systems and levels. This aspect is difficult to both conceptualize and measure, but minority stress theory is a promising approach for capturing this dimension. This theory recognizes that oppressive structures and negative beliefs marginalize and discriminate against sexual minorities in myriad ways and that these social and cultural processes affect interactions at the micro-level and are internalized by individuals in ways that affect their self-awareness and other aspects of their psychological and emotional well-being. Three studies reviewed in this chapter provide illustrations of the mesosystem. First, Coston’s (2017) study measured certain demographic characteristics of intimate partners as forms of social power that were used within relationships. This

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connects individual, ontogenic factors to both microsystem/interpersonal factors as well as macrosystem institutional factors. A second and similar example is Cook-Daniels’ (2015) discussion of how social structures and cultural beliefs regarding transgender people can be used as “power and control weapons” and tactics by both transgender and cisgender partners in intimate partner relationships. She also describes how professionals working with survivors of IPV may make assumptions about who has more power in the relationship based on attributions of gender (e.g., male, cisgender). These insights recognize the connections between wider cultural beliefs and systems of oppression at the macrosystem level, and relationship dynamics at the microsystem level, as well as interactions with practitioners at the exosystem. Finally, related to the minority stress framework is the concept of polyvictimization, which refers to multiple types of violence and abuse, such as sexual, physical, and emotional abuse as an adult, as well as exposure to domestic violence as a child, committed by different people (e.g., intimate partners, family members, strangers, or service providers) at various times throughout one’s lifetime. This is more common among LGBTQ than heterosexual and cisgender individuals and can have a cumulative and negative effect on one’s well-being and sense of self (Miller et al. 2016). This concept recognizes multiple ways in which individuals might experience victimization throughout their lives, and that risk factors exist at various levels such as individual/personal, interactional, cultural and structural.

Conclusion Recent strides in studying IPV within LGBTQ relationships have contributed greatly to our understanding of risk factors and areas for intervention. Currently, the empirical literature on IPV in LGBTQ relationships focuses substantially on minority stress theory which has helped expand our understanding of violence beyond traditional feminist theory by prioritizing individual and relational level factors and identifying factors unique to sexual minorities (Badenes-Ribera et al. 2016). Although this has been a major contribution, attention to and understanding of other levels of the social-ecological model remain less examined. Specifically, we need to expand our attention to structural and cultural level factors that create oppression and systematic discrimination and shape interactions and individual experiences. One limitation of prioritizing individual-level factors alone without connections to the macrosystem and exosystem is that such oversight can lead to pathologizing socially caused “characteristics.” Several researchers have identified areas for future research on IPV in LGBTQ relationships. Edwards et al. (2015) share my recommendation for including variables at the community and societal level of the social-ecological model, rather than focusing exclusively on individual, relational-level correlates. Edwards and Sylaska (2013) suggest that a necessary next step includes theoretical work to better understand the etiology of internalized homonegativity and the perpetration of partner violence.

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Graham et al. (2019) call for the continued application of the social-ecological minority stress framework as an opportunity to identify areas for intervention. Research on IPV victimization and perpetration should also include a heterosexual sample comparison to test explanatory mechanisms to explain the higher rates among LGBTQ individuals. Additional methodological challenges need to be overcome to strengthen work in this area. Standard measures of IPV should be used for the various types of IPV (e.g. sexual, psychological, emotional, physical, stalking), as well as severity (e.g. chronic versus isolated event). Measures should include consistent timeframes (e.g. the last 6 months or lifetime). Researchers should include both measures of perpetration and victimization and should strive for standard measures of important indicators such as various dimensions of minority stress. In sum, recent developments in research on IPV among LGBTQ individuals have made important improvements to our understanding of risk factors. They have corrected traditional feminist theory’s limited focus on macro-level structures, its heteronormative lens and binary understanding of gender. The next steps include developing more comprehensive and inclusive approaches that address and account for the various levels of the social-ecological system, both conceptually and empirically. The more we understand about the causes of violence in all relationships, the more we can intervene to prevent it from happening.

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Langenderfer-Magruder, L., Wall, N. E., Whitfield, D. L., Brown, S. M., & Barrett, C. M. (2016). Partner violence victimization among lesbian, gay, bisexual, transgender, and queer youth: Associations among risk factors. Child and Adolescent Social Work Journal, 33(1), 55–68. Longobardi, C., & Badenes-Ribera, L. (2017). Intimate partner violence in same-sex relationships and the role of sexual minority stressors: A systematic review of the past 10 years. Journal of Child and Family Studies, 26(8), 2039–2049. McKenry, P. C., Serovich, J. M., Mason, T. L., & Mosack, K. (2006). Perpetration of gay and lesbian partner violence: A disempowerment perspective. Journal of Family Violence, 21(4), 233–243. Mennicke, A., & Kulkarni, S. (2016). Understanding gender symmetry within an expanded partner violence typology. Journal of Family Violence, 31(8), 1013–1018. Messinger, A. M. (2017). LGBTQ intimate partner violence: Lessons for policy, practice, and research. Berkeley, CA: University of California Press. Miller, D. H., Greene, K., Causby, V., White, B. W., & Lockhart, L. L. (2001). Domestic violence in lesbian relationships. Women & Therapy, 23(3), 107–127. https://doi.org/10.1016/j.cpr.2007. 05.003. Miller, E. C., Goodman, L. A., Thomas, K. A., Petersen, A., Scheer, J. R., Woulfe, J. M., & Warshaw, C. (2016). Trauma-informed approaches for LGBTQ* survivors of intimate partner violence: A review of the literature and set of practice observations. Boston, MA: GLBTQ Domestic Violence Project. Retrieved from http://www.glbtqdvp.org/wp-content/uploads/2016/06/TIP-for-LGBQTSurvivors_LitReview.pdf. Price, L. S. (2005). Feminist frameworks: Building theory on violence against women. Fernwood. Pepper, B. I., & Sand, S. (2015). Internalized homophobia and intimate partner violence in young adult women’s same-sex relationships. Journal of Aggression, Maltreatment & Trauma, 24(6), 656–673. Rosen, L. N. (2006). Origin and goals of the “Gender Symmetry Workshop”. Violence Against Women, 12(11), 997–1002. https://doi.org/10.1177/1077801206293326. Sevelius, J. M. (2013). Gender affirmation: A framework for conceptualizing risk behavior among transgender women of color. Sex Roles, 68, 675–689. Syzmanski, D. M., & Chung, Y. B. (2001). The lesbian internalized homophobia scale: A rational/theoretical approach. Journal of Homosexuality, 41(2), 37–52. Telesco, G. A. (2003). Sex role identity and jealously as correlates of abusive behavior in lesbian relationships. Journal of Human Behavior in the Social Environment, 8, 153–169. https://doi.org/ 10.1300/J137v08n02_10. Walters, K. L., Simoni, J. M., & Evans-Campbell, T. (2002). Substance use among American Indians and Alaska natives: Incorporating culture in an “indigenist” stress-coping paradigm. Public Health Reports, 117(Suppl 1), S104. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC1913706/pdf/pubhealthrep00207-0109.pdf. Yerke, A. F., & DeFeo, J. (2016). Redefining intimate partner violence beyond the binary to include transgender people. Journal of Family Violence, 31(8), 975–979.

Sarah Jane Brubaker Ph.D. is a professor of Criminal Justice and Public Policy at Virginia Commonwealth University. A sociologist by training, her research and teaching focus on various forms of gender violence, sociological theory, adolescent sexual health, and juvenile justice reform from intersectionality, social justice, and community-engaged perspectives. She also directs a Certificate in Gender Violence Intervention and teaches its required course Theorizing Gender Violence. She recently published a book by the same name based on the course.

Chapter 5

Who’s the Victim Here? The Role of Gender, Social Norms, and Heteronormativity in the IPV Gender Symmetry Debate Betsi Little

Gender Symmetry Debate We, in fact, have to fundamentally change the culture, the culture of how women are treated… No man has a right to raise a hand to a woman in anger other than in self-defense, and that rarely ever occurs. So we have to just change the culture, period, and keep punching at it and punching at it. —Joe Biden, 5th Democratic Presidential Debate, November 20, 2019

Intimate partner violence (IPV)—also known as domestic violence—has been examined, explained, and addressed in the form of public education and resource availability for over 40 years. Despite the years of research, many academic studies conducted, and millions of dollars spent, it is still unclear how many people are victims of IPV. Although it may seem intuitive that statistics regarding the frequency and severity of IPV should be easy to source, many barriers prevent researchers, police, and social service agencies from capturing an accurate portrait of IPV. Most of these barriers are socially constructed in nature and demonstrate more about the stereotypes and norms utilized to define the concept of a “victim of domestic violence.” Before one can be perceived as a victim of IPV, he or she must first be seen as a member of a legitimate couple, behaving in the appropriate (i.e. feminine) manner, who are suffering under prescribed abuse that is physical/sexual/severe and unidirectional. In other words, before we can assess how many people are impacted by IPV, we must first define what IPV is and who is, or is not, considered a legitimate victim. If asked to describe a “typical” victim of IPV, most individuals imagine a feminine, passive woman who is terrorized by her partner and is physically assaulted. Indeed, IPV has been typically defined and portrayed as a heterosexual woman’s issue, as demonstrated by Vice President Biden in the quote above. However, research shows that those in homosexual relationships report the same, or even higher, levels of IPV B. Little (B) Palomar College, San Marcos, CA, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_5

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compared to women in heterosexual relationships (Bureau of Justice Statistics [BJS] 2016). Even more difficult to ascertain is the number of heterosexual males who are victims of IPV. In other words, the general belief about IPV has been historically gender asymmetrical, or that women are predominantly the victims and are rarely batterers. Indeed, because of what Johnson (1995) identified as “patriarchal terrorism” (i.e., the believed cultural structure and tradition of male dominance over females), IPV is predominantly perceived as an act that involves a male batterer and a female victim (Olson 2002). Though it is suggested that about 75% of IPV offenders are males (Caldwell et al. 2012), other studies (e.g., Katz et al. 2002) support the gender symmetry theory and demonstrate that women are almost equally likely to commit acts of aggression towards men (Caldwell et al. 2012; Drijber et al. 2013; Harris and Cook 1994). Despite culturally structured forces (e.g., patriarchal societal structure) that influence an individual’s perceptions of IPV, the prevalence of this issue is of concern due to its psychological, physical, even tragic outcomes (Próspero 2008). Several studies have been put forth to find prevalence IPV, but the theoretical underpinnings these researchers hold may dictate how IPV is defined and measured, as well as selecting the populations to be sampled. These practices may inherently exclude other victims of IPV due to how IPV, victims, or offenders are defined. This chapter will examine these different definitions in the hope to understand more fully the debate on gender symmetry in IPV.

Defining IPV Intimate partner violence is most often defined as the use of physical or sexual violence, or psychological aggression, including stalking and verbal/emotional abuse, by a current or former intimate (romantic) partner (Smith et al. 2018; for complete review see Cannon et al. 2015). IPV is multifaceted in that there is more than violence used to control one’s partner. Intimidation, coercion, threatening the loss of economic support or children, or the threat to out one’s partner for those in homosexual relationships, can all be considered aspects of IPV. As such, it can be hard to determine the veracity and prevalence of IPV reports since many groups and cultures perceive IPV differently when abuse moves out of the physical realm. Moreover, depending on the social norms and culture of the individual, some may not even consider themselves “victims” of IPV as they had not defined the abusive behavior as IPV. Indeed, for many, there is a cultural push to re-define abuse to fit more “normal” or stereotypically gendered heteronormative behavior. This push, therefore, would lead individuals to believe that a woman cannot possess the physicality to abuse her male partner. Thus, any attempt at violence would often be dismissed as humorous or even well-deserved. How IPV is defined in the research can have a major impact on the reported prevalence of IPV. Finding the appropriate population to sample from, inclusion criteria,

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and type of reporting method have ramifications that exceed beyond generalizability and validity concerns. From the perspective of the research, prevalence rates are impacted by IPV typologies used, frequency and severity measures, and interpretations of motivation. When looking at crime statistics provided by police and non-profit organizations, issues regarding reporting, the context for the abuse, and even theoretical perspectives can prevent us from comparing stats from one reporting agency to another (Johnson et al. 2016).

The Statistics Intimate partner violence also referred to as domestic violence (DV) by many sources of data collection, is generally described as physical, sexual, and psychological abuse, as well as economic coercion that occurs within an intimate partner relationship. According to the National Crimes Victims’ Rights Week (NCVRW) Resource Guide Crime and Victimization Fact Sheets (2018), this definition includes the motivation of one partner to assert power and control over the other. In the 20 years from 1995 to 2015, estimated rates of IPV have decreased from 15.5% for women to 5.4%, and from 2.8 to 0.5% for men (Office for Victims of Crime 2017). According to the National Institute of Justice (NIJ), nearly 1.3 million women and 835,000 men in the United States are physically assaulted by an intimate partner annually (Tjaden and Thoennes 2000). Women are not only more likely to suffer an injury as a result of the IPV (39% compared to a male partner injury rate of 24.8%), but they are also more likely to receive a fatal injury. Indeed IPV-related deaths make up 40–50% of all murders of women (Tjaden and Thoennes 2000). According to the National Intimate Partner and Sexual Violence Survey (NISVS), conducted by the National Institute of Justice (NIJ), 47% of men and women will experience psychological abuse by an intimate partner at some point in their life. Thirty-two percent of women will experience physical violence and 16% will experience sexual violence, compared to 7% of men who experience sexual violence (Black et al. 2011). The NIJ reports a lifetime prevalence of IPV at 25% for women and 7.6% for men. Additionally, belonging to a marginalized group increases the risk of IPV as demonstrated in reports by multi-ethnic women and lesbian, gay, or bisexual individuals. Indeed, compared to heterosexual women whose prevalence rates are approximately 35%, bisexual women have a higher risk of experiencing IPV at 61%. This trend holds true for bisexual men with an IPV prevalence rate of 37%, compared to 29% of heterosexual men (BJS 2016). The National Family Violence Survey (NFSV) found equivalent rates of IPV among both men and women at about 11%. However, when pushing, shoving, or other “minor” aggressions are included, that rate increases to 14% (Black et al. 2011). This is in contrast with other studies conducted by the NIJ (2007) and BJS (2016) that found women were significantly more likely to report rape, physical assault, or stalking. However, those studies that found gender symmetry utilized the

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Conflicts Tactics Scale (CTS) which has been widely criticized for not including motivation, control, coercion, and sexual assault in the measure. Identifying how many men experience physical violence remains a challenge within the research. The BJS (2016) National Crime Victimization Survey measures IPV within the context of general crime victimization. The NCVS combines multiple IPV incidents that occur within a 6-month period which may underestimate the number of victimizations. However, researchers have found that when respondents are asked behaviorally oriented questions, the incidents coded as IPV increase. Indeed, the gender symmetry of physical IPV is an artifact of the method, focus, and measures of researchers (Hamberger and Larsen 2015). When asking the question “are women as violent as men,” the answer is dependent on who was included in the sample. For example, when college students are the sample, they report less violent experiences among both genders with IPV (Hamberger et al. 2016). However, when samples come from clinical settings (such as those who have experienced or committed IPV and require court-enforced interventions) men use more severe violence and are six times more likely to kill than women. When examining who initiates the violence, 88% of women use violence to respond to IPV, compared to 15% of men (Kernsmith 2005). However, Hamberger and Larsen (2015), could not find any studies that demonstrate women initiate more. This suggests that what we believe about IPV, including who we think are likely victims and abusers, as well as how we ask about IPV, impacts reported rates of IPV.

Reporting Outcomes for IPV Victims Some male victims of IPV are reluctant to report. Indeed, women were 4 times more likely to report IPV than males, and when males did report the crime, it was seen as a less serious crime (Espinoza and Warner 2016). Moreover, third-party reporters of IPV in which the victims are male receive better results (such as more follow-up or arrests) than when male victims reported the abuse themselves (Poon et al. 2014). Reporting the abuse can also have legal ramifications for the victims as well as the perpetrator. Males accused of perpetrating IPV are charged, arrested, and convicted more often than female offenders (Espinoza and Warner 2016). Additionally, in “No Injury” reports of IPV, where neither party suffered a physical injury, men were 16 times more likely to be charged than women. When males were injured, the female offender was arrested 62% of the time, compared to a 91.1% arrest rate for male offenders (Espinoza and Warner 2016). Sex of the victim is the best predictor of whether a restraining order is granted with protection given to 1 male victim for every 13 female victims requesting a restraining order (Espinoza and Warner 2016). The question of who a legitimate victim of IPV can be is often muddled with the consequences of that IPV. For example, women suffer disproportionately from IPV in terms of injuries sustained from the violence, and experience more longterm fear and post-traumatic stress disorder compared to male victims (Caldwell et al. 2012). Additionally, and to no surprise, women report less satisfaction in the

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relationship if there is IPV present. Caldwell’s et al. (2012) review of the research found that women report IPV three times more often than men. They speculate this is in part due to the effect of the violence in producing long-term fear for the victim. In fact, 70% of women reported being frightened after an IPV event compared to 85% of men reporting no fear after the IPV event (Caldwell et al. 2012). Despite these findings, gender did not influence the health impacts on victims. However, women did report higher levels of depression, PTSD, and substance abuse (Caldwell et al. 2012, therefore suggesting men and women experienced different types of abuse which have different lasting outcomes. Although it can seem obvious that IPV can occur in any type of relationship, evidence of female-initiated IPV—in both lesbian and heterosexual couples—can occur as often as male-initiated IPV (Langhinrichsen-Rohling et al. 2012) and is often dismissed as less serious, severe or continuous. Thus, the question becomes less about who initiates the IPV, but whether the IPV itself and the negative consequences for victims of IPV are equivalent. Cummings et al. (2013) surveyed Hispanic couples and found that although there was symmetry, the genders did differ on motivation in that women utilized violence in response whereas men initiated the violence. Indeed, they raised the question about the presence of sexism, both hostile and benevolent, within this cultural group. Hostile sexism explicitly keeps women in a subordinate position and is even a precursor for sexual harassment and violence toward women (Begany and Milburn 2002, as cited in Mastari et al. 2019). Benevolent sexism is an implicit form of sexism that is expressed in a seemingly positive way but nevertheless implies the subordinance of women. Allen et al. (2009) found, overall, females that perpetrated violence performed more “minor” acts of aggression and that those acts were in response to their partner’s initial violence. In contrast to these results, Mennicke and Kulkarni (2016) found that gender was non-symmetrical in 71% of the cases examined.

Theories of Intimate Partner Violence Feminist Theory The rise in awareness of domestic violence began in the 1980s. This awareness co-occurred with the rise of gender studies courses, women’s studies, and other Feminist Theory-driven areas of research. The hallmark of this academic field was using “gender” and “woman” as categories of analysis. Although some argue that the movement from sex to gender, undermines the experience of biologically- (sex) identified females (Mikkola 2008), the term gender encompasses gender-role expectations that come along with the physical identification as “woman” or “man.” It is from this academic movement that IPV, or then domestic violence, became a topic of interest both in a direct applied way, but also from a theoretical perspective. As such, a biological push-back to looking at sex and gender separately—and an emphasis on

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diversity—led to the idea that IPV is a (heterosexual and cisgender) woman’s issue. This may have created a resistance to reject the Feminist Theory that explains IPV as a patriarchal, control, and dominance strategy used by men on women (Bracke 2012). Likewise, Bano (2010) suggests that the deconstruction of heteronormativity allows researchers to make comparisons to queer thinking and women’s movements. Indeed, in its extreme, honor killings can be understood and explained through the lens of IPV and cultural ideas of masculinity (Asquith 2015). This focus on Feminist Theory denormalized men assaulting their wives which was universally seen as a positive outcome. However, this same system fails to protect all victims, ignores other relationship configurations of IPV (such as same-sex relationships), and ignores the different motivations behind IPV (Cannon and Buttell 2016). This is a considerable problem as the implications for services, treatment, and other resources are limited for those who do not fit the heterosexual norm of IPV, including heterosexual male victims of IPV. To simply ask the research question if gender symmetry exists in IPV creates a defensive position for Feminist Theory. To contrast this view, Straus (2009) argues that symmetry can be found in even severe intimate terrorism. In a review of 200+ studies, Straus (2009) found no evidence that suggests asymmetry in IPV. Additionally, Straus (2009) contends that the idea of gender symmetry in IPV has been responded to so negatively, particularly by feminists, that it has created a chilling effect within the research community. Straus (2009) states that “a climate of fear” has inhibited research and publication that suggests that gender symmetry does exist in IPV. Moreover, this negative pressure to keep IPV a women’s issue reinforces the patriarchy ideology and the treatments that have emerged from this perspective. Indeed, Straus (2009) criticizes other IPV researchers of espousing a surplus of discussion and application of theory, yet do not provide evidence to support those claims (Straus 2009). Indeed, Allen (2011), comments on the continuation of fierce debates but notes that researchers often exclude relevant information such as who initiated the IPV, what was his or her motivation, and who suffers most from the aftermath of IPV. It is within these domains, Allen (2011) claims researchers do find gender differences. In a very real way, IPV is defined both by the act, but also by the outcome of the IPV. How we as researchers, law enforcement, and social service providers define IPV determines the type of victims and perpetrators who “qualify” as legitimate.

Johnson’s Four Typologies of IPV Two major questions that must be asked when understanding IPV are: what is considered domestic violence and who is considered a legitimate victim. There have been many attempts to explain IPV, but all of these theories vary in the use and understanding of power and control. Although there is much debate about the reasons behind male-initiated violence and female-initiated violence, Johnson (1995, 2005,

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2011) found that depicting common typologies of IPV can help us researchers better understand the gender symmetry debate. Johnson (2005), therefore, created four typologies, two of which have demonstrated gender symmetry while the other two do not. Overall, these four different types of violence each have unique behavioral and motivational patterns, as well as radically different results after the IPV event. The first typology, intimate terrorism, is a form of violence that uses coercion and control to dominate one’s partner. This is the type of IPV that people most commonly think of due, in part, to the physical nature, as well as the serious injury risk for the victims (Johnson 2005). Also called coercive controlling violence (CCV), this occurs when one partner in a relationship, typically a man, uses coercive control and power over the other partner (Anglin and Mitchell 2014) using threats, intimidation, and isolation. CCV relies on severe psychological abuse for controlling purposes and when physical abuse occurs, it too is severe (Johnson 2005). Intimate terrorism is more likely to escalate over time, compared to other forms of IPV, is less likely to be mutual, and more likely to involve serious injury (Nicolson 2010). Because this type of violence is most likely to be extreme, survivors of intimate terrorism are most likely to require medical services and the safety of shelters, (Garcia-Moreno et al. 2006). This type of IPV is historically gender asymmetrical (Nicolson 2010). Indeed, research suggests that 97% of the perpetrators of intimate terrorism were men (Howe 2012). The second typology, violent resistance (VR) (considered a form of self-defense), is violence perpetrated by victims against their partners who have exerted intimate terrorism against them. VR can occur in response to an initial attack or become a defense mechanism after prolonged instances of violence (Johnson 2011). This form of resistance can sometimes become fatal if the victim feels as though their only way out is to kill their partner (Johnson 2011). As Howe (2012) reports, 96% of the violent resisters are women. Situational couple violence, also called common couple violence, is a single argument where one or both partners physically lash out at the other (Howe 2012) and is not considered a long-standing pattern of behavior. Johnson (1995) states that situational couple violence involves a relationship dynamic in which conflict occasionally gets “out of hand,” leading usually to ‘minor’ forms of violence and rarely escalating into serious or life-threatening forms of violence. This is the most common form of intimate partner violence, particularly in the western world and among young couples, and involves members of both sexes nearly equally. Among college students, Johnson (2011) found it to be perpetrated about 44% of the time by women and 56% of the time by men. Lastly, mutual violent control (MVC) is a rare type of intimate partner violence occurring when both partners act violently, battling for control (Johnson 2005). Johnson and Ferraro (2000) define mutual violent combat as a battle of control between two aggressive partners who are violent and vying for control (Johnson 1995, 2005). Each partner is likely to use a variety of tactics such as psychological and verbal abuse to control and regulate the other (Tjaden and Theonnes 2000; Yodanis 2004). The key concept that differentiates MVC from intimate terrorism is the reciprocal nature of violence and abuse.

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Gender symmetry in Johnson’s Typologies. Renner and Whitney (2010) found evidence of gender symmetry in the 4 types of IPV. They examined demographic data for gender, race, sexual orientation, age, and socio-economic status. Forty percent of those surveyed experienced IPV. Most of those were bi-directional, although not symmetrical. These results were more prominent for younger couples. As Johnson (1995) points out, there are widely differing reports of IPV based on the population sampled. For example, 11% of people surveyed from the general population report IPV compared to 68% from a court-drawn sample. Moreover, 79% of those drawn from a shelter reported IPV. As Archer (2000) notes, those surveyed from within the justice and social support system reported being victimized by men. However, when the general public was asked about experience with IPV, Archer (2000) found evidence of gender symmetry. Archer’s results support Johnson’s (1995) assertion that men utilize intimate terror more than other forms, but situational couples’ violence demonstrates symmetry.

Variables Influencing IPV Perceptions Gender Norms and Stereotypes IPV includes all verbal, physical, and sexual assaults (Alhabib et al. 2010); abusive behaviors perpetrated by one or both partners in the relationship (Drijber et al. 2013). IPV is often considered a form of patriarchal terrorism due to the stereotypical belief that violence is a demonstration of male power and control over females (Johnson 1995; Olson 2002; Oringher and Samuelson 2011; Próspero 2008). Such a perspective is suggested to be exclusive to IPV cases that break its stereotypical ideologies (Renzetti 1999). While studies have found that women are most likely to be victims of IPV (Alhabib et al. 2010; Olson 2002; Wei and Brackley 2010), men are also equally believed to be victims of IPV (Drijber et al. 2013). Drijber et al. (2013) found that 46% of IPV male victim participants had been abused more than 10 times a year and overall, 79% reported being aggressively abused for more than a year. In most cases, male victims did not report the abuse because of the bias actions judicial entities take; e.g., police are less likely to report an IPV case when the male is a victim or a couple breaks stereotypical gender-based stereotypes of masculinity and femininity (Drijber et al. 2013; Seelau and Seelau 2005). On the other hand, through use of parallel literature searches of 6 databases, Alhabib et al. (2010) found that despite age, race, ethnicity, country of residence, the prevalent violence against the female gender is considered an epidemic issue known to cause higher death rates as those compared to cancer. The current trend of gender-based stereotypes has influenced most of societal perceptions towards this issue of IPV. However, IPV is perceived differently by observers, victims, and offenders (Stamp and Sabourin 1995). Most men do not

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perceive themselves as violent (Smith 2007; Wei and Brackley 2010), while Sugarman and Cohn (1986) suggest that offenders are seen as responsible for causing the violence while the victims are accountable for stopping the violence (Stamp and Sabourin 1995). For such perception variations, it is suggested that overall perceptions of IPV are influenced by gender-based stereotypes, especially those about masculinity and femininity (Deaux and Lewis 1984; Green and Ashmore 1998). Social psychologists describe stereotypes are cognitive categorizations (Viss and Burn 1992). Ashmore and Del Boca (1979) suggested that stereotypes consist and are applied based on three categories: defining, identifying, and ascribing attributes (Green and Ashmore 1998). When defining attributes an individual perceives “essential criterial features of a concept’s meaning” (Ashmore and Del Boca 1979, p. 233); e.g., the male gender is biologically defined by the chromosomal (i.e., XY) composition (Green and Ashmore 1998). For identification, an individual classifies a particular social stimulus (e.g., hairstyle, clothing fashion) into a category (i.e., male/female, masculine/feminine), (Ashmore and Del Boca 1979; Green and Ashmore 1998). Finally, ascribing attributes refer to personal qualities perceived due to (male/female) categorization (e.g., a perceived male will be speculated to possess instrumental, masculine personality traits such as aggressiveness, dominance, competitiveness), (Green and Ashmore 1998; Wellman and McCoy 2013). Ascribing attributes for women are based on expressive, feminine personality traits (e.g., being emotional, nurturing), (Green and Ashmore 1998). Studies such as Broverman et al. (1972) have found that in societal perceptions, women are believed to be “warmth” (i.e., loving, caring) while men are generally known as expressive, tough, and confident (Deaux and Lewis 1984; Green and Ashmore 1998; Wellman and McCoy 2013). Feminist Theory suggests that IPV is a result of a patriarchal societal structure that stereotypes males and females into gender-based roles (Próspero 2008). These stereotypes develop expectations (Smoreda 1995; Seelau et al. 2003) that categorize an individual’s physical appearance, role behaviors, and sexuality into a masculine or feminine identity (Aube et al. 1995; Deaux and Lewis 1984; Green and Ashmore 1998). Stereotyped gender roles suggest that the business executive professional field fulfills male and masculine role ideologies and the housewive perception conforms that of a female and feminine role (Green and Ashmore 1998). Yarmey and Kruschenske (1995) found that based on stereotypes of physical appearance which encompasses three general elements (i.e., physical appearance: body shape, posture, and face; uniform: the outfit; and setting: the location, the action that is being done), are very influential in perceptions of IPV (Gula and Yarmey 1998; Green and Ashmore 1998; Smoreda 1995; Yarmey and Kruschenske 1995). Stereotypes (e.g. facial stereotypes) become memory schemes that influence perceptions about who is classified offender or victim in the IPV situation (Gula and Yarmey 1998; Green and Ashmore 1998; Jackson et al. 1987). After conducting a study based on images (both on photographs and video) of 20 women (10 selfbattered, and 10 self-nonbattered reported), Gula and Yarmey (1998) found that individuals highly rated 13 out of the 20 women as to be more likely to fall under the two categories (battered, nonbattered). However, only 9 out of the 13 were ranked

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in their respective categories. This study which used both colored photographs and videotapes describing a normal trip to the grocery store found that only one woman from both categories was highly ranked to match behaviorally and physically their respective category. Stereotypes fall under the patriarchal umbrella that says IPV is only experienced by women and is caused by men (Olson 2002). It is stereotypically believed that masculinity is learned and portrayed by males and not by females (Próspero 2008). Though culture teaches men to dominate (Wei and Brackley 2010), it is suggested that in many cases violence is mutual and reciprocal (Caldwell et al. 2012; Drijber et al. 2013; Harris and Cook 1994; Olson 2002). Straus et al. (1980) found that both male and female participants disclosed having committed violent acts against their partners; however, overall views on IPV are still restricted to heterosexual couples that portray a masculine male offender male and a feminine female victim. Because societal gender-based stereotypes about masculinity and femininity influence our general thoughts of IPV, one’s perception of IPV will be based first on gender-based roles, and secondly based on heteronormative ideas of who constitutes a legitimate couple (Little and Terrance 2010). As Espinoza and Warner (2016) note, social approval of men hitting women (e.g., in media) decreased from the 1960s on. The reverse, however, is not true. Gendered stigmatization allows male victims to be seen as deviating from masculine gender guidelines, thus setting up the situation for a male to either identify as masculine and thus not report or perceive abuse or be perceived as a victim but suffer in how “manly” they are perceived (Espinoza and Warner 2016). On the other hand, female perpetrators of violence are seen as a joke or acting in a situational, rather than stable, manner. While a small minority of women claim to act in self-defense (Kernsmith 2005), the abuse towards men can be severe. Some research has indicated that female perpetrators, particularly those who are younger, are more likely to initiate IPV and to use a weapon (Williams et al. 2008). Espinoza and Warner (2016) further delineate the ignorance of female-on-male IPV to normative values that criticize male-on-female IPV but simultaneously excuses women hitting men by depicting it either as self-defense or humorous. Indeed, Espinoza and Warner (2016) found that partners are less likely to view themselves as a victim when the abuse is reciprocal. This supports the view that this type of violence is situational versus reactive. Despite the statistics, female-to-male IPV is perceived to be less frequent, less consequential, and thus more permissible (Espinoza and Warner 2016). Cook (2009) described media portrayals of female on male IPV as humorous, atypical, and tacitly accepted compared to media portrayals of male-on-female violence. “Female perpetrators of violence defy many stereotypes of femininity; thus, media entities may seek to restore public perceptions of gender stereotypes by highlighting the abnormality of female perpetration” (Carlyle et al. 2014, p. 961).

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Unilateral Versus Bilateral Violence IPV research and prevention has historically focused on heterosexual couples with male offenders and female victims (Cannon and Buttell 2016). In this way, IPV is perceived as unilateral with one partner, usually the male or masculine partner, committing the abuse. This framework supports a feminist paradigm where men abuse women to assert power and control. However, some research suggests that IPV is bilateral; meaning that men and women abuse each other (Langhinrichsen-Rohlin et al. 2012). When comparing rates of IPV by gender, it appears that there are higher rates of female offenders and greater violence in bi-directional IPV than was originally thought or reported on in the research or crime statistics (Espinoza and Warner 2016). In one study conducted by Espinoza and Warner (2016), bilateral IPV was found to be more frequent than unilateral IPV with only 1 in 5 reporting unilateral violence. Self-reports of physical IPV demonstrate similar rates between genders. Filbert and Flynn (2010), reported that 50% of self-reports indicated bidirectional violence (as cited by Mennicke and Kulkarni 2016). Whitaker et al. (2007) found a similar relationship between bi-directional behavior, also referred to as reciprocal IPV. In their study of adults age 18–28, almost 24% of all relationships had some violence, and half (49.7%) of those were reported as bi-directionally violent. In nonreciprocally violent relationships, in which only one partner is performing the abuse, 70% of those reports indicated that the abuse was performed by women perpetrators. Reciprocity, or responding to violence with violence, was associated with more frequent violence among women, but not men (Whitaker et al. 2007). One notable trend of their findings, which is consistent with other studies, showed that men were more likely to inflict injury than were women (Whitaker et al. 2007). Whitaker et al. (2007) also found evidence that reciprocal intimate partner violence was associated with greater injury than was nonreciprocal intimate partner violence regardless of the gender of the perpetrator. This research, in sum, demonstrated that it may not be who performs the abuse, but rather who is left with the greatest injury. Gerstenberger and Williams (2013) examined arrest policies, including the presence of officer discretion versus mandatory arrest of those reported to be perpetrators of IPV. They also examined assessed risk or the likelihood that an individual could experience IPV again in their life, versus the actual persistence of IPV over their lifetime. They found that male victims were more at risk to be arrested (dual arrest) along with their abuser compared to female victims. This rate was even higher than female offenders who were the only one of the partners arrested (Gerstenberger and Williams 2013). Additionally, they reported 73.92% of offenders included were males while 26.08% were females. Seventy-nine percent of male-on-female violence ended in single arrests, whereas 21% were dual arrests. Of the 42% of violence that was female-on-male, 58% of those ended in dual arrests. Since the 1990s, dual arrests for IPV calls have increased, thus indicating male victimization has also increased or has been finally reported (Das Dasgupta 2002). This highlights the difficulty in defining DV/IPV for researchers as well as police

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and social services providers. Early IPV data collected from crime reports focused on physical and sexual assaults exclusively, due in part to the stigma of reporting of non-physical abuse, which shaped much of the general understanding of IPV, has focused on physical assaults exclusively (Chen and Ullman 2010). However, the changing cultural norms regarding gender roles and social power can explain these newer trends of males reporting being victims of IPV. Indeed, physical violence that occurs between men and women has historically been defined as mutual combat or family violence (Loseke and Kurz 2005). As women, and their advocates, began asserting that IPV is a serious social issue impacting women, male victims were more likely to counter-report the reciprocal abuse they experienced (Holmes et al. 2019). Despite the increase of male victims and dual arrests, researchers still note that women do suffer more serious injuries than men. Because these injuries are more severe, female violence has been categorized as self-defensive or retaliatory (Das Dasgupta 2002). Indeed, for women who commit violent acts within the relationship, they are perceived as violating a gender role, whereas men feel a sense of entitlement to the role of the abuser (Gilbert 2002). Additionally, abusive women are perceived as internalizing misogynistic cultural norms and displaying more malelike behaviors (Ristock 2005). When considering IPV in lesbian relationships, the feminist approach is applied such that power and control, and who wields power and control, is considered masculine (Cannon and Buttell 2016). Gilbert (2002) pointed out that: the way that society talks about women and their use of violence and force has grave implications for social policy and women’s experiences in the criminal justice system. Society’s cultural stereotypes about women and gender color the way professionals in law enforcement, the legal system, the courts, and social policy agencies treat women who commit violent acts of aggression. (p. 1271)

IPV in Same-Sex Relationships These aforementioned issues are not just faced by male victims of IPV at the hands of female perpetrators. IPV research has nearly exclusively focused on heterosexual couples in which the male is the offender and the female is the victim (Cannon and Buttell 2016). Societal beliefs, with support from Feminist Theory, describe IPV as a violent manner in which men abuse women to assert power, control or dominance. However, some support, including research examining homosexual couples (gay males and lesbians) as well as female-on-male domestic violence, suggest that violence within a couple is often bi-directional, or when both partners acting as aggressors as often as being the victim (Langhinrichsen-Rohling et al. 2012).

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Heteronormativity Heterosexuality is a structure that maintains “the gender hierarchy that subordinates women to men,” (Cameron and Kulick 2003, p. 45). Heterosexuality is a binary sex system that takes for granted the different gender roles (perceived as femininity and masculinity) and views them as a natural extension of biological sex differences as well. Similarly, heteronormativity is a socially constructed organizing concept (Ward and Schneider 2009) that has both institutional and rhetorical effects. It uses the concepts of masculinity and femininity to identify roles for women and men, and the appropriate behaviors within a couple. Indeed, Eaton and Matamala (2014) found that an increase in heteronormative beliefs about men and women encourages verbal and sexual coercion. In contrast, Kitzinger (2005) concluded that “homosexuality is a social construct invented to diagnose, circumscribe, and control certain kinds of behaviors. Samesex relationships are treated as a social problem” (pg. 447). These constructs delineate social norms and create families as a categorization device. Indeed, Schilt and Westbrook (2009) refer to the “process of doing gender” and that by emphasizing masculinity and femininity, it maintains the heteronormative expectations.

Same-Sex Versus Opposite-Sex IPV Estes and Webber (2017) point out that same-sex IPV is not examined as often, or as seriously as opposite-sex IPV. As Lorenzetti (2017) found, same-sex IPV is not given the same legitimacy as heterosexual IPV in part because of the reliance on “traditional” gender and sex norms. They also note the lack of resources available to this population of victims, as well as the possible social exclusion, felt within the gay and lesbian community to be contributing factors as well. Finneran et al. (2012) reported that 25–50% of gay men report physical IPV and 12–30% reported being victims of sexual violence. Although physical violence was reported more often than sexual violence, this may be due, in part, to the social stigma of being a gay male and a victim of IPV. Indeed, those who reported IPV still felt both expressed homophobia but also internalized homophobia. Internalized homophobia is a self-prejudice that occurs when gay men and lesbians are exposed to society’s negative perceptions and/or intolerance towards homosexuality, and as a result, identify with those perceptions and inwardly believe them (Shidlo 1994). Brown and Bulanda (2008) further delineate these issues regarding reporting by noting the interference from gender socialization, heterosexism, power dynamics, and the intersection of identity. For example, the Disempowerment Theory—a process in which people gain (or lose) the belief that they can influence their surroundings and the direction of events (Rappaport 1984)—suggests that lesbians are likely to underreport abuse because of fear from service providers. These individuals report

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minority stress and other barriers to reporting. Still, gender is a stronger predictor of those who will report, compared to sexual orientation (Brown and Bulanda 2008). When applying the Feminist Theory to homosexual couples, the distinction changes from male-on-female violence to masculine-on-feminine violence. In this way, the concept of male or masculine dominance can still be used to explain how IPV subjugates women, or the feminine (Cannon and Buttell 2016). To further extrapolate, power and control are a characteristic or even a hallmark of masculine characteristics. Thus, even gay male and lesbian IPV are viewed through a heteronormative binary (Cannon and Buttell 2016). Indeed, when it comes to IPV in lesbian relationships, Irwin (2016) suggests that IPV is minimalized, even by friends that are sought out as social support for a lesbian victim of IPV. Indeed, those victims reported feeling marginalized as those friends did not appear to understand the seriousness of the relationship violence. Just as Little and Terrance (2010) reported, lesbian victims of IPV were only perceived as legitimate victims when the couple overall fit a heteronormative dyad. In other words, as long as one partner was perceived to be feminine and the other masculine, the IPV was considered more legitimate than two masculine or two feminine women as partners. Wellman and McCoy (2013) suggested that men and women who are perceived to have opposite gender-based stereotyped traits are many times perceived as homosexual rather than heterosexual. Due to stereotypes about homosexuality, and gender roles, individuals might perceive feminine-looking males and masculine-looking females as homosexuals. It is possible that individuals who do not perceive congruence in gender appearance and roles, may not perceive the event as violent compared to the other variations (Wellman and McCoy 2013). Seelau et al. (2003) found that despite the victim’s sexual orientation, female observers showed more empathy towards the victims. It is suggested that such responses are because of the history of victimization as the data shows the female gender is most likely to be a victim of IPV (Seelau et al. 2003). Despite gender-based characteristics, female observers of IPV perceive the IPV events as more serious, severe, and violent compared to male participants. Males involved in IPV situations are less likely to experience societal and individual sympathy and therefore male observers may perceive a male victim of IPV not only as less serious, severe, and violent but also as less likely to occur (Seelau et al. 2003).

Conclusion IPV is a pervasive issue that affects both physically and psychologically both males and females. However, gender-based stereotypes about masculinity and femininity influence the way we classify victims and offenders involved in an IPV situation. Even though society has set structured ideologies and stereotypes about IPV, studies (e.g., Caldwell et al. 2012; Drijber et al. 2013; Harris and Cook 1994) show that men are as likely as women to be victims of IPV, and women to be offenders. Because

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studies support the gender symmetry theory that both males and females can be victims of IPV (e.g., Katz et al. 2002), social and legal systems should move beyond Johnson’s (1995) patriarchal terrorism perception of IPV and other feminist held theories that focus on men’s violence against women. Anyone can be a victim of IPV and as Renzetti (1999) suggests, there should be a more societal humanistic approach toward IPV, i.e., an overall more inclusive perspective. Das Dasgupta (2002) posits to fully understand IPV, the past experience, the current situation, the current culture, and historical culture (defining masculinity and femininity), as well as how it all plays a role in the interpretation of an act of violence in the relationship that should be included in the definition IPV. As researchers wrestle with how to examine the question of who a victim of IPV is, understanding the research methodologies, recognizing their theoretical perspectives, and acknowledging that there may be hidden populations of IPV victims, are all important to the understanding of IPV through the lens of gender and gender symmetry

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Betsi Little is an Assistant Professor at Palomar College. She received her Ph.D. in Experimental Psychology at the University of North Dakota in 2006, and her B.A. in Psychology and Criminal Justice from Indiana University. Prior to joining Palomar in 2019, she was an Associate Professor at National University for 4 years and served as the Department Chair of the Psychology department at Trinity Lutheran College. Dr. Little teaches a variety of courses, including introductory psychology, research design and statistics, social psychology, and positive psychology. In addition to teaching, Dr. Little has served as a Jury consultant for over 10 years. Her research focuses on the perceptions held of, and by, marginalized populations. Her current research focuses on the legitimacy of domestic and interpersonal violence, in heterosexual and homosexual couples. She

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is also conducting research on how one perceives and presents their own gender identity and sexual orientation. Future research will examine the perceptions of transgender use of public spaces. She lives in San Diego with her husband, toddler and beagle, Kyle.

Part II

A Broader Understanding of Partner Violence and Barriers to Help-Seeking

Chapter 6

Trans Prejudice and Its Potential Links to IPV Among Trans People Veanne N. Anderson

Introduction Trans people have become more visible in U.S. politics, popular media, and social activism over the last 20 years. For example, Danica Roem was the first openly trans woman to be elected to the Virginia General Assembly (Olivo 2018) and Phillipe Cunningham was the first openly trans man to be elected as a city councilperson in Minneapolis (Johnson 2017). Several television series feature trans actors and actresses including Pose which focuses on the Latinx and Black LGBTQ+ community in New York City during the 1980s and 1990s. In the very popular show, Orange is the New Black, Laverne Cox—a trans person herself—portrayed a trans woman and she has won awards for her acting as well as her advocacy work on behalf of trans people. Many trans individuals have even written memoirs of their experiences, for example, Boylan (2003), McBride (2018), and Green (2004). These memoirs describe the joys as well as difficulties associated with discovering one’s gender identity and the authors provide intimate details about how this discovery affected their family relationships, friendships, and intimate relationships. In research (Hyde et al. 2019) and clinical practice (American Psychological Association [APA] 2015), many psychologists have embraced an understanding of gender that includes trans and other identities. Additionally, attitudes in the United States toward trans individuals have become more positive and people have become more supportive of rights for trans people over the last five years (Greenberg et al. 2019) although these attitudes are moderated by political affiliation, religious affiliation, and age (Brown 2017; Greenberg et al. 2019; Smith 2017). These changes in attitudes toward trans people reflect social progress but constant vigilance and advocacy for trans people’s rights are still needed because trans people continue to face widespread and systemic prejudice and discrimination, and they are often stigmatized for their gender identities V. N. Anderson (B) Indiana State University, Terre Haute, IN, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_6

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(van Anders et al. 2017). For example, President Trump’s administration in the fall of 2018 proposed passing a law that would define gender as “a biological, immutable condition determined by genitalia at birth” (Green et al. 2018). Many trans individuals already have difficulty accessing healthcare (James et al. 2016; Pear 2018; Schimmel-Bristow et al. 2018), are often prevented from using public restrooms of their choice (Kralik 2017; Schilt and Westbrook 2015), and have been banned from military service as of April 2019 (Human Rights Campaign 2019a). More relevant to the focus of this chapter, trans individuals also experience high rates of harassment, violence, and abuse (Human Rights Campaign 2015; James et al. 2016; Roch et al. 2010). Passing a law that severely restricts the definition of gender would essentially make trans people “invisible” and further endanger their human and civil rights. The purpose of this chapter is to discuss some of the factors that predict prejudice and negative attitudes toward the trans community and how this prejudice may contribute to the high rates of intimate partner violence and abuse experienced by trans people. The first section provides definitions of some of the terms that will be used. The second section is a review of some of the research investigating trans prejudice and its predictors. The third section provides information on intimate partner violence (IPV) among trans people and its potential associations with trans prejudice.

Definition of Terms Trans people is an umbrella term that refers to a very diverse group of individuals who may identify themselves in various ways—for example: transgender, gender non-conforming, having a trans history, trans masculine, trans feminine, MTF (maleto-female), FTM (female-to-male), non-binary, bi-gender, agender, gender fluid, genderqueer, etc. (Simmons and White 2014). Furthermore, these labels are constantly evolving, and may have different meanings for different people (Erickson-Schroth and Jacobs 2017). In contrast, cisgender is used to describe people who identify with their gender assigned at birth. Additionally, transphobia literally means an irrational fear of trans people whereas trans prejudice is used to refer to prejudicial and negative attitudes toward trans people. The distinction between transphobia and trans prejudice is important to note because not all people who hold negative views of trans individuals necessarily have an irrational fear of them. Finally, IPV has been used to describe violence and abuse experienced within an intimate relationship such as marriage, dating, sexual relationship, people who cohabit, etc. (Walker 2015). Abusive behaviors may include physical violence, psychological abuse, sexual abuse, and economic abuse. This may also include abuse that is more specific to trans people (e.g., an intimate partner’s “coercive control of gender transition or gender presentation”) or what Peitzmeier et al. (2019, p. 2381) refer to as transgender-related IPV (T-IPV).

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Predictors of Trans Prejudice Research on trans prejudice has burgeoned over the last 10–15 years and we are beginning to have a better understanding of the factors that underlie the problem. The purpose of the following review is to discuss some of the predictors of prejudice toward trans people that may help the reader understand its relation to IPV, especially T-IPV. Although, it is not a comprehensive review of all of the literature on trans prejudice, this chapter seeks to provide a high-level overview of previous and current research into the subject.

Gender Social Identity Theory (SIT) has been a useful framework for understanding some aspects of trans prejudice as they relate to the gender of the rater (the person judging the individual) and target (the individual being judged) (Tajfel and Turner 1986). According to SIT, individuals are members of multiple social groups (or in-groups) such as gender, age, ethnicity, and sexual orientation. Membership in these in-groups can influence a person’s self-identity and how they view other members of their ingroups as well as members of out-groups (groups to which they do not belong). When group membership is salient and important to a person’s self-identity, that person may engage in various behaviors to maintain the distinctiveness of their group’s status relative to an out-group (and by extension their own individual status). This especially occurs when an individual feels threatened by an out-group (Tajfel and Turner 1986). These perceived threats may result in an individual extolling the positive virtues of their in-group (e.g., cisgender people demeaning the out-group of trans people). Perceptions of the out-group as being different from and inferior to one’s in-group can promote stereotyping of the out-group, which can lead to prejudice and discrimination toward the out-group (Kilianski 2003; Tajfel and Turner 1986). This, therefore, partially explains how the belief in the gender binary—that there are only two distinct categories of genders that are “biologically determined, apparent at birth,” and “stable over time…” (Hyde et al. 2019, p. 171)—has held sway for decades, especially in Western cultures (Sanz 2017). Prescribed and proscribed behaviors and attitudes are also important aspects of the gender binary, such as women are more emotional than men or men should avoid feminine mannerisms (Hyde et al. 2019). In contrast, many trans people do not identify with the distinct categories of woman/man or feminine/masculine (Erickson-Schroth and Jacobs 2017; Nagoshi et al. 2012) and prefer non-binary terms for identifying their gender (Broussard et al. 2018). Even when trans people identify themselves as being a woman or a man, they may still be perceived by others as not conforming to the gender binary because of their physical appearance and gender presentation (e.g., clothing, mannerisms). Therefore, trans people may be perceived as threatening the gender-binary which could result in trans prejudice, especially in individuals who

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adhere to the belief that there are only two genders. Furthermore, gender is a very salient social category and decisions about someone’s gender are made almost automatically (Jost and Hamilton 2005; Macrae and Bodenhausen 2000). These almost automatic decisions may lead to misidentification of someone’s gender, which in turn may give rise to prejudicial attitudes. Indeed, perceived violation of gender identity norms (Adams et al. 2016) and endorsement of the gender binary (Elischberger et al. 2018; Norton and Herek 2013; Prusacyk and Hodson 2019) are associated with more negative attitudes toward trans people. This may be especially true for settings where gender segregation is expected, such as public restrooms or locker rooms, compared to non-gender segregated settings such as classrooms (Buck and Obzud 2018). Furthermore, trans people whose physical appearance conforms to their gender identity (e.g., a trans man who appears masculine) are more likely to be viewed as being the gender they identify with (Doan et al. 2019) and are more likely to be evaluated positively than trans people whose physical appearance does not conform to their gender identity or is ambiguous (Gerhardstein and Anderson 2010). Finally, Broussard et al. (2018, p. 610) found that a stronger belief in the gender binary among cisgender heterosexual people was significantly correlated with more agreement with the idea that “asking about more than two genders (i.e., male and female) threatens the differences between people who are born female and people who are born male”. Much research demonstrates that cisgender heterosexual boys and men report more trans prejudice than cisgender heterosexual girls and women (see Brassel and Anderson 2019; Carrera-Fernández et al. 2014; Nagoshi et al. 2019; Norton and Herek 2013), although there are exceptions (e.g., Wang-Jones et al. 2017). In particular, traditional Western masculinity emphasizes the importance of heterosexuality and anti-femininity (Bosson and Vandello 2011; Kilianski 2003; Vandello et al. 2008). Furthermore, compared to heterosexual women, heterosexual men report more discomfort with gender non-conforming behavior and are more likely to perceive the binary categories of gender to be inclusive of non-binary, gendered people (Allen and Smith 2011; Bosson and Vandello 2011; Broussard et al. 2018; Sloan et al. 2015; Vandello et al. 2008). Trans people challenge the gender binary and traditional gender norms and may be viewed as threatening to cisgender heterosexual men’s gender identity and masculinity. This perceived threat may give rise to trans prejudice (Anderson et al. 2019b). One might also predict that individuals whose gender is very important to their self-identity would report higher levels of trans prejudice. This prediction has been supported in both cisgender heterosexual and bisexual men and women (Anderson 2018; Brassel and Anderson 2019; Glotfelter and Anderson 2017). Trans prejudice levels may also vary as a function of the trans person’s gender identity, although results are mixed. For example, more negative reactions (e.g., discomfort) or behaviors (e.g., teasing) toward trans women than trans men have been found among heterosexual Chinese men (Chen and Anderson 2017), Hong Kong men (Winter et al. 2008), and cisgender heterosexual American men (see Anderson 2018; Glotfelter and Anderson 2017; Nagoshi et al. 2019). In contrast, other researchers have found men to report more discomfort around trans men than trans women,

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however these researchers did not report whether participants were cisgender and/or heterosexual (e.g., Carroll et al. 2012). Trans women in particular may be perceived by cisgender heterosexual men as posing a threat to male privilege and power because they may be seen as violating the traditional masculine norms of anti-femininity (e.g., they are men acting in stereotypically feminine ways) and heterosexuality (e.g., they are men posing as women to lure other men into a “homosexual encounter”) (Bettcher 2007; Nagoshi et al. 2008, 2019; Norton 1997; Schilt and Westbrook 2009; Watjen and Mitchell 2013). The less negative attitudes among cisgender heterosexual men toward trans men may be due to several factors. For example, it may be easier for trans men than trans women to present as the gender with which they identify (American Psychological Association, Task Force on Gender Identity and Gender Variance 2009); therefore, they may be less likely to be targets of harassment and prejudice. Also, trans men may be perceived as “weak competitors in attracting women” because they are not cisgender men, thus lessening their threat to cisgender heterosexual men (Gerhardstein and Anderson 2010, p. 363). Finally, compared to trans women, trans men have been less visible in popular media (Keegan 2014), thus making it “difficult for cisgender people to imagine how they might respond to trans men” (Glotfelter and Anderson 2017, p. 190). Responses to trans women versus trans men are more mixed for heterosexual women than heterosexual men. Similar to results on heterosexual men, some studies indicate that heterosexual women report more teasing of trans women than trans men (Chen and Anderson 2017; Glotfelter and Anderson 2017; Winter et al. 2008). Again, this may be a consequence of the difficulty some trans women have in presenting as the gender with which they identify, as well as generally more negative attitudes toward gender non-conforming behavior in boys and men than in girls and women (American Psychological Association, Task Force on Gender Identity and Gender Variance 2009; Sandnabba and Ahlberg 1999; Schope and Eliason 2004; Winter et al. 2008). Cisgender heterosexual women also report more discomfort around trans men than trans women (Glotfelter and Anderson 2017). This discomfort may arise from imagined or perceived sexual interest from trans men that may be unwanted or potentially threatening to cisgender heterosexual women’s sexual orientation (Schilt and Westbrook 2009). Indeed, one study found that perceived unwanted sexual interest from trans men predicted trans prejudice in cisgender heterosexual women (Anderson et al. 2019b). It should be noted that other studies have found no differences in heterosexual women’s discomfort around trans women and trans men (Chen and Anderson 2017; Winter et al. 2008). Although we have learned much about the associations between gender identity and trans prejudice, many questions still remain. For example, most research on the effects of gender on trans prejudice have focused on cisgender participants with a few exceptions. Less is known about trans prejudice of participants of other gender identities—for example, attitudes of agender or genderqueer individuals toward people who identify as trans women or trans men. Also, information is lacking on attitudes toward people who may be considered under the trans umbrella but do not identify as trans men or trans women (e.g., genderqueer, gender fluid, agender, non-binary, drag king, etc.).

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Sexual Orientation The bulk of research on trans prejudice has focused on attitudes of heterosexual individuals. Despite being included in the LGBTQ+ acronym, trans people do not necessarily feel welcomed or accepted by people of other sexual orientations such as gay men, lesbian women, and bisexual individuals (Gan 2013). Also, some individuals belonging to gay and lesbian organizations may discriminate against or ostracize trans people because they are not viewed as “real women” or “real men” (Devor and Matte 2006; Stone 2009; Weiss 2003). Nevertheless, on average, LGB individuals tend to exhibit less trans prejudice than heterosexual individuals (Morrison 2010; Warriner et al. 2013), although Cragun and Sumerau (2015) found that bisexual people (but not lesbian women and gay men) had lower levels of trans prejudice than heterosexual individuals. However, none of these studies indicated whether their participants were cisgender or some other gender identity, a factor that could definitely influence levels of trans prejudice. Lindner and Anderson (2015), Brassel and Anderson (2015), and Anderson et al. (2019a) found that cisgender people who identified as something other than “heterosexual only” had lower levels of trans prejudice than cisgender heterosexual individuals. Unfortunately, there were not enough people in the “other than heterosexual only” category to discriminate between attitudes of individuals with different sexual orientations (e.g., asexual, bisexual, queer, pansexual, etc.). In another study, Anderson (2018) compared trans prejudice levels of cisgender men who identified as gay, bisexual, or heterosexual. Analyses revealed that gay and bisexual men reported significantly lower levels of trans prejudice and less discomfort around trans women and trans men than heterosexual men. The lower levels of trans prejudice among bisexual and gay men may be due to their recognition of shared or similar experiences with prejudice, discrimination, and stigmatization. These shared experiences, in turn, may blur the distinctions between the in-group (e.g., bisexual and gay men) and the out-group (e.g., trans people), and may also reduce negative attitudes towards the out-group (Craig and Richeson 2016). This may be especially true of gay men who, like trans people, are likely to have personal experiences with gender non-conforming behavior (Bailey et al. 2016). Additionally, compared to heterosexual men, bisexual and gay men may be more likely to interact and have contact with trans people, a factor that is associated with lower levels of trans prejudice (Claman 2007; Hill and Willoughby 2005; King et al. 2009; Norton and Herek 2013). Although bisexual men had lower levels of trans prejudice than heterosexual men, their levels were still significantly higher than those of gay men (Anderson 2018). This is surprising because bisexual men have been marginalized, stigmatized, and accused of being confused about their sexual orientation by gay men and lesbian women (Weiss 2003). Instead of commiserating with another marginalized out-group (i.e., trans people), bisexual men may view their stigmatization and discrimination as more serious than the out-group which could lead to more negative attitudes (Craig and Richeson 2016). This explanation is speculative, however, and more research is

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needed on the conditions under which the marginalized status of cisgender people of different sexual orientations contributes to low or high levels of trans prejudice. Finally, Anderson (2018) found that cisgender bisexual and gay men reported more teasing of trans women than trans men, although the levels were lower than for cisgender heterosexual men. As noted by Sánchez (2016) and Sánchez and Vilain (2012), some gay and bisexual men have strong anti-effeminacy attitudes which could contribute to the higher levels of teasing of trans women versus trans men.

Additional Variables Gender role ideologies. Not surprisingly, trans prejudice is associated with other factors related to gender including benevolent sexism (i.e., attitudes toward women that on the surface appear positive but are paternalistic) and more traditional gender role attitudes (Brassel and Anderson 2019; Nagoshi et al. 2008, 2019; Tebbe and Moradi 2012). These associations are not surprising given that trans people are often viewed as transgressing gender norms by not fitting into the gender binary (Adams et al. 2016). In addition, feminists have long been concerned with gender oppression, although at times their relationships with trans activists have been antagonistic. For example, some feminists have pathologized trans women, viewed trans women as not “real women,” and denied them access to feminist spaces (Heyes 2013; Raymond 1994; Whittle 2006). However, a strong feminist orientation may predict lower levels of trans prejudice in women and men (Fitz et al. 2012; Worthen 2012), although Brassel and Anderson (2019) found this association to be stronger in cisgender heterosexual men than women. Another variable associated with gender— sexual prejudice or prejudice toward sexual minorities—also predicts trans prejudice although the relation may be stronger for heterosexual men than heterosexual women (Glotfelter and Anderson 2017; Nagoshi et al. 2008). Nagoshi et al. (2008, p. 529) suggest that heterosexual men’s “beliefs about gender roles, gender identity, and sexual orientation… are all driven by a common ideology,” giving rise to prejudice and discrimination against individuals who are perceived as violating those beliefs, such as gender and sexual minorities. Conceptualizations of gender. Trans people are often viewed as violating gender identity norms, especially by cisgender heterosexual people, but how do cisgender individuals conceptualize the term transgender and would those conceptualizations be related to levels of trans prejudice? Buck (2016) predicted and subsequently found evidence in their sample of cisgender heterosexual individuals that people who view “gender as a unique and personal psychological experience” (p. 467) and who conceptualize transgender as a gender identity exhibited lower levels of trans prejudice than someone who focused only on a person’s outer appearance (e.g., dressing as another gender, changes to one’s preferred gender, or gender affirming surgery). Furthermore, no significant differences were found in the categories of definitions supplied by women and men. Anderson et al. (2019a) replicated those findings and also found similar results among cisgender people who identified with

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other sexual orientations. In addition, people of other sexual orientations were more likely than heterosexual people to define transgender as a gender identity. As discussed earlier, belief in the gender binary is associated with more trans prejudice. The belief in the gender binary is an example of psychological essentialism or the idea that individuals belonging to a particular social group share “an underlying essence….often assumed to be biological in nature, based in the brain, genes, and/or hormones…” (Ching and Xu 2018, p. 228). Ching and Xu (2018) found that people primed with a neuroessentialist perspective on gender (e.g., that women and men are fundamentally different neurologically and this gives rise to gender differences in behavior) reported more trans prejudice than people primed with an interactionist perspective (e.g., gender differences result from interactions between neurological and environmental factors). This research suggests that people’s views on the origins of gender identities, including trans identities, may be associated with their attitudes toward trans people. For example, do people believe that being trans is primarily a choice that people make? Or do people believe trans people are born with their identity? Additionally, how are these beliefs associated with trans prejudice? Of course, the origins of gender identity are complex and cannot be reduced to all “nature” or all “nurture” (Hyde et al. 2019). Nevertheless, similar controversies have arisen over the origins of different sexual orientations and have influenced attitudes toward sexual minorities. As with sexual prejudice (Bailey et al. 2016), some research suggests that a belief that people are born trans is associated with lower levels of trans prejudice (Anderson 2018; Claman 2007; Elischberger et al. 2018; Landén and Innala 2000; Woodford et al. 2012). Such a belief among cisgender individuals may enhance their distinctiveness from trans people (i.e., trans people are born with distinct biological factors that are different from cisgender people). In turn, this belief may lower the perceived threat posed by trans people leading to less trans prejudice (see Falomir-Pichastor and Mugny 2009). However, this belief could just be another example of acknowledging that the gender binary does not accurately describe everyone’s gender identity at birth. Pathologizing gender identity. In addition to debates about the origins of gender identity, there are debates about whether unhappiness with one’s assigned birth gender should be categorized as a mental disorder. This was realized with the creation of the diagnosis “gender identity disorder” which later became “gender dysphoria” in the most recent edition of the Diagnostic and Statistical Manual (American Psychiatric Association, DSM-5 Task Force 2013). Although some people viewed this as a positive shift in terminology, it has still been controversial (Gorton 2013; Reed et al. 2015). As suggested by Anderson (2018, p. 375), “retaining ‘gender dysphoria’ as a psychiatric diagnosis may still lead to the perception that trans people are mentally ill,” especially given overwhelming evidence that having a mental illness in and of itself can be very stigmatizing (Hinshaw and Stier 2008; Parcesepe and Cabassa 2013). Indeed, higher levels of trans prejudice or negative attitudes toward trans people are associated with more agreement that trans people have a psychological disorder (Anderson 2018; Gerhardstein and Anderson 2010; Reed et al. 2015). Furthermore, compared to cisgender people of other sexual orientations,

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cisgender heterosexual individuals are more likely to believe that trans people have a psychological disorder (Anderson 2018; Anderson et al. 2019a). Religious beliefs. Almost 80% of Americans report a religious affiliation (Newport 2017). This suggests that religious beliefs are important components of many American’s self-identity. Challenges to these religious beliefs may be viewed as threatening, thereby resulting in negative attitudes or prejudice (Tajfel and Turner 1986). This may be particularly true of people high in religiosity—for example, people for whom religion is very important in their lives or who are religious fundamentalists and believe that religion provides “the fundamental, basic, intrinsic, essential, inerrant truth about humanity and deity” (Altemeyer and Hunsberger 1992, p. 118). Indeed, less acceptance of gender nonconforming behavior (Collier et al. 2013) and more trans prejudice (Adams et al. 2016; Claman 2007; Kanamori et al. 2017; Konopka et al. 2019; Nagoshi et al. 2008, 2019; Warriner et al. 2013; Willoughby et al. 2010; Woodford et al. 2012) are associated with higher levels of religiosity and religious fundamentalism, although the association may be moderated by gender, sexual orientation, and nationality (Norton and Herek 2013; Warriner et al. 2013; Willoughby et al. 2010). The relation between religiosity, religious fundamentalism, and trans prejudice may be due in part to their associations with other factors that also predict trans prejudice. These include a conservative political ideology, right wing authoritarianism (RWA) (i.e., a belief in submission to authority and adherence to traditional social norms), and social dominance orientation (SDO) (i.e., a belief in social inequality and hierarchy) (Elischberger et al. 2018; Konopka et al. 2019; Makwana et al. 2018; McCullough et al. 2019; Nagoshi et al. 2019; Norton and Herek 2013; Prusacyk and Hodson 2019). Another cognitive construct that may underlie the associations between religiosity, conservative political ideology, RWA, SDO, and trans prejudice is the need for closure. The need for closure is defined as a need for “quick and definite answers… and freezing the obtained answer and hence protecting the acquired knowledge against contradictory information” (Hill et al. 2010; Roets and Van Hiel 2011, p. 350). Because trans people are perceived as violating and blurring the gender binary, it is not surprising that people high in the need for closure tend to report higher levels of trans prejudice (Makwana et al. 2018; Tebbe and Moradi 2012).

Reducing Trans Prejudice Reducing prejudice is a challenge but one tactic that has received a lot of research attention and has been shown to be effective is positive contact with out-groups. Several researchers have found a significant association between contact with trans people and lower levels of trans prejudice (Elischberger et al. 2018; Hill and Willoughby 2005; King et al. 2009; McCullough et al. 2019; Norton and Herek 2013; Walch et al. 2012; Willoughby et al. 2010). Positive interactions with trans people may reduce anxiety, perceived threats, and an individual’s need for closure and social dominance

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orientation, as well as increase empathy and trust (Hodson 2011; Hodson et al. 2018). In turn, these effects may lead to lower levels of trans prejudice.

Trans Prejudice and IPV Among Trans People Over the last 40 plus years, the practice of viewing “gender solely from a binary perspective, assuming perpetrators and victims of IPV are always female or male, and excluding transgender people” (Yerke and DeFeo 2016, p. 975) has often rendered trans people’s experiences with IPV invisible. This, in turn, has influenced the kinds of questions asked in research on IPV among trans people and the support and services that are available and accessible to trans people who experience IPV. Overall, rates of IPV among trans people are high. For example, Roch et al. (2010) found that 80% of their sample of 60 trans people who were primarily from Scotland reported some form of domestic abuse from one or more intimate partners. James et al. (2016) found around 54% of a sample of more than 27,000 trans people from the U.S., Washington D.C., American Samoa, Puerto Rico, Guam, and overseas U.S. military bases reported experiencing IPV, and these experiences tended to be more common among people of color as well as respondents who were homeless, had disabilities, or were involved in sex work (Whitton et al. 2019a). An underlying theme of IPV is an attempt to control a partner, and many forms of IPV experienced by trans people are similar to those experienced by cisgender people including emotional, physical, verbal, and sexual abuse (James et al. 2016; Roch et al. 2010; Whitton et al. 2019a, b). However, some forms of IPV may be more specific to trans people because of trans prejudice and the stigma associated with identifying as a trans person.

Measuring IPV in the Trans Community Peitzmeier et al. (2019, p. 2386) developed a measure that assesses four domains of IPV that are specific to trans people (or T-IPV). “Coercive control of gender transition or gender presentation” was the most commonly reported domain at 33.6% prevalence over ones’ lifetime (e.g., partner pressures them to forego surgery or a name change, partner tells them what type of clothing or hairstyle to wear). “Emphasizing the undesirability of transgender individuals as intimate partners” was the second most common domain at 13.4% over their lifetime (e.g., partner says that no one else would want to be in a relationship with them). The third most common domain was “blackmail via ‘outing’” with a lifetime prevalence of 7.4% (e.g., partner threatens to divulge their gender identity). “Sabotaging transition” was the least common at 2.7% lifetime prevalence (e.g., partner hides or destroys hormones, clothing, etc.). Although Peitzmeier et al. (2019) studied individuals who identified as trans masculine, their findings may generalize to other trans people. For example, James et al. (2016) found that 27% of their diverse sample of 27,715 trans people reported some

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type of IPV that was related to their gender identity. More specifically, 25% reported having been told that they were not “real men” or “real women,” 11% reported that their partner threatened to divulge their gender identity, and 3% reported that their partner prevented them from having or taking their hormones. The rest of this section focuses on potential associations between trans prejudice, its predictors, and T-IPV, as well as how trans prejudice might affect the care and support of trans people who have experienced T-IPV. However, this focus is not intended to dismiss or ignore the importance of trans prejudice in understanding other forms of IPV. In addition, some of this discussion is speculative due to the relative lack of research on trans prejudice or other attitudes among intimate partners of trans people.

Violence Toward Trans Intimate Partners Previous research has shown that positive contact with trans people tends to decrease trans prejudice (Elischberger et al. 2018; Hill and Willoughby 2005; King et al. 2009; McCullough et al. 2019; Norton and Herek 2013; Walch et al. 2012; Willoughby et al. 2010). Therefore, one might think because of their close contact with a trans person, intimate partners of trans people would be less likely than others to exhibit trans prejudice. However, an intimate partner may not know of their trans partner’s identity until later in a relationship; perhaps when the trans partner is considering gender affirming surgery, beginning to take hormones, and/or beginning to present as their preferred gender. Therefore, it is during these times that a trans person may be particularly susceptible to T-IPV from their intimate partner because of the partner’s underlying trans prejudice or other beliefs associated with trans prejudice (Roch et al. 2010; Walker 2015). Intimate partners who adhere to the gender binary or who have traditional ideas about gender norms and roles may feel uncomfortable with, and even threatened by, their trans partner’s attempts to transition to, present as, and/or live in their preferred gender. Partners may react by minimizing or denying the trans person’s gender identity, claiming that they are no longer a “real woman” or a “real man,” or by being frustrated and confused with how the trans partner’s identity might affect their own gender identity and sexual orientation (Cook-Daniels 2015; Levitt and Ippolito 2014; Pulice-Farrow et al. 2017; Roch et al. 2010). Furthermore, in an effort to reduce the threat to their belief in the gender binary, an intimate partner may sabotage a trans person’s efforts to present as their preferred gender by hiding medication and/or convincing their partner to not seek gender affirming surgery (James et al. 2016). An intimate partner may also have gendered expectations for how bodies should look and behave, especially during sexual interactions (PuliceFarrow et al. 2017). Changes in the trans person’s body or gender presentation may be met with disapproval or even disgust which could escalate into more severe abuse. As mentioned earlier, having any psychological disorder can be stigmatizing (Hinshaw and Stier 2008; Parcesepe and Cabassa 2013) and the belief that trans people

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have a psychological disorder is associated with more trans prejudice (Anderson 2018; Gerhardstein and Anderson 2010; Reed et al. 2015). If someone believes their trans partner has a psychological disorder, they may experience what is called “courtesy stigma,” or feeling stigmatized by mere association with an already stigmatized person (Goffman 1963). This could potentially lead the intimate partner to react negatively and become controlling and abusive (Rogers 2017). Furthermore, the intimate partner may try to convince their trans partner that they need psychological treatment to help them overcome their desire to transition or present as their preferred gender.

Familial Influences and Perceptions In addition to being an important factor to consider in the abuse of trans people by their intimate partners, trans prejudice may also play a role in the responses to T-IPV of other people in the trans person’s life, including family members. James et al. (2016, p. 8) found that “a majority of respondents (60%) who were out to the immediate family they grew up with said that their family was generally supportive of their transgender identity”; however, some family members may pressure the trans person to give up transitioning. In addition, family members who have traditional attitudes toward gender and adhere to the gender binary may deny the trans person’s identity and reject them and may even believe that the trans person deserves the poor treatment they are receiving from their intimate partner (Rogers 2017). These attitudes and beliefs could lead to loss of support and further isolation for a trans person who is experiencing IPV. For example, trans people who were not supported by family members were more likely to experience homelessness, attempt suicide, have poor general health, and psychological distress compared to those who were supported (James et al. 2016).

Health and Welfare Provider Response Responses of health care professionals to a trans person experiencing IPV may also be influenced by trans prejudice. Approximately 33% of respondents to James et al.’s (2016) survey indicated that they had at least one negative experience with a health care provider, including verbal harassment, refusal of treatment, and physical attacks. Because of previous negative experiences with healthcare providers, trans people may not seek necessary medical treatment for IPV-related injuries (Yerke and DeFeo 2016). If they do seek treatment, they could be confronted by health care professionals with traditional views of gender or strong beliefs in the gender binary who may pressure them to not transition, refuse to recognize their gender identity, or even attempt conversion therapy with the trans person (James et al. 2016; Rogers 2016). Before seeking help from health care providers after experiencing IPV, trans people may try to access other services such as assistance from law enforcement and

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domestic violence shelters. As stated by Yerke and DeFeo (2016, p. 976), “police officers are commonly the first point of contact when IPV victims seek support.” Unfortunately, a significant proportion of trans people have reported being mistreated, harassed, disrespected, and assaulted by law enforcement officers which may decrease the likelihood of reporting IPV (James et al. 2016). For example, approximately 49% of trans people who interacted with law enforcement officers reported that even the officers “who thought or knew they were transgender” deliberately used incorrect pronouns (James et al. 2016, p. 186). In addition to law enforcement, shelters for IPV victims and survivors can be lifesaving, yet trans people may experience discrimination, harassment, assault, and lack of respect in some shelters (James et al. 2016; Yerke and DeFeo 2016). Moreover, trans people may be excluded from some shelters because of policies that prohibit people who do not identify as cisgender from using their services (Greenberg 2012). Such policies of exclusion may be based on trans prejudice and the notion that trans people are threatening to the well-being of cisgender people in the shelter (Greenberg 2012). This unfortunate breakdown in support within each institution can prove detrimental to trans individuals’ health and well-being when they need it most.

Conclusion Although research on trans prejudice, its antecedents, and its consequences continues to grow, much more needs to be done. For example, other factors not discussed in the preceding sections may underlie and/or moderate the associations between trans prejudice and IPV. These include characteristics of the trans person’s partner such as age, gender identity, sexual orientation, religious beliefs, and knowledge of the trans person’s gender identity. As alluded to earlier, trans people are very diverse in their gender identities, racial/ethnic identities, and ability status—all of which may influence their experiences with trans prejudice and IPV (James et al. 2016). For example, the majority of trans women who were killed in the U.S. in 2018 were Black and some of these deaths were at the hands of acquaintances and partners (Human Rights Campaign 2019b). Many obstacles still remain for trans people who have experienced IPV and are trying to access life-saving services and support. For instance, trans people who experience IPV are protected under the Violence against Women Act (National Center for Transgender Equality n.d.), although that act has been weakened under the Trump administration. However, some organizations that are obligated to assist individuals regardless of gender identity have instituted policies on working with trans people including the APA (2015) and American Medical Association (n.d.). Additionally, there are regulations regarding health care for trans individuals that have been implemented, legal protections for trans people who have been discriminated against when trying to access domestic violence shelters, and good online resources regarding legal rights for trans people who have experienced IPV (Apsani 2018; National LGBT Bar Association n.d; Steuer and Davis 2017). The adoption of such

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policies and regulations and the increasing availability of online resources reflect a decrease in trans prejudice and a concomitant growth in support for trans people’s rights in the U.S. over the last few decades. Nevertheless, trans activists, their advocates, and allies need to remain vigilant and continue demanding that trans people not be marginalized and made invisible. The reduction of trans prejudice will facilitate progress toward a more inclusive world where everyone, regardless of their gender identity, will be accepted and have an opportunity to contribute to society.

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Elischberger, H. B., Glazier, J. J., Hill, E. D., & Verduzco-Baker, L. (2018). Attitudes toward and beliefs about transgender youth: A cross-cultural comparison between the United States and India. Sex Roles, 78(1–2), 142–160. https://doi.org/10.1007/s11199-017-0778-3. Erickson-Schroth, L., & Jacobs, L. A. (2017). “You’re in the wrong bathroom!”: And 20 other myths and misconceptions about transgender and gender-nonconforming people. Boston, MA: Beacon Press. Falomir-Pichastor, J. M., & Mugny, G. (2009). I’m not gay…I’m a real man!”: Heterosexual men’s gender self-esteem and sexual prejudice. Personality and Social Psychology Bulletin, 35, 1233– 1243. https://doi.org/10.1177/0146167209338072. Fitz, C. C., Zucker, A. N., & Bay-Cheng, L. Y. (2012). Not all nonlabelers are created equal: Distinguishing between quasi-feminists and neoliberals. Psychology of Women Quarterly, 36(3), 274–285. https://doi.org/10.1177/0361684312451098. Gan, J. (2013). Still at the back of the bus. In S. Stryker & A. Z. Aizura (Eds.), The transgender studies reader 2 (pp. 291–301). New York, NY: Routledge. Gerhardstein, K. R., & Anderson, V. N. (2010). There’s more than meets the eye: Facial appearance and evaluations of transsexual people. Sex Roles, 62(5–6), 361–373. https://doi.org/10.1007/ s11199-010-9746-x. Glotfelter, M. A., & Anderson, V. N. (2017). Relationships between gender self-esteem, sexual prejudice, and trans prejudice in cisgender heterosexual college students. International Journal of Transgenderism, 18(2), 182–198. https://doi.org/10.1080/15532739.2016.1274932. Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. New York, NY: Simon & Schuster. Gorton, R. N. (2013). Transgender as mental illness: Nosology, social justice, and the tarnished golden men. In S. Stryker & A. Z. Aizura (Eds.), The transgender studies reader 2 (pp. 644–652). New York, NY: Routledge. Green, E. L., Benner, K., & Pear, R. (2018, October 21). ‘Transgender’ could be defined out of existence under Trump administration. The New York Times. Retrieved from https://www.nytimes. com/. Green, J. (2004). Becoming a visible man. Nashville, TN: Vanderbilt University Press. Greenberg, D., Najle, M., Jackson, N., Bola, O., & Jones, R. P. (2019). America’s growing support for transgender rights. Retrieved from https://www.prri.org/research/americas-growing-supportfor-transgender-rights/. Greenberg, K. (2012). Still hidden in the closet: Trans women and domestic violence. Berkeley Journal of Gender, Law & Justice, 27(2), 198–251. https://doi.org/10.15779/z38j678w3d. Heyes, C. (2013). Feminist solidarity after Queer theory: The case of transgender. In S. Stryker & A. Z. Aizura (Eds.), The transgender studies reader 2 (pp. 201–212). New York, NY: Routledge. Hill, D. B., & Willoughby, B. L. B. (2005). The development and validation of the genderism and transphobia scale. Sex Roles, 53, 531–544. https://doi.org/10.1007/s11199-005-7140-x. Hill, E. D., Cohen, A. B., Terrell, H. K., & Nagoshi, C. T. (2010). The role of social cognition in the religious fundamentalism-prejudice relationship. Journal for the Scientific Study of Religion, 49, 724–739. https://doi.org/10.1111/j.1468-5906.2010.01542.x. Hinshaw, S. P., & Stier, A. (2008). Stigma as related to mental disorders. Annual Review of Clinical Psychology, 4, 367–393. https://doi.org/10.1146/annurev.clinpsy.4.022007.141245. Hodson, G. (2011). Do ideologically intolerant people benefit from intergroup contact? Current Directions in Psychological Science, 20(3), 154–159. https://doi.org/10.1177/ 0963721411409025. Hodson, G., Crisp, R. J., Meleady, R., & Earle, M. (2018). Intergroup contact as an agent of cognitive liberalization. Perspectives on Psychological Science, 13, 523–548. https://doi.org/10. 1177/1745691617752324. Human Rights Campaign. (2015). Addressing anti-transgender violence: Exploring realities, challenges, and solutions for policymakers and community advocates. Retrieved from http://hrc-assets.s3-website-us-east-1.amazonaws.com//files/assets/resources/HRCAntiTransgenderViolence-0519.pdf.

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Veanne N. Anderson is a professor of psychology and gender studies at Indiana State University. Her research interests include factors associated with attitudes toward trans people, sexual minorities, and feminism.

Chapter 7

Understanding Power Dynamics in Bisexual Intimate Partner Violence: Looking in the Gap Sarah Head

Being Bisexual: The Current Societal Context …bisexuality, in general, is not an accepted orientation (Erickson-Schroth and Mitchell 2009, p. 299).

Bisexual invisibility is not a new concept (Barker et al. 2012). Non-adherence to monosexual categories of sexuality (either heterosexual or homosexual) challenges the dominant social narratives about the two counterpoints of human sexuality (Erickson-Schroth and Mitchell 2009). If society has no shared understanding about the social identity of a bisexual person, a person’s legitimacy about being an expert of their own experience will be undermined. To have no shared societal understanding about bisexuality is a form of epistemic injustice (Fricker 2007). Epistemic injustices are enacted in structural power dynamics during interpersonal exchanges where the hearer refuses to (or is unable to) acknowledge the speaker’s position. Bostwick and Hequembourg (2014) posit that bisexual people experience both testimonial injustices (where a hearer affords less credibility to the speaker due to their social identity) and hermeneutical injustices (where collective resources of understanding prevent the speaker from being understood by others). Within the context of bisexual IPV, testimonial injustice refers to the discrimination bisexual people experience from both general and LGBT society. If a bisexual person’s experience of IPV is not believed, it is harder for them to identify the abuse which creates barriers to help-seeking (Bornstein et al. 2006; Head and Milton 2014). Hermeneutical injustice is evident in the lack of bisexual IPV-specific research and the application of inappropriate theoretical paradigms to explain the phenomenon; for example, sexual minority IPV research that excludes participants who have had partners of both genders (Halpern et al. 2004). Despite bisexual people’s testimonies, society and academics continue to frame their sexuality inadequately and incorrectly. S. Head (B) London, UK © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_7

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The muting of the bisexual experience is particularly concerning considering the size of the bisexual population. International population surveys identify that the LGBT population size is roughly 60% homosexual to 40% bisexual (Gates 2011). In the US, it has been found that the bisexual population is slightly higher than homosexual: 1.8% compared to 1.7% (Gates 2011). Within the UK and the US, the bisexual population is estimated to account for approximately 0.7% (1.1 million) and 3.5% (approximately 10 million) respectively of the total population (Gates 2011; Government Equalities Office 2018; Newport 2018). Since 2012, there has been a noticeable increase in the number of people self-identifying as LGBT with greater populations found in urban areas (Office for National Statistics 2019). This has been attributed to increased bisexual identification in younger members of the population (Newport 2018; Office for National Statistics 2019). However, the validity of these population statistics needs to be scrutinized. It is possible that due to minority stress and proposed double marginalization (both by heterosexual and homosexual populations), bisexual people may not necessarily respond to population surveys or simply may not self-identify in the way that the data is collected (Gates 2011). While societal attitudes towards the LGBT community are improving, bisexual people report less acceptance within the LGBT community and society than their homosexual counterparts (Park and Rhead 2013; Pew Research Center 2013). It has been posited that bisexuality is one of the most isolated sexualities; there is no societal space that belongs to them (SafeLives 2018). Such a marginalized context will understandably have an impact upon a person. This impact is identified as “minority stress” which refers to the specific stressors (experiences of stigmatization and discrimination) an individual will experience due to their minority group membership (Balsam and Szymanski 2005; Meyer 2003). Minority stress can have long-term implications. For instance, it has been found to impair emotional regulation in LGBT youth which has been found to compromise resilience and mental health in later life (Bostwick and Hequembourg 2014; Reuter et al. 2017). Bostwick and Hequembourg (2014) critique the minority stress model due to its tendency to ignore the stressors within the LGBT “community,” thus implying that all stressors are equal within this population. Owing to the dual-sourced binegativity (hostility towards someone of a bisexual orientation), both within heterosexual and LGBT populations, bisexual people are at an enhanced risk of minority stress (Dollimore 1997). Much vulnerability has been attributed to the enhanced minority stress bisexual people experience (Rollè et al. 2018). For instance, it may help explain why bisexual people, especially bisexual women, are the most vulnerable for IPV (Walters et al. 2013) and poor mental health (Reuter et al. 2017; SafeLives 2018; Varney and Newton 2018). Hence, it is from this contextual position of enhanced minority stress and bi-invisibility that we shall begin to explore how IPV manifests for bisexual people.

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IPV: Adopting a Bisexual Lens Bisexual relationships will not necessarily adhere to heteronormative or homosexual assumptions. Whilst helpful to recognize IPV similarities within the LGBT population, to assume a homogeneous experience of IPV based upon LGBT group membership will disguise dynamics and abuse tactics that are sexuality specific. This could impact a person’s ability to recognise, be screened, and be appropriately supported for IPV. If one were to glance at the IPV literature in sexual minorities, you could mistakenly assume bisexual IPV is either homogenous to homosexual IPV, is an amalgam of heterosexual domestic violence (DV), or simply does not exist. The absence of bisexual-specific IPV knowledge, research, and guidance for treatment and support marks a stark contrast to research findings that, across sexualities, consistently places bisexual people at the highest risk for IPV (Barrett and St. Pierre 2013; Walters et al. 2013). Within the field of intimate partner violence, feminist and queer theory has been applied to understanding heterosexual and same-sex partner violence. The understanding developed from these gender-based and sexual orientation models of IPV have been fundamental for developing insight and much needed change in many areas such a policy making. For example, in 2013, the feminist paradigm (the advocacy for equality between the sexes) informed the amendment of the Violence Against Women Act to include IPV against LGBT women. In the UK, the queer paradigm (the recognition of human intimacy within and outside of the gender binary) facilitated amendment of The Domestic Violence, Crime and Victims Act (2004) to ensure legal protection against domestic violence for those in civil partnerships and same-sex cohabitations. While feminist theory has been fundamental for informing thinking about the importance of patriarchal power dynamics in heterosexual relationships (Cannon and Buttell 2015), its applicability to romantic relationships outside of the heterosexist gender frame needs to be challenged. As a paradigm, it fails to explain violence between same-sex couples and female perpetration. Consequently, in the US, males currently have virtually no legal protection against IPV. This runs contrary to the evidence that reported rates of victimization for men and women are similar (Black et al. 2011). In bisexual relationships, it may serve to mask the (female) perpetrator. Queer theory, while fundamental for challenging views on heterosexist assumptions, is problematic in its applicability to relationships that are non-homosexual (Erickson-Schroth and Mitchell 2009). Unintentionally both theoretical paradigms marginalize those that do not self-identify in binary notions of gender or sexual object choice. There is an urgent need for developing insight into bisexual IPV as bisexual people have consistently been identified as the sexual orientation that has the highest risk for IPV (Barrett and St. Pierre 2013; Walters et al. 2013). Bisexual women present with the greatest risk of IPV for psychological, sexual, and severe physical violence from an intimate partner (Walters et al. 2013). Both bisexual men and women report having only one perpetrator of IPV with high rates reporting the perpetrator to be the opposite gender (Barrett and St. Pierre 2013). Nearly half of bisexual people

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report financial and emotional abuse (46.8%), and just over a quarter report sexual abuse (28.6%) along with a significantly higher rate of physical abuse than those who identified as homosexual (Barrett and St. Pierre 2013).

The Bisexual Experience of IPV For both heterosexual perpetrators and survivors, there is a substantive domestic violence literature base. Subsequently, work for sexual minority groups has tended to draw upon this heteronormative, patriarchal framework to evolve understanding into LGBT IPV. Roe and Jagodinsky (1995) adapted the Duluth Model—incorporating minority stress factors and LGBT specific abuse tactics such as “outing”—to develop the Power and Control Wheel for LGBT Relationships. Such an adaptation, unfortunately, lacks insight into abuse tactics that are specific for each distinct sexuality. Developing IPV models from hetero-patriarchal paradigms can result in erroneous assumptions about relationship dynamics when a bisexual person is in opposite-gender relationships (e.g., the hypothesis that the high rates of opposite-sex perpetration of IPV for bisexual people may not be connected to sexual orientation, but might be a manifestation of male-female relationships) (Barrett and St. Pierre 2013). Such a proposal, serves to dismiss bi-specific abuse tactics, omits to explain female perpetration, and fails to consider more complex psychosocial factors that contribute towards abuse of power and control in romantic relationships (Cannon and Buttell 2015). Additionally, disempowerment and minority stress theories have been used to explain violence in LGBT relationships in adolescence and adulthood (Edwards and Sylaska 2013). This theory posits that individuals who feel inadequate and have less self-efficacy are more likely to use non-traditional forms of power assertion such as violence (Archer 1994; McKenry et al. 2006). In the absence of research, we need to be careful about generalizing the applicability of these theories to bisexual people. For instance, applying disempowerment theory to bisexual people could lead to the assumption that high numbers of bisexual people perpetrate IPV. Sexual minority IPV research and literature typically uses two categories for sexual orientation: lesbian, gay, bisexual, and transsexual (LGBT) or same-sex (typically lesbian and/or gay) couples. This categorization is problematic for bisexuals as the results are not separated into sexuality specific results. Alternatively, researchers use the gender of the participant’s partner to assume the sexual orientation of the participant. Thus, the current sexual minority IPV literature fails to recognise and incorporate different expressions of sexuality other than heterosexual or homosexual, and arguably just expands old categories to incorporate new facts (Erickson-Schroth and Mitchell 2009). Though many IPV similarities exist between LGBT member groups, it is imperative to highlight and understand the nuanced differences between them; particularly if we are to heed warnings of “recognition failure” (Rollè et al. 2018, p. 6) and reduce the heightened risk of IPV for bisexual people (Barrett and St. Pierre 2013).

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Fig. 1 Head and Milton (2014) portrays the theory of adjusting for consonance in bisexual people’s experience of partner abuse

In the absence of visible models to help educate and raise the profile of bisexual IPV, perpetrators will benefit because survivors will lack a frame of reference for understanding their experience as abusive and remain in the relationship longer (Bornstein et al. 2006; Head and Milton 2014). Therefore, highlighting the differences between sexual minority groups will facilitate timely self-recognition of abusive dynamics and enhance the probability of appropriate provisions of support. A bi-affirmative bisexual model of IPV that incorporates bi-specific factors and provides accurate insight into the bisexual experience of IPV has been proposed by Head and Milton (2014) (Fig. 1). This dynamic theoretical model utilizes (Festinger’s 1962) cognitive dissonance theory to explain the psychological process bisexual people undergo as they attempt to move away from, or remain in, an abusive relationship. For instance, an abused person will experience a sense of dissonance when their experience and their beliefs about what a relationship should be conflict with each other. So, when a partner, for example, threatens to “out” a bisexual person to their children’s school to undermine how their parenting is viewed, this behavior conflicts with an abused person’s belief that their partner acts in their family’s best interest. Such an abusive tactic will evoke a degree of discomfort (or dissonance) for the abused person. All people will experience a process of “getting lost in the relationship” as their dissonancereducing mechanisms are utilised (e.g., “he loves me and our kids, he wouldn’t really use my sexuality to suggest I’m an unfit mother”) which serves to maintain the relationship. However, after a period, these mechanisms will no longer be effective,

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and people will begin their process of “lifting the veil” (which is the point at which a bisexual person can disentangle themselves from an abusive relationship) and will start to disengage from their abusive relationship. There can be a period of to-ing and fro-ing between the two states of getting lost and lifting the veil. As this model was based upon the experience of bisexual people who had experienced abuse, it naturally accounts for biphobia and minority stress. However, there are limitations to this model. It was developed using a non-representative, self-selecting, and selfidentifying sample. Also, this model only accounts for sexuality-based stressors and, as such, cannot be transferred to transgender people who identify as bisexual. Despite this, the model is an invitation for further discussion and development—such as in the field of intersectionality—and provides a platform from which to explore and enhance our understanding of bisexual IPV.

Exploring Intersectionality Human behavior is complex and is best explained through the consideration of a number, and combination, of factors. In recognition of this, there is an increasing body of literature (Barrett and St. Pierre 2013; Goldberg and Meyer 2013) which specifies the need to adopt an intersectional perspective for developing insight into LGBT IPV. Through challenging assumptions and theoretical paradigms, academics have started to shift away from a gender model explaining sexual minority IPV towards a model that is starting to explore psychosocial factors that contribute towards abuse of power and control in romantic relationships (Cannon and Buttell 2015). The aim of an intersectional approach is one which attempts to recognize the complex and multiple layers of an individual’s identity that permits for group membership (Furman et al. 2017). Such a paradigm shift could also facilitate the consideration of differential vulnerabilities that exist for the LGBT population (Barrett and St. Pierre 2013). Intersectional identities include gender, sexual orientation, socioeconomic status, age, geographic locale, HIV status, and any other experiences that shape an individual’s life (Turell et al. 2012). For (but not exclusive to) bisexual people, additional factors may need to be considered—such as the gender of an abusive partner when there is a polyamorous relationship (Head and Milton 2014). Irrespective of the identities selected for study, readers will always need to be mindful of the interpretations that can be made as interaction effects will vary according to the political structure an individual is located within. Gender and sexual orientation are only two variables that could contribute to understanding IPV. Yet, it is these two variables that have dominated the field of research in heterosexual and homosexual IPV. Whilst sexual orientation has been found to be a heavily weighted factor in IPV when intersectional differences are controlled (Barrett and St. Pierre 2013; Goldberg and Meyer 2013), this finding has been inconsistent across studies (Reuter et al. 2017). In its very nature, disentangling intersectional factors is difficult; even more so when the identified sexuality has its findings enmeshed in a larger LGBT population with a very limited evidence

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base to draw from. Despite this, we shall attempt to consider intersectional factors that research has identified as significant for bisexual IPV as Cannon and Buttell (2015) have proposed through recognizing IPV as a symptom of psychosocial factors, perpetrator identification, and a lack of appropriate provision of support. Age. Associations that have been identified between age and partner abuse in same-sex relationships have been inconsistent (Bartholomew et al. 2008; Turell 2000). To date, no studies have sought to identify the associations between bisexual people, IPV, and age. To develop insight into how age impacts and relates to IPV, Halpern et al. (2004) identified that the abusive relationship dynamics which precipitate IPV can be present in adolescence for same—sex couples. In the adolescent literature base, this dynamic is more commonly referred to as “dating violence” (Reuter et al. 2017, p. 2). Sexual minority youth have been found to be at greater risk of dating violence and perpetration than adolescents in the general population (Dank et al. 2014; Plitcha 2018) with 43.5% of LGBTQ college students reporting dating violence in the last 12 months (Jones and Raghavan 2012). Much of the work on dating violence is not sexuality specific but instead focuses on a sexual minority population. Such an approach may be appropriate for this developmental life stage due to a recognition that a person’s sexuality is emerging during adolescence (Saewyc 2011). However, where participants could self-identify to a distinct sexual orientation, results have been inconsistent. Some found that there were no significant differences to vulnerability of dating violence between sexual orientations (Reuter et al. 2017; Ryan et al. 2010). Others found a pattern that maps onto adult literature where female bisexual adolescents were at the greatest risk for any type of dating violence and male bisexual adolescents were at the greatest risk for sexual abuse (Freedner et al. 2002; Reuter et al. 2017). The most common form of abuse used against bisexual adolescents was bisexual “outing”. This was a tactic predominately used by female perpetrators (Freedner et al. 2002). Additionally, during adolescence, perpetrator gender was not found to be significant; bisexual adolescents were at equal risk of violence from both genders (Freedner et al. 2002). Although reporting similar frequencies of violence as males, female perpetrators reported inflicting less severe violence (Halpern et al. 2004). Looking at the limited research analyzing help-seeking challenges facing bisexual adults, older bisexual populations typically find shelters and domestic violence support groups to be uncomfortable and isolating (Hillman 2019). Beyond this, we know little of their experiences of IPV—there is a real paucity of literature. This is of real concern as older bisexual adults (particularly bisexual women) could be at heightened risk of IPV due to their extended exposure to discrimination, stigma, and biphobia (Barrett and St. Pierre 2013; Bermea et al. 2018; Hillman 2019). Gender. Multiple studies have identified that bisexual people are at higher risk of IPV when in opposite-sex relationships (Furman et al. 2017; Goldberg and Meyer 2013; Messinger 2011; Walters et al. 2013). Such a finding suggests that IPV studies, which categorise their population sample based on same-sex partners, will provide erroneous results for bisexual people. In perpetration, West (2012) found that bisexual women were the most physically aggressive perpetrators of violence and that they would use more LGBT-specific tactics such as “outing” in their psychological abuse.

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Running contrary to the idea that internalized biphobia increases the risk of IPV, research has found that bisexual men are at greater risk of physical and psychological violence if they were more “out” compared to bisexual women (Bartholomew et al. 2008). Being bisexual and female places a person at highest risk to IPV (Barrett and St. Pierre 2013; Walters et al. 2013). That may be because of the possibility that gender is the most weighted identity for placing a person at risk to IPV. As a factor, gender has proven more significant than sexual orientation and/or ethnicity (West 2012). In their review of sexual minority IPV literature, Edwards et al. (2015), found only 21 of 96 studies asked about the gender of the person’s partner. Consequently, it is possible that in many sexual minority IPV studies, the categorization and interpretation of data has been misleading and unrepresentative of the bisexual populations that were studied. Race, ethnicity, and sociodemographic identities. The evidence base on race as a factor for sexual minority IPV is unclear. Hipwell et al. (2013) did not find race to be a significant factor in dating violence. Reuter et al. (2017) found that females and young sexual minority Black/African Americans were at significantly higher risk for IPV; although when accounting for gender, race was not a significant factor. Similar findings have been discovered elsewhere but, when accounting for sociodemographic identities, race was less significant and led West (2012) to conclude that race alone is not a causal factor for IPV. The risk of IPV victimization for sexual minorities is higher when combined with other risk factors, especially for those who are economically and socially disadvantaged (National Coalition of Anti-Violence Programs [NCAVP] 2010). Building upon this, Rodriguez et al. (2009) found that being female and from an ethnically diverse background further enhanced IPV risk due to the increased probability that they will be living in poverty. Research has also identified that being a young, single, bisexual female from a disadvantaged sociodemographic (low income and less educated) background who has a mental/physical impairment is the most at-risk group for IPV (Barrett and St. Pierre 2013). Sexual behaviors. Valentine and Pantalone (2013) found that sexual minority individuals were more likely to experience IPV if they had HIV. Higher rates of psychological abuse and (to a lesser extent) physical abuse was evident for males who have same-sex partners over their heterosexual counterparts (Bartholomew et al. 2008). Pantalone et al. (2012) had the same findings but also identified that being a woman with HIV places you at greater risk to IPV than being a man with HIV. Bartholomew et al. (2008) propose that HIV positive males who have same-sex partners have a higher degree of relational stress which may explain higher degrees of bi-directional abuse. The presence of IPV can also make it harder for a person to negotiate safer sex—they are more preoccupied with protecting themselves from emotional and physical abuse instead (Heintz and Melendez 2006). Those who had experienced rape before were more likely to fear their partner’s response to safe sex requests as well (Heintz and Melendez 2006). In light of these findings, it is appropriate to recommend that IPV be screened for in HIV clinics and that there be shelters available for those with an HIV status.

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Currently, there is no evidence that explores sexual behaviors, bisexuality, and risk to IPV. Substance misuse/abuse. There is no clear link between substance misuse, IPV risk, and sexual orientation. We know for all people, regardless of sexual orientation, there is an association between elevated rates of substance misuse disorders (SUDs) and partner violence (Kelly et al. 2011). However, the association with IPV is complicated as SUDs are not necessarily the cause but will contribute to the presence of aggressive behaviors (Kelly et al. 2011). Sexual minority people are at increased risk to SUDs which suggests that minority stress and lifestyle options are the reasons for this (Hughes et al. 2010; Kelly et al. 2011). If minority stress does place an individual at greater risk of SUDs, supporting services need to be mindful of the enhanced vulnerability bisexual people may have in light of their exposure to double minority stress and the role this may play in both perpetration and victimization. For instance, Kelly et al. (2011) suggested that victims might use drugs to cope with feelings of shame, and perpetrators use to cope with feelings of guilt. Specific types of abuse also increase bisexual peoples’ risk to SUDs. Bisexual women have been identified as being at greater risk of victimization and SUDs when they have experienced child and adult sexual abuse, IPV, and assault with a weapon (Hughes et al. 2010). The same work identified that being assaulted with a weapon had a strong effect on determining SUDs for bisexual males. For substance abuse services where an individual is able to identify as bisexual, it may be imperative that the person be screened for IPV and/or assault with a weapon to ensure the provision of appropriate, holistic support.

Getting Help Positive and validating experiences of assistance are key for helping bisexual people move away from an abusive relationship (Head and Milton 2014). Therefore, it is important to consider what might impede access to such help. Additionally, some suggestions on how to enhance bi-affirmative support for bisexual victims of IPV to facilitate a more timely exit from an abusive relationship will be provided. As with other sexualities, isolating bisexual people from support has been found to be key for facilitating ongoing abuse, as it prevents people from exiting abusive relationships sooner (Bornstein et al. 2006; Head and Milton 2014). Likewise, a bisexual person will only activate help-seeking when things have become so difficult for them that they are no longer able to deny their abusive experience to themselves. This stage has been identified by Head and Milton (2014) as “Lifting the Veil”. It is at this stage that they will be able to engage in a bi-directional approach to help (Turell et al. 2012), and they will likely approach a range of sources that are both professionals, peers, and acquaintances (Head and Milton 2014). However, bisexual people have reported that their requests for help are not always met (Head and Milton 2014).

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Key barriers to help-seeking in bisexual IPV. Carlton et al. (2016) identified three key barriers to help-seeking for IPV in the LGBT population: limited understanding of the phenomena, stigma, and systemic inequalities. The LGBT population is minimally aware of IPV within their “community” (Turell and Herrmann 2008). This may be even more so for bisexuals due to the invisibility that exists around bispecific IPV. Queer services are thought to provide access to a shared sense of understanding with others utilizing these provisions (Bornstein et al. 2006). Therefore, it is unlikely that the LGT population would access mainstream, macro IPV support services (Bornstein et al. 2006; Turell and Herrmann 2008). This may be a falsehood for bisexual people though; seemingly, not everyone enjoys equal membership to the LGBT population. Bisexual people report feeling uneasy within LGBT spaces (Bostwick and Hequembourg 2014) and tend to be less engaged with “community” events (Pew Research Center 2013). Due to the low levels of acceptance bisexual people experience from the LGBT population (Pew Research Center 2013), they may feel less able to seek support from the LGBT community at times of personal crisis due to biphobia (Turell and Herrmann 2008). Matters are further complicated by the societal view that bisexuality is a phase, and (for example, if a bisexual woman is leaving a relationship with a male partner) they may be perceived by the LGBT population as heterosexual and thus denied support by the LGBT population (Bermea et al. 2018). Bisexual women who are survivors of IPV are known to seek help at a much higher rate than other sexual minority groups (Furman et al. 2017; SafeLives 2018). This finding queries the applicability of Carlton et al.’s (2016) third barrier to help for bisexual people: systemic inequalities. Bisexual people use similar support systems as lesbians and heterosexual women when attempting to identify their abusive experience (Baly 2010; Head and Milton 2014; Renzetti 1992). Bisexual women report that their experience of IPV is often disbelieved by the queer community. This is thought to occur because the LGBT population has a fear of disrupting the ideals of non-heterosexual relationships (Bermea et al. 2018). Therefore, if their experience of IPV is denied by a listener, and a bisexual person is in an opposite-sex relationship, they will activate their heterosexual privilege to access mainstream, non-LGBT services for help (Bermea et al. 2018; Head and Milton 2014). In early instances of help-seeking and at a time of vulnerability and personal crisis, it is possible that in colluding with heterosexist assumptions, bisexual people may minimize their exposure to biphobia. Whilst a non-LGBT service might be a helpful starting point for a bisexual person, SafeLives’ (2018) National Scrutiny Panel found limited knowledge among non-LGBT domestic violence services about specific issues faced by LGBT survivors. Consequently, when accessing non-LGBT IPV services, bisexual people may not have their abusive experience correctly identified or have their needs appropriately supported. Models of help-seeking behaviors. Considering the above, it is proposed that Carlton et al. (2016) three barriers to help-seeking need to be considered within a sexuality-specific context as the barriers faced are not homogeneous in the LGBT population. In addition to this, the generalizability of Turell and Herrmann (2008) Diamond Model of lesbian and bisexual help-seeking for IPV needs to be reviewed. In

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this model, Turell et al. (2008) posit that lesbian and bisexual women seek help from individuals who identify as LGBT in the short and long-term with generic services offering a middle phase of support. From the bi-specific barriers mentioned here, and from the fledgling research into this topic, it is proposed that the help-seeking model for bisexual people begins with any person or service that validates their experience of IPV regardless of sexual orientation. Further research is required to identify and clarify the bisexual help-seeking journey before a diagrammatic model can be developed. Shelters. When fleeing or leaving an abusive relationship, a key factor is having a safe place to run to. In the US, Messinger (2011) states that LGBT-specific shelters do not exist which echoes the situation in the UK where less than one percent provide specialised LGBT support (Head and Milton 2012; Smith and Miles 2017). NCAVP (2016) found that only 27% of their LGBTQ sample attempted to access a shelter, with 44% of them being denied access due to their gender. Sex-segregated emergency shelters are problematic for LGBTQ people and for bisexual women where 20% identify as non-gender conforming (Bermea et al. 2018). This pattern of shelter non-entry for LGBTQ people is mirrored in the UK (House of Commons 2016). Tragically, these findings support the assumption that emergency shelters do not cater to non-heterosexual people. Utilizing gender-based shelter provision is demonstrative of the heteronormative, patriarchal paradigm of domestic violence that does not serve all survivors of abusive relationships (least of all those who identify as male). Even when access is possible, some find shelters to be a threatening place. Lesbian, bisexual, and trans women stated that they would be less willing to access shelters as they felt it was not possible for their abusers to be screened out (Bornstein et al. 2006). How can we make shelters more accessible for sexual minority people? Turell and Cornell-Swanson (2005), while recognizing that LGBT IPV is not homogenous, recommend a focus on resourcing staff and service providers through training rather than developing LGBT-specific shelters. At a time of scarce public and third sector funding, this is a more viable option than developing LGBT-specific shelters. Once a person’s sexual orientation has been identified in a sensitive and open manner, Rollè et al. (2018) recommend the use of more inclusive language and a shift towards focusing on the experience of the individual to help make a shelter more comfortable for a sexual minority person. In practice, this would require a lead professional/case worker to ensure that support is tailored to an individual and that any rising concerns are managed (e.g., the entry of a perpetrator or confidentiality breach). In line with what has been mentioned previously, it is proposed that staff be trained in abuse tactics and dynamics specific to each distinct sexual orientation (where possible). Adolescents. Within the adolescent and young adult population, Edwards and Sylaska (2013) suggest that internalized homophobia is the greatest risk factor for IPV. Internalized homophobia or stigma has been found to prevent disclosure and enhance self-blame (Balsam and Szymanski 2005; Edwards et al. 2015). Internalized stigma makes resilience even harder in the face of adversity (Hendricks and Testa 2012) and may help explain why young bisexual people, who are going through the process of attempting to clarify their sexual orientation, find that this period of

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uncertainty acts as a barrier to them accessing help when in an abusive relationship (SafeLives 2018). Interventions during this life stage might be enhanced if the outcome aims to reduce double-minority stress factors for bisexual people. Racial and ethnic minorities. Historically, services in the US have been shaped by white culture, but there are cultural implications around how ethnic minorities use services due to cultural perceptions around IPV and a person’s willingness to access both mental health and other support services (Modi et al. 2014; Rodriguez et al. 2009). Though not bi-specific, the intersection of race and ethnicity also informs help-seeking behaviors. Help seeking was found to be very strong in Hispanic women, but there were distinct discrepancies across ethnic groups (Rodriguez et al. 2009). For instance, some ethnic groups choose the community over an individual. Consequently, if a perpetrator is of the same racial or ethnic community as the survivor, disclosure may feel like a betrayal to the ethnic (as well as LGBT) population (Turell and Herrmann 2008). Therefore, bisexual (or LGT) people of minority ethnicity may face additional barriers to accessing help and support. Services, thus, need to be aware of the cultural demographics of their LGBT population to take into consideration how help-seeking may present at a micro level. It is also possible that concerns around deportation may prevent help-seeking from people of an ethnic minority, especially if a person’s visa status is dependent upon their (abusive) partner.

Implications for Screening, Practice, and Interventions Conversations about heterosexual domestic violence are inherently difficult. Having conversations about intimate partner violence within a sexual minority context may feel overwhelming for many professionals. It is believed that current services lack the sensitivity and training to deal with sexual minority IPV (Duke and Davidson 2009). For the bisexual population, the systemic silence and lack of understanding into the dynamics of bisexual IPV may compound why service provision is still inadequate (and lacking) for bisexual survivors and perpetrators. Recognizing that bisexual IPV is not about genders, but power and control, is helpful for the bisexual population as it makes gender stereotypes redundant which will enhance visibility of the partner abuse that is more common for the bisexual population (Cannon and Buttell 2015). To provide appropriate professional support for bisexual survivors and perpetrators of IPV, it is proposed here that four levels of training are required: human sexuality and its diversity; generic understanding about domestic violence; sexual minority IPV; and sexuality-specific abuse, risks, tactics and dynamics. The American Psychological Association (2011) and the British Psychological Society (2019) provide practice guidelines for psychologists working with sexually and gender diverse clients. Specific training for this client group is recognized as important to ensure that practitioners can work in a respectful and inclusive manner. For counselors to overcome heterosexist practice, Troutman and Packer-Williams (2014) propose that student counselor programs go beyond minimum requirements to ensure that culturally proficient training is provided to develop competent counselors for the LGBT

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DomesƟc Violence: Training in the heterosexual patriarchal, feminist informed, power and control model

Same-sex IPV: Training in minority stress, heterosexual privilege, homophobia, queer informed and mono-sexual models of IPV

Bi-specific IPV: Training in risk status, double-minority stress, biphobia, bisexual model of IPV, bi-specific abuse tacƟcs

Fig. 2 Proposed three-step training approach to educate about bisexual IPV

population. In their systematic review, Sekoni et al. (2017) found that for healthcare students with LGBT-specific healthcare training, students could incorporate more inclusive values and attitudes towards LGBT clients in their practice. As bisexual people, will approach non-LGBT and queer services (Bornstein et al. 2006; Head and Milton 2014), all professionals who might encounter partner violence and abuse would benefit from training that incorporates the following three-step approach (Fig. 2). The rationale behind this approach is that through step one, a professional is provided with the foundation from which they can identify an abusive relationship. Then, if working with a person who does not identify as heterosexual, training from the following two steps ought to provide some appropriate insight so that they are in a position from which they can help a person make sense of their difficult experience. The aim of the third step (which ought to cover all sexuality specific IPV training but due to the topic of this chapter, focuses on bi-specific IPV), is to help a professional tease apart the nuances of bi-specific abuse to ensure that a person’s experience is validated and responded to in the most appropriate way. Such a comprehensive training would enable staff to sensitively approach topics of sexuality and IPV which is vital to reduce barriers and survivors’ fears about facing stigma and discrimination at such a vulnerable time. It may be possible that queer services naturally default to this type of training considering their specialism and, as such, don’t make assumptions that are more common in non-LGBT organizations. This training is much needed as negative experiences of therapy were had when counselors and therapists were unable

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to accurately recognize a person’s situation as abusive and lacked the awareness of bisexual-specific abuse tactics (Turell et al. 2012). Service provisions and expectations. Support services and providers may be unrealistic about the readiness of bisexual people and the LGBT population to recognize and address issues of sexual minority IPV. This further emphasizes the need for professionals to be able to identify an abusive relationship as those within one, may genuinely not be aware of this. Turell et al. (2012) propose that services would do well to assume lower levels of readiness than presumed, so it would be appropriate to implement strategies to raise readiness for addressing sexual minority IPV. They suggest a three-level approach to building readiness in the LGBT population. Level one: build awareness within LGBT communities regarding IPV. Level two: develop the capacity of LGBT organizations, groups, and leaders within the LGBT population to respond to IPV within the community (e.g., distributing leaflets, publishing articles, presenting information about local related community groups). Level three: initiate events and ask for time on local groups’ meeting agendas to discuss the topic. To help support against increasing biphobia within the LGBT population, it is proposed that the homosexual profile of IPV be raised first. Once accepted and acknowledged by the LGBT population, there may be more willingness and less stigma to help raise the profile of bisexual, trans, and other minority orientation IPV. Service provision that provides community-based interventions shaped by bisexual peoples’ experience of IPV would be the ideal. However, to get to this point, it has been suggested that sites be developed where people can go to help reduce their sense of isolation and explore their experiences openly and in a non-judgmental way (Bornstein et al. 2006). In practice, this would require an organizational commitment to developing grass-roots connections and advocates in local bisexual communities so people are aware such a place exists. To help develop services, and in the absence of local programs, the distribution of information about national best practices can be helpful (Turell et al. 2012). Bornstein et al. (2006) provides examples of innovative practice such as that demonstrated by the North-West Network who developed the FAR Out (Friends Are Reaching Out) Project that works with survivors and their existing friend and family networks to develop more meaningful, open, and honest connections to help support a survivor. Building upon existing relationships could sustain a person in an abusive relationship and be imperative for helping them to “lift the veil” to end abusive relationships with a support network in place. From a service perspective, this approach is economic and would outlast any provision a service could offer. The North-West Network has also developed a Relationship Skills Class Curriculum which has its basis in survivor experience. The curriculum covers a range of topics with the view to help the LGBT population understand and learn about healthy LGBT relationships. Organizations that run IPV interventions should also consider running classes for their local LGBT population to help develop understanding and connections. Communication and disclosure. To disclose one’s sexuality to a professional, is risky; you never know what beliefs (and stigmas) they may hold. Disclosure to a person who holds negative views of the LGBT population could result in invalidation,

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judgment and rejection from someone whose help you need at a desperately vulnerable time. Consequently, training for professionals in sexual diversity is imperative to ensure that personally help beliefs are recognized, explored and updated to incorporate more inclusive values informed by LGBT culture. If, for whatever reason, a professional is unable to work in a supportive, non-judgmental way with the LGBT population, they need to recognize the limits of their practice and refer clients to a colleague who can approach working with sexuality and gender diverse clients, from a more supportive and understanding position. If a person feels able to disclose that they are bisexual to support services, sensitive screening for IPV ought to become routine due to bisexual people being at high risk for IPV (Walters et al. 2013). By no means does this imply that all bisexual people will have experienced intimate partner violence. However, to not inquire may delay or prevent a person’s access to help. Goldberg and Meyer (2013) proposed that, for bisexual survivors, services need to screen historical as well as current relationships, especially if previous partners have been opposite-sex. Considering this information, how do you start to ask about bisexual IPV? Language is key for helping people to identify and understand their experience. The relationship between labels and their ability to identify a person’s experience of IPV is difficult and can lead to a mismatch between a person having experienced abuse and labeling their experience as such (Valentine and Pantalone 2013). Head and Milton (2014) found that their bisexual participants did not identify with the concept of their relationship being “violent.” Instead, they more readily identified their experience as “abuse.” This was due to the participants reporting that they typically experienced psychological abuse and the term violence was thought to pertain more to physical abuse. However, for bisexual people, such a variation in the label may be gender specific. For instance, we know bisexual women are at greater risk of emotional abuse, so they could benefit from the term “intimate partner abuse” to help identify their experience of IPV. However, for bisexual males who are at greater risk for physical abuse, they may benefit from the term “intimate partner violence” to help identify their experience of IPV. While labels are a starting point to enable someone to identify the dynamics of their romantic relationship, it is their experience of the abuse that determines future adjustment (Valentine and Pantalone 2013). This identifies the importance of having a conversation with a survivor about the abuse that they have experienced and the impact it has had upon them. If screening tools are used, they ought to include openended questions that demonstrate insight into bi-specific abuse tactics and dynamics as well as facilitate a conversation about how a person experienced their abuse. In turn, this should provide richer information about the types of treatment or support options a person may benefit from, rather than assuming a one-size fits all mentality (e.g., all members of the LGBT population receiving same-sex partner support). Possibly in response to the lack of routine screening for men who have sex with men (compared to American Medical Association-endorsed IPV screening for women in Emergency Room and Ambulance services), Stephenson et al. (2013) has produced a brief six question screening tool. The questions on this screening tool are closed but, if used clinically, any affirmative questions might facilitate a dialogue between a survivor and a professional. With bisexual males being at heightened risk for serious

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physical abuse (Walters et al. 2013), screening for IPV needs to be completed by medical services and ambulances. An additional role for health professionals may be related to the high levels of sexual violence bisexual people experience which places them at high risk of HIV transmission. Health professionals also need to screen for safe sex practices and, if absent, should support people with developing safer sex safety plans that facilitate negotiation between partners which can protect them from sexually transmitted diseases (Heintz and Melendez 2006). Sexual minority youth. Teen dating violence could be perceived as a developmental stepping stone towards adult IPV (Dank et al. 2014). To change the trajectory of IPV for bisexual people, interventions need to target adolescents and young adults. Perpetrator behavior in emerging sexual minority youth has been found to be stable and consistent over time (i.e., being a perpetrator of sexual minority dating violence will likely lead to a sexual minority adult who perpetrates IPV) (Shorey et al. 2017). This provides supporting evidence for early help intervention where a sexual minority youth who perpetrates dating violence needs to be identified and supported to prevent repeating abusive dynamics in later life. Fortunately, there is an emerging body of evidence that can help inform interventions and service provisions for young bisexual people. Bisexual adolescents were found to get help primarily from female friends (Freedner et al. 2002; Jones and Raghavan 2012) with social support acting as a buffer against IPV for LGBTQ college youths (Edwards et al. 2015). Consequently, developing educational programs for middle school-aged children (11–13 years old), about supporting friends and developing healthy romantic relationships (heterosexual and LGBT) could help enhance the support system for bisexual adolescents (Plitcha 2018). In the UK, Bradlow et al. (2017) found that healthy relationships and safe-sex education for same-sex relationships has taken place for 11–19-year-olds in schools. Though unintentional, such an approach from a key LGBT organization colludes with the invisibility of other sexual orientations and the perceived rights of these young people to have healthy romantic relationships. Moreover, protective factors against dating violence have been identified for sexual minority youth. Higher rates of parental acceptance and identifying with a specific sexual orientation group acts as protective barrier against poor mental health and a range of physical health difficulties (Ryan et al. 2010). These factors may also be indicative of a lower tolerance for abusive relationship dynamics for adolescents who have greater support systems, self-esteem, and resilience. Larger schools have also been identified as a protective factor for sexual minority youth (Halpern et al. 2004). It was believed that a larger school equates to greater anonymity/sexual diversity, greater exposure to healthy role models, and increased partner choice (Halpern et al. 2004). However, the applicability of this study for the bisexual adolescent population is questionable as they adopted a behavioral definition of sexual orientation and opted to omit participants who reported having partners of both genders.

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Criminal Justice Response and Policy Implications Police interaction with the LGBT community. Whilst societal attitudes towards the LGBT population are increasingly favorable (Kenny and Patel 2017; Park and Rhead 2013), there is a long history of mistrust with law enforcement (Aldridge and Somerville 2014; Briones-Robinson et al. 2016). Of LGBT survivors who had contact with the police, 48% reported police misconduct (Mallory et al. 2015) and high levels of dissatisfaction were common (Aldridge and Somerville 2014; Hunt and Fish 2008). Often, a request for help involves a person having to “out” their sexual orientation to police who have a historical background of stigma and discrimination against sexual minorities. Understandably, disclosure of a sexual minority status to such an audience at a time of heightened personal distress is incredibly challenging. Even after disclosing sexual orientation, police have demonstrated that in cases of LGBT IPV, the survivor was arrested 29.7% of the time (NCAVP 2016). According to Russell (2018), police perceptions about IPV are gender based and rely largely upon feminist ideology (Hamel and Russell 2013). In the US, many local and state agencies focus their training on the heterosexual model of domestic violence (Hamel and Russell 2013) with no acknowledgement of power and control wheels for female perpetrators, lesbians, gays, bisexuals, or transgendered people (Hamel and Russell 2013). The impact of this is if police are called for support regarding an abusive or violent partner situation, they implement a gender bias and are more likely to arrest the male partner (Russell 2018). Hamel and Russell (2013) also found no guidance is given to police in their training manuals on how to approach and manage same-sex partner violence. This is problematic as evidence suggests that men and women, as well as LGBT and heterosexual people, are victimized at similar rates (Black et al. 2011; Hamel and Russell 2013). Therefore, such poverty of training and preparation will likely prevent accurate assessment of a mixed-gendered relationship in which the male is bisexual. Considering this, it would be pertinent to investigate the arrest rates of bisexual males who are in opposite-sex relationships as they are more likely the victim than the perpetrator. Moreover, a bias towards perceiving male homosexual violence as less severe is evident as police are more inclined to provide informal advice and mediate than make arrests (Russell and Sturgeon 2018); a concerning notion as IPV against males is on the rise (Walters et al. 2013). With these problems in mind, it is evident that police forces need to look beyond gender stereotypes to ensure the safety of IPV survivors, and to make accurate risk assessments of their own danger (Russell 2018). To facilitate this, there is a need for community response training and guidance around the type and dynamics of the abuse a bisexual (and other sexual minority) person will experience (Cannon et al. 2016). Considering the guidelines and training that police have in many US states—which is setting them up to fail sexual minority people who experience IPV— Hamel and Russell (2013) have called for police training manuals to be updated with empirical research findings, peer-reviewed studies, and theoretical underpinnings that reach beyond the traditional feminist perspective of domestic violence/partner abuse.

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Improving police relationships with the LGBT community is possible. Whilst not an isolated example, in the Brighton and Hove area in England, a lot of work has been invested to improve relations through enhanced police support for the local LGBT population. This approach has resulted in high levels of IPV reporting to the local police constabulary (Browne and Law 2007). Building upon this, police outreach needs to continue to show support for their local LGBT populations and form connections with the community through the utilization of their LGBT liaison units (where these exist) or through attendance at community events. Aldridge and Somerville (2014) encourage police to adopt a coordinated response with medical institutions and domestic abuse agencies representing both queer and non-LGBT, thereby ensuring appropriate and timely responses for those in need of help. Where constabularies in the UK have Lesbian and Gay Liaison Officers (LAGLOS), they are trained in the use of non-gendered, open questions to help inform police response (e.g., “can you tell me who hit you?” rather than “did your husband hit you?”). The intersection between the courts and the LGBTQ community. In the US, without clear LGBTQ guidance for eligibility of a protection order, many states review LGBTQ requests on a case-by-case basis. Such a position has led to large numbers of requests being deemed ineligible due to the assumptions and personal biases of the judge reviewing a case. Potoczniak et al. (2003) suggest that those cases deemed ineligibility is more reflective of a judge’s level of homonegativity and bias than the fair and impartial rule of law. Even when an LGBTQ case goes to court, jurors have been found to view the abuse as less serious than heterosexual domestic violence (Hill 2000). In general, it was found that being perceived as homosexual (but without clarification of a person’s sexual orientation)—as either the victim or defendant—is a disadvantage in the court room (Hill 2000); jurors tend to rule in the favour of those they deem to have high moral character (Potoczniak et al. 2003). Considering the social stigmas and negative assumptions bisexual people experience, they may be perceived to have the lowest moral character compared to other sexual orientations placing them at further disadvantage if they were to “out” themselves as they attempt to explain the impact of bi-specific abuse tactics. In England and Wales, the Domestic Violence, Crime, and Victims Act (2004), ensures that cohabitants as well as those in civil partnerships and marriages have access to protection and non-molestation orders. Such an approach lends itself to survivors being protected against the biases, or beliefs, of an individual judge.

Researching, Capturing, and Understanding the Bisexual Experience Conceptualizing the bisexual experience. Bisexuality is not a homogeneous sexual orientation category (Galupo et al. 2017). If we are to bring the bisexual experience of IPV into social consciousness, we need to move towards a more open-ended categorization to capture the spectrum of this sexuality. From an empirical research

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perspective, this is problematic as the current narrow bisexual categorization does not truly reflect the bisexual population. Considering this, we need to carefully reconsider how research can capture the bisexual experience. One suggestion is provided by Galupo et al. (2017), who found that people with partners of multiple genders tend to use multiple labels for identifying their sexuality. As such, they proposed a more “plurisexual” category to capture the variety of experiences within bisexuality. Future research needs to consider the implications labels might have on valid recruitment samples and be aware that mislabeling could skew data. Thus, historical research, without such careful consideration of their bisexual categorization, needs to be interpreted with caution for its validity and generalizability to the bisexual population. Review and utilization of batterer/perpetrator programmes. Batterer (hereafter will be referred to as “perpetrator”) programmes need to be reviewed for their validity to the LGBT or female populations, as group programmes are typically based within the patriarchal Duluth model (Kernsmith and Kernsmith 2009). Adopting such a one size fits all approach has proven to be ineffective (Kernsmith and Kernsmith 2009) and lacks the contextual sensitivity required when working with any relationship that falls outside of heteropatriarchal assumptions. Where adaptations have been made, they were found to be largely superficial—for example, leading to changes in the use of language to adapt the Duluth model rather than adaptations being made for cultural sensitives distinct to each sexuality (Cannon et al. 2016). Many providers did not believe that they had the resources available for sexual minority perpetrators, nor was it felt that there was a sufficient need for this population (Cannon et al. 2016). These ideas run contrary to the high prevalence rates of sexual minority IPV (Walters et al. 2013) and may instead be indicative of poor relationships between local LGBT populations and services rather than an absence of need. In reviewing perpetrator programmes that have been run for the LGBT population, only one percent of the sample population identified as bisexual in Cannon and colleagues’ study (2016). Such a finding suggests that bisexual perpetrators are not accessing the programmes as evidence is supportive that bisexual people can be perpetrators as well as survivors of IPV (Messinger 2011; Reuter et al. 2017). Considering this, it is appropriate to propose that a curriculum of perpetrator programmes be developed to incorporate multiple factors including, at a minimum, sexual orientation and gender. Staff who run perpetrator programmes will need to receive training on the differences that exist within abusive relationship dynamics for bisexual couples and other sexual orientations. To enhance staff compassion, training around societal pressures, stigmas, and discriminations that exist both within the general and LGBT populations would also be beneficial for group members. When running groups for the LGBT population, maintenance of confidentiality is vital for group membership as well. Since local LGBT populations tend to be small, this increases the possibility perpetrators may encounter a person who is in some way connected to their survivor when in a group setting. Due to the stigmas and discriminations that exist within the LGBT population, bi-, trans-, and homophobia need to be addressed and challenged—both within organizations and groups—to ensure a genuinely safe space for all.

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The exigency for future research. In the absence of relevant literature, there is an enormous need for further research into bisexual intimate partner violence. For instance, both bisexual men and women report having only one perpetrator of IPV (Barrett and St. Pierre 2013). What is the protective factor within bisexuality that safeguards against multiple abusive relationships? It is still too early to be able to develop a comprehensive review of the intersectionality of bisexual IPV. The evidence base is still too interwoven with other sexualities for a clear intersectional bisexual understanding to be deciphered. However, intersectionalities of bisexuality need to be identified and embraced in future work. There is still a paucity of work for transgendered people who self-identify as bisexual as well. A starting point for such work may be the amalgamation of trans-specific abuse tactics (FORGE 2013) and the bisexual IPV model proposed by Head and Milton (2014). We need to seek out and identify how bisexual people experience both heteronormative and LGBT services. While aware that there is a sense of dissatisfaction within the LGBT population, we have not yet heard a distinct bisexual voice about whether this is the bisexual experience. There is also an urgent need for longitudinal work into bisexual IPV. For instance, in adolescence, abuse tactics were found to be more physical (Edwards et al. 2015) but in adulthood, this has been seen to evolve into greater levels of emotional abuse (Head and Milton 2014; Walters et al. 2013). When and how does this evolution of abuse tactics occur? Does the mutual battering seen in sexual minority youth (Plitcha 2018) continue into bisexual adulthood? Balsam and Szymanski (2005) found that in a longitudinal sample, bisexual men and women were not only at greater risk of childhood violence and IPV (due to LGBT status), but were specifically higher in risk for certain types of violence—such as sexual coercion and rape—compared to homosexual participants. Is it possible to repeat this study with a purely bisexual sample to ascertain the reliability of the finding and, if appropriate, to implement sexual health management training in schools to create protective factors for bisexual youth? The possible research questions into bisexual IPV are endless as we still know so little about the phenomenon. For example, current literature into bidirectional IPV does not even isolate results to sexual orientations, but instead categories according to partner’s gender (Bartholomew et al. 2008; Langhinrichsen-Rohling et al. 2012). Therefore, it is difficult to draw conclusions for the bisexual population from the current evidence base available for bidirectional IPV. However, considering the vulnerabilities the aforementioned work has identified, it is imperative that academics and researchers explore bidirectional IPV within the bisexual population. Ultimately, this chapter attempts to identify the vast absences of information and seeks to invite future research to inform paradigms, service provisions, and support for those bisexual people whose lives are impacted by IPV. In recognition of the underrepresentation of the bisexual population in IPV literature, Bermea et al. (2018), completed an empirical review of bisexual womens’ experience of IPV. Of the 36 articles published between 2000 and 2016, there was little bisexual representation in the samples and only one study utilized an entirely bisexual sample (Head and Milton 2014). This qualitative study sought to develop

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a model to explain the psychological process of both male and female biseuxal survivors of IPV. The invisibility around male, transgender and non-binary bisexual IPV is staggering. This is perhaps demonstrative of how identifying with a female gender is a more accepted factor for exploring abusive romantic relationships, thus research adheres to the societal narrative of a patriarchal model of abuse for bisexual people (Bostwick and Hequembourg 2014). For bisexual people who do not identify as female, such positioning enhances the possibility that they remain in an abusive relationship due to their lack of insight (and external support) for what they are experiencing. Head and Milton’s (2014) bisexual model of IPV is in no way complete; it omits to use an intersectional approach but instead uses bisexuality as focus for explaining IPV. We know that sexual orientation as the dominant factor, produces inconsistent results (Reuter et al. 2017). Therefore, future work needs to develop a more integrative, intersectional, psychosocial model to understand bisexual IPV, accounting for a range of factors to include sexual behaviors (e.g. polyamory), mental and physical health, age, sociodemographic, race, ethnicity, HIV status, etc. Developing insight into bi-specific factors and their relational effect, it is hoped that it will become more possible to identify and understand the protective factors, risks, and dynamics within bisexual IPV. From this more informed position, we will be better placed to offer more appropriate support and interventions. As of yet, there is no literature available on bisexual perpetrators of IPV. This may feel like a charged topic considering the invisibility and discrimination that bisexual people experience. However, if we consider disempowerment theory, a natural research question for such a disempowered sexual orientation would be: does the bisexual population have an increased probability of perpetration? Emerging work does provide us with some foundations for such a question. For instance, Reuter et al. (2017) found that adolescent bisexual people were more likely to be perpetrators of abuse than their gay or lesbian peers. Additionally, Bartholomew et al. (2008) found that internalized homophobia was a significant factor for perpetration, not victimisation, and proposed that people often under report their perpetration of partner violence. Considering the extent of biphobia and binegativity present in society, it is possible that bisexual people are very vulnerable to internalised biphobia and, as such, it is suggestive of future research needing to consider the potential for bisexual people being perpetrators of IPV.

Conclusion Through this chapter, it has become evident that bisexual IPV consists of complexities beyond the scope that monosexual and heteropatriarchal models of IPV can explain. With this awareness, future work needs to transition from these paradigms to develop models that incorporate psychosocial factors to better capture the experience of IPV for a broader range of gender and sexual orientations.

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The information provided here challenges the default position of “no need” that many non-LGBT and LGBT organizations adopt regarding bisexual IPV. Considering the enhanced minority stress that bisexual people face, service development and support agencies need to ensure that interventions are informed by local-level need. As such, this will target the appropriate level of readiness to enhance the potential for positive change. To determine local levels of readiness for LGBT populations, it is proposed that support services and organizations engage meaningfully with their LGBT population. Developing these grass-roots relationships will empower local LGBT populations to identify their needs and help lead change. Considering the lifetime risk bisexual people have for abuse in their romantic relationships, there is a desperate need for education about healthy bisexual relationships. Ideally, such a programme would be delivered to children from the ages of 11+. With the more recent development and acceptance of healthy same-sex education programmes, we now need to provide information about healthy relationships that covers not just bisexuality, but a broad range of sexualities and gender identities. Within the UK, our legal system is supportive of such a change, but social stigma may be preventing the development of such programmes, thus leaving future generations of sexual minorities at risk to IPV. Awakening both general and LGBT society to the presence of bisexual intimate partner violence will be met with resistance. Thus far, this resistance has taken the form of silencing: bisexuality and bisexual IPV is denied. For too long, the fear and discomfort around possibly enhancing or facing biphobia has taken precedent over the needs of bisexual people who are especially vulnerable to partner abuse and violence. Bisexual people and their allies (professional as well as personal) need to come together to support each other so that the needs and vulnerabilities of bisexual people can be seen and heard.

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Sarah Head is a Chartered Counselling Psychologist based in London and has worked therapeutically with clients across the lifespan. Currently, Sarah works therapeutically with children as a Clinical Lead in the public health sector. Sarah is an Associate Lecturer for the University of Surrey and Regents University, London. She has published peer reviewed articles on the topics of Bisexual IPV and LGBT IPV within the UK.

Chapter 8

Help-Seeking Barriers Among Sexual and Gender Minority Individuals Who Experience Intimate Partner Violence Victimization Jillian R. Scheer, Alexa Martin-Storey, and Laura Baams

Sexual and gender minority (SGM) individuals (e.g., those who may identify their sexual orientation as lesbian, gay, bisexual, pansexual, or queer, and their gender identity as transgender or gender nonbinary) disproportionately experience potentially traumatic events compared to heterosexual and cisgender (non-transgender) individuals (Alessi et al. 2013; Brown and Pantalone 2011; Katz-Wise and Hyde 2012; Roberts et al. 2010). Intimate partner violence (IPV) victimization refers to the systemic use of physical, sexual, emotional, psychological, and economic abuse with the intent to harm, threaten, control, isolate, restrain, or monitor another person in an intimate partnership or dating relationship (Jewkes 2002; Sullivan 2019). Notably, IPV represents one of the most common forms of interpersonal violence faced by SGM individuals compared to hate crimes, childhood abuse, and non-partner physical abuse (Brown and Herman 2015; Roberts et al. 2010). Despite SGM individuals’ heightened risk of IPV victimization, the feminist paradigm’s exclusive focus on IPV victimization among cisgender, heterosexual women perpetuate heteronormative biases and fails to accurately capture IPV among SGM people (Brown and Herman 2015; Langenderfer-Magruder et al. 2016). J. R. Scheer (B) Center for Interdisciplinary Research on AIDS, Yale School of Public Health, Yale University, 135 College Street, New Haven, CT 06510, USA e-mail: [email protected] A. Martin-Storey Department of Psychoéducation, Université de Sherbrooke, 2500 Boul. de l’Université, Pavillon A7, Sherbrooke, QC J1K 2R1, Canada e-mail: [email protected] L. Baams Department of Pedagogy and Educational Sciences, University of Groningen, Grote Rozenstraat 38, 9712 TJ Groningen, The Netherlands e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_8

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Consistent evidence demonstrates mental and physical health consequences of IPV among SGM youth and adults including posttraumatic stress disorder, depression, anxiety, substance use, chronic health conditions, HIV, and suicidality (Bostwick et al. 2010; Miller et al. 2016; Scheer and Mereish in press; Woulfe and Goodman 2019). Moreover, mental and physical health consequences of IPV victimization are amplified for racial and ethnic minority SGM individuals, given their experiences of multiple interlocking systems of oppression (i.e., racism, sexism, homophobia, transphobia; Grant et al. 2011; Miller et al. 2016). In addition, psychosocial risk factors for experiencing IPV victimization among SGM individuals include lower socioeconomic status, younger age, substance use, low self-esteem, risky sexual behavior, HIV positive status, childhood abuse, and a history of sex work and incarceration (Finneran and Stephenson 2013). Social support networks and formal services reflect critical components to improving the mental health and safety of IPV survivors (Coker et al. 2002). Given the widespread health consequences of experiencing IPV victimization among SGM individuals, intervention and prevention strategies should identify readily accessible and culturally competent services for this population (Calton et al. 2016). Nevertheless, SGM individuals experiencing IPV victimization face unique individual-, interpersonal-, and systemic-level barriers to accessing informal and formal support services needed to recover from abuse (Edwards et al. 2015; Helfrich and Simpson 2006). In this chapter, we provide an overview of IPV victimization prevalence rates among SGM individuals in the context of the minority stress framework and highlight unique forms of IPV victimization affecting this population, namely identity abuse. We review the literature on help-seeking processes among IPV survivors in general and discuss help-seeking patterns specifically among SGM individuals who experience IPV victimization. Next, we highlight SGM individuals’ IPV-related help-seeking barriers in the context of minority stressors (e.g., discrimination, internalized stigma, rejection sensitivity, concealment). We cover empirical evidence on the minority stressors at individual, interpersonal, and structural levels that act as barriers to help-seeking among SGM individuals who experience IPV victimization. Finally, we review emerging evidence for interventions aimed to reduce help-seeking barriers among SGM individuals experiencing IPV victimization and conclude with a discussion of future research directions on help-seeking barriers in this population.

IPV Victimization Prevalence Among SGM Individuals Documenting the prevalence of IPV victimization experiences among SGM individuals is necessary to advancing knowledge of how best to serve and support this population. Epidemiological research suggests that SGM individuals experience IPV victimization at higher rates compared to cisgender, heterosexual individuals (Centers for Disease Control and Prevention [CDC] 2010). According to the National Intimate Partner and Sexual Violence Survey, bisexual (61%) and lesbian women

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(44%) reported experiencing IPV victimization compared to 35% of heterosexual women (Walters et al. 2013). In addition, 63% of gay and bisexual men, compared with 29% of heterosexual men, reported experiencing IPV victimization (Walters et al. 2013). Further, sexual minority women assigned female at birth are at heightened risk for experiencing sexual IPV victimization compared to sexual minority men and heterosexual men and women (Messinger 2011; Whitton et al. 2019). Findings also suggest that sexual minority youth are at an increased risk of experiencing IPV victimization compared to cisgender, heterosexual youth (Edwards et al. 2015; Martin-Storey 2015). One study found that sexual minority youth reported physical IPV victimization (43.0%), psychological IPV victimization (59.0%), and sexual IPV victimization (23.0%) at greater rates than heterosexual youth, who reported rates of 29.0%, 46.0%, and 12.0% for IPV, respectively (Dank et al. 2014). Determining accurate estimates of IPV victimization among gender minority populations remains difficult due to a lack of studies with representative samples. In fact, excluding gender minority individuals from IPV research maintains a traditional gender-based heterosexual model of IPV (Goldenberg et al. 2018). Among the few studies that exist, results from the U.S. Trans Survey using a nonprobability sample of 27,715 gender minority individuals demonstrate that 35% reported physical abuse and 16% reported sexual abuse by a partner (James, et al. 2016). Further, some research suggests that gender minority individuals, regardless of sexual identity, report more physical IPV victimization compared to cisgender sexual minority and cisgender heterosexual individuals (35% vs. 14% and 12%, respectively; Landers and Gilsanz 2009).

SGM IPV in the Context of Minority Stress In addition to risk factors that contribute to IPV among cisgender heterosexual individuals (e.g., alcohol abuse, childhood exposure to IPV; Balsam and Szymanski 2005), SGM individuals face additional stressors related to their stigmatized identities (i.e., minority stress; Meyer 2003) that may further elevate their IPV risk (Balsam and Szymanski 2005). According to the minority stress theory (Meyer 2003), commonly identified health disparities observed between sexual minority and heterosexual populations can be explained via the stigma associated with sexual minority status and the resulting higher levels of discrimination, internalized heterosexism, anticipation of discrimination, and identity concealment. While initially developed to contextualize vulnerabilities among sexual minority populations, this theory also helps to frame gender minority individuals’ elevated health risks compared to cisgender individuals (Testa et al. 2015; Timmins et al. 2017). One central tenet of the minority stress theory reflects that SGM individuals experience higher levels of stress at individual, interpersonal, and structural levels deriving from their marginalized social status (Meyer 2003). Further, Meyer (2003) conceptualized minority stressors as: (1) additive to general stressors that the general population experience; (2) chronic, as they relate to stable social structures; and, (3) socially based rather than stemming from

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isolated events or people (Hatzenbuehler and Pachankis 2016). In this chapter, we utilize the minority stress framework to contextualize help-seeking barriers among SGM populations who face IPV victimization.

Identity Abuse as a Form of IPV Victimization For SGM individuals, IPV victimization occurs within a larger societal and systemic context of heterosexism (i.e., a system that privileges heterosexual individuals) and cissexism (i.e., a system that results in disadvantages for gender minority individuals; Katz-Wise and Hyde 2012; Scheer and Baams 2019). Along with more traditional forms of IPV, intrapsychic, interpersonal, and structural forms of stigma can be used as tactics of control against SGM people (Balsam and Szymanski 2005; GuadalupeDiaz and Anthony 2017; Miller et al. 2016; Scheer et al. 2019; Woulfe and Goodman 2018; Woulfe and Goodman 2019). This IPV dynamic is known as identity abuse, or the targeting, discrediting, belittling, and devaluing of a partner’s already-stigmatized SGM identity (Guadalupe-Diaz and Anthony 2017; Scheer et al. 2019; Woulfe and Goodman 2018). Identity abuse contains four broad domains: (a) disclosing a partner’s SGM status to others such as family members or an employer without the partner’s consent; (b) undermining, attacking, or denying a partner’s SGM status; (c) using slurs or derogatory language regarding a partner’s SGM status; and, (d) isolating a partner from SGM communities (Guadalupe-Diaz and Anthony 2017; Woulfe and Goodman 2018). Few studies have formally examined prevalence estimates of identity abuse victimization among SGM individuals, because until recently, no formal measure existed to assess for SGM-specific identity abuse (Scheer et al. 2019; Woulfe and Goodman 2018). Within SGM populations, emerging findings suggest that gender minority individuals may be uniquely affected by identity abuse compared to sexual minority individuals given their differentially stigmatized status relative to their sexual minority counterparts (Scheer and Baams 2019; Woulfe and Goodman 2018). Additional research is needed to uncover the ways in which transphobia is used and experienced as a tactic of power and control among gender minority individuals.

Health Consequences of Experiencing IPV Victimization IPV victimization experiences represent a key driver of SGM health disparities (e.g., suicidality, substance use, depression; Walters et al. 2013). Notably, sexual minority men and transgender individuals who experience IPV victimization are at heightened risk of HIV transmission, attributable to trouble negotiating safer sex practices due to a decreased perception of control over sex and fear of IPV (Heintz and Melendez 2006). In addition, identity abuse victimization is associated with depression and posttraumatic stress disorder above and beyond the effects of psychological and

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physical forms of IPV victimization among SGM individuals (Woulfe and Goodman 2019). Emotional and tangible support from informal or formal avenues can protect against the deleterious health impact of IPV victimization (Liang et al. 2005). While it is critical for SGM individuals who experience IPV victimization to report IPV and seek assistance without fear of harm, rejection, or criminalization (Ford et al. 2013), this population faces significant help-seeking barriers directly related to their stigmatized social status (Calton et al. 2016). The next section discusses general IPVrelated help-seeking processes and reviews the literature on help-seeking patterns and barriers among SGM individuals who experience IPV victimization.

Help-Seeking Processes Among Individuals Who Experience IPV Victimization Help seeking among individuals who experience IPV victimization represents as a multistage process that involves: (1) recognizing and defining the abusive situation as unmanageable; (2) deciding to seek help; and, (3) accessing assistance from formal or informal avenues to remedy the situation (i.e., repair the relationship, protect against future abuse, leave an abusive situation or relationship; Liang et al. 2005). Formal avenues of support include seeking mental health, medical, legal, advocacy, and housing services whereas informal avenues may include asking friends, family, or co-workers for a safe place to stay, child-care help, financial assistance, or emotional support (Goodman et al. 2003). Informal and formal support increase IPV survivors’ sense of self-efficacy and adaptive coping efforts (Goodman et al. 2005). However, contextual barriers such as inadequate structural responses (e.g., non-enforcement of protection orders) and inaccessibility of appropriate resources (e.g., domestic violence shelters) can hinder IPV-related help seeking (Liang et al. 2005; Overstreet and Quinn 2013). In addition, barriers to accessing informal support may include experiencing dismissive attitudes from family or friends after revealing IPV experiences (Weisz et al. 2007). Recent work considers the cultural context of IPV-related stigma (e.g., loss of status within social networks because of IPV victimization) in reducing help-seeking behavior in general (Overstreet and Quinn 2013). Relevant to SGM individuals who experience IPV victimization, many also face stigma related to their SGM identity when seeking help (Finneran and Stephenson 2013).

IPV-Related Help-Seeking Patterns Among SGM Individuals Understanding specific services that SGM individuals utilize following experiences of IPV victimization has important clinical and public health implications for outreach efforts and resource allocation. Similar to cisgender and heterosexual adults,

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SGM adults initially disclose IPV victimization to informal supports (e.g., friends, family, co-workers) than to formal supports (e.g., law enforcement, clergy, crisis lines, shelters; McClennen et al. 2002). When accessing formal services, SGM individuals may prefer those that covertly address IPV victimization (e.g., mental health counseling) rather than IPV-specific services such as domestic violence shelters (Hardesty et al. 2011). In addition, rates of disclosure among SGM individuals may vary as a function of SGM status, among other demographic characteristics. For example, sexual minority women are more likely to report IPV victimization to legal services than sexual minority men due to internalized masculinity norms that discourage acknowledging victimization experiences (Kuehnle and Sullivan 2003). Compared to cisgender, heterosexual youth and young adults, help-seeking patterns for IPV victimization may differ for SGM youth and young adults. For instance, SGM youth who experience IPV victimization, particularly gender minority youth, may seek formal services such as shelters, transitional living programs, crisis lines, and advocacy (Scheer and Baams 2019). One recent study demonstrated that among SGM youth and young adults who experienced IPV victimization, 1.9% sought housing support, 17.7% sought support services (e.g., advocacy), 21.7% sought medical care, and 37.8% sought mental health services (Scheer and Baams 2019). However, while almost a third of SGM young adults experienced IPV victimization in the past year, less than half of these participants sought IPV-related services (Scheer and Baams 2019). This same study documented gender identity disparities across several of the IPV-related services sought by SGM youth and young adults. Specifically, gender minority youth and young adults reported 2.06 times the odds of seeking IPVrelated medical care services, 1.66 times the odds of seeking mental health services, and 2.15 times the odds of seeking support services compared to cisgender, sexual minority youth and young adults (Scheer and Baams 2019). Gender minority youth and young adults may be especially vulnerable to accessing affirming informal support for IPV victimization due to social isolation and anticipated or enacted rejection of their stigmatized gender identity and thus may turn to formal IPV-related services at greater rates than cisgender, sexual minority youth and young adults (Scheer and Baams 2019; Weisz et al. 2007). Taken together, given the high prevalence of IPV victimization and relatively low IPV-related help-seeking behavior among SGM youth and adults, service providers and policy makers should increase their awareness of risk factors associated with IPV victimization and determinants of help-seeking patterns and barriers in this population.

Minority Stress as a Social Determinant of Help-Seeking Barriers Among SGM Individuals SGM-related stigma creates multiple barriers to seeking and receiving adequate care and support related to IPV victimization experiences. The current section explores

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individual-, interpersonal-, and structural-level minority stressors in relation to IPVrelated help-seeking barriers in this population.

Individual-Level Minority Stressors and IPV-Related Help-Seeking Barriers Individual-level minority stressors refer to individuals’ cognitive, affective, and behavioral responses to stigma (Hatzenbuehler and Pachankis 2016). Specific to SGM populations, individual-level minority stressors include: (1) internalized heterosexism and cissexism (i.e., negative feelings or beliefs about one’s SGM status); (2) rejection sensitivity (i.e., a learned psychological process whereby SGM individuals anticipate stigma-based rejection based on previous discrimination experiences); and, (3) concealment behaviors (i.e., hiding an SGM status to avoid future victimization; Hatzenbuehler and Pachankis 2016; Mendoza-Denton et al. 2002; Meyer 2003). For SGM individuals who face IPV victimization, the shame associated with these experiences may be compounded by internalized homophobia, biphobia, and transphobia, which may have specific ramifications for IPV-related help seeking in this population (Scheer and Poteat 2018). SGM individuals who face IPV victimization may internalize negative messages fueled by laws, policies, and social values that privilege those within the gender binary, portray homosexuality as deviant, and perpetuate a hegemonic understanding that only cisgender women—not cisgender men, transgender women, or transgender men—experience IPV victimization (Guadalupe-Diaz and Jasinski 2017; Helfrich and Simpson 2006; Scheer and Poteat 2018). These negative feelings and beliefs may prevent SGM individuals from identifying or addressing abuse within their relationship, further contributing to the denial of abuse, isolation, lack of reporting violence, and avoidance of seeking help commonly seen in this population (Bornstein et al. 2006; Edwards et al. 2015). Sexual minority men may normalize physical and psychological injuries as part of being a man (i.e., physical strength), and consequently, may actively work to conceal their IPV victimization (Bacchus et al. 2017). In addition, SGM individuals who experience IPV victimization fear that seeking help from formal services may reinforce negative stereotypes about the SGM community in general, and negative stereotypes about SGM relationships in particular, contributing to the silence about IPV in this population (Bornstein et al. 2006; Edwards et al. 2015; Ollen et al. 2017). As such, SGM individuals report interest in covert help such as through crisis hotlines to avoid further stigmatizing the SGM community (Edwards et al. 2015). Experiences of discrimination also contribute to SGM individuals’ sensitivity to or anticipation of rejection (Hatzenbuehler and Pachankis 2016; Meyer 2003), which may act as an important barrier to IPV-related help-seeking. Rejection sensitivity refers to the psychological process through which some SGM individuals

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may anticipate or fear future rejection based on previous experiences of discrimination or prejudice (Mendoza-Denton et al. 2002). Indeed, fear of inappropriate, insensitive, or discriminatory treatment affects when and where SGM individuals who experience IPV victimization seek help (Freedberg 2006). For instance, SGM individuals who experience IPV victimization may choose to avoid seeking help from legal, mental health, medical, housing, or advocacy services due to the fear of rejection or stigma from service providers (Ard and Makadon 2011). In addition, SGM individuals may worry about further victimization by providers who lack competence in SGM-related issues and by other non-SGM clients accessing similar services (Bornstein et al. 2006). Expectations of unequal treatment in IPV-specific programs (e.g., domestic violence shelters) may also contribute to the likelihood that SGM individuals in general, and sexual minority men and transgender women in particular, do not seek help (Finneran and Stephenson 2013). SGM individuals may feel reluctant about reporting IPV victimization to law enforcement given the high rates of violence, including excessive force, unjustified arrests, and raids of this population by police, especially among sexual minority men and transgender women of Color (National Coalition of Anti-Violence Programs [NCAVP] 2013). SGM individuals who experience IPV victimization may also hesitate to seek help from their religious or faith community or from cisgender, heterosexual friends and family if they had previous experiences of heterosexism and cissexism in these contexts (Ard and Makadon 2011). Experiences of heterosexism and cissexism can lead SGM individuals who face IPV victimization to conceal their SGM status to avoid future discrimination from formal and informal sources of support, including healthcare providers, co-workers, and family members. Both quantitative and qualitative work with SGM individuals suggests that fears around disclosing one’s own or their partner’s SGM status can act as a barrier to accessing and engaging in IPV-related support services (Finneran and Stephenson 2013; Guadalupe-Diaz and Jasinski 2017). Indeed, given that SGM individuals may carefully manage who knows about their sexual orientation or gender identity or expression, those who face IPV victimization may not reach out for formal or informal support and instead will remain in abusive relationships (St Pierre and Senn 2010). Notably, those who disclose their SGM identity generally report lower levels of internalized stigma, both of which are associated with increased likelihood of accessing help following IPV experiences (St Pierre and Senn 2010).

Interpersonal-Level Minority Stressors and IPV-Related Help-Seeking Barriers Minority stressors experienced at the interpersonal level include overt forms of prejudice and discrimination such as victimization and harassment as well as unintentional actions including microaggressions (Hatzenbuehler and Pachankis 2016). Concerns

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about potential interpersonal prejudice when seeking IPV-related services seem justifiable based on a sizeable literature documenting service providers’ homophobic and transphobic attitudes towards SGM individuals as well as denial that IPV victimization occurs in this population. For instance, Legal (2010) documented that more than half of all sexual minority individuals in general—not just those who experienced IPV victimization—reported refusal of needed care, blame for their health status, and experienced healthcare professionals as physically rough and verbally abusive. SGM individuals who face IPV victimization often report experiences of police misconduct after the initial violent incident, including excessive force, unjustified arrests, entrapment, and raids (NCAVP 2013). Moreover, reports of discrimination by service providers are associated with delayed service usage and reduced likelihood of future service usage among SGM populations (Jaffee et al. 2016). Indeed, providers’ lack of awareness of SGM IPV as well as discriminatory attitudes towards SGM populations contribute to the overall health burden and thwart SGM individuals’ recovery and healing by preventing those who experience IPV victimization from receiving adequate care. Similar to service providers more generally, those who work with IPV survivors in particular may have received little training on the specific needs of SGM populations (Simpson and Helfrich 2005). As a result, consistent evidence demonstrates that among SGM individuals who sought formal help for IPV victimization, many reported that services were not tailored to SGM individuals’ needs and thus were perceived as unhelpful and even harmful (Bornstein et al. 2006; Edwards et al. 2015; St Pierre and Senn 2010). For example, Turell and Cornell-Swanson’s (2005) review of the help-seeking literature indicated that SGM individuals who experienced IPV victimization were broadly dissatisfied with formal support services, including domestic violence agencies, shelters, crisis lines, police, attorneys, and clergy. Moreover, service providers, including police officers and victim advocates, may view SGM IPV as less serious than IPV among cisgender, heterosexual individuals, are less likely to see an SGM person in a same-gender relationship as a victim, are more likely to see both partners as perpetrators, and perceive violence between same-gender couples as being less likely to escalate over time (Russell et al. 2010, 2015; Russell and Kraus 2016; Russell 2018; Simpson and Helfrich 2005). As a result, SGM individuals who experience IPV victimization and report negative experiences with staff at non-SGM agencies and programs may instead rely on the SGM community for assistance (Bornstein et al. 2006). Such experiences of discrimination regarding service usage disproportionately affect vulnerable subpopulations of SGM people, including transgender women, sexual minority men, bisexual women, those living in poverty or with HIV, and SGM individuals who identify as racial, ethnic, or immigrant minorities (Grant et al. 2011; Lambda Legal 2010). These disparities in healthcare quality are especially concerning because of the heightened need for services—as well as barriers to service usage—among these groups. For instance, SGM individuals who are immigrants or living in poverty report that their abuser uses the survivor’s financial strain and/or citizenship status as additional leverage to discourage the survivor from leaving the abusive relationship and accessing IPV-related services (Greenberg 2012).

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Notably, sexual minority men and transgender individuals underreport IPV victimization to police because of systemic maltreatment from law enforcers (Herek 2002). Among those who do report IPV victimization, Black gay men are 2.8 times more likely to experience excessive force from police than those who do not identify as Black (NCAVP 2016). Moreover, shelters—often the first point of contact for IPV survivors—are inaccessible to transgender individuals because of the gendered assumptions of victimization and discriminatory-housing practices in shelters. Gender minority individuals report disbelief from formal service providers about their IPV victimization experiences either because they are “too butch” or they were “once a man” (Guadalupe-Diaz and Jasinski 2017). Indeed, enacted stigma reduces the propensity for seeking help among multiply marginalized SGM individuals who experience IPV victimization. Beyond formal help seeking, enacted interpersonal discrimination and prejudice may also impede informal help seeking for SGM individuals who experience IPV victimization. Due to hegemonic heterosexism and cissexism, SGM individuals who face IPV victimization may have fewer options, compared to cisgender, heterosexual individuals, when seeking informal support such as from family, friends, or clergy members (Pearson and Wilkinson 2013). Further, SGM individuals often create ‘chosen families’ consisting of friends, mentors, and other members from the SGM community. While ‘chosen families’ provide an important source of support, accessing IPV-related support from these networks may be particularly difficult given that many SGM people in relationships share the same network of SGM peers. Furthermore, isolating SGM individuals from accessing social support reflects a common tactic of IPV in general (Bornstein et al. 2006), and of SGM-specific identity abuse (Woulfe and Goodman 2018). Finally, perpetrators who have not disclosed their SGM identity for fear of discrimination may deter their partners from forming close friendships and openly discussing their intimate relationship in effort to continue to conceal their own stigmatized identity (Walters et al. 2013). Additional concerns for SGM individuals include fears of losing one’s social network by disclosing IPV (Ollen et al. 2017). SGM people may hold dismissive attitudes towards SGM IPV, which may relate to the limited support they can provide. As is the case with formal help seeking, fears of confirming negative stereotypes about SGM relationships, or even concerns about outing themselves or their partners as abusers in the process of seeking informal support, may also reduce informal help-seeking behavior among SGM people.

Structural-Level Minority Stressors and IPV-Related Help-Seeking Barriers Minority stressors at the structural level include societal conditions, cultural norms, and institutional policies that constrain the opportunities, resources, and wellbeing

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of SGM people and contribute to the production of SGM health disparities (Hatzenbuehler et al. 2013; Hatzenbuehler and Pachankis 2016). Anti-SGM structural stigma also uniquely hinders SGM individuals from accessing trauma-informed, effective, and culturally sensitive formal services (Edwards et al. 2015; Helfrich and Simpson 2006), particularly among those with multiple stigmatized identities. For example, SGM individuals who face IPV victimization and also live with HIV, identify as people of Color, are sex workers, or live in poverty may experience additional institutional barriers to accessing formal support (e.g., geographic isolation, lack of outreach to these communities and transportation options to domestic violence programs; Miller et al. 2016). Transgender women of Color in particular face disproportionate levels of poverty, discrimination, and denial of health care, contributing to their overall greater risk for IPV, HIV, and service barriers compared to other SGM people (Guadalupe-Diaz and Jasinski 2016). Resulting from the extensive systemic adoption of the gender paradigm that frames cisgender men as batterers and cisgender women as victims, policy and intervention services ignore SGM people’s needs and prevent effective and accessible services for this population (Cannon and Buttell 2015). For example, not until 2013 did the Violence Against Women Act (1996) include protections for SGM people (Cannon and Buttell 2015). Perceptions that abuse among SGM people is mutual and less severe than among cisgender, heterosexual people reflect the justice system’s gendered model of IPV (Guadalupe-Diaz and Jasinski 2016). These harmful myths further contribute to the profound difficulty that police officers and service providers have in assessing for and identifying IPV among SGM individuals (Cannon and Buttell 2015). Law enforcement and service providers’ general lack of understanding, language, and education about SGM IPV may deter SGM individuals who experience IPV victimization from seeking help from general domestic violence services that are not SGM-specific (Calton et al. 2016; Hamel and Russell 2013). Transgender individuals who experience IPV victimization report needing to educate their doctors about transgender issues to receive adequate care (Grant et al. 2011). Moreover, providers lack the knowledge and skills related to SGM issues, despite wanting to improve services for this population (Helfrich and Simpson 2006). Providers’ lack of awareness of SGM issues can result in the expression of non-affirming beliefs through culturally insensitive policies (Helfrich and Simpson 2006). Mainstream domestic violence programs may use heterosexist and cissexist language in program materials or have ambiguous policies regarding service provision for SGM people who experience IPV victimization (Helfrich and Simpson 2006; Miller et al. 2016). One study found that of the 15% of SGM individuals who experienced IPV victimization and sought shelter services, 21% were denied entry due to services designated only for cisgender women (NCAVP 2014). In addition, homeless shelters are often segregated based on sex assigned at birth, which may alienate or endanger transgender individuals who require housing services to leave abusive situations (NCAVP 2014; Simpson and Helfrich 2005). Indeed, transgender men may be less likely to access support from domestic violence shelters due to fears that their masculine gender expression will result in rejection from service providers and

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clients (Simpson and Helfrich 2005). In fact, transgender men and women are 3.5 times more likely to experience hate crimes while in shelters compared to cisgender men and women (NCAVP 2015). Legal and police remedies represent the least sought forms of help and are often the least helpful among SGM individuals who experience IPV victimization (Grant et al. 2011). SGM individuals who experience IPV victimization do not report their experiences of IPV or seek other types of help from law enforcement given the welldocumented history of violent maltreatment and harassment of SGM communities by police, especially among SGM people of Color, those living with HIV, transgender women, immigrants, and sex workers (Nadal et al. 2015). For those SGM individuals who do report IPV victimization to the police, the NCAVP found that in 2010, almost a fourth of SGM people stated that either the victim or both the victim and the perpetrator were arrested and 29.7% who called the police received no arrest—up from 21.9% in 2010 (NCAVP 2013). Transgender women are increasingly unlikely to report IPV victimization to police due to their experiences of harassment and discrimination by law enforcement (Finneran and Stephenson 2013). One study found that transgender women who experienced IPV victimization were over six times as likely to report physical violence while interacting with police than cisgender individuals (NCAVP 2015). These findings are consistent with existing theoretical and empirical work suggesting that transgender women may face significant structural barriers to accessing IPV-related legal services due to societal and institutional transphobia, homophobia, and misogyny (Greenberg 2012; NCAVP 2013). Barriers to accessing legal services among SGM individuals who experience IPV victimization may directly relate to anti-SGM stigma and discrimination by the justice system. State laws for protective orders are written using language that excludes SGM people (Calton et al. 2016). For example, SGM individuals are either omitted from protection order statutes and thus unable to apply for protection or there lacks clarity whether SGM individuals are included in the statutes—resulting in inconsistent and biased decisions from local authorities (Potocznick et al. 2003). In 2010, the NCAVP documented that 55% of the protection order requests were denied among SGM people who experienced IPV victimization (Calton et al. 2016). SGM survivors of IPV victimization who have a cisgender or heterosexual partner also face resistance from the courts when attempting to maintain or gain custody over their children (Courvant and Cook-Daniels 2003). Further, judges may determine the threshold for obtaining a protection order and thus require that SGM IPV survivors—but not cisgender, heterosexual IPV survivors—prove they were cohabitating with their abusive partner at the time the violence occurred (Calton et al. 2016).

Practice and Policy Implications Insufficient education in SGM-related issues among mainstream providers and legal and domestic violence services translates into lack of culturally sensitive care for SGM individuals who experience IPV victimization. As such, reducing help-seeking

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barriers among SGM individuals who experience IPV victimization, requires that prevention and intervention efforts focus on enhancing SGM-affirmative training among providers, agencies, and services. To prevent enacted anti-SGM stigma in healthcare and legal settings, agencies and providers should implement interventions that promote: (1) the use of SGM-inclusive language and services; (2) awareness of minority stressors at individual-, interpersonal-, and structural-levels; (3) education of the bidirectionality of abuse as well as unique power and control dynamics in SGM relationships; and, (4) awareness of the strengths and resiliencies of this population (Woulfe and Goodman 2019). Practitioners should also evaluate the accessibility and availability of their services in terms of inclusivity (e.g., SGM-specific shelters, gender options beyond man/woman on intake forms), location, and implementation of SGM-affirmative care (Scheer and Poteat 2018). Providers, agencies, and legal services should consider consulting with SGM-specific organizations such as NCAVP, FORGE, and the Northwest Network to ensure SGM-affirmative approaches to service delivery (Calton et al. 2016). In order to provide maximally effective services for SGM individuals who experience IPV victimization, providers, agencies, and services should assess for: (a) the gender identity and sexual orientation of the survivor and the person using abuse in the relationship; (b) the frequency and severity of unique tactics of violence that leverage systemic oppression such as heterosexism and cissexism (i.e., identity abuse); (c) psychosocial and health effects of IPV victimization experiences; (d) access to affirming informal supports that SGM individuals who experience IPV victimization can seek help from; (e) whether IPV is bidirectional; and, (f) the degree of outness of the SGM survivor and/or abuser. Ongoing assessment of support systems could also provide information when making community-based referrals and treatment recommendations for this population. In addition to facilitating training and assessment among sources of formal support, enhancing SGM-affirming informal support services for those experiencing IPV victimization also represents a critical public health and clinical need. Recognizing that SGM individuals disclose IPV more often to informal supports such as family, friends, and the SGM community than to formal supports, and that community connectedness protects against the effects of stigma and violence (Meyer 2003; Scheer and Poteat 2018), activists and allies should continue to raise awareness of IPV among the broader SGM community and the general public. Moreover, interventions aimed at informal supports can have positive effects, including fostering understanding and acceptance of SGM individuals’ minority statuses and IPV victimization experiences (Edwards et al. 2015).

Trauma-Informed Care for SGM Individuals Who Experience IPV Victimization Trauma-informed care (TIC) represents a service delivery approach initially developed in response to the realization that most people who seek services experience

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some form of trauma or violence (Harris and Fallot 2001). At its core, a TIC approach involves providing culturally sensitive services that build on survivor strengths, facilitate opportunities for social connection, and foster empowerment to help survivors regain control (e.g., offering collaborative opportunities during treatment planning; Elliott et al. 2005). Designed to minimize the risk of re-traumatization while seeking services, TIC includes six dimensions: (a) fostering agency and mutual respect; (b) providing psychoeducation about trauma and its effects; (c) increasing opportunities to connect with other survivors; (d) building on clients’ strengths; (e) cultural sensitivity; and (f) support for parenting (Elliott et al. 2005; Goodman et al. 2016). Although TIC does not target specific SGM minority stressors (e.g., identity concealment, institutional discrimination; Meyer 2003), cultural sensitivity is increasingly central to healthcare service provision (Elliott et al. 2005). Thus, when applying TIC principles to SGM individuals who experience IPV victimization in service delivery, it is critical to include an understanding of—sensitivity towards—the additional and unique minority stressors that SGM people face (Scheer and Poteat 2018). Although developed in the context of mental health, TIC principles apply across various service settings, including medical, housing, and legal services (Miller et al. 2016). Moreover, previous studies provide substantial evidence for the effectiveness of TIC in addressing and improving numerous psychosocial and health concerns such as depression, substance use, physical health concerns, shame, and loneliness among those who experience trauma—including SGM individuals who face IPV victimization (Butler et al. 2011). TIC should be delivered in conjunction with evidence-based treatment protocols adapted for SGM populations (e.g., SGM-affirmative cognitive-behavioral therapy; Pachankis 2014) to improve the psychological functioning and health for this population.

System-Level Changes to Address Structural Barriers to Help Seeking Federal and local policies that protect SGM civil rights consequently disrupt the social exclusion and societal-level stigma faced by SGM survivors of IPV victimization and could ultimately reduce the overall health burden in this population. Anti-SGM systemic and institutional policies need to be addressed and reformed such as including SGM individuals in protection orders statutes (Calton et al. 2016). In addition, passing legislation that renders systematic discrimination against SMG people (e.g., housing and employment discrimination) illegal, may help to improve societal acceptance of this population. Increasing awareness of SGM IPV could increase funding and allocation of services specific to this population. Finally, it is important for activists and researchers to monitor the implementation of the Violence Against Women Act to ensure domestic abuse networks provide equitable services for LGBTQ survivors.

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Summary and Future Directions This chapter highlights the increased prevalence of IPV victimization for SGM individuals compared to cisgender, heterosexual individuals. Estimates suggest that 23– 63% of SGM individuals experience at least one form of IPV victimization—two-fold the prevalence among cisgender, heterosexual individuals. As previously mentioned, IPV victimization is clearly detrimental to SGM people’s health and wellbeing: SGM individuals who experience IPV victimization have poorer mental and physical health outcomes such as posttraumatic stress disorder, depression, anxiety, substance use, chronic health conditions, HIV, and suicidality compared to SGM people who do not face IPV victimization. Risk is further amplified for SGM individuals of Color and immigrant minorities who navigate multiple systems of oppression that perpetuate stigma associated with race/ethnicity, sexual orientation, gender identity/expression, and IPV victimization (Miller et al. 2016). Stigma related to IPV victimization experiences and SGM status creates multiple barriers to seeking and receiving adequate care and support. First, individual-level barriers include minority stress processes (e.g., internalization of negative beliefs about one’s identity or experiences and fearing rejection and unequal treatment by service providers or family and friends) that may prevent SGM individuals from seeking help or disclosing their experiences of IPV victimization. Second, interpersonal-level barriers include experiences of discrimination and prejudice by service providers, law enforcers, family, friends, and clergy members, or isolation from SGM communities (e.g., identity abuse). Third, minority stressors at the structural level include cultural norms and societal conditions that prevent SGM individuals from receiving the support they need, such as a lack of effective care and services tailored to this population. Future directions. Although research on SGM IPV consistently shows disparities related to sexual orientation and gender identity/expression, we have limited information about IPV victimization and barriers to service usage among certain SGM subgroups, for example transgender and gender non-binary individuals. Datacollections—local and federally mandated—should include comprehensive measures of sexual orientation and gender identity/expression to identify at-risk SGM groups and their unique experiences, relationship trajectories, and service needs. More research is needed to better understand the risk factors for bidirectional IPV among SGM people as well as service use and barriers to help-seeking among SGM people who perpetrate IPV. In addition, considering that existing research highlights increased risk of IPV victimization experiences among SGM individuals of Color and immigrant minorities, future work should focus on mechanisms of risk, marginalization, and discrimination as barriers to help seeking in these communities. Further, research discussed in this chapter highlights the risks of IPV victimization experiences among SGM adolescents and young adults. We currently know very little about how SGM youth navigate their first intimate relationships, nor do we have any knowledge on how previous experiences with rejection and violence in the peer-context impact their intimate relationships or help-seeking behaviors.

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As outlined in this chapter, efforts are being made to reduce help-seeking barriers among SGM individuals who experience IPV victimization, for example affirmative training and tailoring interventions to SGM individuals’ needs. However, work still needs to be done to evaluate the effectiveness, accessibility, and inclusiveness of intervention approaches such as trauma-informed care for SGM individuals who experience IPV victimization.

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Herek, G. M. (2002). Gender gaps in public opinion about lesbians and gay men. Public Opinion Quarterly, 66, 40–66. Jaffee, K. D., Shires, D. A., & Stroumsa, D. (2016). Discrimination and delayed health care among transgender women and men. Medical Care, 54(11), 1010–1016. James, S., Herman, J., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. A. (2016). The report of the 2015 US transgender survey. National Center for Transgender Equality, Washington, DC. Retrieved from http://www.transequality.org/sites/default/files/docs/usts/USTS%20Full% 20Report%20-%20FINAL%201.6.17.pdf. Jewkes, R. (2002). Intimate partner violence: Causes and prevention. The Lancet, 359(9315), 1423– 1429. Katz-Wise, S. L., & Hyde, J. S. (2012). Victimization experiences of lesbian, gay, and bisexual individuals: A meta-analysis. Journal of Sex Research, 49, 142–167. Kuehnle, K., & Sullivan, A. (2003). Gay and lesbian victimization: Reporting factors in domestic violence and bias incidents. Criminal Justice and Behavior, 30(1), 85–96. Legal, L. (2010). When health care isn’t caring: Lambda Legal’s survey of discrimination against LGBT people and people with HIV. New York: Lambda Legal. Landers, S., & Gilsanz, P. (2009). The health of lesbian, gay, bisexual, and transgender (LGBT) Persons in Massachusetts: A survey of health issues comparing LGBT persons with their heterosexual and nontransgender counterparts. Boston, MA: Massachusetts Department of Public Health. Retrieved from http://www.mass.gov/eohhs/docs/dph/commissioner/lgbt-health-report. pdf. Langenderfer-Magruder, L., Whitfield, D. L., Walls, N. E., Kattari, S. K., & Ramos, D. (2016). Experiences of intimate partner violence and subsequent police reporting among lesbian, gay, bisexual, transgender, and queer adults in Colorado: Comparing rates of cisgender and transgender victimization. Journal of Interpersonal Violence, 31(5), 855–871. Liang, B., Goodman, L., Tummala-Narra, P., & Weinstraub, S. (2005). A theoretical framework for understanding help-seeking processes among survivors of intimate partner violence. American Journal of Community Psychology, 36, 71–84. Martin-Storey, A. (2015). Prevalence of dating violence among sexual minority youth: Variation across gender, sexual minority identity and gender of sexual partners. Journal of Youth and Adolescence, 44(1), 211–224. McClennen, J. C., Summers, A. B., & Vaughan, C. (2002). Gay men’s domestic violence: Dynamics, help-seeking behaviors, and correlates. Journal of Gay & Lesbian Social Services, 14(1), 23–49. Mendoza-Denton, R., Downey, G., Purdie, V. J., Davis, A., & Pietrzak, J. (2002). Sensitivity to status-based rejection: Implications for African American students’ college experience. Journal of Personality and Social Psychology, 83(4), 896–918. Messinger, A. M. (2011). Invisible victims: Same-sex IPV in the national violence against women survey. Journal of Interpersonal Violence, 26, 2228–2243. Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. Miller, C. M., Goodman, L. A., Thomas, K. A., Peterson, A., Scheer, J. R., Woulfe, J. M., & Warshaw, C. (2016). Trauma-informed approaches for LGBQT* survivors of intimate partner violence: A review of literature and a set of practice observations (Produced by the GLBTQ domestic violence project). Retrieved from https://pdfs.semanticscholar.org/ee3e/ f17e241ad08157a68105ed13d919cda29c29.pdf. Nadal, K. L., Quintanilla, A., Goswick, A., & Sriken, J. (2015). Lesbian, gay, bisexual, and queer people’s perceptions of the criminal justice system: Implications for social services. Journal of Gay & Lesbian Social Services, 27(4), 457–481. National Coalition of Anti-Violence Programs. (2013). Lesbian, gay, bisexual, transgender, queer, and HIV-affected intimate partner violence. Retrieved from http://www.avp.org/storage/ documents/ncavp_2012_ipvreport.final.pdf.

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National Coalition of Anti-Violence Programs. (2014, April 14). LGBT advocates commend new VAWA non-discrimination guidance, urge other federal agencies to follow lead [Press release]. Retrieved from http://www.avp.org/storage/documents/2014.4.24_ncavp_ma_lgbtjointvawa.pdf. National Coalition of Anti-violence Programs (U.S.). (2015). Anti-lesbian, gay, bisexual and transgender violence in 2014: A report of the National Coalition of Anti-Violence Programs. New York, NY: Author. Retrieved from http://www.avp.org/storage/documents/Reports/2014_HV_ReportFinal.pdf. National Coalition of Anti-Violence Programs (NCAVP). (2016). Lesbian, gay, bisexual, transgender, queer, and HIV-affected intimate partner violence in 2015. New York, NY: Emily Waters. Ollen, E. W., Ameral, V. E., Palm Reed, K., & Hines, D. A. (2017). Sexual minority college students’ perceptions on dating violence and sexual assault. Journal of Counseling Psychology, 64(1), 112–119. Overstreet, N. M., & Quinn, D. M. (2013). The intimate partner violence stigmatization model and barriers to help seeking. Basic and Applied Social Psychology, 35(1), 109–122. Pachankis, J. E. (2014). Uncovering clinical principles and techniques to address minority stress, mental health, and related health risks among gay and bisexual men. Clinical Psychology: Science and Practice, 21(4), 313–330. Pearson, J., & Wilkinson, L. (2013). Family relationships and adolescent well-being: Are families equally protective for same-sex attracted youth? Journal of Youth and Adolescence, 42(3), 376– 393. Potocznick, M. J., Mourot, J. E., Crosbie-Burnett, M., & Potocznick, D. J. (2003). Legal and psychological perspectives on same-sex domestic violence: A multisystemic approach. Journal of Family Psychology, 17, 252–259. Roberts, A. L., Austin, S. B., Corliss, H. L., Vandermorris, A. K., & Koenen, K. C. (2010). Pervasive trauma exposure among US sexual orientation minority adults and risk of posttraumatic stress disorder. American Journal of Public Health, 100(12), 2433–2441. Russell, B. (2018). Police perceptions in intimate partner violence cases: The influence of gender and sexual orientation. Journal of Crime and Justice, 41(2), 193–205. Russell, B., Chapleau, K. M., & Kraus, S. W. (2015). When is it abuse? How assailant gender, sexual orientation, and protection orders influence perceptions of intimate partner abuse. Partner Abuse, 6(1), 47–64. Russell, B., & Kraus, S. (2016). Perceptions of partner violence: How aggressor gender, masculinity/femininity, and victim gender influence criminal justice decisions. Deviant Behavior, 37(6), 679–691. Russell, B. L., Ragatz, L., & Kraus, S. (2010). Self-defense and legal decision making: The role of defendant and victim gender and gender neutral expert testimony of the battered partner’s syndrome. Partner Abuse, 1(4), 399–418. Scheer, J. R., & Baams, L. (2019). Help-seeking patterns among LGBTQ young adults with intimate partner violence exposure. Journal of Interpersonal Violence, 1–20. https://doi.org/10.1177/ 0886260519848785. Scheer, J. R., & Mereish, E. H. (2019). Intimate partner violence and illicit substance use among sexual and gender minority youth: The protective role of cognitive reappraisal. Journal of Interpersonal Violence. https://doi.org/10.1177/0886260519881001. Scheer, J. R., & Poteat, V. P. (2018). Trauma-informed care and health among LGBTQ intimate partner violence survivors. Journal of Interpersonal Violence, 1–23. https://doi.org/10.1177/ 0886260518820688. Scheer, J. R., Woulfe, J. M., & Goodman, L. A. (2019). Psychometric validation of the identity abuse scale among LGBTQ individuals. Journal of Community Psychology, 47, 371–384. Retrieved from https://doi.org/10.1002/jcop.22126. Simpson, E. K., & Helfrich, C. A. (2005). Lesbian survivors of intimate partner violence: Provider perspectives on barriers to accessing services. Journal of Gay & Lesbian Social Services, 18(2), 39–59.

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St Pierre, M., & Senn, C. Y. (2010). External barriers to help-seeking encountered by Canadian gay and lesbian victims of intimate partner abuse: An application of the barriers model. Violence and Victims, 25(4), 536–552. Sullivan, T. (2019). The intersection of intimate partner violence and HIV: Detection, disclosure, discussion, and implications for treatment adherence. Topics in Antiviral Medicine, 27(2), 84–87. Testa, R. J., Habarth, J., Peta, J., Balsam, K., & Bockting, W. (2015). Development of the gender minority stress and resilience measure. Psychology of Sexual Orientation and Gender Diversity, 2(1), 65–77. Timmins, L., Rimes, K. A., & Rahman, Q. (2017). Minority stressors and psychological distress in transgender individuals. Psychology of Sexual Orientation and Gender Diversity, 4(3), 328. Turell, S. C., & Cornell-Swanson, L. V. (2005). Not all alike: Within-group differences in seeking help for same-sex relationship abuses. Journal of Gay & Lesbian Social Services, 18(1), 71–88. Walters, M. L., Chen, J., & Breiding, M. J. (2013). The national intimate partner and sexual violence survey (NISVS): 2010 findings on victimization by sexual orientation. Atlanta, GA: Centers for Disease Control and Prevention, 2013. Journal of Interpersonal Violence, 28(5), 1109–1118. Weisz, A. N., Tolman, R. M., Callahan, M. R., Saunders, D. G., & Black, B. M. (2007). Informal helpers’ responses when adolescents tell them about dating violence or romantic relationship problems. Journal of Adolescence, 30(5), 853–868. Whitton, S. W., Dyar, C. E., Mustanksi, B., & Newcomb, M. E. (2019). Intimate partner violence experiences of sexual and gender minority adolescents and young adults assigned female at birth. Psychology of Women Quarterly, 43, 232–249. https://doi.org/10.1177/0361684319838972. Woulfe, J. M., & Goodman, L. A. (2018). Identity abuse as a tactic of violence in LGBTQ communities: Initial validation of the identity abuse measure. Journal of Interpersonal Violence, 1–21. https://doi.org/10.1177/0886260518760018. Woulfe, J. M., & Goodman, L. A. (2019). Weaponized oppression: Identity abuse and mental health in the LGBTQ community. Psychology of Violence. http://dx.doi.org/10.1037/vio0000251.

Jillian R. Scheer is a T32 postdoctoral research fellow at the Center for Interdisciplinary Research on AIDS at the Yale School of Public Health and a counseling psychologist. Jillian’s research focuses on identifying the co-occurring epidemics (i.e., syndemics such as intimate partner violence, sexual assault, posttraumatic stress disorder, substance use) facing at-risk sexual and gender minority individuals. Alexa Martin-Storey is an associate professor at L’Université de Sherbrooke and holds the Canada Research Chair in Stigma and Psychosocial Development. Her work addresses the link between stigma and interpersonal processes among adolescents and young adults, with a particular focus on sexual and gender minority populations. Laura Baams is an assistant professor in the Pedagogy and Educational Sciences department of the University of Groningen, the Netherlands. Her work focuses on mental health disparities among LGBTQ adolescents and young adults.

Part III

Intervention and Prevention of IPV Among Sexual Minorities

Chapter 9

Primary Prevention of Intimate Partner Violence Among Sexual and Gender Minorities Katie M. Edwards, Ryan C. Shorey, and Kalei Glozier

Overview and Chapter Aims As documented in previous chapters in this book (see Parts I and II), intimate partner violence (IPV) is a serious public health problem among sexual and gender minority (SGM) individuals. Not only does IPV among SGMs occur at high rates (Etaugh 2020), but there are deleterious consequences of IPV among SGMs (Scheer et al. 2020). Thus, there is a sense of urgency to identify primary prevention efforts to prevent IPV among SGMs. Primary prevention refers to preventing violence before it happens (Centers for Disease Control and Prevention 2004). Individuals between the ages of 16 and 24 are most at risk for IPV compared to other demographics (Rennison 2001). Also, adolescence and young adulthood is the period where IPV increases and peaks (Shorey et al. 2017; O’Leary 1999). Moreover, the majority of adult victims of IPV report that their first IPV experiences occurred prior to the age of 25 (Black et al. 2011). Taken together, it is critical that primary prevention efforts start early, ideally before the start of dating and throughout early dating experiences. Thus, in this chapter we focus on the primary prevention of IPV among SGMs in adolescence and young adulthood. The goal of this chapter is to provide readers with evidence-based information on how to prevent IPV among SGMs adolescents and young adults. In order to accomplish this overarching goal, we first start with a brief review of risk and protective K. M. Edwards (B) University of Nebraska Lincoln, 160 Prem S. Paul Research Center at Whittier School, Lincoln, NE 68583, USA e-mail: [email protected] R. C. Shorey · K. Glozier Department of Psychology, University of Wisconsin Milwaukee, P.O. Box 413, Milwaukee, WI 53201, USA e-mail: [email protected] K. Glozier e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_9

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factors for IPV among SGMs (see Parts II and IV for a more in depth review), both those that are shared with cisgender, heterosexual individuals as well as those that are unique to SGM individuals and grounded in minority stress theory (for a discussion of minority stress theory, see Brubaker and Scheer et al.). Second, we review existing IPV prevention programs for adolescents and young adults that have been rigorously evaluated and report on the extent to which these programs have been impactful in reducing IPV among SGMs. Third, we discuss programmatic and policy initiatives not specific to IPV that seek to reduce minority stress which may, in turn, reduce IPV among SGMs. Finally, we suggest avenues for future research on the prevention of IPV among SGMs adolescents and young adults and offer implications for practice and policy.

Risk and Protective Factors for IPV Among SGMs Risk and protective factors for IPV perpetration among heterosexual, cisgender adolescents and young adults has been the topic of empirical studies for several decades (e.g., East and Hokoda 2015; Iconis 2013; Vagi et al. 2013). However, this cannot be said for SGM populations, as few studies have focused on risk and protective factors for IPV among SGM adolescents and young adults. In this section, we briefly review major risk and protective factors for IPV perpetration identified in the primarily cisgender and heterosexual adolescent and young adult literatures. Although there is no theoretical or empirical reason to suspect these risk and protective factors would not operate similarly for SGM populations, research is sorely needed that examines these risk and protective factors in SGM populations. At the individual level, mental health problems are a risk factor for IPV perpetration in non-SGM populations. For instance, symptoms of anxiety, posttraumatic stress, and depression are positively associated with IPV perpetration among adolescents and young adults (e.g., Dardis et al. 2015; Kaukinen 2014; Rothman 2018). Since LGBT individuals are disproportionately affected by mental health issues (Reuter and Whitton 2018), this could partially explain higher rates of IPV in SGM populations. In addition to mental health, historical factors—including previous experiences with IPV, childhood abuse, past trauma, and witnessing parental violence—are also risk factors for IPV perpetration in non-SGM populations (Ellis and Dumas 2018; Kaukinen 2014). It is possible that childhood abuse or maltreatment may also partially explain the increased rates of IPV perpetration in SGM populations as they are more likely to report physical and sexual abuse experienced in childhood than heterosexual and cisgender populations (Edwards 2015; Edwards and Sylaska 2013). One study with a diverse sample of sexual minority young adults demonstrated that childhood abuse was positively associated with IPV perpetration (e.g., Martin-Storey and Fromme 2017).

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Substance use is another prominent risk factor for IPV in non-SGM populations (Banyard et al. 2019; Dardis et al. 2015), with some preliminary research also suggesting substance use is a risk factor for IPV among SGM populations. Specifically, alcohol has been shown to be a risk factor for perpetrating all types of IPV among non-SGM adolescents (Banyard et al. 2019; Strauss et al. 2018) and young adults (Shorey et al. 2011). Since SGM adolescents and young adults are more likely to use alcohol than their heterosexual and cisgender peers due to minority stressors (Edwards 2015; Fish et al. 2017), this may also partially explain higher rates of IPV in these populations. Preliminary cross-sectional research has also shown alcohol use to be positively associated with IPV perpetration among sexual minority young adults (Martin-Storey and Fromme 2017). At the relational level, social support is a protective factor for IPV perpetration. Research shows that perceptions of support may decrease the risk for IPV perpetration in non-SGM populations as support can act as a buffer between stressful life experiences and perpetration (Dardis et al. 2015; Kaukinen 2014). Social support in SGM populations is often influenced by others acceptance of the individual’s identity as a gender or sexual minority (Hall 2018; Woodford et al. 2015), therefore potentially resulting in decreased social support among SGM populations. Research also offers satisfaction with social support in SGM populations as a protective factor for suicidal behavior (Eisenberg and Resnick 2006) which is likely true for IPV perpetration as well, although empirical research is needed to confirm this finding. Perceptions of social norms are also associated with IPV perpetration. Research in adolescent populations has shown that adolescents who associate with peers who use, or approve of using, aggression in dating relationships are more likely to perpetrate IPV than those who do not associate with those peers (Dardis et al. 2015; Shorey et al. 2017). Research also suggests that greater levels of acceptance of IPV is associated with increased risk of perpetrating IPV (Dardis et al. 2015; Karlsson et al. 2018). Beyond individual- and relational-level variables, research suggests that community-level variables are also related to IPV experiences among cisgender, heterosexual youth. For example, research by Edwards and colleagues documented that community—(Edwards et al. 2014) and school—(Edwards and Neal 2017) level poverty was related to IPV experiences among adolescents and young adults which can be explained by social disorganization theory. This theory posits that three issues in the structure of community social organization—low economic status, ethnic heterogeneity, and residential mobility—account for differences in crime and delinquency (Sampson and Groves 1989). Moreover, communities with higher levels of collective efficacy—socially cohesive communities with mutual trust and willingness to intervene for the common good thereby strengthening informal social control— also have lower rates of IPV (Edwards et al. 2014; Pinchevsky and Wright 2012). Research also suggests that alcohol outlet densities, the number of locations that serve or sell alcohol in a specific geographic region, as well as the availability of alcohol are related to higher rates of IPV among youth (Cunradi et al. 2012; Edwards,

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Wheeler et al. 2019; Livingston 2011). These are just a few examples of communitylevel processes related to rates of IPV in cisgender heterosexual individuals, and we would expect that these factors would also predict IPV in SGM populations.

SGM-Specific Risk and Protective Factors There are risk factors for IPV perpetration that are specific to SGM populations which also is one of the main theoretical explanations for the increased rates of IPV among SGM individuals. The minority stress model asserts that there are unique stressors experienced by SGM people (see a detailed overview of the minority stress model in Parts 1 and 2 (Brubaker 2020; Scheer et al. 2020; Meyer 2003). Minority stress experiences have rarely been examined as risk and protective factors for IPV perpetration in gender minority populations, with the limited research in this area primarily restricted to sexual minority populations. Research has found that lifetime discrimination based on sexual minority status was related to physical IPV perpetration as well as psychological IPV perpetration among sexual minority youth, and lesbian and bisexual women (Balsam and Szymanski 2005; Decker et al. 2018; Edwards and Sylaska 2013; Martin-Storey and Fromme 2017). Also, multiple studies have found positive associations between internalized homophobia (negative thoughts and ideas held against one’s own marginalized sexual identity), and physical and sexual IPV perpetration in sexual minority populations including in college student populations (Edwards et al. 2015; Edwards and Sylaska 2013). Having negative thoughts about oneself likely increases proximal risk factors for IPV, such as relationship dissatisfaction and alcohol use; thus explaining why minority stress increases risk for IPV (Balsam and Szymanski 2005; Decker et al. 2018; Edwards et al. 2015; Martin-Storey and Fromme 2017). Research also suggests a negative association between level of outness and IPV perpetration, finding that individuals who reported being more open about disclosing and discussing their sexual identity with individuals such as family, friends, and peers were at a lower risk for IPV perpetration (Edwards and Sylaska 2013). Having a network comprised of sexual minority friends has also been found to be negatively related to IPV perpetration among gay men (Stephenson et al. 2013). In sum, there are myriad individual-, relational-, and community-level factors that are related to increased risk for IPV in cisgender, heterosexual individuals. Although research is lacking on how these factors predict IPV experiences in SGMs, we would expect that many of these factors would operate similarly for SGM individuals, although research is sorely needed to confirm this. The higher rates of IPV experienced by SGM individuals may be explained by the minority stress theory, and especially experiences of internalized homonegativity, which is critical to address in primary prevention efforts.

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Existing IPV Prevention Programs and Their Impact on Rates of IPV Among SGMs Existing IPV Prevention Programs Numerous prevention programs have been developed for adolescent and young adult IPV perpetration and several recent reviews and meta-analyses have examined the effectiveness of these programs (e.g., Brem et al. 2018; De Koker et al. 2014; De La Rue et al. 2017; Lundgren and Amin 2015; Shorey et al. 2012; Storer et al. 2016). As these programs have been discussed and reviewed extensively elsewhere, we will present a brief overview of the most common programs with a focus on the empirical evidence for their effectiveness in reducing IPV among adolescents and young adults, especially in SGM populations. IPV prevention programs that teach relationship skills. Among middle and high school students, two of the most common programs examined in the empirical literature—and the two programs touted as having the best empirical support for their effectiveness—are Fourth R: Skills for Youth Relationships (Wolfe et al. 2009; simply referred to as “Fourth R”) and Safe Dates (Foshee et al. 1996). These schoolbased programs promote healthy relationships through various lessons (21 lessons for Fourth R; 9 lessons for Safe Dates) that target risk and protective factors for IPV (e.g., communication skills, substance use, gender stereotypes, anger management) and include various exercises to increase skill acquisition and retention of material (e.g., role-plays, poster contests). Several other school-based programs have been developed and evaluated, such as Shifting Boundaries (Taylor et al. 2015), Coaching Boys into Men (Miller et al. 2012), Teen Choices (Levesque et al. 2016), and Dating Matters (Niolon et al. 2019). In general, these other programs follow similar outlines as Fourth R and Safe Dates in that they are multi-session, multi-component programs (e.g., lessons, posters) that are intended to increase healthy relationships and decrease violence. Promising findings have been reported on several of these programs. For instance, Fourth R was shown to reduce physical IPV among 9th grade adolescents up to 2.5 years after the intervention relative to a control group (Wolfe et al. 2009). Research on Safe Dates has shown that, among 8th and 9th grade adolescents, those who received Safe Dates evidenced lower rates of psychological, sexual, and moderate physical IPV perpetration up to 3 years after completing the program relative to adolescents who did not receive the intervention (Foshee et al. 2005). Additionally, Dating Matters evidenced improvements in IPV perpetration across middle school relative to adolescents who received standard care, which was Safe Dates (Niolon et al. 2019). Despite these results, a recent meta-analysis of school-based interventions reported discouraging findings. Specifically, De La Rue et al. (2017) conducted a meta-analysis of school-based interventions for reducing teen IPV which included 23 separate studies (including evaluations of Fourth R, Safe Dates, and Shifting Boundaries). Findings showed moderate effects of programs on increasing knowledge of

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IPV, decreasing attitudes supporting of IPV, and improving conflict resolution skills immediately following program participation and at follow-up assessments. However, no significant effects were found for decreasing IPV perpetration at follow-up assessments. IPV prevention programs that teach bystander intervention skills. Among young adults, specifically college students, the empirical literature has focused heavily on evaluating the impact of various bystander-based programs for reducing violence (see Brem et al. 2018; Cornelius and Resseguie 2007; Edwards et al. 2017; Shorey et al. 2011 for reviews of other IPV interventions among young adults). Increasingly, these programs are also being evaluated in high school populations (Coker et al. 2017; Cook-Craig et al. 2014; Edwards, Banyard et al. 2019). Bystander programs, which broadly focus on increasing active bystander behavior among individuals who witness violent situations and behaviors (Coker et al. 2015), have been primarily focused on reducing sexual assault on college campuses. However, some research has extended these programs to focus on IPV (e.g., Coker et al. 2015, 2017; Edwards, Banyard et al. 2019). Two specific bystander-based programs which have been evaluated for effects on IPV include Green Dot (Coker et al. 2011; Coker et al. 2017) and Bringing in the Bystander (BITB; Edwards, Banyard et al. 2019; Leyva and Eckstein 2015). Green Dot attempts to increase awareness of violence through motivational speeches to students, faculty, and staff as well as training select groups of students in bystander intervention (Coker et al. 2016). According to Edwards, Banyard et al. (2019), BITB: [T]eaches students how to safely and effectively intervene before, during, and after situations of relationship abuse and sexual assault to both prevent and stop these forms of abuse from happening as well as supporting victims in the aftermath of these experiences. (p. [490]).

Some research with Green Dot has found that college campuses that implemented the program reported less physical and psychological IPV relative to campuses that did not implement the program (Coker et al. 2015). With high schools, research has shown lower rates of IPV perpetration for schools that received Green Dot relative to control schools (Coker et al. 2017). However, several studies that have examined bystander programs for IPV have not reported the impact of these programs on IPV perpetration (e.g., Borsky et al. 2018; Palm Reed et al. 2015; Peterson et al. 2018). Effectiveness of existing IPV prevention programs for SGM adolescents and young adults. Very few studies have examined whether IPV prevention programs effectiveness varies among SGM adolescents and young adults relative to their cisgender and heterosexual peers. In the De La Rue et al. (2017) meta-analysis, no supplemental analyses were reported on whether findings varied based on gender identity or sexual orientation. In fact, out of the 23 studies included in the De La Rue et al. (2017) meta-analysis, none reported the sexual orientation of their samples, none of the studies reported the gender identity of their samples, and no study examined whether findings varied for SGM adolescents. However, there are ongoing efforts to re-evaluate existing IPV prevention program data to examine whether program effects differ for SGM people (D. Espelage, personal communication, September 11, 2019). In a recently published study that reported on a more in-depth evaluation

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of the Green Dot program implemented in Kentucky high schools, Coker et al. (2020) found that most of the positive intervention outcomes were specific only to heterosexual students and not sexual minority students. More specifically, whereas both sexual minority and heterosexual students reported reductions in stalking victimization and perpetration associated with the intervention, only heterosexual students reported reductions in sexual violence, sexual harassment, and physical dating violence victimization and perpetration associated with intervention exposure. These data provide support to the growing consensus in the field that additional components that address minority stress are needed for IPV prevention programs to be impactful for sexual minority individuals. SGM-specific IPV prevention programs. It has been suggested that specialized IPV prevention programs for SGM adolescents and young adults may need to be created, or existing programs need to be modified, to address the unique needs of SGM adolescents and young adults (e.g., Reuter and Whitton 2018; Shorey et al. 2019). As detailed by Reuter and Whitton (2018), there are at least four primary reasons why specialized IPV programming may be necessary for SGM populations. First, most explanatory/theoretical models for IPV are based on research conducted with primarily heterosexual and cisgender populations which may not fully translate to SGM relationships. Second, most existing IPV prevention programs include intervention material and components that focus on male-female relationships and other heterosexist biases which may alienate SGM adolescents and young adults. Indeed, research with college students has shown that sexual minority students are critical of existing sexual assault programs due to their heteronormative biases (Worthen and Wallace 2017). Third, it is important that program facilitators have competencies working with SGM populations, as SGM people may have a difficult time connecting with facilitators without this expertise. Finally, IPV prevention programs that are specifically designed for SGM people will have the ability to address the risk and protective factors for IPV that are unique to SGM populations (e.g., risk and protective factors informed by minority stress theories; see Scheer et al. Part II for a review). Given the relatively poor outcomes for IPV prevention programs to date, empirical and theoretical support for SGM people having unique risk and protective factors for IPV, and suggestions by other researchers that SGM populations may need tailored IPV prevention programs, we believe that the best path forward for reducing IPV among SGM adolescents and young adults is to develop SGM-specific IPV prevention programs. Unfortunately, we are unaware of any IPV prevention program that has been developed specifically for SGM adolescents or young adults, or any existing IPV prevention program (e.g., Safe Dates, Fourth R, BITB) that has been modified to address the unique needs of SGM adolescents and young adults. Existing evidence demonstrates that SGM-specific interventions show promise in improving relationship-specific processes (e.g., communication skills, justification for using violence) that may impact risk for IPV perpetration. For example, Queer Sex Ed (Mustanski et al. 2015), an online, multimedia, sexual health intervention for LGBT adolescents and young adults has evidenced pre-post improvements in communication skills, sexual self-efficacy, justification of violence, as well as

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improvements in constructs specific to SGM people that may impart risk for IPV (e.g., connectedness to SGM community, internalized homophobia).

Reducing Minority Stress Among SGMs Whereas high-quality IPV-specific prevention programs inclusive of SGM experiences are critical to reducing IPV among SGMs, IPV-specific programming is not enough. In order to reduce IPV among SGMs, minority stress must be tackled both at its root causes (e.g., unjust and discriminatory social structures) while simultaneously building resilience in SGMs to cope with minority stress. Thus, minority stress can be alleviated either directly by lessening the stressor (e.g., creating inclusive and protective policies) or by bolstering the resilience and coping resources of SGMs to mitigate stress effects (Chaudoir et al. 2017; Lazarus and Folkman 1984). Although the ultimate goal is to eradicate all sources of minority stress, this type of change takes time, and thus, in the interim, it is critical to equip SGMs with coping strategies to mitigate deleterious effects of minority stress. In what follows, we discuss evidence-based strategies for reducing minority stress at all levels of the social ecological model.

Programs that Seek to Reduce Minority Stress in SGMs via Resilience and Coping Coping resources that can be used to mitigate minority stress include those that are more individual (such as self-esteem and healthy coping behaviors), as well as those that are more interpersonal (such community social support and attachment to healthy SGM role models) (Chaudoir et al. 2017; Edwards and Sylaska 2013; White Hughto et al. 2015). Thus, programming that seeks to build resilience in SGM individuals should focus on helping to bolster both individual and interpersonal coping resources. Individual-level. A large proportion of the programming to date that seeks to reduce minority stress in SGMs consists of individual-level interventions which aim to enhance resilience and promote healthy coping behaviors (Chaudoir et al. 2017; White Hughto et al. 2015). Although varied, elements of individual-level programming includes strategies to reduce depressive symptoms linked to one’s sexual orientation and/or gender identity; reduce shame specific to one’s sexual orientation and/or gender identity; identify positive aspects of one’s sexual orientation and/or gender identity; identify minority stressors along with their sources and ways to cope with the minority stress in emotionally, cognitively, and behaviorally healthy ways; develop cognitive and emotional processing of upsetting and/or traumatic experiences specific to one’s sexual orientation and/or gender identity; and identify

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and debunk negative stereotypes about being a SGM (Chaudoir et al. 2017; White Hughto et al. 2015). Interpersonal-level. Beyond individual-level programs, some interventions are more interpersonal in nature and focus on teaching SGMs skills to form meaningful relationships even in the face of experiences of minority stress and adversities (Chaudoir et al. 2017). Moreover, there are interventions that focus on creating systems of social support for SGMs, especially social support that includes other SGMs (e.g., support groups) as well as community involvement and activism around a shared cause (White Hughto et al. 2015).

Initiatives that Seek to Directly Address the Source of Minority Stress Beyond programs that focus on reducing minority stress directly in SGM individuals, it is critical to directly target the sources of minority stress. Addressing sources of minority stress could, in turn, reduce SGMs experiences of minority stress which could subsequently reduce rates of IPV. Individual-level. Individual-level efforts focus on reducing stigma and acts of discrimination in heterosexual individuals through varied methods such as perspective taking simulations to build empathy and reduce bias, panel discussions, movies, and/or theatre performances to raise awareness about the negative impacts of homophobia and negative stereotypes towards SGMs (Chaudoir et al. 2017; White Hughto et al. 2015). Interpersonal-level. Interpersonal-level efforts also focus on reducing stigma and acts of discrimination in heterosexual individuals but in ways that are more relationally based. For example, increasing interpersonal contact between heterosexual individuals and sexual minority individuals is one way to do this, and research suggests this is an effective method of reducing prejudicial attitudes and discriminatory behaviors (Chaudoir et al. 2017). Other interpersonally-focused interventions involve parents and family members of SGMs that focuses on reducing rejecting behaviors and increasing positive family interactions (Chaudoir et al. 2017; White Hughto et al. 2015). Another interpersonal-level intervention is training professionals (e.g., educators, medical professionals) in sexual and gender identity development, raising awareness about negative stereotypes, promoting competency in working with SGM populations, and ensuring the delivery of SGM-appropriate interventions (Chaudoir et al. 2017; White Hughto et al. 2015). Structural-level. Structural-level initiatives are varied and include components such as school district policies specific to nondiscrimination and anti-bullying of SGMs; gay-straight alliances (GSAs); access to gender transition-related care; and laws regarding same sex marriage, hate crime legislation, antidiscrimination laws, and bathroom bills (Chaudoir et al. 2017; White Hughto et al. 2015). Research suggests that many of these structural-level interventions reduce minority stress or factors

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related to minority stress such as depression (Chaudoir et al. 2017; White Hughto et al. 2015). For example, in schools with GSAs (regardless of SGM involvement with GSAs), sexual minority students have better psychological and academic outcomes (Chaudoir et al. 2017). Research also suggests that students who attended colleges who have higher perceived levels of community readiness to address IPV in SGM students (e.g., efforts, community climate) had marginally lower rates of IPV perpetration. Moreover, research suggests that sexual minorities employed in workplaces with sexual diversity policies are less likely to report discrimination and more likely to report satisfaction and commitment (Button 2001). Finally, sexual minority residents of cities and states with nondiscrimination policies report experiencing less minority stress, more social support and disclosure of sexual orientation, and less internalized homonegativity (Chaudoir et al. 2017; Hatzenbuehler et al. 2009; Rostosky et al. 2003).

Research, Practice, and Policy Implications There are several avenues for future research on the prevention of IPV in SGMs. First, it is imperative that future research examine the moderating impact of sexual orientation and gender identity on IPV prevention program outcomes. In other words, we need researchers to examine the extent to which IPV prevention program impacts extend to SGM individuals. This means including measures of sexual and gender identities in survey batteries and process evaluation research that asks SGMs to describe the ways in which the prevention programming did or did not meet their needs. It will also be important for researchers to not assume programs may impact all SGM individuals in the same way. That is, research has shown that bisexual individuals experience higher rates of IPV relative to other sexual minorities (Turell et al. 2018), and individuals who identify as a gender minority may experience increased health disparities relative to sexual minorities (e.g., Schnarrs et al. 2019). Thus, when feasible, researchers should examine whether program impacts vary across the diverse subgroups of SGM adolescents and young adults using mixed methodological methods inclusive of the voices of SGM individuals that are at the forefront of the work that we are doing. We also need to focus on creating and evaluating programming specifically for SGM adolescents and young adults that focuses simultaneously on reducing minority stress while delivering evidence-based IPV prevention strategies that are inclusive of SGM experiences. There is also a need to better understand how reductions in experiences of minority stress directly or indirectly influence reductions in IPV. Population-based studies that include measures of SGM status along with minority stress and IPV could allow us to examine how changes in policies over time impact rates of minority stress and IPV. Moreover, we also need to better understand how changes in minority stress at one level of the social ecology impacts minority stress on another level of the social ecology. Finally, there is a need to understand how other marginalized identities (e.g.,

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race, ability status) intersect with SGM experiences to influence outcomes of IPV prevention efforts. As we begin to identify effective and inclusive IPV prevention programs, these should be widely implemented by schools and communities. Alongside IPV programming initiatives, there is a need for multi-level and comprehensive approaches to addressing minority stress at all levels of the social ecology. These holistic and comprehensive approaches should, in theory, lead to reductions in IPV among SGMs. In sum, IPV is a public health crisis in SGMs. The good news is that IPV among SGMs is preventable, and we have started to identify promising strategies for the prevention of IPV in SGMs. More research is needed to determine how to most effectively prevent IPV in SGM populations which must include a focus on eradicating minority stress at all levels of the social ecology in addition to IPV-focused prevention programming.

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Katie M. Edwards is an associate professor of Educational Psychology and faculty at the Nebraska Center for Research on Children, Youth, Families, and Schools at the University of Nebraska Lincoln. Dr. Edwards’ interdisciplinary program of research focuses broadly on better understanding the causes and consequences of interpersonal violence, primarily intimate partner

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violence and sexual assault among adolescents and emerging adults. Dr. Edwards work has been funded by the Centers for Disease Control and Prevention, the National Institute of Health, the Department of Justice, and the National Science Foundation. Dr. Edwards deeply values community partnerships grounded in participatory action principles, strong researcher and practitioner collaborations, and student and community engagement in all phases of the research. Ryan C. Shorey is an Assistant Professor of Psychology at the University of Wisconsin—Milwaukee. His research focuses on intimate partner violence among adolescents and young adults, with an emphasis on alcohol-related intimate partner violence. Kalei Glozier received his B.A. from the University of Michigan. He currently serves as a project coordinator and lab manager in the Department of Psychology at the University of Wisconsin— Milwaukee. His research focuses on sexual and gender minorities, intersectionality, and their experience with minority stress.

Chapter 10

Learning What You Need: Modifying Treatment Programs for LGBTQ Perpetrators of IPV Clare Cannon

Introduction Intimate partner violence (IPV) is a pervasive and pernicious public health problem that is experienced by approximately 25% of women and 10% of men in the U.S. (Center for Disease Control and Prevention [CDC] 2019). According to U.S. crime reports, approximately 16% of all homicide victims are killed by an intimate partner (Cooper and Smith 2011). Specifically, half of all women killed in the U.S. are killed by a current or former male partner. IPV is associated with other adverse health outcomes such as cardiovascular, reproductive, musculoskeletal, and nervous system conditions (Black 2011). Experiences of IPV are also associated with higher risks of engaging in health risk behaviors (e.g., smoking, binge drinking, and HIV risk) (CDC 2019). In addition to homicide and adverse health effects, there is a high social cost to IPV. The lifetime economic cost of medical services for IPV-related injuries, lost productivity from work, criminal justice costs, and/or victim property loss or damage is estimated to be $3.6 trillion (per 2014 US dollars) (Peterson et al. 2018). Not to mention the social cost to those directly and indirectly affected by this violence impacts, for example, families, children, and communities. Intimate partner violence includes physical violence, sexual violence, stalking, and psychological aggression and may range in frequency and severity (CDC 2019). Most often, multiple types of IPV occur simultaneously. Although understudied, recent research into prevalence rates of IPV in sex and gender minority communities estimates that IPV occurs at similar if not exceeding rates as opposite sex couples (Breiding et al. 2014; Smith et al. 2018). Hamel (2014) and Black (2011) similarly estimate that bisexual women experience the highest rates of IPV (61%). These data

C. Cannon (B) Department of Human Ecology, University of California, Davis, South Africa e-mail: [email protected] Department of Social Work, University of the Free State, Bloemfontein, South Africa © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_10

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evidence IPV is not just an epidemic for female victims and male perpetrators, but an epidemic experienced across sexual orientation and gender in the U.S. Despite this prevalence, it is not yet clear if traditional perpetrator interventions are effective in treating LGBTQ abusers. To that end, in this chapter 1 detail batterer intervention programs (BIPs): the most common form of treatment for IPV perpetrators. Next, I outline IPV in sex and gender minority communities. From there, I map out present and proposed modifications to treatment interventions to increase retention and efficacy of LGBTQ abusers. Lastly, I discuss implications for policy, treatment, and future research on LGBT perpetration of IPV.

BIPs as the Predominant Treatment Option for Perpetrators of IPV Batterer intervention programs (BIPs) are a predominant form of counseling/education programs, mostly in a group format, to which those arrested and prosecuted for IPV are mandated to attend. Most states have mandatory-arrest and pro-arrest laws that prescribe law enforcement officers must make an arrest for all domestic violence incidents, no matter the incident or outcome and whether there is any evidence of who committed the offense (Babcock et al. 2016). These policies have led to an extreme increase in overall arrests (Buzawa et al. 2015). States have influenced BIPs such that almost all programs supported with public funding focus on power and control issues, and 75% of states specify that BIPs address some form of power and control (Price and Rosenbaum 2009). Two U.S.-wide surveys of BIPs have begun to shed light on program characteristics (Cannon et al. 2016; Price and Rosenbaum 2009). For instance, Cannon and colleagues (2016) found that cognitive behavioral therapy interventions (CBT) is the primary treatment approach for 29.1% of programs and the secondary approach for another 25%. CBT interventions assume that individuals use violence to endorse their own distorted thinking about self, partner, and the utility of violence to navigate relationships (Banks et al. 2013). Of the 50 U.S. states, 45 have state standards written into legislation (Maiuro and Eberle 2008). Many of these state standards emphasize power and control model of treatment, rather than focus on models that focus on mental health issues and personality (Maiuro and Eberle 2008). Results from Maiuro and Eberle’s (2008) study suggest that about two-thirds of states engage representatives from victim programs and other agencies to create and oversee BIPs standards. Approximately a quarter of states regulate these standards through health and social agencies (Maiuro and Eberle 2008). Importantly, most states do not conduct program evaluations or effectiveness (Maiuro and Eberle 2008). Much research has attempted to ascertain the efficacy of BIPs to decrease recidivism rates (Babcock et al. 2016; Eckhardt et al. 2013). For instance, Babcock and colleagues (2004) found that shorter BIP treatments (less than 16 weeks) had a larger effect size than longer

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BIP treatments (16 or more weeks) for reducing recidivism of heterosexual male perpetrators based on police report and partner reports. Perpetrator treatment programs predominantly provide group therapy with differing treatment modalities such as the power and control model (the so-called Duluth model), and/or CBT (Cannon et al. 2016). The pervasive Duluth model is a psychoeducational treatment orientation based on a feminist theory that understands IPV to result from patriarchal ideology in which men are expected and encouraged to control their partners (Condino et al. 2016). A program using the Duluth model emphasizes the education of men to shift their beliefs and behaviors towards a relationship with women that is more equal. Although developed with a male perpetrator and female victim in mind, some have argued that the Duluth model can treat female perpetrators with male victims and LGBTQ perpetrators because IPV is always about power and control (Cannon 2019). Another approach that is increasingly being used in conjunction with the Duluth model is CBT (Cannon et al. 2016). The CBT approach focuses on learning to mediate relationships without violence through skills training (e.g., anger management, communication skills). CBT approaches typically address perpetrator attitudes towards victims. CBT approaches have been found to be more successful when treating violence offenders when based on a risk-need-responsivity model that assigns treatment based on threat level and history of violence (Bonta 1996). Both approaches focus on a re-education of the perpetrator as opposed to a psychotherapeutic model that seeks to identify the cause of violence related to behavioral deficits and trauma (Condino et al. 2016; Eckhardt et al. 2013). Approximately 45% of BIPs also offer individual therapy (Cannon et al. 2016). Couples and family-based approaches are used by less than 15% of BIPs and often are restricted by state standards (Babcock et al. 2016). Social science research has found that more treatment interventions should utilize family systems theory in order to reduce the negative outcomes associated with children witnessing intimate partner violence (see Appel and Holden 1998; Margolin and Gordis 2003; Sturge-Apple et al. 2012). Family systems theory holds that any disturbance in a particular family relationship cannot be fully decoded without understanding the relationship structures, power arrangements, and communication patterns of the other family subsystems as well as the whole family unit (Davies and Cicchetti 2004). BIP standards tend to be based on a “one-size fits all” approach to treating intimate partner violence without paying close attention to the heterogeneity of IPV (Cantos and O’Leary 2014). State standards limit treatment interventions in some important ways, such as the overall program approach, program content, and treatment orientation (Babcock et al. 2016). There is recognition on behalf of surveyed providers that alternative forms of treatment, such as psychotherapeutic approaches, are necessary to combat the many different types of abusers and kinds of IPV (Cannon et al. 2016). Although no empirical studies have been conducted on treatment outcomes for LGBT offenders (Babcock et al. 2016) several researchers have reported theoretical and clinical recommendations (e.g., Coleman 2003; Hamel 2014).

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IPV in LGBTQ Relationships Group Comparisons Due to limited empirical research, it is difficult to determine the rates of IPV in the LGBTQ community, but recent data estimates IPV is experienced by same-sex partners at similar rates as heterosexual partners (Mason et al. 2014; Walters et al. 2013). For instance, in their study of the Center for Disease Control and Prevention’s (CDC) latest National Intimate Partner and Sexual Violence Survey (NIPSVS), Walters et al. (2013) found that 43.8% of self-identified lesbians, 61.1% of bisexual women, and 35% of heterosexual women reported to have been physically victimized, stalked, or raped by an intimate partner in their lifetime. The majority of bisexual women (89.5%) and heterosexual women (98.7%) reported only male perpetrators. Of lesbian women, 67.4% reported only female perpetrators. Additionally, approximately 26% of gay men, 37.3% of bisexual men, and 29% of heterosexual men have experienced rape, physical violence, and/or stalking by a partner during their lifetime (Walters et al. 2013; Hellemans et al. 2015). Of men who have experienced IPV, 90.7% of gay men reported only male perpetrators, and 78.5% of bisexual men and 99.5% of heterosexual men reported only females as perpetrators (Walters et al. 2013). The NIPSVS is the most comprehensive national survey of its kind collecting detailed data and yet it does not collect data on transgender and genderqueer people. As such, there is very little data on prevalence rates of partner abuse in transgender relationships. An important step is for this national survey to collect data on transgender and genderqueer relationships so that researchers can more thoroughly investigate these marginalized populations. Although a significant problem in LGB relationships, intimate partner violence, sadly, remains an understudied phenomenon (for a review of the literature on empirical research, see Langhinrichsen-Rohling et al. 2012).

Exacerbated Circumstances of Transgender Individuals Although the NIPSVS does not collect data on trans identified people, the largest U.S. national survey for transgender people, the U.S. Transgender Survey (USTS 2015), does. Conducted by the National Center for Transgender Equality, the USTS surveyed 27,715 respondents from all fifty states. Of those surveyed about 10% of respondents reported being sexually assaulted in the year preceding the survey completion, and 47% reported being sexually assaulted at some point in their lifetime (James et al. 2016). Of all those surveyed, 54% have experienced IPV (James et al. 2016). Transgender individuals in the U.S. also experience high rates of poverty with 29% of respondents reportedly living in poverty compared to the national average (14% in the U.S.) (James et al. 2016; Herman 2016). Transgender people surveyed also have a high unemployment rate (15%) compared to the national average at the time (5%)

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(James et al. 2016). High poverty and unemployment rates have been shown to be risk factors for perpetration of IPV due to the interaction between socioeconomic environment and individual level characteristics (for review see, Capaldi et al. 2012). Owing to compounding effects including homelessness—often caused by being forced out of their homes due to their gender identity—and unemployment—often due to discrimination and lack of workplace protections—many transgender people engage in sex work for income (James et al. 2016). One out of five respondents of the USTS have participated in the underground sex work economy for income. Of these, 77% have experienced IPV (James et al. 2016). In their analysis of the 2014 Behavioral Risk Factor Surveillance System (BRFSS) data, Meyer and colleagues (2017) found that transgender individuals have a higher prevalence of poor general health, poor physical, and mental health compared to cisgender individuals. They also found that transgender people are less likely than cisgender people to have health care coverage and a health care provider, which evidences minority stress and health disparities research (Meyer et al. 2017). More data is needed in order to advance our understanding of the health disparities, particularly IPV, that transgender people experience.

Batterer Intervention Programs State Standards for BIPs As discussed earlier in this chapter, state standards regulate and inform perpetrator intervention programs. In their review of state BIP standards in 42 states, Kernsmith and Kernsmith (2009) found that 51% of these standards assumed males were always or often perpetrators of domestic violence against women. These standards express a heteronormative bias—the assumption that men are perpetrators and women are victims—which makes it difficult to treat male perpetrators with male victims and female victims of female perpetrators (Cannon and Buttell 2015). In their seminal review of the effectiveness of batterer treatment programs, Eckhardt and colleagues (2013) found that BIPs provided no specific data on LGBTQ relationship, and in turn could not assess the efficacy of approaches for this population. Although intervention programs are based on a “one size fits all” model (Price and Rosenbaum 2009), scholars increasingly advocate for culturally relevant treatment interventions (Babcock et al. 2016; Cannon et al. 2016; Eckhardt et al. 2013; Gelles 2001; Goldenson et al. 2009; Hamel 2014; Kernsmith and Kernsmith 2009; Maiuro and Eberle 2008). Eckhardt et al.’s (2013: 198) thorough review of research on BIPs found that due to the assumption that violence is a natural outgrowth of male socialization, gender reeducation or exposing harmful beliefs of patriarchy/misogyny and promoting gender egalitarianism approaches, was the most predominant model for BIPs.

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LGBTQ Prevalence, Problems, and Recommendations in Batterer Intervention Programs Although same-sex couples were less likely to call the police (Pattavina et al. 2007) and although 78% of BIPs surveyed were willing to provide services to “homosexual batterers” (Price and Rosenbaum 2009), approximately 1% of BIPs clients openly identified as LGBTQ. This finding raises two major concerns and two subsequent recommendations for treatment modifications. First, current treatment programs cannot convincingly guarantee the safety and comfort of LGBTQ persons. Second, this finding suggests a lack of outreach to the LGBTQ community on potential treatment options (Ford et al. 2013). Cannon and colleagues (2016) found in their survey of batterer intervention programs in the U.S. and Canada that LGBTQ populations were the most common population for which specific interventions were adapted from core curriculums. When asked, respondents to this survey reported they made LGBTQspecific interventions because LGBTQ-specific groups may be far away or have a population that is relatively small. Cannon et al. (2016) identified the most common approach by practitioners to LGBTQ abusers was to provide individual counseling instead of a group setting. However, doing so means LGBTQ abusers do not get the added benefit of group therapy (Cannon 2019). Although many respondents reported that the LGBTQ population was too small to warrant their own treatment curriculum and groups, prevalence rates of IPV in LGBTQ relationships are comparable or worse than opposite-sex relationships (see Hamel 2014; Walters et al. 2013).

LGBTQ BIPS Recommendations Researchers and practitioners alike have developed recommendations to address specific issues facing LGBTQ communities in which IPV is a silent epidemic. BIP practitioners reported a range of LGBTQ client needs apart from the standard intervention, including LGBTQ-specific groups, and specific curriculum to address LGBTQspecific or LGBTQ-sensitive needs. Such specific and sensitive needs entail, for example, dealing with trauma around family of origin, training to address instances of homophobia and oppression by group members, groups that are not sex-segregated, and strategies to address concerns and issues of safety for all clients (Cannon et al. 2016). Two important recommendations to address these limitations suggested by surveyed providers are to have more LGBTQ-identified facilitators and to increase outreach through LGBT centers on treatment options (Cannon et al. 2016). Through outreach to LGBT community centers, BIPs as well as victim advocacy and service organizations can alert LGBTQ individuals to resources available to them through already existing community infrastructure, bridging the gap between resources and the community (Ford et al. 2013). LGBT community centers, in turn, can provide much needed insight into the kinds of struggles, challenges, and threats LGBTQ people face. Doing so can inform IPV practitioners so that they can better serve this

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population. Such coordinated and collaborative efforts can also inform curricula for BIPs to use to improve treatment outcomes for their LGBTQ clients. Collaboration across existing centers and programs is vital particularly since research suggests that treatment providers need to be knowledgeable about sexual minority subgroup issues in order to treat LGBTQ perpetrators effectively (Coleman 2003). Understanding the unique identities and forms of abuse specific to LGBTQ people (e.g., impacts of homophobia and heteronormativity experienced by abusers) may aid providers in successfully locating motivations for IPV in sexual and gender minority populations (Coleman 2003). Given the pervasiveness of IPV in LGBTQ relationships and the higher rates of substance abuse, stigmatization, and discrimination (Klostermann et al. 2011; Lewis et al. 2012, 2017), BIPs must be able to treat not only the causes and consequences of IPV but also such co-morbid effects (Cannon 2019).

Treatment Modifications for LGBTQ BIPs In their qualitative study of BIP services for LGBTQ-identified perpetrators of IPV in the U.S. and Canada, Cannon (2019) found six major themes from deductive and inductive coding of the North American Survey of Domestic Violence Intervention Programs. These themes are: 1. 2. 3. 4. 5. 6.

Whether or not LGBTQ clients have specific needs. Specific challenges BIPs face with LGBTQ clients. Particular interventions for LGBTQ clients. Current and future LGBTQ-specific services. Additional training in cultural sensitivity for BIP practitioners. Practitioner recommendations for improving BIPs led to primary findings and subsequent recommendations.

The six major and corresponding recommendations argued for by Cannon (2019) based on this research to modify BIPs are: 1. 2. 3. 4.

LGBTQ specific group settings with LGBTQ identified facilitators. Training in anti-homophobia, anti-racism, anti-sexism. Utilize new theories such as intersectionality for framing interventions. Develop specific curriculum to address challenges experienced by LGBTQ individuals. 5. Engage LGBTQ centers to increase outreach. 6. Connect researchers and practitioners to study IPV for treatment development. One recommendation from surveyed providers was to create a database of resources and curricula for LGBTQ-specific clients that multiple programs could use in their own treatment programs (Cannon 2019). Another important recommendation is to create training modules for providers that teach anti-racism, anti-homophobia, and anti-sexism so that providers can utilize the latest research to create safe spaces

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for all clients regardless of their identities (Cannon 2019). Doing so will help ensure safety of all members which has been a concern raised by practitioners and advocates alike. As researchers have increasingly called for a more diverse set of theoretical orientations to treatment beyond the feminist, Duluth model of power and control (e.g., Ferreira and Buttell 2016; Ferreira et al. 2017), there is an opportunity to modify BIPs to better address the needs of their clients. The first method, in addition to these psychoeducational models, is to incorporate psychodynamic approaches that take into account values and attitudes of perpetrators may go a long way to effectively treating sex and gender minority perpetrators of IPV (Ferreira and Buttell 2016). Psychodynamic, psychotherapeutic approaches would focus on identifying individual causes of violence due to behavioral deficits, trauma, or psychopathology (Eckhardt et al. 2013). For example, this kind of approach could take into account trauma experienced by abusers due to their belonging to a sex and gender minority. Programs must institute such approaches and more research is necessary to evaluate the effectiveness of this approach (Eckhardt et al. 2006). Secondly, adapting specific treatment curricula to account for and address experiences of LGBTQ-identified people may help both re-education away from violence as a tactic for mediating relationships, and to re-orient values and attitudes that no longer support the use of violence. One such example that could be adapted is the Alcoholics Anonymous (AA) batterer intervention approach. This approach is formed from the firsthand experiences of those who struggle with substance abuse and battering (Gondolf 2004). Similarly, LGBTQ curricula could be formed from the experiences of LGBTQ batterers as both members of sex and gender minorities and as those who use violence in their relationships. Third, BIPs must reach out to LGBTQ centers across the U.S. in order to coordinate outreach of services to this vulnerable population as well as to inform BIPs of the specific needs of LGBTQ clients. Additionally, LGBT centers can incorporate the latest research and intervention practices into their own services for those experiencing IPV. For instance, the Los Angeles LGBT Center offers individual, couples, and group therapy to address instances of IPV in LGBTQ couples. In addition to counseling, the LGBT center can connect both abusers and survivors with other resources such as LGBTQ-specific legal services, LGBTQ-sensitive shelters, prevention services, and court-approved batterer intervention among others. Such centers are already embedded within local LGBTQ communities as well as connected to LGBTQ-sensitive services. By creating a network with these centers, BIPs will be better equipped to serve their clients and better able to refer their clients to the center for other kinds of support and services. Similarly, although New York City’s The Center has robust services for LGBTQ folks and offer group therapy, connecting with a local BIP can help ensure that community members are getting access to all the resources available to help them live their fullest and healthiest lives. Given these two centers are located in two of the largest metropolitan areas in the country, some might argue that only large urban areas can make such connections. But there are LGBT community centers across the country. For instance, the LGBT Community

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Center of Greater Cleveland offers wellness classes and a drop-in coordinator that can help connect members with resources in the community (e.g., local BIPs).

LGBTQ Organization Engagements with IPV In addition to LGBT community centers, there are national organizations that can help connect LGBTQ people struggling with abuse to resources and to educate their communities about the latest research on prevalence and relationship dynamics that leads to abuse. For instance, FORGE—a national transgender anti-violence organization founded in 1994—provides direct services to transgender, gender non-conforming, and gender non-binary survivors of sexual assault. Moreover, FORGE provides training and technical assistance nationally to providers who work with transgender survivors of sexual assault and IPV. They also provide a number of resources (e.g., worksheets, webinars, toolkits) online for providers and researchers to access. In addition to FORGE, there is the National Center for Transgender Equality (NCTE), which focuses on ending discrimination and violence against transgender people through education and advocacy. In addition to their focus on a range of issues of importance to the transgender community, such as social acceptance and legal protections, the NCTE conducts studies on transgender health outcomes as well as experiences of IPV. Additionally, as can be seen in the Table below, there are other organizations that aim to benefit the LGBTQ communities. The National LGBTQ Institute on IPV works with local, state, and national efforts to reduce and prevent IPV in LGBTQ communities. They provide technical assistance, share current research and advocate for policy changes to better support LGBTQ abusers and survivors of IPV. They also provide events and training to reduce IPV disparities in sex and gender minority communities. Other organizations, such as the Anti-Violence Project (AVP), seek to empower LGBTQ communities to end all forms of violence through organizing and education, while providing direct services for IPV survivors. Additionally, AVP provides support for community organizing and public advocacy, economic empowerment, and legal services. AVP is also part of the National Coalition of Anti-Violence Programs (NCAVP) and New York State Lesbian, Gay, Bisexual, Transgender & Queer Intimate Partner Violence Network (or The Network). Through such connections and through LGBTQ communities across the country, AVP is able to inform practices and policy across the U.S. AVP also has its own training and technical assistance center to support and work with providers across the country on creating cultural competency to address issues LGBTQ people face. Such resources will be incredibly useful for BIPs in working with both LGBTQ and heterosexual clients. Providers should be made aware of these toolkits and handouts so that they may be better able to support their clients. These resources are essential to developing safe spaces and addressing the needs of LGBTQ abusers. (See Table 10.1 for a list of organizations with a brief description and websites referenced in this chapter.)

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Table 10.1 Resources for LGBTQ communities with IPV content listed in alphabetical order Organization

Brief description

Website

Anti-Violence Project

Organization aims to end violence through education, training, and advocacy

https://avp.org/about-us/

FORGE

National transgender anti-violence organization

https://forge-forward.org/

LGBT Community Center of Greater Cleveland

Center provides programs, training and advocacy for LGBT people in the greater Cleveland area

https://lgbtcleveland.org/

Los Angeles LGBT Center

Center that offers programs, services, and advocacy for the greater Los Angeles area

https://lalgbtcenter.org/ health-services/mentalhealth/intimate-partnerdomestic-violence

National Center for Transgender Equality

Organization that advocates for greater understanding and acceptance of transgender people in policy and society

https://transequality.org/

National Coalition of Anti-Violence Programs

National coalition of member programs that work to prevent and respond to all forms of violence against and within LGBTQ communities through data analysis, policy advocacy, education, and technical assistance

https://avp.org/ncavp/

National LGBTQ Institute on IPV

National center seeking to prevent and end violence in the LGBTQ community

http://lgbtqipv.org/

New York State LGBTQ IPV Network

Statewide, multidisciplinary group of service providers, community-based agencies, advocates, educators, and policymakers who work to end partner violence in LGBTQ communities

https://avp.org/resources/nyslgbtq-ipv-network/

The Center, The Lesbian, Gay, Bisexual & Transgender Community Center (NYC)

Center that provides advocacy, health and wellness programs, entertainment and cultural events and family support services

https://gaycenter.org/

VAWAnet

An online resource library from the National Resource Center on Domestic Violence

https://vawnet.org/sc/whoare-lgbtq-communities

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Overall, these centers are an important and necessary resource to support the LGBTQ community, but there is a pitfall to these organizations. Surprisingly, and importantly, AVP and other organizations surveyed here do not provide LGBTQ abuser specific materials. Therefore, more work needs to be done to connect researchers who study abusers and the intervention programs that treat abusers with these important LGBTQ groups. Providing resources and services to only IPV survivors cannot, on its own, combat this epidemic. Moreover, such centers need the latest cutting-edge research to inform their own workshops and handouts so that LGBTQ providers and community members are getting the most current understanding of IPV. For instance, AVP provides a handout on the intersection of the power wheel from Duluth model and LGBTQ-specific characteristics (AVP 2000). The Duluth power wheel(s) are the most common abusive behaviors or tactics identified by battered women (Domestic Abuse Intervention Programs 2019). The adapted wheel for LGBTQ people provides thirteen areas of abuse of power and control. These include transphobia, homo/biphobia, heterosexism, isolation, intimidation, HIV-related abuse, sexual abuse, economic abuse, using children, entitlement, physical abuse, threats, and psychological and emotional abuse (AVP 2000). Although useful, this power and control wheel is from 2000 and much research since then has focused on the multiple use of theoretical orientations to frame treatment interventions beyond the Duluth model.

Feminist Versus Family Theoretical Perspectives for LGBTQ Abusers As recent scholarship has pointed out, a traditional feminist understanding of IPV may miss important protective factors and risk factors for LGBTQ abusers and victims alike (see Baker et al. 2013; Cannon and Buttell 2015; 2016a, b; West 2012). LGBTQ abusers may need a different theoretical orientation for explaining their use of violence in their intimate relationships. Just as these organizations call for and provide resources for culturally responsive materials for LGBTQ people, we might also need different or adapted explanations for the use of violence in the first place. Doing so realizes that sexuality and gender are constitutive of abuse dynamics not just outcomes (Cannon et al. 2015). Calling into question such traditional paradigms as the Duluth model for explaining the use of violence by LGBTQ people may also tell us more about IVP motivations, dynamics, and context in other populations (Baker et al. 2013). For instance, Johnson’s seminal research (1995, 2005, 2008) considers that difference in approaches between feminist (i.e. Duluth) and family approaches (i.e. CBT) are definitional in nature. Johnson argues that feminist and family scholars argue over two different types of IPV, “patriarchal terrorism” for the former and “common couple violence” by the latter. “Common couple violence” is understood as violence used between two partners of perceived relative equal power and neither

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person experiences violence as coercive or controlling. “Patriarchal terrorism” is understood as a type of violence more typically referred to as “domestic violence,” where a man is using multidimensional abuse (described in the power wheel) to control and dominate his female partner. The two different theoretical orientations, feminist and family, understand the use of violence differently and subsequently drive different modalities for treatment. Thus, how we understand the use of violence informs how we treat the use of violence in intimate relationships—yet, how we understand the use of violence may not be mutually exclusive. As Cannon and colleagues (2016) found in their North American survey of BIPs, most interventions use both the Duluth model and CBT to treat abusers. Increasingly researchers and providers alike find that there may be multiple drivers and types of violence occurring within one relationship (Cannon et al. 2015, 2016). Thus, multidimensional treatment interventions spanning many theoretical models are necessary to effectively treat the multiple types and uses of violence in intimate relationships. More research is necessary to develop such curricula and to evaluate the effectiveness of current and future interventions (Eckhardt et al. 2006). Such research, in turn, can inform policy proscriptions to regulate more effective treatment interventions.

Creating a Multidimensional Treatment and Intervention Network LGBTQ abusers of IPV provide an opportunity to create such multidimensional treatment interventions as described above. Given the specific risk and protective factors experienced by sex and gender minorities, a whole field of study dedicated to understanding the use of IPV in LGBTQ relationships has grown since this LGBTQ power and control wheel was published (e.g., Cannon 2019; Cannon and Buttell 2015; 2016a; Hamel 2014; Langhinrichsen-Rohling et al. 2012; West 2012). Scholars must work with community organizations (e.g., see Table 10.1) as well as practitioners to provide their latest research to inform the best evidence-based practices to treat not only survivors of IPV but also abusers. To end this silent epidemic of violence, it is imperative that we not only acknowledge the existence of LGBTQ abusers, but also develop effective treatment for them. Creating a network among researchers, providers, and centers will help improve coordination so that the most effective resources and treatment interventions can be delivered to the most vulnerable communities in a useful and culturally specific way. For instance, the Association of Domestic Violence Intervention Providers (ADVIP) is an organization that seeks to connect IPV researchers and providers in order to inform and improve the use of evidence-based practices (ADVIP 2019). ADVIP and other organizations like it can connect with national and local LGBTQ organizations to create a network. Such a network can enable information sharing across the different expertise of each group. For instance, ADVIP can provide LGBTQ organizations the latest research and evidence-based practices for supporting and treating IPV

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abusers. LGBTQ organizations in turn can share this information with their communities and providers. Moreover, LGBTQ organizations are able to share their many resources on LGBTQ language and culturally specific materials with intervention providers. Doing so would not only ensures more effective treatment for LGBTQ people in BIPs but also will serve entire BIP populations. As scholars increasingly suggest incorporating anti-homophobia, antitransphobia, anti-colonialism, anti-sexism, and anti-racism curricula in BIPs, such changes can help alleviate uses of violence through a re-orientation of attitudes and values. Such re-education works to remove the burden of change and equity on already marginalized communities and to create a transformative experience for all clients. A great deal of expertise across intervention treatment providers, IPV researchers, and LGBTQ communities already exist. To maximize impact and improve treatment for LGBTQ abusers of personal-based violence, this expertise must be connected to create a pipeline of knowledge and resources across current infrastructures.

Implications for Future Research, Treatment, and Policy There are several important strategies to combat this silent epidemic of violence. Primary preventions are an important strategy in precluding IPV. Specifically, such strategies include disrupting development pathways towards violence, teaching safe and healthy relationship skills, and strengthening economic supports for families (CDC 2019). Effective treatment of IPV perpetration is another important strategy to reduce IPV. Researchers and treatment providers have begun to investigate and cultivate treatment modalities that account for differing risk and protective factors of minority communities to create more effective perpetrator treatments. This work moves beyond a “one size fits all” model that seeks to fit every perpetrator’s experience into the same framework in order to reduce IPV. Teaching culturally relevant psychoeducational, as well as behavioral and attitudinal, adjustments will go a long way to reducing IPV prevalence. To better develop such treatment, more research is necessary to understand the causes and consequences of IPV in sex and gender minority communities specifically. The question that ultimately necessitates an answer is: how are their experiences of perpetration of violence similar and different from opposite-sex perpetrators of IPV? To improve policy and treatment approaches of the perpetration of IPV by sex and gender minority people, more research is also necessary to better understand dynamics and impacts of personal-based violence in sexual gender minority communities. As Eckhardt and colleagues (2006) have argued, more robust research is necessary to evaluate the effectiveness of all IPV treatment interventions. Recent scholarship has also shown that culturally inclusive and relevant curricula are necessary to improve treatment outcomes (e.g., Cannon et al. 2016; Hamel 2014; West 2012). Coordinating across LGBTQ centers and IPV researchers and providers will provide a network that can leverage the strengths and resources of each to better

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treat LGBTQ abusers of IPV. State and federal policy has a long way to go to catch up to the realities of IPV prevalence in LGBTQ relationships (Cannon and Buttell 2015, 2016b). Through coordination across LGBTQ centers, advocates, providers, and through future research suggested here, policymakers will have to take seriously this silent epidemic and to craft policy that more adequately and equitably treats IPV in LGBTQ communities.

References Appel, A. E., & Holden, G. W. (1998). The co-occurrence of spouse and physical child abuse: A review and appraisal. Journal of Family Psychology, 12(4), 578–599. https://doi.org/10.1037/ 0893-3200.12.4.578. Anti-Violence Project. (2000). Building safe communities for lesbian, gay, transgender, bisexual and HIV-affected New Yorkers: Power and control in lesbian, gay, transgender & bisexual relationships. Retrieved from https://avp.org/2000_avp_ipv_wheel/. Association of Domestic Violence Intervention Providers. (2019). Home page. Retrieved from https://domesticviolenceintervention.net/. Babcock, J., Armenti, N., Cannon, C., Lauve-Moon, K., Buttell, F., Ferreira, R., … Solano, I. (2016). Domestic violence perpetrator programs: A proposal for evidence-based standards in the United States. Partner Abuse, 7(4), 355–460. https://doi.org/10.1891/1946-6560.7.4.355. Babcock, J. C., Green, C. E., & Robie, C. (2004). Does batterers’ treatment work? A meta-analytic review of domestic violence treatment. Clinical Psychology Review, 23, 1023–1053. https://doi. org/10.1016/j.cpr.2002.07.001. Baker, N. L., Buick, J. D., Kim, S. R., Moniz, S., & Nava, K. L. (2013). Lessons from examining same-sex intimate partner violence. Sex Roles, 69(3–4), 182–192. https://doi.org/10.1007/ s11199-012-0218-3. Banks, J., Kini, S., & Babcock, J. (2013). Interventions that work to stop intimate partner violence. In L. A. Craig, L. Dixon, & T. A. Gannon (Eds.), What works in offender rehabilitation: An evidence-based approach to assessment and treatment (pp. 159–172). West Sussex, UK: WileyBlackwell. Black, M. C. (2011). Intimate partner violence and adverse health consequences: Implications for clinicians. American Journal of Lifestyle Medicine, 5, 428–439. https://doi.org/10.1177/ 1559827611410265. Bonta, J. (1996). Risk-needs assessment and treatment. In A. T. Harland (Ed.), Choosing correctional options that work: Defining the demand and evaluating the supply (pp. 18–32). Thousand Oaks, CA: Sage. Breiding, M. J., Chen J., & Black, M. C. (2014). Intimate partner violence in the United States— 2010. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Buzawa, E. S., Buzawa, C. G., & Stark, E. D. (2015). Responding to domestic violence: The integration of criminal justice and human services. Thousand Oaks, CA: Sage. Cannon, C. E. B. (2019). What services exist for LGBTQ perpetrators of IPV in batterer intervention programs across North America? A qualitative study. Partner Abuse, 10(2), 222–242. https://doi. org/10.1891/1946-6560.10.2.222. Cannon, C., & Buttell, F. (2015). Illusion of inclusion: The failure of the gender paradigm to account for intimate partner violence in LGBT relationships. Partner Abuse, 6(1), 65–77. https://doi.org/ 10.1891/1946-6560.6.1.65.

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Cannon, C. E. B., & Buttell, F. (2016a). Pushing the paradigm: Addressing controversies over LGBTQ intimate partner violence. Journal of Family Violence, 31, 967–971. https://doi.org/10. 1007/s10896-016-9900-5. Cannon, C., & Buttell, F. (2016b). Policy discussions on LGBTQ intimate partner violence in North America. In R. Laratta (Ed.), An analysis of contemporary social welfare issues (pp. 5–12). Rijeka, Croatia: InTech. Cannon, C., Hamel, J., Buttell, F. P., & Ferreira, R. J. (2016). A survey of domestic violence perpetrator programs in the United States and Canada: Findings and implications for policy and intervention. Partner Abuse, 7(3), 226–276. https://doi.org/10.1891/1946-6560.7.3.226. Cannon, C., Lauve-Moon, K., & Buttell, F. (2015). Re-theorizing intimate partner violence through post-structural feminism, queer theory, and the sociology of gender. Social Sciences, 4, 668–687. https://doi.org/10.3390/socsci4030668. Cantos, A. L., & O’Leary, K. D. (2014). One size does not fit all in treatment of intimate partner violence. Partner Abuse, 5(2), 204–236. https://doi.org/10.1891/1946-6560.5.2.204. Capaldi, D. M., Knoble, N. B., Shortt, J. W., & Kim, H. K. (2012). A systematic review of risk factors for intimate partner violence. Partner Abuse, 3(2), 231–280. https://doi.org/10.1891/19466560.3.2.231. Center for Disease Control and Prevention (CDC). (2019). Violence Prevention: Fast Facts. Retrieved from https://www.cdc.gov/violenceprevention/intimatepartnerviolence/fastfact.html. Coleman, V. E. (2003). Treating the lesbian batterer: Theoretical and clinical considerations—A contemporary psychoanalytic perspective. In D. Dutton & D. J. Sonkin (Eds.), Intimate violence: Contemporary treatment innovations (pp. 159–206). Bringhampton, NY: Haworth Maltreatment & Trauma Press. Condino, V., Tanzilli, A., Speranza, A. M., & Lingiardi, V. (2016). Therapeutic interventions in intimate partner violence: An overview. Research in Psychotherapy: Psychopathology, Process and Outcome, 19(2), 79–88. https://doi.org/10.4081/ripppo.2016.241. Cooper, A., & Smith, E. L. (2011). Homicide trends in the United States, 1980–2008: Annual rates for 2009 and 2010. Washington, D.C.: Bureau of Justice Statistics. NCJ 236018. Davies, P. T., & Cicchetti, D. (2004). Toward an integration of family systems and developmental psychopathology approaches. Development and Psychopathology, 16(3), 477–481. Domestic Abuse Intervention Programs (DAIP). (2019). FAQ about the Wheels. Retrieved from https://www.theduluthmodel.org/wheels/faqs-about-the-wheels/. Eckhardt, C. I., Murphy, C., Black, D., & Suhr, L. (2006). Intervention programs for perpetrators of intimate partner violence: Conclusions from a clinical research perspective. Public Health Reports, 121(4), 369–381. https://doi.org/10.1177/003335490612100405. Eckhardt, C. I., Murphy, C. M., Whitaker, D. J., Sprunger, J., Dykstra, R., & Woodard, K. (2013). The effectiveness of intervention programs for perpetrators and victims of intimate partner violence. Partner Abuse, 4(2), 196–231. https://doi.org/10.1891/1946-6560.4.2.196. Ferreira, R. J., & Buttell, F. P. (2016). Can a “Psychosocial Model” help explain violence perpetrated by female batterers? Research on Social Work Practice, 26(4), 362–371. https://doi.org/10.1177/ 1049731514543665. Ferreira, R. J., Lauve-Moon, K., & Cannon, C. (2017). Male batterer parenting attitudes: Investigating differences between African American and Caucasian men. Research on Social Work Practice, 27, 572–581. https://doi.org/10.1177/1049731515592382. Ford, C. L., Slavin, T., Hilton, K. L., & Holt, S. L. (2013). Intimate partner violence prevention services and resources in Los Angeles: Issues, needs, and challenges for assisting lesbian, gay, bisexual, and transgender clients. Health Promotion Practice, 14, 841–849. https://doi.org/10. 1177/1524839912467645. Gelles, R. J. (2001). Standards for programs for men who batter? Not yet. Journal of Aggression, Maltreatment & Trauma, 5, 11–20. https://doi.org/10.1300/J146v05n02_02.

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Goldenson, J., Spidel, A., Greaves, C., & Dutton, D. (2009). Female perpetrators of intimate partner violence: Within-group heterogeneity, related psychopathology, and a review of current treatment with recommendations for the future. Journal of Aggression, Maltreatment & Trauma, 18, 752– 769. https://doi.org/10.1080/10926770903231791. Gondolf, E. W. (2004). Evaluating batterer counseling programs: A difficult task showing some effects and implications. Aggression and Violent Behavior, 9(6), 605–631. https://doi.org/10. 1016/j.avb.2003.06.001. Hamel, J. (2014). Gender inclusive treatment of intimate partner abuse: Evidence-based approaches (2nd ed.). New York, NY: Springer Publishing Co. Hellemans, S., Loeys, T., Buysse, A., Dewaele, A., & De Smet, O. (2015). Intimate partner violence victimization among non-heterosexuals: Prevalence and associations with mental and sexual well-being. Journal of Family Violence, 30(2), 171–188. https://doi.org/10.1007/s10896-0159669-y. Herman, J. L. (2016). LGB within the T: Sexual orientation in the National Transgender Discrimination Survey and implications for public policy. In Y. Martínez-San Miguel & S. Tobias (Ed.), Trans studies: The challenge to hetero/homo normativities (pp. 172–188). New Brunswick, NJ: Rutgers University Press. James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality. Johnson, M. P. (1995). Patriarchal terrorism and common couple violence: Two forms of violence against women. Journal of Marriage and the Family, 57(2), 283–294. https://doi.org/10.2307/ 353683. Johnson, M. P. (2005). Apples and oranges in child custody disputes: Intimate terrorism vs. situational couple violence. Journal of Child Custody, 2(4), 43–52. https://doi.org/10.1300/ j190v02n04_03. Johnson, M. P. (2008). A typology of domestic violence: Intimate terrorism, violent resistance, and situational couple violence. Lebanon, NH: Northeastern University Press. Kernsmith, P., & Kernsmith, R. (2009). Treating female perpetrators: State standards for batterer intervention services. Social Work, 54(4), 341–349. https://doi.org/10.1093/sw/54.4.341. Klostermann, K., Kelley, M. L., Milletich, R. J., & Mignone, T. (2011). Alcoholism and partner aggression among gay and lesbian couples. Aggression and Violent Behavior, 16(2), 115–119. https://doi.org/10.1016/j.avb.2011.01.002. Langhinrichsen-Rohling, J., Misra, T. A., Selwyn, C., & Rohling, M. L. (2012). Rates of bidirectional versus unidirectional intimate partner violence across samples, sexual orientations, and race/ethnicities: A comprehensive review. Partner Abuse, 3(2), 199–230. https://doi.org/10. 1891/1946-6560.3.2.199. Lewis, R. J., Mason, T. B., Winstead, B. A., & Kelley, M. L. (2017). Empirical investigation of a model of sexual minority specific and general risk factors for intimate partner violence among lesbian women. Psychology of Violence, 7(1), 110–119. https://doi.org/10.1037/vio0000036. Lewis, R. J., Milletich, R. J., Kelley, M. L., & Woody, A. (2012). Minority stress, substance use, and intimate partner violence among sexual minority women. Aggression and Violent Behavior, 17(3), 247–256. https://doi.org/10.1016/j.avb.2012.02.004. Maiuro, R., & Eberle, J. A. (2008). State standards for domestic violence perpetrator treatment: Current status, trends, and recommendations. Violence and Victims, 23(2), 133–155. https://doi. org/10.1891/0886-6708.23.2.133. Margolin, G., & Gordis, E. B. (2003). Co-occurrence between marital aggression and parents’ child abuse potential: The impact of cumulative stress. Violence andVvictims, 18(3), 243–258. https:// doi.org/10.1891/vivi.2003.18.3.243. Mason, T. B., Lewis, R. J., Milletich, R. J., Kelley, M. L., Minifie, J. B., & Derlega, V. J. (2014). Psychological aggression in lesbian, gay, and bisexual individuals’ intimate relationships: A review of prevalence, correlates, and measurement issues. Aggression and Violent Behavior, 19(3), 219–234. https://doi.org/10.1016/j.avb.2014.04.001.

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Meyer, I. H., Brown, T. N., Herman, J. L., Reisner, S. L., & Bockting, W. O. (2017). Demographic characteristics and health status of transgender adults in select US regions: Behavioral risk factor surveillance system, 2014. American Journal of Public Health, 107, 582–589. https://doi.org/10. 2105/AJPH.2016.303648. Pattavina, A., Hirschel, D., Buzawa, E., Faggiani, D., & Bentley, H. (2007). A comparison of the police response to heterosexual versus same-sex intimate partner violence. Violence Against Women, 13(4), 374–394. https://doi.org/10.1177/1077801207299206. Peterson, C., Kearns, M. C., McIntosh, W. L., Estefan, L. F., Nicolaidis, C., McCollister, K. E., … Florence, C. (2018). Lifetime economic burden of intimate partner violence among U.S. adults. American Journal of Preventive Medicine, 55, 433–444. https://doi.org/10.1016/j.amepre.2018. 04.049. Price, B. J., & Rosenbaum, A. (2009). Batterer intervention programs: A report from the field. Violence and Victims, 24, 757–770. https://doi.org/10.1891/0886-6708.24.6.757. Smith, S. G., Zhang, X., Basile, K. C., Merrick, M. T., Wang, J., Kresnow, M., & Chen, J. (2018). The National Intimate Partner and Sexual Violence Survey (NISVS): 2015 data brief—updated release. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Sturge-Apple, M. L., Cicchetti, D., Davies, P. T., & Suor, J. H. (2012). Differential susceptibility in spillover between interparental conflict and maternal parenting practices: Evidence for OXTR and 5-HTT genes. Journal of Family Psychology, 26, 431–442. https://doi.org/10.1037/a0028302. Walters, M. L., Chen, J. & Breiding, M. J. (2013). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 findings on victimization by sexual orientation. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. West, C. M. (2012). Partner abuse in ethnic minority and gay, lesbian bisexual, and transgender populations. Partner Abuse, 3(3), 336–357. https://doi.org/10.1891/1946-6560.3.3.336.

Clare Cannon Ph.D. As Assistant Professor in the Department of Human Ecology at the University of California, Davis, Dr. Clare Cannon is excited to continue her research into social inequality and health disparities, with an emphasis on feminist theories and methods. Her research areas include intimate partner violence, sex and gender minorities, gender and society, socioenvironmental inequality, and climate change and natural hazards. Dr. Cannon has two main research lines: (1) investigating environmental inequality and health; and, (2) analyzing policies and interventions to treat personal-based violence. Dr. Cannon’s research continues to evolve in studying social vulnerability due to climate change related disasters and socio-environmental health in environmental justice communities. Dr. Cannon received her doctorate from the interdisciplinary City, Culture + Community program at Tulane University. She received a B.A. in American Studies with a minor in Gender and Women’s Studies from Scripps College of the Claremont Colleges Consortium. She earned a M.A. in Social Ethics and Depth Psychology and Religion from Union Theological Seminary, Columbia University in New York City.

Chapter 11

Beyond Gender: Finding Common Ground in Evidence-Based Batterer Intervention John Hamel

Introduction: Batterer Intervention Today Beginning in the early 1980s, domestic violence, also known as intimate partner violence (IPV), has been recognized as a major social problem in the United States—one that affects millions of families. Initially, individuals arrested on a domestic violence battery charge were almost exclusively male offenders who had committed serious assaults upon their partners. With the introduction of mandatory arrest and “no-drop” prosecution policies, arrests increased as well as the proportion of cases involving lesser offenses. Arrests of female perpetrators increased somewhat before declining once again after victim advocates pushed for “dominant aggressor” guidelines. These guidelines discouraged dual arrests even though the violence among partner-abusive couples is mostly bi-directional (Langhinrichsen-Rohling et al. 2012), and favored the arrest of males on the presumptions (now known to be false) that women rarely initiate IPV or seek to exercise power and control over partners (Hamel 2011). On the other hand, among same-sex partners, where the parties are more likely than among straight couples to be of similar physical size, the violence is often assumed to be “mutual” when in fact one partner may dominate. Consequently, social service agencies have traditionally misunderstood the problem, and it has been treated as inconsequential, even humorous, by law enforcement and therefore not worthy of criminal arrest (Brown and Groscup 2009; Letellier 1994; West 1998, 2012). As an alternative to incarceration, intervention programs were established for IPV perpetrators. Known as batterer intervention programs (BIPs), they were grounded in theories linking the cause of men’s IPV primarily to patriarchal attitudes and social structures, and the desire of men to control their female partners (e.g., Dobash and Dobash 1979; Pence and Paymar 1993); although some BIPs did incorporate findings

J. Hamel (B) Private Practice, San Francisco, CA, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_11

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and principles from the mental health fields including cognitive-behavioral therapy (CBT) (e.g., Sonkin and Durphy 1997). The population IPV perpetrators is now a heterogeneous one, yet in most states all adjudicated offenders, regardless of the severity of the crime, are mandated to a same-sex psychoeducational group program for a specified number of weeks (e.g., 52 in California). In a majority of states, couples and family therapy are forbidden with individual therapy a limited option (Babcock et al. 2016). This “one-size-fits-all” approach persists, even though mandatory arrest policies have led to a substantial increase in offenders; many of whom may be less dangerous than those arrested in previous decades, whose offenses are difficult to charge (mandatory arrest policies have led to a 60% decrease in convictions Hirschel 2008), and who may not need the full number of sessions required by law. Conversely, judges often sentence defendants to a minimal course in anger management, when they require more intensive treatment. These flaws in arrest and prosecution policies may explain the minimal impact of BIPs on recidivism rates (e.g., in California, only 50% of individuals mandated to a BIP complete the program California State Auditor 2006).

Current Research on IPV Critics of domestic violence policy and intervention have long argued that BIPs could be more effective in reducing rates of recidivism among offenders if they were based on the empirical research evidence rather than the feminist/gendered models championed by victim advocates (Dutton 2010; Dutton and Corvo 2006). According to results from the National Intimate Partner and Sexual Violence Survey (Black et al. 2011; Walters et al. 2013), rates of both physical and psychological IPV are comparable across gender, and are as high, or higher, among LGBTQ populations as they are among straight couples. Additionally, when controlling for socioeconomic status, IPV rates are similar across ethnic groups (Malley-Morrison and Hines 2004; West 2012). IPV, particularly in the United States, is a human problem, not one of gender, culture, or sexual orientation. There is no doubt that throughout the world, including the United States, patriarchal structures continue to impact women’s social, economic, and political wellbeing, and that many individual men harbor misogynistic attitudes. Clearly, gender equality remains a goal worth championing, but while there is some overlap between the status of women and rates of IPV, these should be considered separate problems. Even in non-Western industrialized counties, the impact of patriarchal structures (based on the United Nations Gender Empowerment Measure designed to determine the relative empowerment of women across countries) on rates of male-perpetrated IPV are not clear-cut (Esquivel-Santovena et al. 2013). Furthermore, Sugarman and Frankel’s (1996) meta-analysis found correlations between physical abuse and attitudes condoning such violence; however, traditional gender role attitudes did not differentiate non-violent men from those who abuse their partners. As pointed out by Felson (2002), societal power does not automatically translate to personal power.

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Table 1 Symmetry and asymmetry across gender Symmetry

Asymmetry

Mixed/Inconclusive

Rates of physical abuse

Rates of sexual abuse

Impact of emotional abuse

Rates of emotional abuse

Rates of physical stalking

Abuse in non-Western countries

Rates of non-physical

Impact of physical abuse stalking

Causes and risk factors Impact on children/families Self-reported motives

Gendered models, of course, also fail to account for the high IPV rates found among lesbians, and may reinforce common stereotypes about this population, e.g., that perpetrators are necessarily “butch,” and are acting “like a man.” Findings from a series of literature reviews (Hamel et al. 2012)1 support the viability of individual, couples, and family counseling as an alternative or adjunct to the group format; and the high level of symmetry across gender in the rates of physical and psychological abuse/control, motivating factors, and the causes, characteristics, and dynamics of IPV (see Table 1), calls into question the ubiquity of Duluth and similar gender-based interventions—interventions that might be more effective if applied to selected populations rather than part of a one-size-fits-all curriculum. While the relative importance of gender roles/patriarchy as risk factors for IPV continue to be debated, there has been greater consensus about those most associated with the perpetration of physical and emotional abuse. They include; stress from low-income or unemployment; having an aggressive personality; including proviolent beliefs; poor impulse control and anger management problems; alcohol and drug abuse; being in a high-conflict/abusive relationship; and having experienced violence/dysfunction in one’s family of origin. With minor exceptions, risk factors were found to be the same across gender (Capaldi et al. 2012), with homophobia is an additional risk factor in LGBQ relationships (Letellier 1994; West 1998). Offender types. In the typology by Holtzworth-Munroe and Stuart (1994), male perpetrators can be broadly categorized into three types. The first, the family-only types (estimated to account for about half of the IPV offender population), are regarded as the least dangerous with low levels of psychopathology and less serious domestic violence histories. About 25% of the offending population are the second type of offender, what the authors call dysphoric/borderline, and consist of men with characteristics of borderline personality disorder (BPD), often suffering from depression, who are typically not violent outside the home but who have very poor impulse control, tend to be emotionally insecure, are controlling and possessive, and are capable of serious, injury-producing violence. Finally, the men categorized as 1 The

Partner Abuse State of Knowledge Project (PASK), can be accessed by anyone for free at www.domesticviolenceresearch.org, and consists of 17 articles (2,657 pp.) previously published in 5 issues of the peer-reviewed journal, Partner Abuse.

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generally-violent/antisocial account for the rest of the offender population. In contrast to men in the other categories, they have engaged in criminal activities including interpersonal violence outside the home. They are extremely impulsive and highly dangerous, frequently abuse substances, and are controlling of their partners. In contrast to borderline men, their attachment style is dismissive rather than preoccupied (clingy). Similar categories have been found among populations of female offenders as well (Babcock et al. 2003). As mentioned previously, partner violence is more often than not bidirectional (Langhinrichsen-Rholing et al. 2012), thus limiting the usefulness of typologies such as Holtzworth-Munroe and Stuart’s which focus on the characteristics of only one party in a relationship. The model put forth by Johnson (2008) sought to reconcile survey data showing comparable rates of violence between the sexes and findings from clinical populations that pointed to greater asymmetry in frequency and severity of IPV. While critics have called into question some of Johnson’s conclusions regarding rates of serious IPV perpetration across gender (e.g., Bates et al. 2014; Jasinski et al. 2014), the typology proposed has been helpful in identifying the treatment needs of a heterogenous offending population (e.g., Hamel 2014; Potter-Efron 2005). In particular, individuals who engage in controlling/coercive abuse fit the pattern of behavior characteristic commonly known as battering, which implies a long-standing use of physical, psychological, and sometimes sexual abuse to dominate one’s partner that tends to escalate over time and is more likely to lead to life-threatening injuries. The partners of these offenders may or may not be abusive themselves. In comparison, the majority of relationship abuse is less frequent or consequential. Johnson’s term for this type of abuse, situational violence, reflects a reactive dynamic of escalating conflict and emotional expression in contrast to more conscious attempts by a partner to dominate and harm the other. Rates of both situational and controlling/coercive abuse are comparable across gender (Jasinski et al. 2014). Although formal typologies have not yet been formulated for LGBTQ offenders, there is evidence from various studies that the violence in a majority of this population, like heterosexual IPV offenders, is situational, driven by escalated conflict attachment insecurity (e.g., Bartholomew et al. 2008; McKenry et al. 2006). More consequential violence among LGBTQ perpetrators closely resemble the various battering patterns found among straight populations (e.g., Walker’s three-phase cycle, PTSD among victims, extreme jealousy and personality disorders on the part of the perpetrator), although some forms of controlling behaviors (e.g., threatening to “out” one’s partner) are specific to the LGBTQ community (see Coleman 2002; Hamel 2014 for further discussion).

Primary BIP Treatment Models Duluth. The most well-known and imitated model for IPV group intervention regards the primary cause of IPV to be patriarchal social norms that presumably support male privilege, and beliefs held by men that they can abuse their partners to maintain male

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dominance over women (Pence and Paymar 1993). In a highly structured group format, male participants are educated about the nature of the patriarchal actions they use to control women such as intimidation, isolation, and economic abuse, and to foster an egalitarian mindset. The program is not considered to be “treatment,” but an opportunity for perpetrator re-education that subsequently comprises merely one component in the broader community-wide response to IPV. Cognitive-Behavioral Therapy (CBT). In this model, IPV is believed to be rooted in distorted thinking about self and partner, and the utility of violence to dominate or to resolve problems. It addresses all relevant risk factors including childhood-of-origin violence and disfunction; aggressive personality; poor emotion management and interpersonal functioning; and substance abuse. Main intervention components include strategies that target thoughts, emotions, and behaviors through a mixture of psychoeducation, discussion, homework assignments, and cognitive reframing. Interpersonal deficits are targeted through a skills training approach (e.g., Murphy and Eckhardt 2005; Sonkin and Durphy 1997; Wexler 2000). Process/Psychotherapeutic. Intimate partner violence, according to this view, is an acting-out problem rooted in one’s upbringing and is best understood in light of a client’s emotional problems and social maladjustment. Long-term desistance is more likely when a client addresses these emotional and social issues, is empowered to get his or her needs met, and has achieved a positive sense of self. There is less of an emphasis on didactic presentations; the primary vehicle for change comes from gaining insight, overcoming inner resistance, working through inner conflicts, healing past trauma, and feeling understood in a supportive therapeutic environment (Bowen 2009; Stosny 2004, 1995).

Controversy and Mistrust Over the years, the author has observed that among the various stakeholders involved in IPV policy—intervention and treatment—some regard IPV as a social and behavioral problem while others regard IPV more as a mental health issue. The first group (mostly consisting of law enforcement, victim advocates, and some batterer intervention providers), would argue that focusing on anger, trauma, or substance abuse prevents clients from taking responsibility. Their indoctrination in the gender paradigm makes them wary of the term “evidence-based,” which implies therapeutic interventions best suited for the general population. Instead, they value the experiences of the victims and favor Duluth or other feminist-psychoeducational models. The second group (among them mental health professionals and some batterer intervention providers) rejects Duluth as unscientific and contrary to professional codes of ethics (Corvo et al. 2009; Corvo and Johnson 2003; Lee et al. 2009). Others have deemed gendered models to be “heterosexist” and inadequate for the treatment of samesex violence (Letellier 1994). This unnecessary schism, unfortunately, has limited potentially beneficial cooperation between researchers and providers.

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In this chapter, an attempt is made to establish common ground among all stakeholders from the perspective of a scholar-practitioner. Areas of core agreement will be proposed, such as the importance of client engagement to prevent drop-outs or the acquisition of pro-social skills. The importance of gender equality and the rights of LGBTQ individuals can be agreed upon, without the presumption of misogyny among all male perpetrators. Given that relationship conflict is a known IPV risk factor, gender roles and gender differences can be a legitimate focus of treatment for many clients, without the cumbersome and potentially alienating theoretical architecture of gendered intervention models that fail to address both LGBTQ and femaleperpetrated abuse. Front-line providers, it will be argued, can better meet the needs of their specific populations by combining clinical experience with established and promising empirical research findings drawn from a broad overview of BIP research, as well as relevant research with other populations including general psychotherapy clients, correctional populations, and individuals active in 12-step and other self-help programs. But first, it is crucial that the term “evidence-based practice” is properly defined.

Evidence-Based Practice To improve BIP outcomes, intervention providers should be familiar with the full range of available treatment options, including the research evidence. The American Psychological Association defines “evidence-based practice” as the “integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences” (APA Presidential Task Force 2006, p. 273). Given the practical limitations of an average agency conducting randomized control outcome research, can a program be “evidence-based” if it is simply modeled after one that has been found effective under the strictest methodological research designs? If so, how far can it deviate from its model and still meet the needs of a potentially different client population? Before these questions can be answered, two major obstacles must be overcome. The first is the existence of state standards regulating BIPs in the United States that emphasize gendered treatment models advanced by victim advocates (Babcock et al. 2016; Maiuro and Eberle 2008) with limited applicability to a broader range of clients. The second obstacle lies in the subjective biases inherent among some intervention providers, especially those without professional licensure or unfamiliar with research methodology.

Problem of Bias and Subjectivity After three decades conducting and supervising BIPs for court-mandated perpetrators in the San Francisco Bay Area and having regularly met with BIP colleagues, it is the author’s impression that most providers genuinely care about their clients and

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believe they are doing the best they can to help them take responsibility for their violence. However, upon what empirical basis do they assume that their programs are effective in reducing rates of physical and emotional abuse? Upon what empirical basis are they certain that their treatment model is appropriate for the clients they serve? According to the American Psychological Association (APA), “integral to clinical expertise is an awareness of the limits of one’s knowledge and skills and attention to the heuristics and biases—both cognitive and affective—that can affect clinical judgment” (American Psychological Association Presidential Task Force on EvidenceBased Practice, 2006, p. 276). Among the more common of these are the availability heuristic: estimating an outcome on the basis of how easily we can imagine that outcome occurring (e.g., most of our clients are men, so we view them as perpetrators and women as victims); the representativeness heuristic: evaluating something as belonging to a category based on superficial reasons (e.g., all offenders are labelled “batterers,” implying that they all have demonstrated a pattern of serious violence and power/control); and confirmatory bias: the tendency to seek information that would confirm our expectations. In a remarkably courageous act of humility, the late Ellen Pence, co-founder of the Duluth model observed: By determining that the need or desire for power was the motivating force behind battering, we created a conceptual framework that, in fact, did not fit the lived experience of many of the men and women we were working with. The DAIP staff […] remained undaunted by the difference in our theory and the actual experiences of those we were working with […] It was the cases themselves that created the chink in each of our theoretical suits of armor. Speaking for myself, I found that many of the men I interviewed did not seem to articulate a desire for power over their partner. Although I relentlessly took every opportunity to point out to men in the groups that they were so motivated and merely in denial, the fact that few men ever articulated such a desire went unnoticed by me and many of my coworkers. Eventually, we realized that we were finding what we had already predetermined to find. (Pence 1999)

Research on the effectiveness of psychotherapy indicates that treatment outcomes improve when therapists dedicate themselves to ongoing learning and selfexamination. One meta-analysis found that it is not the number of years of clinical experience, per se, that predict treatment outcomes, but rather time devoted to improving one’s therapy skills (Tracey et al. 2015). A survey of psychotherapists (Vollmer et al. 2013) had previously found that clinical knowledge typically increases throughout the period of postgraduate training and then stops. Unless a clinician makes it a point to continue the learning process beyond this, his or her skills may decline, thus reducing treatment flexibility and compromising outcomes. These findings would certainly apply to those batterer intervention providers who lack adequate education in psychology and mental health counseling.

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Research on BIPs The term “evidence-based practice” can be defined in various ways. From a social work perspective, it is a “systematic process that blends current best evidence, client preferences (wherever possible), and clinical expertise, resulting in services that are both individualized and empirically sound” (Shlonsky and Gibbs 2004, p. 137). Elements of this “systematic” process, however, are not equally valuable. Clinical observations are thought to provide the least reliable types of empirical data whereas randomized clinical trials (RCT) are considered the gold standard. Outcome research with similar populations (e.g., substance abusers, correctional populations) can also be useful, setting the stage for more formal research on IPV and may inform interventions where more methodologically-sound research is unavailable. But there does exist a body of batterer intervention outcome research based on RCT and quasi-experimental designs, and this is where we must begin if we are to define, promote, and implement evidence-based intervention policies. One of the first meta-analyses of the BIP outcome literature (Babcock et al. 2004) found minimal effect sizes, ranging from d = 0.01 (from more reliable victim reports) to d = 0.26 (from less reliable police records that do not capture unreported assaults). Effect sizes of 0.2 and under are considered low. A d of 0.5 is considered moderate, and 0.8 is a large effect size. Based on partner reports, court-mandated perpetrators have a 60% chance of being successfully nonviolent following court monitoring and completion of a batterer intervention group. However, their chances without group treatment are 55%: an improvement of only 5%. In comparison, the average effect size for general psychotherapy is d = 0.85, indicating a 40% improvement over no treatment. Effect sizes are also higher for adolescent aggression treatment (d = 0.32; 16% improvement), and adult correctional treatment (d = 0.25; 12% improvement). As part of the Partner Abuse State of Project series of literature reviews, cited earlier, Eckhardt et al. and his colleagues (2013) identified 8 RCTs and 12 quasi-experimental studies of traditional BIPs (Duluth, CBT, or Process/Psychotherapeutic). Some involved a comparison of treatment to a no-treatment condition, and others compared one treatment to another. The authors reported significant positive outcomes (reduced rates of recidivism) in 9 studies, of which 8 used a less rigorous quasi-experimental design. In general, what the outcome literature suggests is that overall effect sizes for group treatment are low, particularly when the data comes from RCT methodology and is based on victim reports. RCT replications have not been conducted on any specific program, and while one review found gender-based models essentially useless (Miller et al. 2013), those found effective (couples counseling and BIP groups for substance abusers) would not be appropriate for many offenders. One promising treatment model has recently emerged (Zarling et al. 2017) based on principles of Acceptance and Commitment Therapy (ACT), a form of CBT that includes mindfulness, emotion management, relationship skill-building, and valuesdirected goals. Clients, who had been referred from mental health clinicians and who had perpetrated at least 2 physically aggressive acts toward their current or former

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romantic partners within the past 6 months, were randomly assigned to a 12-week ACT or a support/discussion control group. At a 6-month follow-up, ACT clients had perpetrated significantly less psychological and physical partner aggression. Replication studies are now underway. Remarkably, no RCT studies have yet been conducted with female perpetrators, nor with those who identify as LGBTQ. Reasons for minimal BIP effectiveness. Some observers (e.g., Gondolf 2011, 2012) suggest that the effectiveness of standard feminist and/or CBT programs is understated and cite larger effect sizes from quasi-experimental designs that take into account confounds due to unmeasured client characteristics (Gondolf 2012). These claims, however, remain controversial. There is no doubt that some RCT studies have been tainted by methodological problems—for instance, assignment to conditions is not always random, the treatment model is not always clearly defined, and making comparisons across models (e.g., between CBT and Duluth) is difficult at best. Effects are also diluted from heterogeneous samples subjected to a “one-size-fits-all” treatment, and research has mostly focused on the effectiveness of one theoretical model compared to another rather than determining what works and building programs around these findings. This will be explored in an upcoming section. Findings from a National BIP Survey. It might be worthwhile to pause and remember that, especially in the absence of clear, replicated experimental outcome findings, clinical experience may yield useful data. This was the rationale for the 15-page questionnaire, the North American Domestic Violence Intervention Program Survey (NADVIPS), sent in 2016 to BIP directors in U.S. and Canada (Cannon et al. 2016). Questions were asked about program characteristics (e.g., populations served, treatment approach, facilitator training and education, relationship with victim advocates, law enforcement and other community organizations), as well as questions intended to gauge facilitator knowledge about IPV rates of perpetration, abuse dynamics, and views on intervention policy. Surveys from a total of 238 respondents were completed, providing both descriptive and analytic data. Based on this convenience sample, it appears that batterer intervention providers in the U.S. and Canada are, for the most part, well-educated (almost half have a Master’s degree), trained (30 h IPV training annually), and experienced (average 8 years). The primary or secondary treatment approach for 47.3% of BIPs is Duluth, and 54% for CBT. The majority of programs provide standard information on power and control behaviors and the effects of domestic violence on children as promulgated by feminist theory, but also teach a variety of well-established emotion-management and relationship skills common to CBT. A variety of interventions are utilized, including hand-outs and exercises, role-play and digital media, as well as “check-in” time for general discussion. When asked about ways to handle typical problems that arise in a group setting (e.g., resistance, interruptions), respondents provided clinically-sound recommendations. The average program intake is conducted over 1.5 h—a reasonably adequate amount of time with which to properly assess a new client. In light of poorly written standards in most states (Maiuro and Eberle 2008), a sizable minority of providers (40%) are willing to work outside these standards or supplement them when necessary.

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Not all responses were as promising, however. When asked to identify the most significant IPV risk factors, 85% identified “need for power and control” as the most important, but only about one third identified having an aggressive personality or being in an abusive relationship. Additionally, only 22% of respondents identified stress from unemployment or low income as a factor. Moreover, they tend to wrongly assume men primarily initiate psychological and physical abuse typically motivated for reasons of power and control, in contrast to female offenders whom they believe are violent in self-defense. Furthermore, Chi-square analyses indicated less educated facilitators to be more inclined to view patriarchy as cause of domestic violence, to be misinformed about motivation factors, and to spend less time conducting assessments. With respect to LGBTQ clients, most respondents found work with this population to be challenging. Facilitators noted that these clients had difficulties feeling safe and talking openly about their issues in group. While some respondents indicated that they strived to address the particular needs of LGBTQ offenders (e.g., adding to the curriculum, seeing clients individually, reaching out to the broader LGBTQ community), others either said that it would be “unrealistic” to provide specialized services (Cannon et al. 2016, p. 249). These findings are not surprising, given that in only about a half-dozen cities are specialized groups for gay or lesbian offenders even available. Although Coleman (2002) has promoted the group format for lesbian batterers and has well-described the features of her own psychodynamic approach, there appears to be a complete absence of outcome studies for the LGBTQ offender population (see Hamel 2014). BIP standards recommendations. A few years ago, 17 experts on IPV intervention were asked by the editors of the peer-reviewed journal, Partner Abuse, to contribute to an exhaustive, up-to-date literature review on the characteristics and efficacy of BIPs (Babcock et al. 2016). Based on this review, the authors arrived at several important conclusions, and made various suggestions to advance evidence-based practice: • Offenders should be held accountable, and this requires a multi-system response. • Treatment should be based on the needs of that individual and threat he or she presents to current and future victims. • Treatment should be delivered by providers with substantial and accurate knowledge of partner abuse. • Treatment plans should be determined through a thorough psychosocial assessment. • Research does not support current mandates that specify modality or treatment models. • Treatment should be based on current best practices informed by empirical research on treatment outcome, treatment engagement, and risk factors for IPV recidivism. • Risk factors that should be emphasized in a psychoeducational curriculum should depend on their significance for the particular client population and the skills they

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require—e.g., confronting patriarchal attitudes for misogynistic men; teaching anger management and relationship skills for clients with poor impulse control. • Length of treatment is not necessarily related to outcomes. • No evidence exists to mandate same-gender group composition. Some individuals are more comfortable sharing with members of the same sex, while others benefit from the diversity inherent in mixed-gender formats. • High-risk offenders and certain populations (e.g., trauma victims) require special interventions, but many low-risk offenders can benefit from a generic type of evidence-based treatment. With these general recommendations as a guide, we now examine in greater detail the treatment strategies most likely to lower IPV perpetration.

Treatment Strategies for IPV Reduction Risk-Need-Responsivity Model. The essential components of what researchers consider to be “evidence-based” or “best practices” are implicit in the Risk-NeedResponsivity (RNR) model—popular among providers of interventions with nonIPV corrections populations (Bonta 1996; Stewart et al. 2013). The core components are that the length and intensity of an intervention be based on the risk posed by the individual’s acting-out behavior to others and that the intervention addresses the client’s basic criminogenic needs. In batterer intervention, those include all of the risk factors previously discussed. The responsivity component considers the client’s individual characteristics and preferences, culture, learning style, relationship to counselor/group facilitator, as well as gender and sexual orientation. This last component of RNR is crucial for treatment success, as we will see when we explore the BIP and general psychotherapy outcome research in the next section. Considerations in differential treatment. RNR would seem to be a promising model for batterer intervention policy, but as with all theories, its ultimate value will depend on how it is applied and with what populations. Within the general psychotherapy client population, there is evidence for the usefulness of both CBT and psychodynamic models in the treatment of various personality disorders (e.g., Leichsenring and Leibing 2003), and Dialectical Behavior Therapy (DBT) groups for BPD specifically (Fruzzetti and Levensky 2000). An early study by Saunders (1986) found a process/psychodynamic group more effective in reducing rates of recidivism for male IPV offenders with avoidant personalities; and a Duluth model group better for men diagnosed as anti-social. This study, however, has not been replicated, and one large, multi-site outcome study found no treatment effects based on personality types (Gondolf 2012). For men with PTSD, trauma models have shown promise (Stosny 2004; Taft et al. 2016). There is evidence that substance abuse history predicts less client engagement and higher drop-out rates (Ting et al. 2009). Therefore, it is not surprising that one RCT study found a substance abuse focus group to be significantly

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more effective than a traditional curriculum for partner-violent men with a history of chemical dependency (Dunford 2000). Eckhardt, et al. (2008) examined group drop-out and recidivism rates in a sample of 199 male offenders and looked for possible correlations to offender type based on Holtzworth-Munroe and Stuart’s (1994) typology, as well as client willingness to take responsibility based on Stages-of-Change theory (Prochaska et al. 1992). “Family-Only” offender subtypes were more likely to be in the pre-contemplation stage compared to more chronic, severe offenders (e.g., those with borderline traits). On the other hand, “family-only” men were less likely to drop out or recidivate compared to men categorized as Borderline (BD) and Generally-Violent/Antisocial. BD clients in the preparation/action stage of motivation were the most likely to drop out or recidivate probably because of poor impulse control, shame, and other factors needing clinical attention. From an RNR standpoint, and the “common factors” research discussed in the next section, personality and motivation considerations should always inform how clinicians/facilitators can create a working alliance with each client and maintain a productive group environment. To what extent individuals should be assigned to separate programs based on typology findings has not yet been determined. Until further research is conducted, there is greater support for homogeneous groups based on general risk categories (e.g., low risk versus high-risk; Babcock et al. 2016; Gondolf 2012). According to Gondolf (2012): The subgroup of repeatedly violent men doesn’t fit into a neat category. They don’t match a distinct personality type; they aren’t predominantly psychopathic or crazed addicts. Not surprisingly, these men are likely to have more violent and criminal pasts and show evidence of psychological problems—but they do not have a distinguishing profile or profiles…One way to improve batterer program outcomes appears, therefore, to lie in enhancing our response to high risk men—the men who are unresponsive to batterer programs regardless of approach. (p. 170)

It has been long-established that many offenders will not recidivate whether or not they complete a BIP, and most recidivism is perpetrated by a small number of repeat, high-risk offenders (Maxwell et al. 2001). Generally speaking, high-risk offenders share certain similar characteristics. For example, based on arrest reports, a California study (MacLeod et al. 2008) found no difference in recidivism across program types, but younger men with longer criminal histories and a history of substance abuse were more likely to recidivate. In general, low-risk offenders are less likely to drop out of treatment compared to high-risk offenders (Gover et al. 2015). Additionally, drop-out rates are typically lower for court-ordered clients, indicating the importance of cooperation between BIPs and the judicial system (Babcock et al. 2016). However, low-risk BIP clients presenting with minimal levels of anger and marital conflict can be at increased risk of dropping out, perhaps due to minimization of their problems, or when self-referred and placed in groups with high-risk courtmandated offenders (Daly and Pelowski 2000). Others may also learn to become more violent/manipulative in such groups (Babcock et al. 2007). Efforts have been undertaken in some jurisdictions to implement IPV intervention policies based on RNR principles. In Florida, when adjudicated male IPV offenders

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were assigned to a low, medium, or high-risk offender group based on a basic risk assessment, recidivism rates were significantly lower than those reported by traditional programs (Coulter and VandeWeerd 2009). More precise assessment instruments have been developed for IPV treatment based on the RNR model, such as the SARA (Spousal Abuse Risk Assessment) and the ODARA (Ontario Domestic Abuse Risk Assessment) (Nicholls et al. 2007). Since 2010, Colorado has assigned offenders to differential treatment levels based on the DVRNA (Domestic Violence Risk and Needs Assessment), and the judgement of a multi-disciplinary treatment team. Group is the preferred modality, but more focused, individual sessions can also be mandated with a length of treatment ranging from 26 to 52 weeks for most offenders (Gover 2011; Richards et al. 2017). Outcome studies have yet to be published, although important data has been collected on issues related to program implementation (Richards et al. 2015). Unfortunately, many providers lack the capacity to offer separate groups, whether for low-risk versus high-risk offenders or on any other basis. In some cases, clients may be referred out to an appropriate program. When this is not possible or desirable, it is the responsibility of the provider to address, as best as he/she can, a client’s needs. This can be done provided that a program is flexible, and treatment is based on a thorough assessment.

Finding Common Ground Results of the North American Domestic Violence Intervention Program Survey indicate a large overlap between the major treatment models (Cannon et al. 2016). Providers who cited Duluth as their primary approach tended to cite CBT as their secondary approach, and vice versa. We have already seen that there is insufficient outcome research showing any model to be clearly superior to another in every case (Babcock et al. 2004). Even if CBT is found to be superior overall, this information does not provide much guidance on how to work with a particular individual. More promising would be for researchers to focus on treatment elements common to all programs, so that providers can develop evidence-based approaches from the “ground up” (Eckhardt et al. 2006).

Overlap Across Treatment Models At least among providers, prevailing models are not inherently incompatible. It can be agreed upon that basic human needs such as safety, love and belonging, and self-esteem are universal, and that aggression represents a misguided effort to meet those needs. The extent to which IPV is expressive or coercive can be viewed on a continuum, rather than as rigid binary opposites, as reflected in findings from the 2016 BIP survey (Cannon et al. 2016). Critics of Duluth cite its over-emphasis on patriarchy and misogyny as IPV risk factors, an authoritarian style of group leadership, and an

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intolerance for dissent that can undermine the facilitator-client relationship and lessen client motivation thereby hindering its overall efficacy (Corvo et al. 2009; Dutton 2010; Dutton and Corvo 2006; Stuart 2005). These are valid criticisms. There is no evidence, however, to indicate that facilitators who work within a CBT or other framework are necessarily more flexible, and common sense would suggest that what some would consider an “authoritarian” style another would deem to be “tough love.” In fact, a primary focus on gender issues would be exactly the type of “evidencebased” approach a misogynist, or someone with rigid gender role beliefs, might very well require. Aside from the ubiquitous “Power and Control Wheel,” a piechart description of certain emotionally-abusive and controlling behaviors assumed to be perpetrated solely by men, Duluth uses some of the same interventions as CBT including progress logs, role plays, videos, action plans, and peer support to foster responsibility, respect, honesty, trust, partnership and negotiation, as well as teach skills such as time-outs, sitting down when agitated, and positive “self-talk” (Miller 2010; Pence and Paymar 1993). The Duluth focus on gender and power imbalance is expanded in one program for Latino male batterers, El Hombre Noble Buscando Balance (Carrillo and Zarza 2006), to include broader issues of intergenerational family abuse, insecure attachment, emotional distress, mental health problems, and substance abuse as well as issues of relevance to many Latinos, such as neighborhood violence, poverty and unemployment, acculturation, and IPV as a private family issue (Carrillo and Zarza 2006). In her own work with abusive Latino men, Welland and Ribner (2008), Welland (2011) blends a gender-based approach with traditional CBT interventions, including concepts from a manualized CBT program popular in southern California (Wexler 2000). In the northern part of the state, Sinclair (2015) offers a highlystructured, gender-based, peer-facilitated BIP, Manalive, that resembles Duluth in many ways, but that uses concepts long-established in psychotherapy such as “authentic” versus “false” self. The concept of the “Hitman” (false self) as an abuser’s way to remain violent while avoiding vulnerable feelings is similar to core components of Acceptance and Commitment Therapy: the basis for an emerging approach to batterer intervention found to be effective in reducing rates of recidivism (Zarling et al. 2015). The Manalive program addresses the effects of childhood abuse and shamebased trauma, and the group encourages compassionate peer support. Its idiosyncratic terminology and scripted rituals are offset with basic CBT skills for emotion management (visualization, relaxation, body awareness) and for what they call “intimating” (“I” statements, validating feedback, setting boundaries, negotiation). Educational material is practiced with examples and role-play.

Peer Versus Therapist Group Facilitation In most states, BIPs are required to be “psychoeducational” in nature, and facilitators are not universally required to be licensed mental health professionals. Unless

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a group is intended to be explicitly psychotherapeutic, licensure may not be necessary provided that the facilitator has a sufficient level of education and training. As already mentioned, results from one national survey indicate that, on the whole, they are adequately trained and educated (Cannon et al. 2016). In some programs (e.g., Manalive), facilitators are not only unlicensed, but actually ex-offenders themselves. Should this be a matter of concern? Probably not; there is no conclusive evidence to suggest that peer models of treatment are necessarily less effective. For example, research has found Alcoholics Anonymous—a self-help program based on the principle that alcoholics are more likely to stay sober if they work with other alcoholics—to be equally as effective as CBT, relapse prevention, harm reduction, and other models in lowering rates of relapse (Knack 2009; McGrady 1994). Among criminal offenders, recidivism rates are substantially lower for men who seek to share their experiences with others (Maruna 2001). One BIP outcome study found that a highly-structured Duluth format was more effective than a completely unstructured self-help group. Equally effective, however, was one that combined self-help group processes with education (Edleson and Syers 1990). Professional and peer models each have their advantages and disadvantages. For starters, a lack of appreciation for the scientific method and poor research knowledge undoubtedly pose some limitations on peer-led interventions. For instance, A.A. views alcoholism strictly as a “disease” despite evidence for other theories, and an incomplete understanding of the relapse process and the heterogeneity of alcoholic populations may actually undermine an individual’s sobriety (Wiechelt 2015). In BIPs, incorrect assumptions by peer facilitators about IPV rates, motives, risk factors, and abuse dynamics can lead to resistance and undermine the therapeutic alliance (Cannon et al. 2016). Without professional training, peer facilitators may lack sufficient knowledge in human development, personality, principles of behavior, and learning disabilities thus restricting the facilitator’s ability to properly diagnose or effectively handle mental health issues. Lacking professional accountability compared to licensed therapists, can lead to unproductive counter-transference issues. Peer models also have their advantages. In A.A., the process of identification allows newcomers to trust and become motivated to change, and sponsors can understand the mindset of newcomers in ways that professionals may not. Similarly, BIP group facilitators can provide a credible example of responsibility-taking. No doubt, having a college degree or a professional license does not automatically confer good judgement that comes from life experiences.

Engaging Clients The weak evidence for the superiority of any of the major treatment models suggests the use of a common core curriculum based on known risk factors, but one that can also be adjusted in accordance with the needs of a particular population (e.g., culturally-focused groups for ethnic minority and LGBTQ clients, specialized groups

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for young mothers). Likewise, how such a curriculum is delivered also matters. If peer-led groups can be as effective as those led by mental health professionals, it would seem worthwhile to determine what it is they have in common that contributes to reduced rates of recidivism. Client engagement—the process by which clients are motivated to fully participate in the counseling process and are therefore more likely to change their behavior—appears to be a crucial factor based on both general psychotherapy studies and BIP outcomes studies. BIP completers, according to the comprehensive literature by Daly and Pelowski (2000), are significantly less likely to recidivate than program dropouts. Motivation is an ongoing concern for professionals working with involuntary clients; as is the case for most IPV perpetrators. Rather than expect cooperation and risk the possibility of unnecessary confrontations with clients, experienced social workers, for example, advise therapists to expect resistance which may reflect a mistrust of authority rather than simply denial or unwillingness to change (Jacobsen 2013). The ability to see the client as capable of change is crucial in establishing a strong facilitator-client alliance and helping clients “buy in” to program expectations (Swift et al. 2012). Psychotherapy outcome studies. As discussed previously, there has been ongoing tension between IPV researchers and batterer intervention providers who are also licensed therapists on the one hand and victim advocates, law enforcement, and non-licensed batterer intervention group facilitators on the other hand. Such prolonged tension stems from the perceived value of empirical research for batterer intervention. A parallel debate among general psychotherapy researchers (Horvath et al. 2011; Wampold and Imel 2015) centers around the question of defining the essential components of a given psychotherapeutic treatment. Those who adhere to the Medical Model (the belief system that psychopathology is a result of one’s physiology) view mental health problems as disorders and their focus is on identifying their cause, the mechanism by which they should theoretically be resolved, and the specific therapeutic procedures for treating them. Just as with diseases and other physical disorders, these procedures are supposed to be formalized and applied consistently. Mental health and behavioral problems, however, do not always lend themselves to such procedures; thus, therapies with different assumptions about the causes and the course of a disorder can work equivalently. For example, both CBT (with its emphasis on changing cognitions) and a behavioral approach (BA) (one that focuses on changing maladaptive behavioral patterns), are equally effective in treating depression. According to the Contextual Model, one reason for this is that because thoughts, feelings, and behaviors are interconnected, targeting any of these can affect the whole person. Another reason is the importance of common factors across all psychotherapy models. As illustrated in Table 2, outcome research finds the differences between treatments to be minimal compared to the effect sizes of the therapeutic alliance and other common factors (Wampold and Imel 2015). Still, something needs to be delivered, manualized or otherwise, to address whatever risk factors are associated with the problem:

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Table 2 Therapeutic factors Common factors

d (effect size)

r (effect over control) (%)

Alliance

0.57

27

Empathy

0.63

30

Goal consensus/collaboration

0.72

34

Positive regard/affirmation

0.56

27

Congruence/genuineness

0.49

24

Expectation

0.24

12

Cultural adaptation

0.32

16

Differences between treatments

0.20

10

[t]he effectiveness of psychotherapy is not derived simply from having a relationship with the patient (i.e., just two people in a room talking), even if that relationship is empathetic, caring, and nurturing, as important as those factors are. According to the Contextual Model, the therapist must provide an explanation of the client’s problem and there must be therapeutic actions consistent with the explanation (i.e., a treatment) that involve means for overcoming or coping with the client’s problems. The client needs to accept and engage in the therapeutic process—not simply be engaged with the therapist but actively working toward a goal in a coherent way (Wampold and Imel 2015; pp. 258–259).

Engagement in batterer intervention programs. One of the most exciting findings in BIP outcome research conducted over the past decade or so has been the superiority of Motivational Interviewing (MI): a client-centered treatment approach that incorporates many of the common psychotherapy factors from Table 2. Whether regarded as a distinct intervention model, or as simply a treatment approach that can be used across models, a core tenet of MI is that motivation to change can best be elicited from the client rather than being imposed upon the client, and that direct persuasion is not effective in resolving ambivalence to change. This counseling style is generally a quiet and evocative one. Readiness to change is not a client trait, but a fluctuating product of interpersonal interaction. Rather than a teacher-student relationship, client and facilitator join together in a working partnership (Dia et al. 2009). In one RCT study, MI has been found to be effective with couples (Woodin and O’Leary 2010). According to the most methodologically-sound studies, adding an MI component to a traditional psychoeducational batterer intervention curriculum correlates positively with a strong client-facilitator alliance, greater homework compliance, lower dropout rates, and reduced rates of physical and psychological abuse upon program completion (Alexander et al. 2010; Musser et al. 2008; Scott et al. 2011; Taft et al. 2003).

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Implications for Group Treatment The importance of a working therapeutic alliance is clear: mismatches between client and facilitator can lead to drop out, resistance, or phony compliance; and can occur due to personality factors or because of the program itself—for example, when a family-only client who wants to work on anger issues is directed instead to address gendered attitudes. Also relevant are ethnic and cultural differences. Culturally focused psychotherapies have been found to be more effective than traditional evidence-based treatments by a factor of d = 0.32 (Benish et al. 2011). Clearly, a viable therapeutic alliance cannot be established when clients feel misunderstood due to their particular ethnic identify or sexual orientation. At the same time, clients must also be helped in engaging with each other, in order to foster group cohesion. When clients are engaged, they are more motivated to acquire and practice actions that will help them become non-violent. Taking positive actions helps not only with a client’s specific problems (e.g., aggression), but increases overall confidence and well-being which leads to more positive actions. This process occurs regardless of the intervention so long as that model appeals to the client, there is a reasonable concordance with the model’s philosophy and its interventions, and the interventions provide tools with which to address a client’s risk factors (Wampold and Imel 2015). Thus, time-outs and active listening can be seen as ways to overcome a patriarchal mind-set (as exemplified in the Duluth model); or strengthening, practicing, and reinforcing positive behavior (as seen with the CBT model). What matters is that the individual is sufficiently motivated and stays long enough for the program to work. Research on group facilitation. The effectiveness of the group format depends, to a large extent, on the qualities of the facilitator. The reader may recall the BIP outcome study cited earlier, finding an unstructured group less effective than a structured one with or without a peer as leader (Edleson and Syers 1990). Even in self-help programs such as A.A., group meetings operate within a proscribed format with someone assigned to enforce group guidelines. Fortunately, there is a large body of research on group facilitation, including qualitative investigations of BIPs that have identified some common client preferences. In general, across all types of counseling groups, research has identified certain facilitator characteristics associated with positive group outcomes (Corey et al. 2010; DeLucia-Waack et al. 2014; Fuhriman and Burlingame 1990; Morran et al. 2004). They include courage; dedication and commitment; openness and non-defensiveness; goodwill; genuineness and caring; and the ability to identify with a client’s pain. There is a growing body of qualitative literature where BIP facilitators and/or clients in small focus groups have been asked to talk about their experiences, including what aspects of their group experience may have helped motivate them to change their abusive behavior (Bolton et al. 2016; Boston 2010; Chovanec 2012; Morrison et al. in press; Roy et al. 2013, 2014; Scott and Wolfe 2000; Silvergleid and Mankowski 2006). Throughout these studies, there is a consensus that clients are more engaged and motivated when facilitators are caring and committed; are non-judgmental; maintain

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a safe working group environment; are honest, humble and genuine; are willing to challenge client behaviors, but in non-confrontational and respectful ways; and who are knowledgeable about IPV and able to provide information and tools with which to change. However, no matter how well-attuned a group facilitator might to issues of culture or sexual orientation, some clients will never feel comfortable or safe enough to develop that motivation even not accepted or understood by the other group members. Gondolf (2007), for example, did not find a culturally-focused group of AfricanAmerican IPV perpetrators as effective as a racially mixed CBT group, but he did report greater effectiveness for men who professed a stronger black identity. Some men may feel more comfortable sharing some of their concerns (e.g., related to sex) with other men, and feel judged or intimidated in a mixed-gender group. Results from the 2016 batterer intervention survey, previously discussed, suggests that many LGBQ perpetrators might have more positive treatment outcomes when included in a group of their peers. The author has observed, over a period of nearly 30 years conducting BIPs in the San Francisco Bay Area, that lesbian clients are more readily accepted in traditional female groups than are gay men, or trans individuals, in traditional male-only groups. Interestingly, gay men who exhibit typically masculine characteristics are more easily integrated than those with more effeminate features, but even so, only in areas where tolerance of gays is highest, such as in San Francisco. Most gay men, therefore, and some lesbians, would benefit from individual work with a therapist versed in LGBTQ issues. When at all possible, client preferences should be taken into account when assigning them to any particular group. BIPs may want to incorporate findings from these qualitative studies into their agency’s facilitator guidelines. For a valid, empirically-based means by which to evaluate group functioning, readers are advised to familiarize themselves with the Group Engagement Measure (GEM) (Macgowan 2006), which measures client engagement in terms of attendance, contribution, relating to facilitator, contracting (supporting group norms), working on own problems, and working on other group members’ problems.

Conclusions and Recommendations What we know about IPV treatment has come almost exclusively from studies with male perpetrators, and there is essentially no empirical research on LGBTQ offenders. Risk factor research, and the few studies that have investigated IPV dynamics among same-sex couples, suggest that a common curriculum might adequately address the treatment needs of all offenders, especially if such a curriculum is delivered by a competent, engaged facilitator within the context of a supportive, working group environment. This should remain speculative, however, until methodologically-sound outcome studies are conducted with female and LGBTQ offenders. Clearly, research scholars ought to further investigate the effects of facilitator personality and group leadership skills on client engagement and treatment outcomes.

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Table 3 “Big Three” areas of batterer intervention group treatment Curriculum content

Facilitator-Client relationship

Group leadership

What works: Address known risk factors through education, homework, role plays, etc.

What works: Use of client-centered and MI techniques

What works: Create group culture in which clients are engaged, cooperative and learning

Research base: Risk factor literature, BIP outcome literature, RNR findings with all offender populations

Research base: Psychotherapy and BIP outcome findings

Research base: Research on mandated populations, BIP outcome studies and qualitative studies

As suggested by Pollio (2006), there is a need for more “bottom-up” cooperation between practitioners and researchers rather than “top-down” where scholars initiate studies based on the concerns, observations, and experiences of front-line providers rather than continuously test and re-test existing theories of interest primarily to academics. Given the demonstrated effectiveness of individual and couples therapy, there is also a need for additional research on the best ways these modalities can be used, whether as the primary treatment approach or in conjunction with group. Meanwhile, findings in the areas of curriculum content, the relationship between therapist/group facilitator and client(s), and group facilitation skills arguably provide BIPs enough of an empirical basis upon which to build effective programs and achieve some basic version of evidence-based practice (see Table 3). Treatment providers need to know who their clients are and acknowledge when their program may not be suitable for a particular individual (e.g., trying to convince an egalitarian man that he is a misogynist or “patriarchal” may lead to unnecessary resistance and reduced engagement). They are also advised to network with other providers like, for example, the Association of Domestic Violence Intervention Programs.2 The author’s manualized treatment program, Alternative Behavior Choices (ABC), employs a curriculum that addresses the major IPV risk factors (Hamel 2014), with a focus on teaching emotion management and relationship skills. Because the risk factors and motivations for violence are comparable across gender and sexual orientation, the same curriculum is used for male and female participants. Clients who are court-mandated to a psychoeducational group format and prevented from utilizing alternative treatment options, are nonetheless administered a variety of assessment instruments to measure their level of interpersonal functioning. The results of these questionnaires are then subsequently used to set treatment goals. This, along with the client-centered and an MI-oriented stance of its facilitators coupled with the ample time allotted for open discussion, helps clients to benefit from a shared group experience while being acknowledged as unique individuals; each with his/her own particular treatment needs.

2 Information

about the Association of Domestic Violence, also known as ADVIP, can be found at www.domesticviolenceintervention.net.

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Making Gender Relevant Again The preference among policy makers and intervention providers for gender-based treatment has hindered the common effort to reduce rates of IPV in our communities. Aside from the cognitive biases discussed previously, or the inherent selfperpetuating nature of institutions and reluctance by those with power to relinquish that power, the persistence of what Dutton (2010) calls the “gender paradigm” has several other explanations. Although patriarchal structures throughout the world give men significant social, economic, and political advantages, women have traditionally viewed the home as their domain where they may feel empowered to use violence to maintain their status (Straus 1999). Yet, as the meta-analytic review by Archer (2004) reminds us, men perpetrate the much larger share of both verbal and physical aggression outside the home, including violent crimes—a reality that is obvious to everyone. Some have argued that some resistance to gender-inclusive intervention models may stem from a sense of collective guilt over the poor treatment of women throughout history, and a misguided effort to “balance the scales” (Corvo and Johnson 2012). Minimizing the impact of female-perpetrated IPV and pretending that patriarchy is the sole (or principal) cause of violence by men does little to advance treatment effectiveness or keep victims safe. The near-obsessive focus in the field of IPV on identifying and eradicating hostile forms of sexism is misguided, and ironically manifests as a sort of “benevolent sexism” (Glick and Fiske 2001) that regards women as uniformly helpless and like children: lacking the agency to make responsible decisions. Those who wish to advance the rights of women should engage in social and political action that will achieve this goal and vote accordingly. Those who wish to lower rates of IPV (against women or men, gay or straight), should favor interventions found to be effective. Both are noble pursuits; neither of them benefits from incompetence and ignorance. Ultimately, it does not serve women well when they are uniformly assumed to be victims, and when ideology is allowed to trump science. The research presented in this chapter provides a framework in which gender can be considered from an empirical rather than political stance. Early in the ABC curriculum, research is cited showing that in most respects, there are far more similarities between men and women than there are differences (Hyde 2014). The principles of egalitarian relationships are discussed, both as an intrinsic good and because couples who are in agreement about gender roles are less likely to dominate one another or engage in the type of conflict that can lead to violence. Sex-based stereotypes are challenged, and participants are asked to ponder the consequences of maintaining either male privilege or, alternatively, female privilege (see Table 4). Clients are asked to complete monthly CBT logs, in which they are expected to identify and challenge all forms of sexist attitudes based in misogyny as well as misandry (e.g., women regarded as “sex objects,” men regarded as “success objects”). Rather than reinforce stereotypes—which gender-based models do when they assume, for example, that

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Table 4 Questions on gender roles and gender privilege Men

Do you see yourself as the “man of the house?” Do you refuse to do household tasks because it’s “women’s work?” Do you expect sex or having your dinner prepared because this is your “right” as a man? Do you expect your partner to always be loving and understanding, because “that’s how women should be?” Do you dismiss what she says because she’s too “emotional”?

Women

Do you think of the home as your “domain,” or that being a woman or mother gives you certain privileges? When you ask your husband to help with household tasks, do you supervise him, or re-do these tasks yourself so they are done “right?” Do you put pressure on him to work more, because “men are supposed to provide?” Do you justify hitting him because he’s physically bigger and should just “take it”? If divorcing, would you automatically assume you should get custody because women are automatically the superior parents?

all men seek power over women—these attitudes are included within the broader category of irrational beliefs. Men and women of course differ in important ways. IPV dynamics are not unaffected by a person’s sex or gender roles. For example, women—who are more physically impacted by IPV—have correspondingly greater fear of their partner and the inherently more threatening nature of men’s aggression is often checked by male norms of chivalry. Within the context of acquiring effective impulse control and relationship-building skills, BIP clients need to be aware of additional differences in the way men and women manage emotions and engage in interpersonal communication. Ignorance of those differences can lead to the toxic kinds of gender stereotypes mentioned above and unnecessarily create relationship discord. For example, while emotions are experienced at comparable rates across gender, women more readily remember emotion-laden situations which men may view as evidence of malicious resentment or pickiness. In fact, women do experience anger for longer periods, but also are more likely than men to feel ashamed about it. Because they are more likely to report intense emotions, and due to higher levels of emotion recognition and empathy, women can be dismissed as “more emotional” or “irrational,” thus making them feel unimportant. Additionally, compared to men, women are better at decoding non-verbal expressions of emotion, and using emotions to understand situations and facilitate solutions to conflicts. This is a great quality but may be threatening to some men who view it as an attempt to dominate and control them. On the other hand, the difficulty that many men have in expressing emotions, especially those that make them feel vulnerable (e.g., hurt, helplessness), may be interpreted as “not caring.” Similar gender-based misunderstandings have been pointed out by Tannen (1990)—for example, how men tend to value autonomy and being competent more than emotional connection and intimacy, whereas women place a higher value on connection and intimacy; or how men typically engage in report talk (to exchange information), whereas women engage in rapport talk (to make a connection). Needless to say, while these are traditional patterns are quite common, gender roles vary widely, and particularly with respect to sexual orientation.

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Participants are reminded that exceptions are numerous and varied (the woman who loves to solve problems, the man who insists on talking things out, the “femme” lesbian who makes the major decisions in her relationship). The objective is to challenge stereotypes, not reinforce them. It is the author’s experience that allowing free discussion of gender roles and socialization, within an empirically-sound educational context, helps clients to better recognize their partners’ positive intentions and more clearly delineate their role and responsibilities in the decision-making process. Clients are empowered when they are given options. Like any other skill, emotion management and communication can be learned. The man, for example, who is taught that a reluctance to exhibit emotions is not evidence of pathology but rather a reality that both partners need to take into account, may become sufficiently motivated to address this issue, thereby leading to greater acceptance from his partner, and enhanced relationship satisfaction.

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John Hamel has a Master’s in social Welfare from U.C.L.A., and completed his Ph.D. at the University of Central Lancashire, U.K., in the psychology department. He has worked with family violence perpetrators and victims since 1992 and is a court-approved provider of batterer intervention and parent programs in five Greater San Francisco Bay Area counties. Mr. Hamel is the author of Gender-Inclusive Treatment of Intimate Partner Abuse, 2nd Edition: Evidence-Based Approaches,(Springer, 20145); co-editor with Tonia Nicholls, Ph.D, of Family Interventions in Domestic Violence: A Handbook of Gender-Inclusive Theory and Treatment (Springer, 2007); and editor of Intimate Partner and Family Abuse: A Casebook of Gender Inclusive Therapy (Springer, 2008.) He has dozens of his research articles published in various peer-reviewed scholarly journals and is Editor-in-Chief of Partner Abuse, a journal published quarterly by Springer Publishing. Mr. Hamel regularly speaks at conferences on domestic violence, has provided case consultation and expert witness testimony, and has trained mental health professionals, victim advocates social service organizations, law enforcement, attorneys and family court mediators.

Part IV

Outreach and Advocacy

Chapter 12

Lessons Learned: One Researcher’s Same-Sex IPV Journey Susan Turell

While this may appear as a vanity piece, I hope it serves as more. I have always loved the Muriel Rukeyser quote “What would happen if one woman told the truth about her life? The world would split open.” (Poetry Foundation). I am not so self-important that I think my journey as a researcher will have that effect. However, as I look back over 35+ years, I hope that sharing my self-reflection and growth might provide some insight into how we need to realize that without constant and humble examination, our world-view will pull us toward hegemony; at best, hegemony likely blinds us to the realities of people’s lived experiences and at worst, reinforces knowledge that perpetuates harm. My own history started in earnest when I became Director of the Rape Crisis Program at the Houston Area Women’s Center (HAWC) in 1982. The program was in its infancy; only a couple of years old, we provided crisis intervention via a 24hour hotline. Early into my role as Director, we expanded services to include groups for victims/survivors; accompaniment to hospitals; advocacy for needed changes in legislation; and started Coordinated Community Response Teams (CCRTs) before they even had a name. It was an exciting time. Rooted in 1970s feminism, the entire HAWC staff would meet weekly to discuss how to offer services from a feminist perspective. Along with the Rape Crisis Program, HAWC offered both residential and non-residential domestic violence programs, and a more generic crisis intervention and referral hotline. During my time as Director, we provided services with over 200 (mostly women) volunteers and three to four staff (during the last year as director, one staff identified as a gay male). Both my direct service work and the agency-wide conversations created a grounding in a grass-roots, victim-survivor- centered perspective that has informed my S. Turell (B) Marywood University, Marywood University Academic Affairs, 200 Liberal Arts Center, Scranton, PA 18509, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_12

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career. I grappled with how to be a Director (with its implied and real hierarchy) while living and working as a feminist. Beneficially, it provided me a strong grounding and sensitivity to the power analyses related to oppression and privilege. Power and control dynamics that underlie both sexual assault and domestic violence were also part of my learning that time. Perhaps in a more limiting way, early analyses in anti-sexual assault were strongly rooted in an essentialist, radical feminist view. I recall that one presenter at a volunteer training stated that ‘all men were potential rapists’. It was easier in some ways to think of rape as something men perpetrated on women and deal with non-male perpetrators and non-female victim/survivors as outliers in discussions. I would acknowledge the possibility but quickly returned to the majority of instances. I found it hard to find ways to discuss experiences that did not ‘fit’ the worldview I was espousing. Part of the tactics to maintain hegemonic thought is to keep those in power comfortable. Was I trying to protect the needs of white, cis-women, like myself? In retrospect, I believe that this simplistic conceptualization and focus on the hegemonic norm did harm to victim/survivors who did not fit that experience. Probably, it resulted in fewer men seeking services and creating less effective community educational efforts, discounting audience members who were male survivors and women sexually assaulted by women. I also am certain that my presentations discussed gendered power dynamics from a white worldview only. However, I believe that even with its flaws, it also formed a feminist foundation to my research that lead to a greater inclusion of the voices of participants moving forward. Eventually, due to the 24/7 nature of the work and the limitations of my undergraduate degree, I quit the job and got my master’s and doctorate in Counseling Psychology. During that time and extending for twenty years, I was a clinical consultant to HAWC, working with both rape crisis and domestic violence program staff to support them regarding secondary and tertiary trauma, and providing trainings. Here too I noticed that the simplistic, gendered-only analysis did not work to explain the (sometimes unhealthy) power dynamics among the all-ciswoman staff. Once I earned my master’s degree, I worked part-time in private practice, which has continued throughout most of my career. At that time, most of the clients were victim/survivors of adult or childhood sexual abuse. My dissertation studied selfmutilation and incest experiences for women survivors, based on what I had learned through listening and learning from the experiences of clients (Turell and Armsworth 2000, 2003). Concurrently, during my internship year in 1991, as an out-lesbian, I provided services through both individual and group counseling to lesbian and bi-sexual women at a mostly women’s university. In the early 1990s, homophobia was far more present in explicit ways. This was the time of ‘don’t ask, don’t tell’, for example. Marriage between same sex people was not recognized; in fact, few, if any, states had domestic partner benefits. This university had a larger than average population of sexual minority women, but one that was largely hidden due to homophobia. My being visible was helpful to clients clinically; I also wrote an article with my internship supervisor to make this population and their needs more visible in the college counseling

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center (Turell and de St. Aubin 1995). Looking back, this work was also informed by listening to and giving voice to the experiences of the participants. With these grass-roots, clinical, and research backgrounds over the span of a decade, I started my career as an academic in my hometown, where I had earned my graduate degrees. Starting then and to the present day, I continued to explore and conduct research related to intimate partner violence, sexual assault, and LGBTQ issues (Turell and Thomas 2001; Mize et al. 2004; Kieffer and Turell 2011; Smith and Turell 2017). While not all the studies were directly related to the trajectory of IPV and LGBTQ research intersections, they added to my knowledge base and challenged my thinking in various ways about all these issues and populations. My thinking also continued to evolve as I brought my knowledge of these topics into my teaching (Turell 1999b, c). In the early 1990s, I was asked to serve on a clinical advisory board of the local community center (now the Montrose Center) with outreach to LGBTQ people. The members of the board were asked to provide both overall direction to the counseling services, as well as provide pro bono supervision to their clinicians. During this time, I began to notice that the clinicians at the community center provided couples counseling with little or no understanding of power dynamics that were indicative of abuse in some relationships. Concurrently, the counseling provided by the staff related to domestic violence and sexual assault (HAWC) were heterosexist in their approach. While well-meaning, each agency needed additional understandings to provide better services to their clients. And I was becoming increasingly uncomfortable with using a gendered-only analysis, whether applied to my teaching in women’s studies, research, or clinical work. In the mid-1990s, I asked people from both agencies to meet to discuss my observations. They politely listened and asked if I had any data to support the prevalence of same-sex intimate partner violence in our city. What they meant was that the qualitative data available—people’s stories—was not enough to change practices. Hegemonic norms value numbers and even agencies providing services to those people who experience oppression often operate within hegemonic norms. There were a few quantitative studies at the time, so I agreed to provide them with that type of data. Living in a large metropolitan city was an advantage. I was able to work with several students to distribute a questionnaire to several hundred LGBT people. The questionnaire asked about their experiences of behaviors that can be or are indicative of intimate partner emotional, physical, and sexual abuses (Turell 2000). It also asked about help-seeking behaviors—ones they had done, would have found beneficial, and barriers to seeking help (Turell 1999a; Turell and Cornell-Swanson 2005). In retrospect, I see that I was also influenced by my training and the valuing of quantitative data. This effort might have been better had I started with interviewing those effected to generate potentially more robust survey items about help-seeking. The items were as inclusive as the limits of my knowledge and the extant literature; had I heard directly from those affected, potentially missing important items might have been included. Conducting the research about same-sex IPV prevalence and incidence, as well as help-seeking, necessitated that I reexamine the heterosexist model of IPV and

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sexual assault that I used in the 1980s. I had to determine how a feminist perspective that was rooted in a gendered analysis might still apply when the perpetrator and the victim/survivor might be male or female. I had to ground my understanding in an intersectional lens rather than one that only examined gender. As an aside, doing this research was not the only impetus for this. I believe one cannot competently and ethically educate or provide clinical services to all people without the continual development to deepen the understanding of one’s own location and that of others across identities. Otherwise, one’s hegemonic worldview, embedded in both privilege/supremacy and oppression, will keep us from seeing people’s lived realities, at best, and at worst, do harm. I grappled with this for a long while related to same-sex IPV. Ultimately, I concluded that one could maintain a gendered analysis even if one decoupled it from the sex of the perpetrator and the victim. (I helped form this after much reading and reflection. I wish that I could recapture all the readings that influenced me and list them here, so that I could specifically provide them the thanks due. A very useful book was hooks’ Feminism is for Everybody [2000]). That is, I concluded that perpetration was gendered in patriarchal masculinity and that victimization was gendered as patriarchally female. Regardless of the sex of the perpetrator, that abusive action was reinforcing the patriarchal norms embedded in masculinity. And when a perpetrator acts coercively or abusively toward another person, they are feminizing them. I was not alone in exploring this. Many feminist psychologist and philosophers have written eloquently about the tensions between various feminist understandings. While this chapter does not focus on this aspect broadly, I found that Tong’s (2013) book to be a valuable framework to both understand various feminist viewpoints as well as examining the tensions that result across conceptualizations. After conducting this preliminary work about same-sex IPV prevalence, my research path focused more heavily on help-seeking behavior. As I explored this further, building on the survey via focus groups and in a different state, I became uncomfortable with ignoring the heterogeneity with the queer community, particularly as it related to the issues of IPV and sexual assault and help-seeking behaviors. With colleagues, we realized that we needed to explore multiple communities— LGB&T—as each population is positioned differently along both issues, and this positionality intersects with gender (Turell and Herrmann 2008). Perhaps not entirely coincidentally, the next study was qualitative: a focus group. In listening to lesbian voices about their experiences, we developed what we referred to as the ‘diamond’ model about seeking help, which assisted us to conceptualize how lesbians sought help over time, and with whom. Most did outcry with friends first; very few sought help with the more traditional systems. Only if necessary, would they seek help from domestic violence programs or medical help. Lastly, if they continued to struggle, later they would seek help with lesbian or women-identified support, either individually or in a group. Although with some fear of lack of confidentiality within the smaller lesbian community, it was preferable to the thought of having to negotiate homophobia/heterosexism within the larger community.

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My co-researcher (Herrmann) and I provided several trainings to IPV service providers during this time frame. Interestingly, most providers, whether or not they were staff at a domestic violence program, first focus on the possibility that IPV victim/survivors will interact with institutional services, such as shelters or law enforcement. This may be an example of the strength of hegemonic thought, both in assuming that ‘support’ exists only via institutions and making the realities of those affected invisible. How does this assumption keep us focusing our efforts on the systems that are hard to change while ignoring the focus on what can make positive differences? How does it serve to maintain the hegemonic norms of organizations and institutions, focusing on providing services but never to examine the policies and practices that reinforce the status quo? Gender itself also played a role in help-seeking within LGBTQ communities. For example, lesbians have a long history of work within the domestic violence movement. Therefore, they were more likely to recognize IPV behaviors and were more aware of services. If cis-women, they had access to services that cis-men and transwomen and transmen did not. Cis-men were unlikely to label behaviors as abusive to avoid being feminized. If women sexually abused women, they were unlikely to be able to label it, since sexuality is heterosexually normed, as is sexual abuse. That is, sexual abuse is often assumed to have penile penetration; without that act, what acts count as sexual assault between two women? Much like service providers mentioned above, many of the research participants assumed limited sources of help; that is, they would focus on hegemonic institutional organizations and services, rather than community/friends as resources. For example, they assumed that help meant needing shelter if experiencing IPV. They also assumed sexual assault help would necessarily mean reporting and/or medical assistance, as do providers. Participants were more likely to do outreach to friends within their social network, and often in their sub-community; notably, this was easier to define if one was lesbian or gay. Bisexuals did not report having clearly defined bisexual community, and transgender people may or may not seek community with other trans people, based on a variety of factors. Transwomen and transmen have to engage with systems (medical and legal mostly) to transition. They were more ‘willing’ to seek help from the hetero/cis normed systems than lesbians or gay men. (‘Willingness’ in the context of the need to interact with institutional norms of insurance and diagnoses by ‘experts’ is a flawed term and maybe better stated as ‘forced’ or ‘resigned’, even if not the word used by the participants. Another example of how each of us often internalize the hegemonic norms.) Once I realized that help-seeking occurs in the context of multiple communities within LGBTQ, I began work with colleagues around community readiness. Community readiness model (CRM) is a concept developed by the Tri-Ethnic Center for Prevention Research (Plestad et al. 2005). The CRM is an elegant research paradigm that allows one to determine how ready a community is regarding a topic of social health/welfare and aligns strategies for interventions based on the readiness-level of a community. Based on the observances mentioned above, my colleagues and I

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thought the next step would be to examine the readiness of each community separately—L, G, B & T. Further, we looked as geographic locations of urban and rural; that meant we examined each population (LGB&T) in each of two urban and rural locations, resulting in 16 communities. We then were able to examine readiness for each of the 16 separately; the entire sample; urban vs rural; L, G, B, & T; and L, G, B, & T by urban or rural (Turell et al. 2012). We found overall that readiness was relatively low. However, urban lesbians and transgender people were more ready to engage with the issue of same-sex IPV; rural gay men and bisexuals were the least ready to engage. Also, the themes that affect the nuances about readiness differed across populations. Bisexual people had a harder time identifying the existence of a bisexual community or identifying with it if they believed it even existed. Gay men were reluctant to engage due to the fear of being feminized if identified as a victim, or the lack of awareness that men could be victims. Lesbians minimized IPV, in part to maintain a lesbian utopia myth embedded in radical feminism. Transgender individuals often thought that other issues related to transitioning, financial concerns, and isolation affected their readiness. Across populations, mainstream integration in urban areas diminished the readiness to work in the community. These are just some examples of the heterogeneity of influences among the L, G, B, & T communities in dealing with IPV. These results reinforced my commitment that my research moving forward would distinguish among the various L, G, B, & T communities. Unfortunately, this study was limited in that it did not further look at communities of color, class status, disability, and other intersecting identities in addition to and within each of the L, G, B, & T groups. Even with the added complexities—operationally (e.g., finding samples and research design) and conceptually (e.g., the necessity to find a ways to forefront participant voices)—to be really thorough and respectful, I believe that we must make every effort to identify the impact of intersecting identities within and among LGB&T people. To not make this a priority maintains the hegemonic status quo, one that too often focuses only intra-psychically. This regularly leads to blaming the victim for not seeking the ‘right’ help (e.g., institutional) or seeking help the ‘wrong’ way. Also, organizations, even with good intentions but based in a hegemonic norm, often continue to set up programs that at best, don’t help, and at worst, do harm. Lastly, researchers, again with good intentions, may create studies to answer questions rooted in those same norms, with results that reinforce prevailing expertise that is not inclusive of the lived realities of the participants. A few years ago, colleagues and I saw the results of the study that examined prevalence and incidence across sexual identities (National Intimate Partner and Sexual Violence Survey 2010a, b). The results indicated that people who identified as bisexual reported much greater rates of physical violence, rape, and stalking. We wondered about this disparity and conducted an exploratory study to examine what might contribute. We rejected bisexuality identity as a contributing factor, as including it would have blamed the victim. We focused on the myths regarding

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bisexuality, rooted in bi-phobia and bi-negativity. Since none of us identified as bisexual, we consulted throughout with people who identified as bi-sexual to review our work and provide feedback. Our findings supported a key role of perpetrator bi-negativity, as well as variables related to open relationships and perceived or real infidelity (Turell et al. 2018). Our findings also reinforced overall concepts of control related to abusive behavior, such as jealousy, and the nuances that emerge when making meaning of these behaviors within the bi-sexual population, which embraces more varieties of sexuality and polyamory. These nuances would likely not appear if the research merged L, G, B, & T communities into one homogeneous group. Most recently, I have been privileged to provide psychological services to people who are transgender and/or gender non-conforming, mostly in support of their transitioning via a medical clinic. I am also participating in research affiliated with the clinic. The timing is fortuitous. My journey and growth across almost three decades have led me to think more inclusively across genders, breaking down dichotomies and assumptions of homogeneity. I believe my questioning and growth enables me to provide more respectful counseling, congruent with their genders. I also believe my knowledge helps me to design research that is more inclusive, respectful, and equitable. Further, I can to share my knowledge and understanding to date via policy and procedure development, and in training to build capacity with other mental health providers in the region. After all these experiences and reflections, if I am vigilant, I sometimes remember these lessons. Operationally, I often consider which population(s) within the LGBTQ communities are the focus of my work. I consider, overtly or not, if the identified communities are ‘ready’ and how to answer that, rather than assume I already know. Overall, whether I’m thinking of research designs, policies, programming, or counseling I try to remember to ask “Whose voices are included? Whose are left out?” I try to remember the importance of social location related to privilege/supremacy and oppression in people’s lives, including my own. I try to remember to ask, “What am I missing, given my own intersecting identities?” I think the times I have remembered has helped to challenge, and maybe reduce, the harm of conforming to hegemonic norms. Regret about past limitations about my research are not enough. Good intentions are not enough. I wonder as I write this chapter as part of a book focused on samesex IPV, how my observations will reflect on some of my colleagues’ research and chapters. I think my own journey has led me to important questions to consider as I conduct research, design programs, or conduct trainings. Do the other chapters focus on the individual alone or include the context of societal power dynamics? Do they include an awareness of and an attempt to correct the hegemonic norms and assumptions embedded in some type of research? If related to interventions and programming, do the chapters include that awareness and attempt to correct possible hegemonic policies and practices of many institutions? How much stronger could our research and interventions be if we approached the heterogeneity while designing research or intervention, rather than noting it as a limitation after the fact?

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I hope sharing my journey with the reader and future researchers to help remind those of us serving same-sex victim/survivors of IPV of the constant need to ask questions of ourselves, to make hegemony visible, and to strive for equity and inclusion of the voices of those we serve. I also hope that asking these questions will help to inform policies and practices to be as equitable and inclusive as possible.

References hooks, b. (2000). Feminism is for everybody. Boston: South End Press. Kieffer, L. B., & Turell, S. C. (2011). Child custody cases and safe exchange/visitation: A multicultural assessment of battered parent’s needs. Journal of Child Custody, VIII(4), 301–322. Mize, L. K., Turell, S. C., & Meier, J. (2004). Sexual orientation and the sister relationship: Conversations and Opportunities. Journal of Feminist Family Psychology, 16(4), 1–19. (printed 11/2005). National Intimate Partner and Sexual Violence Survey. (2010a). Retrieved from http://www.cdc. gov/violenceprevention/pdf/nisvs_report2010-a.pdf. National Intimate Partner and Sexual Violence Survey. (2010b). Retrieved from http://www.cdc. gov/violenceprevention/pdf/nisvs_victimization_final-a.pdf. Plestad, B., Edwards, R., & Jumper-Thurman, P. (2005). Community readiness: A handbook for successful change. Fort Collins Co: Tri-Ethnic Center for Prevention Research. Poetry Foundation. Retrieved 14 August, 2019, from https://www.poetryfoundation.org/poems/ 90874/kathe-kollwitz. Smith, S. K., & Turell, S. C. (2017). Perceptions of healthcare experiences: Relational and communicative competencies to improve care for LGBT people. Journal of Social Issues, 73, 637–657. https://doi.org/10.1111/josi.12235. Tong, R. (2013). Feminist thought (4th ed.). New York: Westview Press. Turell, S. C. (1999a). Seeking help for same-sex relationship abuses. Journal of Gay and Lesbian Social Services, 10, 35–49. Turell, S. C. (1999b). Community partnership: University students providing rape crisis intervention. Feminist Collections, 20(3), 30–32. Turell, S. C. (1999c). Rape crisis intervention: Activism in academia. Women’s Studies Quarterly, 27(3–4), 51–60. Turell, S. C. (2000). A descriptive analysis of same-sex relationship violence for a diverse sample. Journal of Family Violence, 15(3), 281–293. Turell, S. C., & Armsworth, M. W. (2000). Differentiating incest survivors who self-mutilate. Child Abuse and Neglect, 24, 237–249. Turell, S. C., & Armsworth, M. W. (2003). A log-linear analysis of variables associated with selfmutilation behavior of women with histories of child sexual abuse. Violence Against Women, 9, 487–512. Turell, S. C., Brown, M., & Herrmann, M. M. (2018). Disproportionately high: An exploration of intimate partner violence prevalence rates for bisexual people. Journal of Sexual and Relationship Therapy, 33, 113–131. https://doi.org/10.1080/14681994.2017.1347614. Turell, S. C., & Cornell-Swanson, L. V. (2005). Not all alike: Within-group differences in seeking help for same-sex relationship abuses. Journal of Gay and Lesbian Social Services, 18, 71–88. Turell, S. C., & de St. Aubin, T. (1995). A relationship-focused group for lesbian college students. Journal of Gay and Lesbian Psychotherapy, 2(3), 67–84. Turell, S. C., & Herrmann, M. M. (2008). ‘Family’ support for family violence: Exploring community support systems for lesbian and bisexual women who have experienced abuse. Journal of Lesbian Studies, 12(2–3), 211–224.

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Turell, S. C., Herrmann, M., Hollander, G., & Galletly, C. (2012). Lesbian, gay, bisexual, and transgender communities’ readiness for intimate partner violence prevention. Journal of Gay and Lesbian Social Services, 24, 289–310. Turell, S. C., & Thomas, C. (2001). Where was god? Utilizing spirituality with Christian survivors of sexual abuse. Women and Therapy, 24, 133–147.

Susan Turell brings forty plus years of experience working in the areas of sexual assault and domestic violence, including grass roots organizing, research, teaching/training, clinical and crisis intervention, and policy making. Working almost thirty years in academia, she served in administration for over a decade, and will soon joyfully return to teaching future psychologists at Marywood University.

Chapter 13

Intimate Partner Violence Among Older LGBT Adults: Unique Risk Factors, Issues in Reporting and Treatment, and Recommendations for Research, Practice, and Policy Jennifer Hillman

Although the U.S. government fails to collect census data regarding its older lesbian, gay, bisexual, and transgender adult populations, available estimates suggest that nearly three million LGBT adults age 50 and older currently live in the U.S. By the year 2060, this number is expected to swell to seven million, with more than half of those adults requiring some degree of elder care or related services (The Facts on LGBT Aging 2019). When you include older adults who do not identify themselves as LGBT, but report being attracted to or engaging in sexual behavior with same sex partners, experts predict that by 2060 the U.S. will be home to more than 20 million older LGBT adults (Fredriksen-Goldsen and Kim 2017). Although older LGBT adults, as a group, are resilient (Fredriksen-Goldsen 2018), challenges that face members of this burgeoning population include life-long stigma, discrimination, health care disparities, economic disparities (MetLife 2010), and intimate partner violence (IPV). According to the World Health Organization (2012), IPV represents behavior committed by one partner in an intimate relationship that leads to physical, psychological or sexual harm in the other—regardless of sex, sexual orientation, gender identity, marital status, or age. IPV can include, but is not limited to, hitting, slapping, beating, and burning to rape and sexual coercion, intimidation, insults, threats, and the destruction of property including social isolation, stalking, and exerting control over a partner’s finances, employment, or medical care. For purposes of this chapter, IPV also includes partner and dating violence, and domestic and elder abuse when committed by a current, or former, spouse or relationship partner. IPV can J. Hillman (B) The Pennsylvania State University, Berks College, 119 Franco Building, Tulpehocken Road, Reading, PA 19610, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_13

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also include the use or misuse of technology like social media and assistive medical devices. The negative consequences of IPV among older LGBT adults are significant and include chronic pain, worsening of existing health problems, increased risk of anxiety and depression (Crockett et al. 2015), increased risk of HIV infection, premature hospital and nursing home admissions, and up to a 300% higher mortality rate (Dong et al. 2009). Many professionals, including those in health care, social service, and criminal justice, as well as members of the general public, possess only limited knowledge of IPV among older LGBT adults. Individuals who express limited or no interest in IPV among older LGBT adults because “it doesn’t affect me” could be informed that society, as a whole, literally pays for the consequences of all forms of IPV via related medical, legal, and social service costs. In depth knowledge of IPV among LGBT older adults is urgently needed to generate and promote appropriate recommendations for culturally competent research, assessment, and treatment. Within this chapter, LGBT will be used as an umbrella term to encompass all adults who self-identify with a minority sexual orientation (e.g., lesbian, gay, bisexual, questioning, same gender loving, on the down low) or identity (e.g., transgender, two-spirit, nonbinary, genderqueer). It is important to note that even though LGB and transgender adults are often combined into one group for the sake of convenience, each individual minority population remains unique (e.g., MetLife 2010). Also, within this chapter, for the sake of simplicity, victim will be used to acknowledge and include both individuals who have survived IPV and who have died from IPV. Although it can be helpful from a mental health perspective to identify individuals with a lived experience of IPV as survivors to highlight their resilience, personal agency, and opportunities for the future, it is similarly important to recognize that other individuals who experienced IPV have died as a result of their abuse. All individuals appearing in case examples were assigned pseudonyms, and their identifying information and characteristics have been disguised.

Measurement Issues and Prevalence Rates A significant challenge for researchers is that no nationally representative largescale surveys or reports are available to provide clear prevalence rates of IPV among individual LGBT (Rollè et al. 2018), older adult, and older LGBT adult populations. No federally mandated guidelines exist for individual states’ definitions of IPV, older adulthood, domestic abuse, or elder abuse. Instead, prevalence estimates are based upon findings from large scale surveys that have differing definitions of IPV and older adulthood, or small detailed studies of convenience samples. Within the context of IPV, some states define older adulthood in accordance with recommendations from the Centers for Disease Control and Prevention (CDC) (Breiding et al. 2015) in which individuals age 60 and older are classified as older adults, whereas other states identify individuals age 55 and older, or 50 and older, as older adults. Many states and agencies also neglect to classify reports of elder and domestic abuse by perpetrator

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type (e.g., spouse, partner, adult child, grandchild, professional caregiver), sexual orientation, and gender identity, thus making it impossible to determine which cases actually represent IPV (Crockett et al. 2015). Despite these challenges in measurement, available estimates suggest that lesbian, gay, and bisexual adults experience similar or higher rates of IPV when compared to their heterosexual peers. Specific estimates suggest that 40% of lesbian and 57% of bisexual women, compared to 32% of heterosexual women experience IPV. Additionally, 25% of gay and 37% of bisexual men, compared to 29% of heterosexual men, experience IPV. Overall, bisexual women appear to experience IPV at a higher rate than lesbian women, gay men, and bisexual men (Breiding et al. 2013). Surveys of transgender adults also reveal consistently high levels of experienced IPV and suggest that up to 50% of transgender adults experience abuse from an intimate partner at some point in their life (e.g., Brown and Herman 2015). In contrast, prevalence estimates of IPV among older U.S. adults are lower and range from up to seven percent for older men (Gerino et al. 2018; Poole and Rietschlin 2012) and up to 11% for older women (Teaster et al. 2006). Because detailed investigations suggest that fewer than 1 in 14 cases of elder abuse, overall, are reported to the authorities (National Center on Elder Abuse 1998), actual prevalence rates of IPV among older adults are likely higher. It also is interesting to note that stalking— another form of IPV mentioned previously—occurs at nearly similar rates among older and younger adults, with older women more likely to be victims than older men (Stalking Resource Center and National Clearinghouse on Abuse in Later Life 2015). United States prevalence rates of IPV among older LGBT adults represent estimates and “best guesses” from various reports with limitations in their definitions of IPV and older adulthood; and with limitations in the representativeness of their population samples. Unlike the CDC, which recommends that older adults be defined as individuals age 60 and older, organizations that serve older LGBT adults specifically (e.g., Sage 2019, and Forge (For Ourselves Reworking Gender Expression, Forge 2019)) typically define older adults as individuals age 50 and older. This lower age limit is designed to acknowledge the potentially deleterious impact of life-long stigma, discrimination, and violence experienced by many LGBT adults upon their health (The Facts on LGBT Aging 2019; Meyer 2003), and the significant decline in domestic abuse services both designed for, and utilized by, victims age 50 and older (National Clearinghouse on Abuse in Later Life 2013). Forge (2017, 2019), a national and federally funded organization designed to study and prevent violence against transgender individuals, recommends using a commonly cited series of lifetime prevalence estimates of IPV among older LGBT adults based upon a 2013 analysis of data from the CDC’s National Incidence of Intimate Partner and Sexual Violence Survey. Those estimated lifetime prevalence rates for IPV are 44% for older lesbian women, 26% for older gay men, 61% for older bisexual women, and 37% for older bisexual men (Walters et al. 2013). Furthermore, prevalence estimates of IPV among older transgender adults range from 31% to 50% (Brown and Herman 2015). Note that these estimates of IPV among older LGBT

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adult populations are consistently higher than those among older heterosexual adults, and that older bisexual women and transgender elders appear at greatest risk.

Risk Factors A variety of demographic and other characteristics including female gender, increased age (National Center on Elder Abuse 2004), having a physical or mental disability (Basile et al. 2016; National Center of Elder Abuse 2010), living in poverty, social isolation, racial and ethnic minority group membership (Gerino et al. 2018), and LGBT status serve as risk factors for IPV among older adults. Because older LGBT adults are disproportionately affected by disability, poverty, and social isolation when compared to their heterosexual peers, they also shoulder a disproportionate risk of IPV. These factors often interact synergistically. For example, an older disabled LGBT adult living in poverty who is dependent upon their partner for help with activities of daily living and financial support could become an easy, vulnerable target for IPV, who is unlikely to seek help or report their abuser because they live in social isolation. Consider another scenario in which an older, socially isolated LGBT adult may fall victim to financial IPV in which their partner assumes complete control of their finances. Being unable to access any of their money makes it difficult, if not impossible, for them to seek out and obtain appropriate medical care. Poor medical care can increase the risk of disability, which can lead to feelings of depression and social isolation, and also prevents many victims of IPV from seeking help. Note that among LGBT, versus heterosexual, adults smoking, lack of exercise, obesity, mental distress, participation in high risk behavior, and inferior health care related to stigma and discrimination contribute to an increased risk of disability (Fredriksen-Goldsen et al. 2017). Specifically, 41% of older LGBT adults report at least one disability compared to 35% of older heterosexual adults; and older LGBT adults, including those who are married and have a long-term partner, are more likely to live in poverty than their heterosexual peers (The Facts on LGBT Aging 2019). In terms of social isolation, older LGBT adults are less likely to have close relatives and adult children, and 20% of older LGBT adults report that they have no one to call for help in an emergency, compared with only two percent of their older heterosexual peers (The Facts on LGBT Aging 2019).

Theoretical Perspectives and Pervasive Myths Intimate partner violence, including IPV among older LGBT adults, has traditionally been viewed through the lens of gender and caregiver stress. Early work in partner violence began as the study of domestic violence in which abusive behavior occurred between heterosexual couples with women identified as the classic victim.

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When research on domestic violence expanded to include violence between samesex partners, partner violence was still intimately linked with gender. Specifically, women were assumed to have limited power or control in any relationship (Straus 2009). Related myths included: lesbians do not engage in domestic abuse, gay men engage in mutually acceptable forms of abuse, and (in ambiguous cases of same-sex partner abuse) the more masculine-looking partner will be the perpetrator. Researchers also began to investigate elder abuse, of which partner violence among older adults was considered only a small subset. Elder abuse was viewed historically through the theoretical lens of caregiver stress (Brandl 2000), which purports that the pressure of overwhelming, demanding stressors associated with caregiving causes otherwise peaceful, well-meaning caregivers to snap and engage in isolated and sporadic episodes of abuse. Years later, researchers began to study partner violence among all LGBT populations and partner violence among older LGBT adults. Rather than referring to domestic abuse—which typically represented a private, family matter between heterosexual couples—researchers began to refer to IPV (Sorenson and Thomas 2009): designed to signify a public health issue between current and previous intimate partners, which cuts across sexual orientation, gender identity, age, and other characteristics. With the continued investigation of IPV among older LGBT adults, experts have shifted away from gender and caregiving stress as primary, underlying factors. Rather than relying upon the stereotype that gender drives IPV (in which male gender is naturally linked with increased power and aggression), current theories suggest that an imbalance in interpersonal power between two partners—regardless of their gender, sexual orientation, or sexual identity—is a driving factor behind IPV (Greenwood et al. 2002). Moreover, caregiver stress has also lost favor as a primary factor in IPV (see Brandl 2000). Although many perpetrators of IPV among older adults blame the stress associated with caregiving for their behavior, it appears that the perpetrator’s desire to exert power, control, and fear in the relationship, coupled with the presence of narcissistic and antisocial personality traits (Romero-Martínez et al. 2016) is more likely to account for their participation in abuse. Additional contemporary theories related to IPV among older LGBT adults include the influence of sexual minority stress (Myer 2003): the internalized conscious and unconscious negative attitudes and beliefs maintained by LGBT adults after experiencing years of stigma, discrimination, heterosexism, and homophobia. Also note that older LGBT adults, who have been exposed to historically more discrimination and years of stigma than their younger peers, are more likely to suffer from higher levels of sexual minority stress. Additionally, similar to sexual minority stress, internalized ageism is expected to contribute to IPV among older LGBT adults. Although research has dispelled pervasive myths that older adults are asexual (see Hillman 2017a, b), and too sweet and frail to engage in physical and sexual partner violence, older adults can internalize ageism in which an older adult’s individual and societal worth is significantly devalued (Butler 1969). Unfortunately, older LGBT adults’ increased levels of sexual minority stress, internalized ageism, and health and economic disparities (The Facts on LGBT Aging 2019) can lead to a “perfect storm” of increased risk of IPV.

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Unique Age and LGBT Related Presentations Warning signs of IPV can appear quite different among older versus younger LGBT adult victims. Signs of IPV among older LGBT adults can include under or overmedication (e.g., chemical restraint via sedation), dehydration and weight loss, bruising, dirty and soiled clothing or bedding, and broken or “missing” assistive medical devices like eyeglasses, hearing aids, dentures, walkers, and wheelchairs (Brandl 2004). Financial abuse, which is more likely to occur among older versus younger adults, can be signaled by abrupt changes to legal documents like wills and powers of attorney. Perpetrators of IPV among older LGBT adults may engage in specific forms of abuse that prey upon some combination of their partner’s vulnerabilities in relation to their age, minority sexual orientation or gender identity, health and economic disparities, and lack of legal protection across a variety of settings. Accordingly, IPV among LGBT adults can include threats to “out” a closeted partner’s sexual orientation or gender identity to employers, landlords, family members, friends, neighbors, and others knowing that such disclosure could lead to negative consequences to the victim including losing their job, housing, access to and custody of grandchildren, or friendships, among others. Consider Karen, a 58-year-old, divorced lesbian who reported: I have a wonderful relationship with my two young granddaughters. I love them to pieces and they are the absolute best part of my life. I will never forgive my ex-partner, Rosie, for threatening to tell my daughter [the granddaughters’ mother], that I left her dad because I cheated on him with another woman and ‘got hooked.’ I am still terrified that my daughter will somehow find out that I am a lesbian, because I know she won’t let those kids near me ever again.

It also is important to note that threats to “out” a closeted partner at their place of employment do not necessarily lose their coercive power once that partner celebrates their 65th birthday. Various factors help account for this discrepancy in retirement. LGBT adults have faced decades of workplace discrimination, which typically led to lower wages and an increased likelihood of having a career interrupted due to being fired for their sexual minority status. LGBT adults are less likely to be targeted for financial planning in national advertising campaigns, and due to their increased risk of being disabled are more likely to have accumulated medical bills and debt that can quickly drain retirement savings. Many older LGBT adults worry that if their sexual minority status becomes known in a nursing home, rehabilitation center, or other long-term care setting, their roommates, fellow residents, and the very caregivers assigned to help them may abuse or neglect them instead (MetLife 2010). Abusive threats to send an older LGBT partner to an institutional long-term care setting are particularly frightening when that partner is mentally or physically disabled, or completely financially dependent upon their abusive partner. Threats to “out” a closeted partner already living in a longterm care setting are similarly insidious. Sadly, many older LGBT adults—including those who have been open about their sexual minority status in their own community

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for decades—make the difficult decision to “go back into the closet” when entering institutional care (The Facts on LGBT Aging 2019). Consider Frank, a 71-year-old transgender male-to-female (MTF) who reported: I hated it when Gene [my partner] came to visit me [at the rehab center]. I hated being there in the first place, and I hated that I didn’t do my regular hair, clothing, and make-up because I didn’t want to call any attention to myself. You never know how people are going to react [to a patient being transgender], especially when you are sick and can’t take care of yourself. So, one day Gene brought in a big shopping bag and some crackers and candy that I really like, and I was so happy, and actually started thinking something like, ‘Maybe he misses me, and he is starting to come around,’ when he reaches into the bag and pulls out one of my wigs and my favorite pair of red panties. He starts waving them around over his head and jumping around my room. He kept looking at me and saying things like, ‘I bet that cute guy in physical therapy and your nurses would love to see what you really look like.’ I was so scared that someone would come in and see us. At that moment I hated him so much, but I couldn’t even get out of bed to take [my things] back. Of course, I ended up signing over most of my savings to him. God damn him.

Unique forms of IPV can also occur among socially isolated LGBT elders, who are more likely to be disabled and housebound than their heterosexual peers (The Facts on LGBT Aging 2019; Fredriksen-Goldsen et al. 2017). Although many socially isolated LGBT adults adapt by making connections with other older LGBT adults through online support groups, an abusive partner may damage their partner’s computer, modem, cellphone, or aforementioned medically necessary assistive devices, or even break their fingers so that they cannot use a device; thus inhibiting them from accessing their primary means of social support. Such IPV, in return, leads to increased social isolation and even greater dependence upon an abusive partner. IPV specific to transgender versus LGB adults can include being humiliated by a partner who calls them by their non-preferred pronoun, withholds access to their medically necessary hormone replacement therapy, or destroys or denies access to clothing, accessories, and other belongings connected with their gender identity (e.g., binders [undergarments used to minimize the appearance of female breasts through compression] and make-up). Such IPV can be particularly deleterious for older transgender adults who are more likely to be mentally or physically disabled and unable to obtain or replace those items independently. It is essential to acknowledge that older LGBT adults also engage in physical and sexual IPV, despite traditional stereotypes that elderly adults are asexual or weak. Although limited, available findings suggest that older couples do not “age out” of abuse and that most physical abuse among older adults is committed by an intimate partner (Amstadter et al. 2011). LGBT adults who experience sexual IPV, including rape, face a significantly increased risk of contracting sexually transmitted infections including HIV/AIDS (Hillman 2017a, b). Studies indicate that older gay and bisexual men, and transgender adults who experience sexual IPV (e.g., rape) by a male partner, are significantly more likely to be HIV positive than their gay male, bisexual male, and transgender peers who have not suffered such abuse (Houston and McKirnan 2007; Stall et al. 2003). These older male GBT, and female BT, victims of IPV subjected to unprotected sex with a HIV positive partner face increased risk

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of infection due to overall, age-related declines in their immune systems. Also, considering that postmenopausal women experience normative and age-related thinning of vaginal tissue, older bisexual and transgender women—including those with surgically created vaginas—are more likely to experience micro and macroscopic tears in their vaginal wall during penetrative sex, therefore giving HIV and other sexually transmitted disease vectors easy access to their bloodstream, and further increasing their risk of HIV infection (see Hillman 2017a, b).

Barriers to Assessment and Treatment Variable Community Support Significant barriers may hinder or prevent older LGBT victims from reporting IPV and getting the help that they need. Because victims of LGBT IPV often share the same, local LGBT community as their perpetrator, they may be hesitant to report a partner’s abuse or leave their abusive partner, and risk potentially losing their primary source of social support. Victims of LGBT IPV who live in small and close-knit LGBT communities also may be reluctant to report abuse because they worry that once one member of their community learns of their abuse, word will spread quickly, and their privacy will be completely lost. Still other victims of LGBT IPV face pressure from fellow members in the LGBT community to maintain silence about their abuse; those individuals pushing for silence fear that any release of negative information about the LGBT community will only serve to generate additional stigma and discrimination among members of the heterosexual majority (Rollè et al. 2018).

Age-Related Obstacles to Assistance Unique, age-related barriers to help seeking among older LGBT victims of IPV include heightened minority group stress (Meyer 2003), and feelings of shame associated with beliefs maintained by many older LGBT adults like: “LGBT adults should always be self-sufficient, and able to take care of themselves” and “Everything about my LGBT status needs to be kept secret.” Such beliefs are certainly antithetical to help-seeking. Dependence upon an abusive partner for assistance with activities of daily living (ADLs) due to a mental or physical disability, and fears about being placed in a nursing home without their consent can also serve as a significant barrier. Another age-related barrier to help seeking includes the potential difference between an older LGBT adult’s age and their eligibility for Medicare. Specifically, consider a victim of IPV between the ages of 50 and 62, who obtains their health insurance through their spouse or legal domestic partner and is afraid to report their abuse. Many of these victims are scared to separate or divorce from their partner

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because they do not qualify for Medicaid, are not yet old enough to qualify for Medicare, or they cannot afford health care coverage on their own. Fear of losing access to health care coverage can be particularly salient for older LGBT adults who are more likely to suffer from a disability than both older heterosexual, and younger, adults in general (The Facts on LGBT Aging 2019), therefore increasing their need for health care and other services.

Challenges to Assessment and Treatment Critical barriers to the assessment and treatment of LGBT IPV include a lack of cultural competence during interactions with police officers, emergency shelter staff, and within peer support and other treatment programs. Unfortunately, reports suggest that that LGBT victims of IPV who interacted with the police view those interactions quite negatively. Specifically, victims of LGBT IPV reported that police officers appeared indifferent (47% of the time) and hostile (11% of the time). Five percent of LGBT IPV victims also reported witnessing police misconduct, including the use of excessive force against them as the victim or their abusive partner (National Coalition of Anti-Violence Programs 2018). Police involvement in IPV with LGBT, versus heterosexual, partners result in significantly fewer arrests, an increased likelihood of arresting the victim instead of the perpetrator, and an increased risk of arresting both the victim and the perpetrator (Rollè et al. 2018). Early, and sometimes lifelong, negative experiences with law enforcement often lead older LGBT victims of IPV to assume that, consistent with their previous experience, involving the police in episodes of IPV would only make things worse (e.g., Finneran and Stephenson 2013; Wolf et al. 2003). A lack of culturally competent, LGBT- and aging-friendly emergency shelters represents a serious barrier to care (Crockett et al. 2015; National Clearinghouse on Abuse in Later Life 2013). Many shelters, which typically house young adult women and their children, are typically small, loud spaces with many people cooking, living, and sleeping in a contained area offering only limited opportunities for privacy. Such an active, crowded environment may initially be overwhelming for older victims of IPV. Although shelters and domestic abuse programs often offer therapy and support groups, most older women (Slye and Brandl 2017) and particularly older lesbian, bisexual, and transgender women who decide to attend these programs find few, if any, peers, and risk feeling uncomfortable and isolated. Gaining entry to shelters often poses a significant challenge for many sexual minority elders. A survey of older LGBT victims of IPV within a large urban area revealed that nearly 50% of those victims were denied access to emergency shelters. Moreover, nearly one-third were told directly and specifically that they were denied entry due to their gender identity (National Coalition of Anti-Violence Programs 2018). Findings from this study also suggest that victims of IPV in suburban and rural areas may have even fewer options for LGBT-friendly emergency shelter.

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Also note that even though older lesbian and female bisexual victims of IPV can choose to hide their sexual orientation to gain entry to a traditional shelter housing heterosexual women, older transgender female victims may not have the option to hide their gender identity to gain entry. Unfortunately, no federal laws prevent discrimination against individuals based upon their sexual orientation or gender identity in public housing, including “shared spaces” like emergency shelters. Reports exist in which abused transgender women were turned away from women’s only shelters because their birth certificates stated that they were male, or they refused to answer questions from staff about “what their genitals look like.” Because the vast majority of shelters are geared to serve heterosexual female victims of IPV—with only a few prepared to assist a small number of heterosexual male victims—older gay, bisexual, and transgender male victims of IPV have even fewer options for shelter. Consider the plight of one 54-year-old gay man, Curtis, who lived in a rural area and had considered leaving his abusive partner of three years. Curtis reported: Where I live, the only domestic violence program [and shelter] is called ‘[Our county] Women in Crisis.’ Right off the bat I know that I’m not going to be welcome there…I looked around online and found out that if I drive two hours north there is a domestic violence program thing called ‘Safe [Neighboring County]’ that has one male counselor and actual shelters for both men and women, but the one for men has a whole whopping two slots that are already full. Even if this place had an opening for me, I don’t think I could afford the gas to commute back and forth from there, for four hours a day, to work. I also don’t think the guy [counselor] there is really intended for gay victims. When I looked at their website, I think he’s trained to work with straight guys who get hurt by their wives and girlfriends. Maybe this guy [male counselor] could help me, but I’m not sure I want to take that chance.

Environmental factors in emergency shelters also serve as tremendous barriers to access for certain older LGBT adults. Because most IPV programs and shelters assume, and thus essentially require, that their clients are able to ambulate independently and tend to their own ADLs, an older LGBT victim of abuse who needs to use a wheelchair or presents with even mild cognitive impairment or dementia will likely be ineligible for services. Narrow walkways and bunk beds, as well as a lack of wheelchair ramps and bathrooms with raised commodes and grab bars are the norm in most shelters. Additionally, the presence of cognitive impairments among older victims of IPV can pose significant challenges for Adult Protective Service agencies and the entire legal system (see Ulrey 2016). Many charges of financial and sexual elder abuse are refuted by defense claims that the purported victim was able to give consent to those related activities. In one case, for example, the defense might claim: Despite having some level of cognitive impairment after her stroke last year, this 67-year-old woman, who has been married to the same man for more than 47 years, is simply not a victim of sexual abuse. She was able to nod, wink, and open her arms to her husband, consenting to sex the way her husband says she has done for decades. To adequately refute such claims of non-verbal consent among an older potential victim with dementia, the legal system typically requires a neuropsychological evaluation conducted by a geropsychologist or geriatric psychiatrist. When the ability to locate

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such professionals and obtain funding to pay for their specialized evaluations is limited, some Adult Protective Service agencies rely, instead, upon general cognitive screening instruments like the Folstein Mini-Mental State Exam (MMSE) which are woefully inadequate for determining a potential older victim’s sexual consent capacity (see Hillman 2017a, b). It also is important to note that published guidelines for the assessment of sexual consent capacity feature virtually no case examples of older LGBT adults. In terms of safe and effective treatment, a lack of client screening at many partner abuse programs and shelters can pose significant challenges. Without attentive screening, a victim’s same-sex abuser can pose as a victim of IPV themselves and gain entry to the same support group or emergency shelter. If the actual victim of IPV has not declared their true sexual orientation or gender identity to staff, the simple presence of their abuser in what is supposed to be a “safe” therapeutic space can lead that victim to abruptly leave treatment when they need it the most. Another challenge in treatment is that many older, compared to younger, victims of IPV (including older LGBT adults) want to maintain a relationship with their abuser even after they are separated. This is especially likely if they shared a lifelong relationship (Slye and Brandl 2017). Maria, a 68-year-old victim of IPV who identified herself as bisexual—and who had been married to her abusive husband for 44 years and is now living with her daughter—reported: I am glad that [my husband and I] don’t live together anymore, and that he can’t hit me anymore. But, he is the father of my children, and the grandfather of my grandchildren. I know everything there is to know about him, and he knows everything there is to know about me. What am I supposed to do at holidays– ask my family to make two Christmas and two Easter dinners because we aren’t allowed to be in the same room together? What about my granddaughter’s graduation next month? If my husband insists on going to her graduation party, which I’m sure he will, I don’t want to have to stay away and miss it. There has to be a way around this.

Many helping professionals are unfamiliar or uncomfortable with such an approach, in which the survivor of IPV (who has been in that relationship for decades) wants to maintain a relationship with their abuser. Although unconventional, arranging for scheduled, supervised visits, particularly during holidays and family celebrations and events, can help ensure the survivor’s safety as well as their desire for contact.

Future Directions Recommendations for Research A top priority within the context of research is the need to generate older adult IPV prevalence estimates from nationally representative, large-scale surveys. All states can be encouraged to come to consensus and adopt standardized definitions of

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IPV and older adulthood, and to record information about IPV including the sexual orientation and gender identity of its victims and abusers, as well as information about their health and economic status. Federally funded research studies on IPV should also be required to include older adult participants in their samples and gather demographic information for each participant’s age, sexual orientation, and gender identity. This practice would allow for analysis of all related IPV data by both age group and individual LGBT population. Due to a relative dearth of information—and to encourage the scientific, social services, health services, law enforcement, and even political communities to remember that LGBT adults actually represent multiple, distinctly different groups of people— researchers are encouraged to investigate IPV among individual older lesbian, gay, bisexual, and transgender adult populations. Similarly, when presented with a large data set, researchers are encouraged to analyze and report upon those individual LGBT populations’ issues and characteristics whenever possible. Research findings are also desperately needed regarding IPV among understudied and underrepresented subpopulations of LGBT elders, including those who identify as a racial or ethnic minority (e.g., American Indian, Asian, Black, Latino, Middle Eastern, Native Alaskan Indian), who are immigrants, cognitively disabled, physically disabled, HIV positive, and who are socially or geographically isolated. Moreover, research designed to identify additional risk factors (e.g., for online “sweetheart” scams) and preventive factors for IPV among older LGBT adults; to evaluate the effectiveness of older LGBT-friendly screening measures for IPV and the treatment of perpetrators of abuse; and to evaluate the effectiveness of cultural competence and sensitivity training in LGBT aging among a variety of professions is also needed. Throughout, the use of both qualitative and quantitative methodology (see Orel 2014) is also recommended to ensure the reliability and validity of the data obtained.

Recommendations for Practice A significant need exists to provide culturally competent screening measures for IPV among older LGBT adults. Health care providers are encouraged to screen for IPV with any patient or client who is female, has a disability (Brandl 2004), is age 50 or older, or self-identifies as LGBT. No one—including older LGBT adults themselves—should assume that signs of bruising, poor hygiene, depression, and anxiety are a normal part of aging. Conducting client or patient interviews, including screenings for IPV, should be conducted privately (Brandl 2004) as perpetrators often accompany their victims to health care and other settings to intimidate them into maintaining silence about their abuse. At the beginning of any interview, all care providers and professionals identified as mandated reporters of elder abuse in their specific state should advise potential victims of any reporting requirements. Initial training, as well as opportunities for continuing education, for client (i.e., victim) centered approaches to IPV among older LGBT adults can be required for

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professionals, staff members, and volunteers working in social service (e.g., ombudsmen), health care, and law enforcement and other criminal justice settings. Within the context of the criminal justice system, jurisdictions can identify and train specialized prosecutors, detectives, and advocates to work with reports and cases involving elder abuse (Ulrey 2016) including IPV among older adults. These specially trained individuals can serve as identified points of contact for mental and physical health care providers, representatives from social service agencies like Adult Protective Services, and even members of the public in their local area. A variety of relatively simple but effective environmental changes can be made in conjunction with culturally competent LGBT and aging training to generate a more welcoming and inclusive environment in individual clinics, offices, shelters, and other settings that may serve older LGBT adults (see National Resource Center on LGBT Aging 2019a). For example, pictures hung throughout the facility can feature images of LGBT couples and families, including older adults from a variety of ethnic and racial minority backgrounds. Similarly, older adult- and LGBT-friendly publications, informational pamphlets, and posters can be displayed in waiting rooms, conference rooms, treatment rooms, and even bathrooms. Sample topics related to older and LGBT populations might include IPV, HIV/AIDS, substance use, elder abuse, organizations for LGBT and aging (e.g., see The Facts on LGBT Aging 2019; Forge 2017), and information about local LGBT and aging related events. Pamphlets and posters can provide listings of local (or the closest available) older LGBT-friendly resources for emergency shelters, treatments, social service programs, and care providers (e.g., therapists, doctors, and lawyers). Additional changes that can be made in an office or clinic to support older LGBT adults includes making restrooms gender neutral, installing grab bars in restrooms, clearly marking steps and changes in the height and type of flooring, making sure that hallways are wide enough to accommodate wheelchairs and walkers, and offering to provide written materials in larger font sizes. To initiate such environmental changes, it can be helpful to introduce them as part of a large group activity at a personnel or staff meeting, or as part of a cultural competency training. For example, in one particular activity all facility staff and volunteers are asked to imagine that they are an 80 year-old gay Black man, a 62 yearold bisexual Latino woman, or a 73 year-old wheelchair bound transgender woman (or whatever demographic of older LGBT clients are deemed appropriate), and that they are a victim of IPV who just arrived at the facility, feeling tired and afraid for their lives. Next, the facility participants are asked to imagine that, for the first time in their entire lives as that victimized adult, they were so desperate for help that they are thinking about disclosing their LGBT status to someone outside their own community. Participants are then asked to spend five to ten minutes moving around the facility, including areas where all clients or patients might go (including restrooms). As they move about the facility, participants are asked to see if they can find any evidence that, as that specific older LGBT adult [e.g., an 80 year-old Black man], they provide an environment that makes them feel welcome at the facility or even recognized as a potential client.

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After the facility participants return to the larger group, everyone is asked to share their impressions, without judgment. Many volunteers and staff enjoy the interactive nature of this exercise, and it can be very poignant to hear someone say “I didn’t see any pictures of anyone that looked like me [as an older gay Black man; older disabled woman]. I never really thought about it before [as a middle-aged White heterosexual woman], but I didn’t like it” or “I’m glad that we are talking about this [race, ethnicity, disability, and LGBT status]. Working here, I’ve always felt like I’ve never seen myself reflected anywhere, in any promotional or educational materials, or even in any of those dumb, you know, ‘think positive’ posters that we always have, and I’m glad we’re going to change that.” Asking participants for specific recommendations for aging- and LGBT-affirming materials like pictures, pamphlets, magazines, posters, and fliers for local events and care providers can increase staff buy in, as well as provide a wealth of resources.

Recommendations for Policy Stakeholders can lobby and advocate for laws and policies that will benefit and assist older LGBT adults, particularly in relation to IPV. For example, it appears essential to pass the Equality Act (2019), which amends the U.S. Civil Rights Act of 1964 to make it illegal to discriminate against any individual, of any age, based upon their sex, sexual orientation, or gender identity. The current bill extends legal protection against discrimination in both public and private businesses, hospitals, and social welfare services, as well as in “shared facilities.” In other words, it would become illegal to turn a transgender victim of IPV away from an emergency shelter based solely upon their preferred (or perceived) gender identity. When Congress renewed funding for the Older Americans Act (1965) in 2012, only 1.1% of the total $1.9 billion budget was directed for the prevention, assessment, and treatment elder abuse (National Health Policy Forum 2012). Lobbying for older LGBT adults to be recognized as s the “greatest social needs group” within the context of the Older Americans Act will provide significantly more federal funding for community-based services and supports for issues affecting those adults, including IPV. Lobbying for more funding to be spent on older adult LGBT IPV, within the broader context of elder abuse, is also essential. A few individual states have adopted legislation to provide older LGBT adults with more supportive, culturally competent care, including that for IPV. (See resources for training on LGBT and aging from the National Resource Center on LGBT Aging (2019b) located at https://www.lgbtagingcenter.org/training/index.cfm.) In 2018, California became the first state to require new police officers and 911 dispatchers to undergo LGBT cultural competency training (Miraglia 2018). This training is designed to help law enforcement provide more effective service to members of the LGBT community, including older LGBT adults who report, or are suspected of experiencing, IPV. California also passed legislation named the Lesbian, Gay, Bisexual, and Transgender Long-Term Care Facility Residents’ Bill of Rights, which requires

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staff in long-term care settings to participate in cultural competency training on LGBT issues and aging. The goal of this legislation—to create more LGBT-friendly long-term care communities—should make it more likely that older LGBT residents feel comfortable disclosing their sexual minority status to caregivers and staff while making it less likely for abusive partners to threaten to “out” a closeted partner living in a care home. All states are encouraged to adopt similar forms of legislation.

Conclusion Older LGBT adults—one of the most overlooked, understudied, and underserved populations in the U.S.—face unique challenges related to IPV including health and economic disparities (e.g., increased risk of disabilities, HIV infection, living in poverty), pervasive societal myths (e.g., IPV is a private family matter; IPV among older LGBT adults is driven by gender and caregiving stress), internalized ageism, sexual minority stress, limited legal protections, and a lack of culturally competent care (e.g., via untrained health care providers, long-term care staff, and police officers) and services (e.g., in clinics and emergency shelters), as well as minimal federal research funding. Although a few individual states have passed legislation that begins to address some of these issues, the overwhelming majority have not. A new multidisciplinary approach is clearly needed to engage researchers, practitioners, social service agencies, the health care system, law enforcement, and state and federal lawmakers in assessing, preventing, and treating IPV as a public health issue among our burgeoning older LGBT population.

References Amstadter, A. B., Cisler, J. M., McCauley, J. L., Hernandez, M. A., Muzzy, W., & Acierno, R. (2011). Do incident and perpetrator characteristics of elder mistreatment differ by gender of the victim? Results from the National Elder Mistreatment study. Journal of Elder Abuse & Neglect, 23(1), 43–57. https://doi.org/10.1080/08946566.2011.534707. Basile, K. C., Breiding, M. J., & Smith, S. G. (2016). Disability and risk of recent sexual violence in the United States. American Journal of Public Health, 106, 928–933. https://doi.org/10.2105/ AJPH.2015.303004. Brandl, B. (2000). Power and control: Understanding domestic abuse in later life. Generations, 24(2), 39–45. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1. 173.4159&rep=rep1&type=pdf. Brandl, B. (2004). Assessing for abuse in later life. National Clearinghouse on Abuse in Later Life (NCALL). Retrieved from http://www.ncdsv.org/images/NCALL_ AssessingForAbuseInLaterLife_2004.pdf. Breiding, M. J., Basile, K. C., Smith, S. G., Black, M. C., & Mahendra, R. (2015). Intimate partner violence surveillance: Uniform definitions and recommended data elements, Version 2.0. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

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National Center on Elder Abuse. (2004). Reporting on elder abuse. Retrieved from http://www. elderabusecenter.org/default.cfm_p_statistics.html#statistics. National Center on Elder Abuse. (2010). Abuse of adults with a disability. Retrieved from http:// eldermistreatment.usc.edu/wp-content/uploads/2016/10/Abuse-of-Adults-with-a-Disability2012.pdf. National Clearinghouse on Abuse in Later Life. (2013). An overview of abuse in later life. Retrieved from http://www.ncdsv.org/images/NCALL_Overview-of-abuse-in-later-life_2013.pdf. National Coalition of Anti-Violence Programs. (2018). Lesbian, gay, bisexual, transgender, queer and HIV-affected hate and intimate partner violence in 2017. New York, NY: New York City Anti-Violence Project. National Health Policy Forum. (2012). Older Americans Act of 1965: Programs and funding. Washington, DC: George Washington University. Retrieved from http://www.nhpf.org/library/ the-basics/Basics_OlderAmericansAct_02-23-12.pdf. National Resource Center on LGBT Aging. (2019a). Inclusive services for LGBT older adults: A practical guide to creating welcoming agencies. Retrieved from https://www.lgbtagingcenter. org/resources/pdfs/NRC_guidebook.pdf. National Resource Center on LGBT Aging. (2019b). LGBT aging: Cultural competency trainings. Retrieved July 10, 2019, from https://www.lgbtagingcenter.org/training/index.cfm. Older Americans Act of 1965. (1965). U.S.C 42, § 3001 et seq. Retrieved from https://legcounsel. house.gov/Comps/Older%20Americans%20Act%20Of%201965.pdf. Orel, N. A. (2014). Investigating the needs and concerns of lesbian, gay, bisexual, and transgender older adults: The use of qualitative and quantitative methodology. Journal of Homosexuality, 61(1), 53–78. https://doi.org/10.1080/00918369.2013.835236. Poole, C., & Rietschlin, J. (2012). Intimate partner victimization among adults aged 60 and older: An analysis of the 1999 and 2004 General Social Survey. Journal of Elder Abuse & Neglect, 24(2), 120–137. https://doi.org/10.1080/08946566.2011.646503. Rollè, L., Giardina, G., Caldarera, A. M., Gerino, E., & Brustia, P. (2018). When intimate partner violence meets same sex couples: A review of same sex intimate partner violence. Frontiers in Psychology, 9(1506), 1–13. https://doi.org/10.3389/fpsyg.2018.01506. Romero-Martínez, Á., Lila, M., & Moya-Albiol, L. (2016). Empathy impairments in intimate partner violence perpetrators with antisocial and borderline traits: A key factor in the risk of recidivism. Violence and Victims, 31, 347–360. https://doi.org/10.1891/0886-6708.VV-D-14-00149. Sage. (2019). Advocacy and services for LGBT elders. Retrieved July 10, 2019, from https://www. sageusa.org/. Sorenson, S. B., & Thomas, K. A. (2009). Views of intimate partner violence in same-and oppositesex relationships. Journal of Marriage and Family, 71, 337–352. https://doi.org/10.1111/j.17413737.2009.00602.x. Slye, A., & Brandl, B. (2017). Recognizing the emergency housing and shelter needs of older survivors on world elder abuse awareness day. Retrieved from https://needv.org/latest_update/ housing-shelter-world-elder-abuse/. Stalking Resource Center and National Clearinghouse on Abuse in Later Life. (2015). Stalking of older adults: An overview. Retrieved from http://napsa-now.org/wp-content/uploads/2015/10/ 101-The-Intersection-of-Stalking-and-Elder-Abuse-3.pdf. Stall, R., Mills, T. C., Williamson, J., Hart, T., Greenwood, G., Paul, J., et al. (2003). Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. American Journal of Public Health, 93, 939–942. https://doi. org/10.2105/ajph.93.6.939. Straus, M. A. (2009). Gender symmetry in partner violence: Evidence and implications for prevention and treatment. In D. J. Whitaker & J. R. Lutzker (Eds.), Preventing partner violence: Research and evidence-based intervention strategies (pp. 245–271). Washington, DC: American Psychological Association.

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Teaster, P. B., Dugar, T. A., Mendiondo, M. S., Abner, E. L., Cecil, K. A., & Otto, J. M. (2006). The 2004 survey of state adult protective services: Abuse of adults 60 years of age and older. Washington, DC: National Center on Elder Abuse. The Facts on LGBT Aging. (2019). Retrieved from https://www.sageusa.org/resource-posts/thefacts-on-lgbt-aging/. Ulrey, P. (2016). Confusion on the front lines: The response of law enforcement and prosecutors to cases of elder abuse. King County Prosecutor’s Office Seattle, WA. Retrieved from https://acl. gov/sites/default/files/programs/2016-09/Ulrey_White_Paper.pdf. Walters, M. L., Chen J., & Breiding, M. J. (2013). The national intimate partner and sexual violence survey (NISVS): 2010 findings on victimization by sexual orientation. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Wolf, M. E., Ly, U., Hobart, M. A., & Kernic, M. A. (2003). Barriers to seeking police help for intimate partner violence. Journal of Family Violence, 18(2), 121–129. https://doi.org/10.1023/ A:1022893231951. World Health Organization. (2012). Understanding and addressing violence against women: Intimate partner violence. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/77432/ WHO_RHR_12.36_eng.pdf?sequence=1&isAllowed=y.

Jennifer Hillman is a Professor of Psychology in the Applied Psychology program at The Pennsylvania State University, Berks College and a licensed Psychologist in the state of Pennsylvania. Hillman is also board certified in Geropsychology (ABPP), making her one of only four in PA and 54 in the country. Hillman’s primary research interests include HIV/AIDS and other STDs in aging, Viagra and other PDE-5 inhibitors, sexual and aggressive problem behaviors in long term care, women’s issues in aging, and grandparents of children with autism. She has published more than two dozen peer-reviewed articles and four books and was awarded Fellow of the Gerontological Society of America for her outstanding contributions to the field of aging. Hillman also received a Penn State University Teaching Fellow Award, and teaches courses in clinical, abnormal, health, and social psychology as well as adult development and aging.

Part V

Criminal Justice Response

Chapter 14

Identifying and Responding to LGBT+ Intimate Partner Violence from a Criminal Justice Perspective Brenda Russell and Celia Torres

On the Road to Equality: The Role of Discretion When it comes to intimate partner violence (IPV), heterosexist ideologies lead to human biases that continue to spread throughout society from sheer acknowledgement of IPV to screening, identifying, responding, protecting victims, and prosecuting perpetrators. As can be seen throughout this text (see Cannon; Edwards et al.; Hamel; Hillman; Scheer; Turell; etc.), there is evidence of differential treatments in sexual orientation service delivery systems designed to assist victims of IPV including access to programs, therapeutic interventions, shelters, and prevention programs. On the front lines are health care workers, advocates, and shelter staff who use discretion in working with victims in a variety of ways. For example, health care workers may be more likely to screen heterosexual women for IPV and intervention, and less likely to openly inquire about a patient’s sexual orientation or gender identity (Ard and Makadon 2011). If they do inquire, are they equipped with the knowledge and willingness to address the health risks associated with IPV in LGBT+ patients? Health care workers choose whether to interview and educate LGBT+ patients about IPV. Additionally, referral decisions will be dependent upon their knowledge of resources available to LGBT+ victims. While researchers are beginning to acknowledge these issues, there is little evidence to suggest that these human service institutions are working toward providing an agenda or a systematic approach toward identifying and measuring inequalities or understanding consequences and offering solutions. Inherent in these systems are bias, discretion, and discrimination that can lead to inequalities within the systems designed to protect victims of IPV. Individuals working in these service delivery systems are not exempt from human bias, nor are people working in the criminal justice system.

B. Russell (B) · C. Torres The Pennsylvania State University, Berks, PA 19508, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_14

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When we consider actions within the criminal justice system, there is a great deal of discretion at each level. First, police exercise discretion in terms of whether to take official action when a suspect has been identified and then they decide on the type of action to take (Shernock 2005; Shernock and Russell 2012). For example, officers in pro-arrest states are often under pressure to make arrests in IPV incidents. However, they can choose to charge an offender with IPV and issue a citation rather than making an arrest or taking the suspect into custody. Officers could choose to arrest for other reasons than IPV such as violation of a protection order, violating conditions of release, or disorderly conduct. There is also discretion used to decide whether to arrest for aggravated or simple assault. Taking one type of action rather than another as a function of sexual orientation can suggest the use of differential treatment. Differential dispositions should be considered in each incident as it affects the direction of the outcome of the incident and victim safety. Similarly, there can be discrepancies as a function of decisions to prosecute that include judgments to accept or reject a case, determine charges (felony/misdemeanor), seeking diversion programs, or dismissing the case. These decisions can be influenced by gender, sexual orientation, culture, ethnicity, or socioeconomic status. Judges also use discretion in this process. They may decide whether to allow the suspect to be released on recognizance (ROR) or set bail. Differences can also occur within the trial itself. Prosecutors, public defenders, or attorneys may hold biases that can affect course preparation. Lastly, juries can find the defendant guilty or not guilty. If convicted, there are options of incarceration, probation, and length of sentencing. For example, let us examine a case of two men involved in a long-term, but tumultuous intimate relationship that ultimately leads to homicide. In this situation, the defense argues his partner threatened to shoot him and, as a response, he picked up a knife lying nearby on the kitchen table and stabbed his partner in self-defense. A series of discretionary decisions will ultimately lead to the outcome of this case in criminal court. The defendant in this case claims to have been a victim of abuse for years and felt he had nowhere to go to seek shelter from his abuser. There are no hospital records to support his claims of abuse as he had no insurance and could not afford hospital bills. He often sought shelter with a friend who witnessed bruises and evidence of the abuse. He had called the police on multiple occasions and nothing had been done. He had sought an order of protection which was not granted. The case goes to trial and he is awarded a public defender. Now lawyers must describe the facts of a case. Since the legal system is adversarial in nature—meaning one side (e.g., the prosecution) is pitted against the other side (e.g., the defense)—it can create its own reality (Hawkins 1986). When representing facts of the case, these can be muddied in the waters of this system of justice. Prosecutors and defense attorneys must present their contrasting views of the “truth” of what happened. Was the killing actually in self-defense or was it premeditated murder? Was there another motive to killing his partner? Lawyers will artfully craft a version of their truth to present to jurors who will decide on a verdict of guilty or not guilty. Trial lawyers will try to anticipate what the other side will do and make decisions accordingly. Of course, the defense

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attorney will provide evidence claiming that the victim was highly abusive and can provide records of previous calls to police who did not provide a lethality or danger assessment of the incidents, or even make an arrest. Evidence of protection orders that were not granted by the criminal justice system and witnesses stating they had seen the defendant abused by the victim will be presented at trial. The defense will state their client’s life was previously threatened on multiple occasions and on this last encounter, the victim pointed a gun at the defendant’s head and threatened to kill him. The defendant, in turn, grabbed a knife sitting on the kitchen table and stabbed his abuser in self-defense. This story suggests the defendant should be found not guilty by self-defense. In contrast, the prosecution will tell the jury that the defendant knew his partner was having a relationship with someone else, and the defendant got jealous and planned to murder his partner —thus implying the defendant should be found guilty of first-degree murder. The jury will integrate evidence presented at trial by witnesses, defense, and prosecution with their own personal knowledge and experience to create a story or narrative (Pennington and Hastie 1986) that best fits which side appears more plausible. In other words, they create a mental framework of the event that fits their reality. Therefore, the facts make up two conflicting images of that reality—a situation represented not only in every criminal trial, but that is present in each encounter with the human and social services designed to support and protect victims of IPV and throughout the criminal justice system. This series of discretionary decisions provide an example of just some of the ways in which gender and sexual orientation can influence the criminal justice system. With that in mind, it is very difficult to isolate each potential step in the criminal justice process to determine the extent to which being LGBT+ can affect a case. This chapter will review some of the research pertaining to human services and the criminal justice system designed to protect victims and identify, rehabilitate, and punish perpetrators.

Intimate Partner Violence Within the LGBT+ Community Prevalence Rates of LGBT+ IPV As we have seen throughout various chapters in this book, rates of intimate partner violence within the LGBT+ community tend to vary in the extant literature. While researchers may not agree on exact numbers, there is a general consensus that the prevalence of IPV within the LGBT+ community is equivalent, and in many cases higher, than rates seen in the heterosexual community (Messinger 2011; Romero et al. 2019; Turell 2000; Walters et al. 2013). According to Walters et al. (2013), prevalence of rape, physical violence, and/or stalking for lesbian women was 43.8%, bisexual women: 61.1%, and heterosexual women: 35.0% as reported in the authors’ 2010 study. Additionally, gay men experienced these methods at a reported rate of

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26.0%, bisexual men: 37.3%, and heterosexual men: 29.0%. Moreover, when considering incidents of severe violence—for example, kicking, hitting with an object, or use of weapons—rates for lesbian women were 29.4%, bisexual women were 49.3%, and heterosexual women experienced these at a rate of 23.6%. Such numbers are consistent with the National Coalition of Anti-Violence Programs’ (NCAVP 2016) report that the most common types of IPV experienced by survivors were physical violence, verbal harassment, threats, intimidation, isolation, stalking, and sexual/financial/economic violence. When comparing bisexual IPV to IPV within the gay and lesbian communities, prevalence rates have shown to be even higher for bisexual individuals as opposed to other groups (Barrett and St. Pierre 2013; Messinger 2011; Romero et al. 2019; Walters et al. 2013). Barrett and St. Pierre (2013) found 46.8% of bisexual-identified individuals in their analysis reported experiencing IPV compared to 26.6% of gay or lesbian individuals. Furthermore, 28.8% of bisexual respondents reported physical injuries resultant from the violence, whereas 15.5% of gay or lesbian respondents reported physical injuries. In Walters et al.’s (2013) report, bisexual women (and sometimes bisexual men) reported higher lifetime prevalence rates of rape, sexual violence, physical violence, and stalking compare to gay, lesbian, heterosexual men, and heterosexual women. Conversely, Turell (2000) found bisexual respondents reported lower rates of abuse compared to gay, lesbian, and heterosexual respondents, but warned caution should be used when interpreting the significance of this finding considering bisexual individuals comprised only five percent of their sample (n = 25). Looking at the transgender and gender nonconforming community, Henry et al. (2018) found in their sample, 56 out of 78 participants reported experiencing some form of intimate partner violence with psychological abuse being the most common followed by physical and sexual abuse respectively. Langenderfer-Magruder et al. (2016) also reported transgender participants in their sample had higher prevalence rates of IPV than cisgender participants. Another study found in their sample of 1,976 LGBTQ survivors of IPV that six of the 13 reported homicides involved transgender women (NCAVP 2016). Additionally, transgender survivors were three times more likely to be stalked and experience sexual and financial violence compared to cisgender survivors. Interestingly, Turell (2000) cautiously noted of the seven transidentified participants in their study, transgender people were more likely to have their children used against them as a means of control compared to gay or lesbian participants and were just as likely as lesbians to be threatened. Thus, a consensus strongly suggests that transgender-identified individuals experience much higher rates of IPV than other members of the LGBT+ community. While these reports of IPV are substantial, the statistics do not capture the true nature of the problem because sexual minorities are less likely to report incidents of IPV because of barriers to help-seeking (Calton et al. 2016) and a history of mistrust, stigma, and anticipation of abuse (Cummings 2007) that will be explored in further depth later in this chapter.

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Beliefs of mistrust and stigma are associated with our general stereotypes and assumptions related to IPV. Intimate partner violence continues to be considered a “crime against women” despite 35+ years of research that consistently finds IPV is as prevalent among sexual minorities (Black et al. 2011). This calls into question the gender binary heterosexist ideology where women are the victims and men are the offenders. It was not until 2013 that the Violence Against Women Act (VAWA) included protections for LGBT couples. However, there is evidence that the public health care providers and the criminal justice systems continue to harbor the belief that heterosexual women are the dominant victims of IPV. This framework cannot help us understand the nuances related to the motivations and experiences of IPV. Nor does this framework help promote policy and create effective treatment programs (for further review see Cannon and Buttell 2015; Cannon 2020a, b; Hamel 2020; Hines and Douglas 2009). While resources and services available to LGBT+ and heterosexual male victims are increasing, existing services cater primarily to female victims of male violence, and there remains an extreme shortage of resources available to these under-served victims of IPV (Douglas and Hines 2011). Three large problems face these under-served victimized populations. First, the heterosexist perspective—an “ideological system that denies, denigrates, or stigmatizes any non-heterosexual form of behavior, identity, relationship or community” (Herek 1990, p. 316)—dictates who can and cannot be a victim of abuse (Brown 2008). Second, and related to the heterosexist perspective, is the history of the criminalization of sexual minorities which continues to leave its stigma. Third, and lastly, is the gap between efforts of legal rights and protections and social service and criminal justice response to IPV. Issues associated with sexual minority communities can leave untrained health care and criminal justice officials at a loss of how to respond or identify the offender and assist the victim. This chapter explores some of the ways in which relying on heterosexist stereotypes can lead to neglect and maltreatment from social services, health care screenings, and virtually every procedural aspect of the criminal justice system.

Heteronormative Assumptions and the Relation to Identification and Response to IPV While authors in Part 1 and Part 2 in this book emphasize the importance of the need for recognition, response, and treatment of IPV in LGBT+ populations, our society continues to embrace heteronormative beliefs surrounding abuse. Research over the past 30+ years suggests IPV is a human phenomenon that can occur to anyone of any age, race, sexual orientation, ethnicity, etc. However, health care, social service, and legal response continues to harbor inaccurate binary views (male/female) of IPV book (see Cannon 2020a, b; Brubaker 2020; Head 2020; Little 2020; Scheer et al. 2020).

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Intimate partner violence in LGBT+ relationships and heterosexual male victimization challenge heteronormative beliefs, therefore the seriousness of IPV is subsequently minimized. Male-to-female IPV is considered more serious, blameworthy, and more likely to be considered abuse than IPV in sexual minority relationships or IPV inflicted by heterosexual females (Russell et al. 2015; Seelau and Seelau 2005; Sorenson and Thomas 2009). Researchers have found IPV initiated by heterosexual females and sexual minorities is less likely to be considered abuse (Russell et al. 2015) or illegal (Sorenson and Thomas 2009) compared to IPV perpetrated by heterosexual males. Health care providers, social service agencies, and police tend to minimize the potential seriousness of IPV incidents or even fail to recognize, intervene, or arrest perpetrators when disputants are sexual minorities (Comstock 1991; Vickers 1996). Moreover, research generally shows that female offenders are treated more leniently in the criminal justice system than male offenders in cases of IPV (Buzawa and Hotaling 2000; Felson and Paré 2005; Shernock and Russell 2012). Brown (2004) stated that “gender is often the most significant factor in predicting how the law-enforcement system responds to incidents of partner violence” (p. 107). If we continue to rely on gender as a predictor of response to IPV, it can have deleterious consequences. Researchers (Hamby and Jackson 2010; Russell et al. 2019) found that because men are perceived as stronger, larger, and more physically aggressive than women, male-to-female violence is perceived as the most dangerous, thus eliciting greater fear of a threat of harm to female victims. However, because individuals in same-sex relationships are perceived as similar in size, strength, and status, violence is considered less serious (Brown 2008). Research has also noted that attributions of abuser or victim blame in IPV incidents is often confounded with gender identity (masculinity/femininity) (Little and Terrance 2010; Russell and Kraus 2016; Wasarhaley et al. 2015). The norms associated with heterosexual gender identity (and an idealized relationship) tend to assume that men are masculine and will use their physical strength and aggression during conflict while women are fragile, compliant, nurturing, and in need of protection (Curry et al. 2004; Messerschmidt 2013; Sellers et al. 2005). When men and women diverge from their prescribed gender roles, there can be harmful consequences. Individuals tend to perceive gay males as less masculine and more feminine than heterosexual men, and conversely lesbians are considered more masculine and less feminine than heterosexual women (Blashill and Powlishta 2009). Studies have found masculine perpetrators tend to be perceived as a greater threat to injury, more blameworthy, and responsible for abuse and injury than feminine perpetrators, whereas feminine perpetrators are attributed the least blame for abuse. Feminine victims are also allocated less blame and responsibility for abuse than masculine victims (Little and Terrance 2010; Russell and Kraus 2016; Russell et al. 2019; Wasarhaley et al. 2015). These studies suggest that gender identity plays a significant role in perceptions of perpetrators and victims of IPV.

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Heteronormative Bias and the History of Criminality of LGBT+ Heteronormative beliefs have their origins in religion, law, psychiatry, psychology, and the media (Herek 1990). Christianity and Judaism promoted the moral virtues of marriage between a man and a woman with the intent to propagate children that will be raised in the faith. Because of the belief in marriage between a man and a woman, there were no legal protections for sexual minorities whatsoever. Sodomy was considered both a “sin” and a “crime” dating back to 1533 and brought to the U.S. under English Common Law which often carried the penalty of death. Under English Common Law, each state adopted some form of sodomy law. In fact, historically, most gender-nonconforming behaviors (e.g., cross-dressing) were forbidden and considered threats to the public order (Capers 2008). Such laws meant being a sexual minority was a crime (Eskridge 2008; Mogul et al. 2011). In the 1940s, psychologists and psychiatrists identified homosexuality as a mental illness that could be cured (Schmeiser 2008) which eventually led to legal ramifications (Woods 2018) when 29 states enacted “sexual psychopath laws” which deemed LGBT+ deviant sex offenders worthy of imprisonment or involuntary commitment (Woods 2018). In the 1960s, an upsurge of research and social movements working to remove the stigma of homosexuality led to the repeal of sodomy laws. In 1968, The Diagnostic and Statistical Manual (DSM II) classified homosexuality as a mental disorder only to remove it five years later (Drescher 2015; Woods 2018). While we have since witnessed recent court cases that have led to greater recognition and rights of sexual minorities, heterosexism and the history of the criminalization of sexual minorities continues to seep through our societal psyche. We will now examine how these biases continue to affect first line responders in social services, health care, and law enforcement.

Social Services and Health Care Providers One would think with increased rights and recognition of IPV in sexual minority populations, coupled with empirical research demonstrating high prevalence rates, logic would necessitate first responders in social services, health care, and law enforcement be well-trained and knowledgeable in interacting with and treating this community. As we have seen in previous chapters (see Cannon 2020a, b; Hillman 2020; Scheer et al. 2020; Turell 2020), that is sadly not a reality for many victims of LGBT+ intimate partner violence. Looking specifically at service providers such as nurses, advocates, and counselors elucidates a culture of heteronormative biases and antiLGBT+ sentiments that is as much insidious as it is pervasive. For example, survivors of IPV voiced fears of their abuse being dismissed due to the sex of the abusive partner, internalized and externalized homophobia (especially transphobia) leading to discrimination, lackluster/discouraging responses that dissuade the victim from

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seeking help, and an overall poverty of available services for the LGBT+ community—fears that are not unfounded (Alhusen et al. 2010; Guadalupe-Diaz and Jasinski 2017; Kay and Jeffries 2010; Sorenson and Thomas 2009; Tesch and Bekerian 2015; Turell et al. 2012; Wise and Bowman 1997). Some of the barriers social service agencies encountered in working with or reaching out to LGBT+ clients included homophobia and the belief that services were not needed (Ciarlante and Fountain 2010; Kay and Jeffries 2010; Simpson and Helfrich 2014). Such a belief tends to focus assistance (e.g., emergency shelters) toward heterosexual cisgender females, therefore leaving lesbians, gay men, and transgender individuals with little-to-no help and potentially denying their entry to such accommodations (Guadalupe-Diaz and Jasinski 2017; NCAVP 2016; Simpson and Helfrich 2014; Sorenson and Thomas 2009; St. Pierre and Senn 2010). Brown and Groscup (2009) noted in their study of the perceptions of same-sex domestic violence (DV) from the perspective of crisis center staff that participants viewed vignettes describing same-sex and oppositesex domestic violence differently: opposite-sex abuse was perceived as being more severe, more likely to reoccur, and more likely to escalate over time compared to same-sex domestic violence. Because of the added factor of sexual orientation to IPV, Wise and Bowman (1997) explained it can lead service providers (and those studying to act as such) to suggest incorrect or inappropriate treatment options for LGBT+ victims compared to heterosexual victims (for review see Parts 3 and 4 in this book; Cannon 2020a, b; Hamel 2020; Hillman 2020; Turell 2020). For example, couples counseling may be recommended for same-sex couples engaging in IPV despite it being one of the last recommended treatments for opposite-sex couples. Additionally, counselors may suggest same-sex couples try to “work it out,” whereas a smaller tendency for such a recommendation for opposite-sex couples was reported due to the perception that battering in lesbian relationships was less severe than in heterosexual relationships (Walters 2011; Wise and Bowman 1997). To exacerbate matters, the health care system tends to fail LGBT+ IPV victims as well. Alhusen et al. (2010) reported sexual minority women (SMW) experience subpar preventive care and screening compared to heterosexual women. The problem potentially lies with the providers’ heteronormative assumptions that their patients are heterosexual unless the patient explicitly states otherwise—beliefs that can prevent the right questions from being asked when members of this community are most vulnerable. One participant who was both a nurse and a survivor reported how their colleagues were “judgmental” of the patient when a lesbian victim would arrive for treatment and would act as if the victim deserved the abuse. This breakdown of help when victims need it most can literally put their lives at risk. Many of the pitfalls in service provider response starts with how they are trained. Ford et al. (2013) found that low levels of training regarding LGBT IPV for outreach staff, failure to document sexual orientation or gender identity, and overall practices that did not consider the special needs of LGBT+ clients were reportedly widespread practices that proved detrimental to victims and survivors of the community. Amazingly, despite the staff’s involvement working with these victims, they still felt largely

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unprepared to assess the needs of LGBT victims—especially men and transgender individuals. For example, transgender victims seeking emergency shelter were stuck in the middle: considered not masculine enough for male shelters or not feminine enough for female shelters, or service providers drew unwanted attention to their trans status because they are worried about what the other shelter residents may think (Guadalupe-Diaz and Jasinski 2017). In order to provide competent services to LGBT victims, providers need to deliver “culturally specific outreach” or present sensitive service that allows victims to feel heard and understood which can start in graduate school (Ciarlante and Fountain 2010; Ford et al. 2013; Furman et al. 2017; Hancock et al. 2014; St. Pierre and Senn 2010). Participants in St. Pierre and Senn’s (2010) study described sensitive service providers as knowledgeable individuals, resourceful, having an understanding and/or experience working with GLBT clients, and not prejudiced. To reach such a bar requires proper training—sensitivity training, sexual orientation-specific IPV training, population considerations—which few service providers receive (Ciarlante and Fountain 2010; Ford et al. 2013; St. Pierre and Senn 2010). Additionally, training can allow providers to recognize and confront their own implicit and explicit biases that they may project upon this demographic (Ciarlante and Fountain 2010). Explicit attitudes operate on a conscious or intentional level where individuals react differently when interacting with unfamiliar groups or situations, often resulting in a bias directed toward those of a different race, gender, or sexual orientation (Fiske and Taylor 2008). Conversely, implicit attitudes are “fast and automatic and operate without intention, often in an unconscious mode” (Akrami and Ekehammar 2005, p. 361). Researchers (Dovidio et al. 2016; Weir 2016) believe all individuals harbor these biases and health care providers, social service agencies, and law enforcement are no different as these biases are ingrained in our history and culture of inequality. These unconscious prejudices toward minorities can be created either through differential exposure to groups or through illusory correlational mechanisms (Kowalski 2003; Smith and Alpert 2007). Researchers (Anselmi et al. 2013; Burke et al. 2015; Sabin et al. 2015) examined implicit and explicit attitudes toward lesbian and gay individuals among health care providers and non-providers. These studies found that overall, health professionals exhibit some explicit bias and almost all exhibit some implicit bias against gay and lesbian individuals. Others (Anselmi et al. 2013) found heterosexual substance abuse counselors demonstrated greater negative biases toward LGBT individuals. Sabin and Colleagues (2015) reported heterosexual men had the strongest implicit preference for heterosexuals than heterosexual women however, heterosexual nurses (male and female) favored heterosexuals over lesbians or gays. The degree of contact and favorability with gays and lesbians predicted more positive implicit and explicit attitudes. Both heterosexual non-health care providers and heterosexual health providers demonstrated implicit preferences consistently favoring heterosexual over lesbian or gays.

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Law Enforcement Attitudes and Response In a similar vein, law enforcement faces parallel problems when serving the LGBT+ community. The homophobic beliefs combined with a reliance upon stereotypes of victims and offenders paves the way for biased policing practices and, subsequently, mistrust between police and LGBT+ individuals (see Alhusen et al. 2010; Franklin et al. 2019; Guadalupe-Diaz and Jasinski 2017; Hassouneh and Glass 2008; Kay and Jeffries 2010). Police mistrust is a significant problem within LGBT+ communities. For example, Guadalupe-Diaz and Jasinski (2017), Kay and Jeffries’ (2010), and Langenderfer-Magruder et al. (2016) reported participants related their reluctance to involve law enforcement out of fear of discrimination, thus most participants had never called the police for assistance unless in extreme cases—especially transgender victims of IPV. In instances when the police were called, research has detailed how responding officers act inappropriately or insensitively toward the victims by not using preferred gender pronouns for trans victims, by appearing not to take samesex IPV seriously, or the overall failure to recognize an incident as IPV (Ciarlante and Fountain 2010; Guadalupe-Diaz and Jasinski 2017; NCAVP 2016; Simpson and Helfrich 2014). According to the NCAVP (2016), out of the 1,976 LGBTQ survivors they surveyed, only 43% made contact with the police while 33% filed an actual report. Moreover, out of the 43% that interacted with law enforcement, 12% of respondents described the police as “hostile” and 13% described them as “indifferent.” Such results are consistent with McClennen et al.’s (2002) study that gay men reported police and attorneys were considered some of the least helpful options in cases of IPV, and they were also sources that were least sought by victims. These experiences with police—whether first- or second-hand—fuel the mistrust, disapproval, and beliefs that law enforcement is a nonlegitimate organization among the LGBT+ community (Finneran and Stephenson 2013; Miles-Johnson 2015). Furthermore, a study from the Williams Institute at UCLA (Mallory et al. 2015) reported that “discrimination and harassment by law enforcement based on sexual orientation and gender identity is an ongoing and pervasive problem in the LGBT communities.” Their survey data concluded that of the LGBT violence survivors who interacted with police, 48% reported they had experienced police misconduct including unjustified arrest, the use of excessive force, and entrapment. Finneran and Stephenson (2013) also found that 40% of gay and bisexual respondents believed that contacting the police in response to a violent incident from an intimate partner would be unhelpful or very unhelpful, and 59% believed the police would be less helpful to a gay or bisexual man than to a heterosexual woman in the same situation. Victim experiences with police have varied based on perceptions of the victim which illustrate the power of stereotypical constructs of IPV victims. For instance, victims who feel they are less likely to be believed, helped, or supported by police tend to be nonwhite, male, or LGBT+ (Guadalupe-Diaz 2016).

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Law Enforcement Training in IPV and LGBT+ Just as the breakdown for the perceived helpfulness of social service providers starts with training, law enforcement also suffers from the same problem. While a few departments have created procedures regarding interaction with sexual minorities, most of these policies offer limited knowledge about the needs of sexual minorities or neglect the importance of maintaining relationships with sexual minorities. One of the key recommendations that came out of the Williams report (Mallory et al. 2015) was that state and local police departments should adopt internal policies and practices including LGBT sensitivity, diversity, and specialization training. While there is little research on this topic, one study (Tesch et al. 2010) surveyed officers from five towns in Illinois and found, even though officers had regular encounters of domestic incidents with same-sex couples, 81% of officer respondents stated they did not know of any departmental procedure addressing the specifics of same-sex IPV calls, and over 70% had no officer training in LGBT DV related calls. Further, researchers (Hamel and Russell 2013) conducted a content analysis of 16 police state training manuals with primary/dominant aggressor laws and found law enforcement training predominantly reflects the paradigm of heterosexual male power and control, and support practices that seriously discount issues related to sexual minorities. Only 1 in 16 states provided information on IPV within sexual minority populations. About half of state training manuals used the term “battered woman” because “women comprise the majority of victims of domestic violence,” and the majority of training scenarios depicted a heterosexual male as the primary aggressor. Most manuals relied on outdated theories and included little, if any, evidence-based research.

Screening Tools for Identifying and Helping Victims One means of providing effective assistance to LGBT+ individuals in abusive relationships is to create screening tools or assessments to aid in the identification of these individuals so services can be provided appropriately. A report from the Centers for Disease Control and Prevention (CDC; see Basile et al. 2007) provided a collection of IPV screening tools commonly used in the United States (US). Unfortunately, most screening tools noted in the report were designed for heterosexual female victims of IPV. There were screening tools found for male victims, but in many cases reliability/validity were not available. This report represents how we continue to be remiss in providing appropriate screening tools for LGBT+ individuals. It is important to note the variety of interacting factors that should be considered when standardizing assessment tools for LGBT+ clients. That said, some researchers have created some tools that have been found effective in LGBT+ populations. One of the most commonly used tools for danger assessment (DA) in IPV was created by Dr. Jacqueline Campbell in 1986. This tool is used to predict women’s risk

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of being killed or seriously injured. Campbell and her colleagues subsequently created the DA-R as a risk assessment of re-assault for women in same-sex relationships (Glass et al. 2008). The authors reviewed the DA and obtained input from victims and perpetrators that might be important to women in same-sex relationships. The measure includes questions about stalking, keeping abuse secret out of fear/shame, help-seeking, and discrimination. The major predictors of re-assault included partner jealousy, social isolation, increases in frequency/severity of physical violence, access to a gun, living with a partner, and threats to previous victim partners. The transgender-related IPV (T-IPV) tool attempts to do just that by measuring four common themes found in previous research as common characteristics of transgender IPV (Peitzmeier et al. 2019). The first theme or domain is “coercive control of gender transition or gender presentation” which can entail the abusive partner attempting to dissuade the victim from transitioning or utilizing tools (e.g., chest binders) that effect their gender presentation. The second and third domains are: “emphasizing the undesirability of transgender individuals as intimate partners” and “blackmail via outing.” The final domain is “sabotaging transition” such as the destruction of tools used to aid in their transition (e.g., throwing out hormones). Taken together these four items provide a well-rounded representation of the experiences of IPV transmasculine individuals face, and also possess adequate internal reliability (KR-20 score of 0.56) and validity. To measure IPV among gay and bisexual men, the IPV-GBM Scale was designed encompassing five common domains of intimate partner violence as reported among the 912 respondents (Stephenson and Finneran 2013). The five domains or factors— physical and sexual IPV, monitoring behaviors, controlling behaviors, HIV-related IPV, emotional IPV—accounted for more than 60% of the variance in IPV definitions and detected higher prevalence for IPV compared to definitions regarding physical and sexual abuse created by the CDC and the Revised Conflict Tactics Scales short form (CTS2S). This sensitivity suggests the IPV-GBM Scale depicts the lived experiences of IPV within this population (Stephenson and Finneran 2013). While there are differences in responses by race between white and African American gay and bisexual respondents, the differences were minute. Additionally, the sample size of Latino and other racial/ethnic groups were too small to deem this scale appropriate, thus necessitating further research for these communities. While researchers have begun to scratch the surface of this process, it is essential for researchers to consider the import of various issues associated with sexual identity, discrimination, and culture. It is also important that we remember to encourage the use of these screening tools within human service and police officer decision making.

Police Officer Perceptions Recent research (Russell 2018; Russell and Sturgeon 2019) investigated officer evaluations of an IPV incident as a function of gender and sexual orientation. The authors found police officers evaluated IPV incidents differently according to gender and

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sexual orientation. Officers considered non-arrest options (e.g., mediation, providing informal advice, threats to arrest if it happens again) as more fair options when the perpetrator was gay or a heterosexual female and believed referrals to shelters were more appropriate for perpetrators in same-sex relationships. Their preliminary research also found effects showing novice officers were more likely than experienced officers to express these beliefs. Officers also rated the severity of victim injury as more severe when the perpetrator was a heterosexual male and the victim was a heterosexual female (Russell and Sturgeon 2019). Police similarly considered a heterosexual male perpetrator as a greater threat of danger compared to gay male, lesbian, or heterosexual female perpetrators. Heterosexual female and gay male perpetrators were considered least likely to have harmed their partner in the past and believed victims of female perpetrators as more responsible for an IPV incident and considered lesbians as displaying behaviors indicative of mental illness (Russell 2018). Moreover, officer frequency and recency of IPV training (Russell and Sturgeon 2019) did not affect responses. This suggests that either biases continue to seep into decision making and/or the content of officer training may not have included information that could minimize potential bias. These results also imply a common practice for police which is to rely on stereotypes of gender presentation (e.g., femininity versus masculinity) and behavior (e.g., hysteria, passivity). These stereotypes play a significant role in decisions of arrest of the primary aggressor. For example, officers may perceive that the more “butch” or masculine looking partner is the perpetrator or a “less believable victim” (GuadalupeDiaz 2016; Guadalupe-Diaz and Jasinski 2017; NCAVP 2016; Russell and Sturgeon 2019; Sorenson and Thomas 2009). Such attitudes are based upon heteronormative constructs of IPV for cisgender heterosexual men and women, as well as biases that direct officers to view male perpetrators as a higher threat compared to female perpetrators (Ciarlante and Fountain 2010; Guadalupe-Diaz and Jasinski 2017; Hassouneh and Glass 2008; NCAVP 2016; Russell 2018; Russell and Sturgeon 2019; Sorenson and Thomas 2009). Such perceptions embraced by police can also lead to dual arrest of the victim and perpetrator. According to the NCAVP (2016), “same gender couples are at least ten times more likely to experience dual arrest […] than opposite gender couples” (p. 33). These arrests are done under the guise of describing the incident as “mutual battering” or “mutual abuse” which subsequently leads victims of IPV to second-guess the decision to reach out to law enforcement for fear of arrest with their abuser (Ciarlante and Fountain 2010; Gehring and Vaske 2017; Rollé et al. 2018; Sorenson and Thomas 2009). If officers do not engage in dual arrest, they may implement non-arrest or informal options (e.g., suggesting one partner walk away to cool off, providing referrals to domestic violence hotlines) if the perpetrators were the same sex as their victims (Russell and Sturgeon 2019). According to Russell and Sturgeon (2019), this potentially suggests that police may view same-sex perpetrators as less serious, and police may have a more difficult time discerning the dominant aggressor in the situation. As reported in the NCAVP’s (2016) report, “these negative and violent experiences with law enforcement are exacerbated with LGBTQ survivors or color, LGBTQ survivors with disabilities, undocumented survivors, and

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other communities that hold multiple marginalized identities that are frequently subjected to violence by police” (p. 33). Ultimately, the lack of training police receive on handling cases of IPV with same-sex couples proves deleterious to the relationship and perceived legitimacy between the criminal justice system and the LGBT+ community.

Studies on LGBT+ in the Courts Juvenile justice. Court systems should be free of bias, yet whether implicit or explicit, attitudes and behaviors within the courts demonstrate problematic issues particularly for sexual minorities. First, in Chap. 8, researchers (Edwards et al. 2020) have demonstrated that sexual minority adolescents and young adults who enter the court systems can be at risk. It is estimated that about 13% of youth in the criminal justice system are sexual minorities (Majd et al. 2009). In 2005, the Equity Project surveyed legal actors, probation officers, and detention staff in juvenile court and detention centers. Majd et al. (2009) found that the criminal justice process for youth is severely lacking in its ability to meet the needs of sexual minority youth. Majd and Colleagues (2009) noted biases found in all aspects of the criminal justice process from arrest to confinement. The authors noted sexual minority youth in detention centers experience more physical, sexual, and emotional abuse by staff and other prisoners because of their sexual orientation or gender identity. Further, many youths were believed, without warrant, to be sexually deviant with a propensity for sex offending and given unnecessary sex offender treatment due to their sexual orientation. Sexual orientation and legal actors. There are few studies that have been conducted to examine sexual orientation bias within the court systems. In fact, there are only three studies of states that have assessed this matter. In 2001, California and New Jersey conducted research to examine the issue. California examined the experiences of jurors, witnesses, litigants, lawyers, and court staff. Of the respondents, 1,225 selfreported as gay and lesbian. Fifty-six percent of survey respondents claimed to have heard negative comments or witnessed negative treatment directed toward gays and lesbians. Almost one-quarter of respondents (22%) felt threatened because of their sexual orientation. The New Jersey Judiciary study examined bias in over 1,900 participants (almost seven percent were self-reported as gay/lesbian/bisexual). They found sexual minorities were seven times more likely to report bias as witnesses or litigants compared to heterosexual respondents. In fact, 61% of sexual minorities involved in the legal processes across criminal, civil, and family law believed their sexual orientation affected their case. It is important to note that while these studies are useful in understanding the extent of bias in the court systems, they are almost 20 years old and may not represent bias of today’s court systems. In a more recent study conducted by Lambda Legal (2014), 965 LGBTQ participants with HIV were surveyed about their experiences in the courts. Nearly 20% claimed they had heard negative comments associated with their gender identity or

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sexual orientation from judges, attorneys, or court staff. The proportion of negative comments were higher for gender non-conforming (33%), people of color (30%), and transgender and gender nonconforming respondents of color (53%). Approximately 30% of attorneys surveyed reported they heard discriminatory language about their own or someone else’s sexual orientation and 30% of witnesses had their gender identity raised in a case when it was not relevant. Jury decision-making. Considering the law enforcement and social service barriers members of the LGBT+ community face when seeking help, if a case of IPV goes any further in the criminal justice system—for instance, formal charges and a court appearance—one would hope a jury of one’s peers would aid in seeing justice through. While extra-legal factors such as sexual orientation, age, gender, attractiveness, ethnicity, etc… should have no role in the legal process, they too have been found to unfortunately play a role in juror decision-making (Wexler 2013). Wasarhaley et al. (2015) found in their study on mock juror decision-making that the same stereotypes that plague the police, shelter counselors, and health care professionals when responding to LGBT+ survivors affect how jurors viewed the survivors as well; perceptions about masculinity and femininity ultimately influenced whether the mock jurors rendered a felony conviction. For example, if the defendant was a woman with masculine features accused of abusing their partner with feminine features, the male participants rated feeling angrier at the defendant than if both the defendant and the victim had feminine features (Wasarhaley et al. 2015). Similarly, Russell and Kraus (2016) found that the perceived masculinity of the aggressor, regardless the gender of the aggressor, influenced perceptions as to whom initiated the assault and posed a greater threat of bodily injury. Additionally, participant perceptions of the seriousness of intimate partner violence were contingent upon the sex of the perpetrator and victim: a case of a male perpetrator with a female victim was believed to be more serious than when both the perpetrator and victim were male (Russell and Kraus 2016; Seelau et al. 2003; Seelau and Seelau 2005). Building upon that, Poorman et al. (2003) found respondents more likely to recommend female victims of male perpetrators press charges than male-male, female-male, and female-female scenarios of IPV. Furthermore, participants viewed heterosexual victims as more believable compared to gay and lesbian victims, thus leading to harsher sentencing recommendations. In a series of studies examining mock juror decision-making in crimes of selfdefense, crimes of passion, and duress (Ragatz and Russell 2010; Russell et al. 2009, 2012), the authors unfailingly found heterosexual female defendants were consistently perceived to be significantly less guilty across studies than gay, lesbian, or heterosexual male defendants. Female heterosexual defendants were more likely to be perceived as acting in self-defense or committing a homicide as a crime of passion compared to gay, lesbian, or heterosexual male defendants. Heterosexual females also were more likely to be believed and received lower sentences in crimes of duress and crimes of passion compared to a gay, lesbian, or heterosexual male defendants. In the case of duress, lesbian and heterosexual male defendants received longer sentence lengths than heterosexual females and gay males, and gay males

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were more likely to be believed than lesbians. This suggests heterosexual females are treated more favorably by mock jurors. Additionally, Olson (2017) conducted a study assessing witness credibility as a function of sexual minority status. Olson (2017) provided a hypothetical scenario of a trial that manipulated defense witnesses’ gender and sexual orientation. Their results found that female witnesses were considered less credible than male witnesses. The only significant effect found for sexual orientation was that lesbian witnesses were rated less credible than gay male witnesses. The fact that there were no interaction effects are encouraging. As a potential juror, most individuals would fail to recognize or admit they harbored bias toward LGBT+ individuals. Additionally, there is very little research on the voir dire process and LGBT+ issues. While this topic is beyond the scope of this chapter, see Shay’s (2014) review of this topic which addresses the many potential problems that can be involved when determining whether to bring up questions related to one’s own sexual orientation.

Policy While it may be simpler to blame responders of IPV for their incompetence in dealing with the LGBT+ community, the problem is more institutional and structural. The organizations and agencies that employ the responders (police, nurses, counselors) do not provide the necessary training or policies to impart the proper guidance necessary. With such ambiguous policies, it requires law enforcement, social service, and health care professionals to interpret these guidelines how they see fit which can be to the detriment of LGBT+ IPV victims (Simpson and Helfrich 2014). This subjective decision-making provides room for inconsistencies in policy adherence and discriminatory behavior towards clients. The latter is exemplified through the use of heterosexist, abusive, and derogatory language directed toward sexual minority members that function as a means of alienation and intimidation (Simpson and Helfrich 2014). Thus, insensitive and abusive language can force victims to keep their sexual identity quiet out of fear or even cutting off a means of help-seeking and, therefore, putting them more at risk. In shelters, for example, it is equally important that clients and staff adhere to these policies and even allow survivors to be placed according to their gender-identity, thus developing a space devoid of heterosexist or transphobic assumptions and creating a more client-centered atmosphere (Furman et al. 2017). Within a similar vein, the laws created to protect victims of IPV must utilize inclusive language that recognizes IPV within the LGBT+ community. For instance, the 1994 Violence Against Women Act initially lacked inclusive language that would have extend protections to individuals within same-sex partnerships until its reauthorization in 2013 (Miller 2013). With the addition of such protections, VAWA, for example, now prohibits the exclusion of LGBT+ victims of IPV from shelters as well as secures the provision of grants to aid in law enforcement and social services

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directed toward helping LGBT+ victims of IPV. Such extensions of protections provide both victims and the courts with a basis for seeking help and enforcing justice. Moreover, with laws on the books, that can aid in increasing exposure of IPV within the LGBT+ community and, subsequently, prosecutions of these crimes (Stanziani et al. 2018). According to Stanziani and Colleagues (2018), increased prosecution can, in turn, lead to growth and improvement in interventions from law enforcement officers responding to DV calls, and encourage LGBT+ victims to seek help and feel confident in the criminal justice system’s response. Furthermore, it is the onus of agencies and organizations to make a concerted effort to reach out and advertise their services to let members of the LGBT+ community to let them know they are there and available. Simpson and Helfrich (2014) reported that participants agreed that if there was active advertisement of services, they would use them. As such, NCAVP (2016) recommends policymakers create campaigns and fund early intervention programs for youth to bring LGBT+ IPV awareness to the public. According to Ciarlante and Fountain (2010), outreach could also help increase reporting of hate/bias crimes as well as IPV. Thus, in order to enact change, it is imperative that we start with the rules at the foundation of the problem and work our way outward. IPV is a serious public health issue involving service providers, social policy, and criminal justice practice that needs reform designed to combat potential biases associated the LGBT+ populations. While there will always be discretion used within these realms, choosing a more inclusive approach that will reduce ambiguity of current policies and practices involving the LGBT+ community can reduce or eliminate some of the negative consequences associated with bias and begin to build a greater trust among all victims that deserve to be treated equally. To do this, we must recognize the problem as well as identify and change societal attitudes that ultimately affect both access to resources for victims and the response from the criminal justice system.

Conclusion The LGBT+ community is one of the most neglected subsets of the population when it comes to identifying and responding to incidents of intimate partner violence. At every step of the help-seeking process, individuals identifying with the community are hindered in their help-seeking processes. Whether it is health care professionals neglecting to screen them as possible victims of IPV, or police arresting neither or both perpetrator and victim, or social service staff bringing unwanted or unnecessary attention to a victim’s gender identity or sexuality, victims of same-sex IPV become revictimized by the very institutions designed as safeguards to such abuse. Despite findings that members of the LGBT+ community suffer equivalent, or at times higher, rates of IPV compared to their heterosexual cisgender counterparts (Messinger 2011; Romero et al. 2019; Turell 2000; Walters et al. 2013), the poverty of services, policies, training for professionals in direct contact with this community, and the rampant pervasiveness of heteronormative biases that infect the policies and professionals

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within these organizations create a virtually insurmountable barrier for help-seeking among victims. Despite the bleak outlook of assistance within the healthcare, social services, and criminal justice realms, changes can be made to help LGBT+ victims of intimate partner violence. First and foremost, a change of policy—the foundation to which these institutions lie—needs to be implemented (Simpson and Helfrich 2014). Changing the policies or rules by which responders to IPV rely upon can aid in ameliorating any ambiguities or uncertainties when it comes to interacting or working with this community. Doing so will create a clear set of standards to which police, shelter staff, nurses, prosecutors, etc… can understand and be held responsible. Additionally, active advertisement of services from social welfare and healthcare organizations as well as the creation and advertisement of LGBT+-specific services allows victims to more easily find and engage with helping professionals without the fear of stigma and/or revictimization (NCAVP 2016; Simpson and Helfrich 2014). Lastly, it is important to encourage the prosecution of such crimes in a court of law despite potential juror implicit and explicit biases. Doing so would bring more awareness to the problem, encourage police intervention, and inspire LGBT+ victims to seek help (Stanziani et al. 2018). Thus, by creating these policies and bolstering these institutions, the protection of the people they preside over comes ever closer to providing equal protection for all.

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Walters, M. L. (2011). Straighten up and act like a lady: A qualitative study of lesbian survivors of intimate partner violence. Journal of Gay and Lesbian Social Services, 23, 250–270. https://doi. org/10.1080/10538720.2011.559148. Walters, M. L., Chen J., & Breiding, M. J. (2013). The national intimate partner and sexual violence survey (NISVS): 2010 findings on victimization by sexual orientation. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Wasarhaley, N., Lynch, K. R., Golding, J. M., & Renzetti, C. M. (2015). The impact of gender stereotypes on legal perceptions of lesbian intimate partner violence. Journal of Interpersonal Violence, 32, 635–658. https://doi.org/10.1177/0886260515586370. Weir, K. (2016, December). Policing in black & white. Monitor on Psychology, 47(11). Retrieved from http://www.apa.org/monitor/2016/12/cover-policing. Wexler, D. B. (2013). Getting and giving: What therapeutic jurisprudence can get from and give to positive criminology. SSRN. https://doi.org/10.2139/ssrn.2220509. Wise, A. J., & Bowman, S. L. (1997). Comparison of beginning counselors’ responses to lesbian versus heterosexual partner abuse. Violence and Victims, 12(2), 127–135. https://doi.org/10.1891/ 0886-6708.12.2.127. Woods, J. B. (2018). LGBTQ in the courtroom: How sexuality and gender identity impact the jury system. In C. J. Najdowski & M. C. Stevenson (Eds.), Criminal juries in the 21st century: Contemporary issues, psychological science, and the law (pp. 61–83). New York, NY: Oxford University Press.

Brenda Russell is a Professor of Psychology at The Pennsylvania State University, Berks. Her scholarly interests include psychology and law, perceptions of victims and perpetrators of domestic violence, homicide defendants, and the social psychological and cognitive aspects of jury decision making. She is particularly interested in how gender and sexual orientation play a role in evaluating and responding to perpetrators and victims in cases of intimate partner violence, rape, sexual coercion, and sexual harassment. She is a fellow at the Midwestern Psychological Association and received the Eisenhower Award for distinguished teaching at Penn State University. Dr. Russell also provides expert testimony in homicide cases and serves as consultant and program evaluator for various federal and state educational, law enforcement, justice, and treatment programs. Celia Torres is a graduate from the Pennsylvania State University’s Applied Psychology and Criminal Justice programs. Her interests in personality and forensic psychology drove her to complete internships in research where she presented original research on personality and political ideology at national and local conferences, co-facilitate group therapy at a partial hospitalization program for adults with mental health diagnoses, and assist with research with Dr. Brenda Russell.

Chapter 15

Policing Transgender People and Intimate Partner Violence (IPV) Toby Miles-Johnson

Introduction Across the United States (US), United Kingdom (UK), Canada, and Australia there is very little known about policing of transgender people in situations of intimate partner violence (IPV). Research examining policing of transgender people and transgender violence in situations of IPV is also lacking in the extant literature. Such gaps exist regarding policing IPV or how police officers and police organizations engage with transgender people (Miles-Johnson 2016a, b). This is not to suggest that research in this area is not forthcoming, but it still requires a great deal of systematic inquiry. According to SafeLives (2018), transgender survivors of IPV are one of the most hidden groups of IPV survivors, and while transgender and cisgender victims face similar patterns of IPV, transgender individuals face specific forms of abuse related to their identity. It is vital, therefore, that police officers acting as frontline first responders are aware of the specific needs of transgender people when responding to incidents of IPV. While other social service agencies, IPV abuse workers, voluntary sector organizations, and health-related industry partners share in the responsibility of recognition of IPV within the transgender community, police have an essential role to play in this process. Police recognition of transgender IPV will: increase the reporting of transgender IPV, effect responses to transgender IPV, increase outcomes of justice for transgender victims, and (importantly) push recommendations in relation to changing current police responses and operational practices regarding IPV in the transgender community (see Broderick 2011; Langenderfer-Magruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013). Yet, police bias towards individuals who identify as transgender has been found in much of the policing literature regarding police perceptions of LGBTIQ+ people and policing of transgender people (see Edelman T. Miles-Johnson (B) Queensland University of Technology (QUT), Brisbane, QLD, Australia e-mail: [email protected] © Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5_15

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2014; Grant et al. 2011; Heidenreich 2011; Miles-Johnson 2016a, b; Redfern 2014; Wolff and Cokely 2007; Woods et al. 2013). Grant et al. (2011) and Stotzer (2013) found that transgender people are generally wary of police interaction regardless of victimization or crime type experienced due to the potential for further victimization or re-victimization by police. However, many studies examining police engagement with transgender people only examined perceptions of police and members of the transgender community within membership of the wider LGBTIQ + community and not as an individual group of people who may be subject to specific forms of victimization or crime type; and or neglected to research how transgender people uniquely experienced violent crime such as IPV (Broady et al. 2014; Poynton et al. 2016; Seymour 2019). Research across much of the US, UK, Australia, and Canada also suggests transgender people are generally uncomfortable seeking help from law enforcement, thus raising questions regarding whether transgender people will seek help from police during times of IPV victimization (see Broderick 2011; Langenderfer-Magruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013). Before policing responses and police engagement strategies can be tailored and implemented toward policing of IPV and members of the transgender community, it is important to understand why members of the transgender community are reticent and reluctant to engage with police.

The Transgender Community and Police Relationship Stigma and Oppression of Minority Groups As police interact with different groups of people in society, they form notions of behavior often considered normal or normative with the people or citizens they police (Miles-Johnson 2013b, 2016a, b; Miles-Johnson and Pickering 2018). Factors such as crime, racial composition, ethnicity, and previous experiences police may have had with the community shape an officer’s perception regarding how citizen-engagement will take place (Lee and Gibbs 2015). Historically, this has had a negative impact on the policing of citizens from different minority groups particularly those minority groups who cross normative notions or expectations of behavior (Miles-Johnson 2016a, b). Certain groups of people such as those who are identified as being “different” to mainstream communities are disproportionately over-policed, differentially policed, or targeted solely because of their identity and their minority group status (Miles-Johnson 2013a, b, 2016a, b). Linked to ideas of stigma, identification of difference is transmitted by majority groups towards minority group members through lineages of discrimination that characterize racial, national, religious, ethnic, sexual, and gender identity differences either in terms of positive or negative (desired or undesired) similarities (Robinson 1996). In this way, stigma is conveyed in assessments or evaluations of non-concealable traits often linked to superordinate identity

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markers such as race and/or ethnicity (Hogg and Vaughan 2002). Stigma is also conveyed in the subsequent devaluation and oppression of the minority group; occurring once the evaluation or assessment of difference has taken place (Miles-Johnson and Pickering 2018). Oppressive behavior from majority groups toward minority group members is a pervasive problem in many Western societies; behavior that is often enacted or upheld by social norms and social conventions through rules, regulations, legislation, and (frequently) by social institutions such as police (Lanham et al. 2019; Miles-Johnson 2013b, 2016a, b; Panter 2018). One such group who has experienced social stigma upheld by a social institution, such as the police, is the transgender community. The stigma of being recognized as a transgender individual as a person who is perceived to be different in regard to social, cultural, and legal expectations associated with their birth sex can have negative consequences for the identified individual that include: assumptions about sexuality; normative expectations of gender behavior; and harassment, bullying, and discrimination by those who do not understand their gender expression (Johnson 2010). The nature of the binary gender divide assigned at birth is such that male and female bodies are deemed mutually exclusive and one, therefore, cannot be both male and female or neither (Broockman and Kalla 2016). Thus, this categorization assumes that all human beings will belong to one of two discrete gender categories designated permanently based on biologically given characteristics (Broockman and Kalla 2016). Many legal and social changes have occurred concerning identification of transgender people, transgender rights, and recognition of status since the history of transgender people in much of the Western world (Johnson 2010). However, the recognition of transgender people is affected by a past that has been influenced by British law, which linked transgenderism to homosexual behavior (Lev 2007). For example, in 1885, the United Kingdom passed the ‘Criminal Law Act’ which made all homosexual behavior illegal (Johnson 2010). People who cross-dressed or who changed the outward appearance of their gender became easy targets of the law due to associations with homosexual subcultures (Miles-Johnson 2016a, b). In many parts of the Western world (such as in the US, UK, Canada, and Australia), cross-dressing or changing gender identity was considered a capital crime and often resulted in harsh treatment from the authorities (Lev 2007). Stereotypical assumptions of gender and presumed connections to differences in sexuality were (and still are) often found to reinforce police officers’ attitudes towards transgender people (Miles-Johnson 2016a, b). This is often underpinned and at times endorsed by many Western police organizations’ policing policies since numerous regulating practices implemented by law enforcement organizations initiate interaction and engagement with members of the LGBTIQ+ community. This leads to the application of policing strategies as a one size fits all approach, which homogenizes the LGBTIQ+ community, as well as associates gender identity difference with sexuality difference a conflation of two different concepts (see Alliance for a Safe and Diverse DC 2008; Berman and Robinson 2010; Edelman 2014; Heidenreich 2011; Miles-Johnson 2016a, b; Redfern 2014; Wolff and Cokely 2007).

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This conflation can prove detrimental for transgender individuals who may not feel connected to other members of the lesbian, gay, and bisexual communities since gender identity is fundamentally different from sexual identity (Miles-Johnson 2013a, b, 2016a, b). Sexual identity is based on sexual orientation (an inherent or immutable enduring emotional, romantic or sexual attraction to other people), whereas gender identity, is based on an individual’s concept of ‘self’ as male, female, a blend of both or neither (Human Rights Campaign 2020). Gender identity, therefore, is how an individual perceives themselves in relation to the heteronormative gender binary of male and female, and how they subsequently identify their gender in terms of personal reference (Human Rights Campaign 2020). Since transgender identity challenges heteronormative notions of gender expression and gender expectations of behavior, it can, therefore, produce challenges to traditional notions of police engagement and interaction for police officers and members of the public toward members of the community (Miles-Johnson 2016a, b).

Systemic Societal Discrimination Social discrimination frequently occurs in the lives of transgender individuals. Globally, transgender people report that they have been ridiculed or embarrassed by the police because of their transgender identity or expression (see Alliance for a Safe and Diverse DC 2008; Berman and Robinson 2010; Edelman 2014; Heidenreich 2011; Miles-Johnson 2013b; Redfern 2014; Wolff and Cokely 2007). Negative perceptions of police built on fear, mistrust, negative responses, and aggressive behaviors on the part of law enforcement have outnumbered any positive responses or behaviors when transgender people report police interaction with members of this community (Lanham et al. 2019; Miles-Johnson 2016a, b). Common complaints received by helpline callers from members of the transgender community suggest that inadequate responses by the police victimizes transgender people and continues to contribute to mistrust and a lack of confidence that transgender people have in policing and police engagement (James et al. 2016). Additionally, research by numerous scholars supports the idea that police behavior is actually a reflection of broader prevailing social expectations and attitudes towards transgender people by members of the public and vice versa: that negative attitudes of the public toward transgender individuals who do not conform to the gender binary of male and female is also reflected in the attitudes of police (see Dario et al. 2019; Miles-Johnson 2016a, b; Miles-Johnson and Pickering 2018). Subsequently, violence perpetrated against transgender people is a phenomenon that has largely gone unnoticed, particularly in police reports and in police documentation (Dario et al. 2019; Hodge and Sexton 2018; MilesJohnson 2016a, b; Pickles 2019). This is one of the reasons why transgender people in the 21st Century still feel disconnected to police since police organizations are frequently being accused of isolated incidences of transphobia and violence towards members of the transgender community, particularly in areas where violence against transgender people is reportedly increasing (Miles-Johnson 2016a, b).

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Numerous cases of police transphobia directed towards transgender people— particularly verbal and physical harassment are documented around the globe, and these include unequal enforcement of the law and the deliberate mishandling of antitransgender violence cases such as the police misgendering (or not identifying) that a victim of violence was transgender or not acknowledging that the anti-transgender violence was motivated by anti-transgender bias (see Alliance for a Safe and Diverse DC 2008; Berman and Robinson 2010; Edelman 2014; Heidenreich 2011; MilesJohnson 2016a, b; Redfern 2014; Wolff and Cokely 2007). Research also suggests transgender people experience higher levels of poverty, unemployment, discrimination, and homelessness than cisgender individuals; thus, they may engage with police officers and enter the criminal justice system more frequently than other members of society (see Dario et al. 2019; Hodge and Sexton 2018; Miles-Johnson 2016a, b; Pickles 2019). Further, despite the fact that there may only be a small number of transgender people who engage in illegal work (e.g. sex work, illegal drug sales for economic survival), transgender individuals face higher levels of police interaction and police engagement than non-cisgender people who are, generally, more likely to find work through legitimate means (James et al. 2016). Consequently, transgender individuals are more prone to ridicule, violence, and harassment within the context of the criminal justice system since this places a transgender person into a position where they are more exposed than others due to the direct effects of interaction within the criminal justice system (Moran and Sharpe 2004). Therefore, they are more likely to experience abuse from the gatekeepers of the criminal justice system such as the police (see Alliance for a Safe and Diverse DC, 2008; Berman and Robinson 2010; Edelman 2014; Heidenreich 2011; Miles-Johnson 2016a, b; Redfern 2014; Wolff and Cokely 2007). Critics of police interaction within the transgender community argue that miscarriages of justice involving members of the transgender community create a lack of cooperation between the two groups (see Dwyer et al. 2017; Ristock and Timbang 2005). One way of improving minority group cooperation between transgender people and police is to increase perceptions of police legitimacy and trustworthiness. However, the disconnection between police and transgender people raises the question regarding how police can effectively construct meaningful and trustworthy (legitimate) partnerships with them. This is particularly problematic when there is a social requirement that minority group members such as the transgender community be provided with a positive social identity from other (more dominant) groups in society (like police), and accordingly, awarded a positive, interactive experience when engagement occurs (Tajfel 2010). Yet transgender people are awarded negative social identities by law enforcement officers due to the disparity between their gender identity and assigned sex. To complicate matters, police have often regarded members of minority groups, such as transgender people, to possess negative social identities, therefore leading members of the transgender community to be subjected to a long history of police harassment and abuse (e.g. subverting procedural rules) (MilesJohnson 2016a, b). The rejection of transgender people by the police emphasizes differences between the two groups and exacerbates differences between diverse

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factions of society as a whole. It also encourages social discrimination between groups of people based on intergroup differences. Unsurprisingly, numerous pieces of research indicate that most members of the transgender community purposely avoid having contact with police (see Alliance for a Safe and Diverse DC 2008; Berman and Robinson 2010; Edelman 2014; Heidenreich 2011; Miles-Johnson 2016a, b; Redfern 2014; Wolff and Cokely 2007), and as such, many incidents of crime experienced by transgender people (such as IPV) have not been reported to law enforcement officials (see Broderick 2011; LangenderferMagruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013). Transgender people frequently report that they will not receive an appropriate response from police officers, that the treatment they do receive from officers is typically less than favorable, and that police officers treat transgender people without neutrality or dignity, thereby increasing levels of mistrust in the police (Miles-Johnson 2016a, b). For many transgender individuals, previous positive or negative experiences with police impact their perceptions and expectations regarding how they will be treated by the police or other authoritarian groups in the future. Whilst this is possibly true for all people, transgender people often perceive that the manner in which police officers will respond to them is reflective of the officer’s attitude, training they received, police department regulations, police culture, the environment in which an officer works, the systems of law-enforcement that police organizations work within (such as in the UK, USA, and Australia), and attitudes from community members (Berman and Robinson 2010). Additionally, research with members of the transgender community suggests transgender people have a fear of secondary victimization discrimination that can occur due to the expression of their gender diversity or due to revealing their transgender status when interacting with or reporting incidents of crime or victimization to the police which can influence their decision to contact law enforcement (Dario et al. 2019; Hodge and Sexton 2018; Miles-Johnson 2016a, b; Pickles 2019).

Underlying Transphobia and Transmisogyny Concerns over police transphobia and police transmisogyny (i.e. the cultural, individual, and state violence as well as discrimination directed toward transgender women, and transgender or gender non-conforming people who present an identity that is judged to be feminine) are very real to transgender people entering the criminal justice system or when making initial contact with police. According to Broockman and Kalla (2016), transphobia is a result of the assumption that the gender binary of male and female is the only legitimate form of gender identity that is acceptable to most people. As such, individuals who are perceived to fall outside of these accepted categories are considered different and therefore deviant (Miles-Johnson 2016a, b). For many individuals, particularly most police officers who have not had or do not have interactions with transgender people, the gender binary is all that is known or understood about gender and the sex of the body (Miles-Johnson 2016a, b). Therefore, for most people (e.g. police), coming across an individual who challenges the

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normative expectations of the outward appearance of male and female is confusing, confronting, and (for some people) frightening (Miles-Johnson 2016a, b). Transgender people are highly aware of this phenomenon, and as a result of their lived experience as a transgender person, this shapes their perceptions of police and potential police engagement (Miles-Johnson 2016a, b). Consideration of police officers’ perceptions of transgender people and their levels of awareness of the transgender community, therefore is, very important.

Influences of Police Culture The police occupy a unique and powerful role in Western society. As agents of social control, police have the power to intervene in many situations. They conduct their activities with relative amounts of independence, which also makes understanding the way officers conduct business and why they engage in certain discretionary behaviors as an important component when researching police behavior. Yet, within nations such as the US, UK, Australia, and Canada, there is a pervasive pattern of discrimination and prejudice displayed towards transgender people often perpetrated by police officers (see Dario et al. 2019; Hodge and Sexton 2018; Miles-Johnson 2016a, b; Pickles 2019; Simpson 2018). This pattern is typically fueled for many reasons such as the inherent culture of machismo within law enforcement and the targeting of individuals who do not conform to gender stereotypes regarding appropriate masculine and feminine behavior (see Alliance for a Safe and Diverse DC 2008; Berman and Robinson 2010; Edelman 2014; Heidenreich 2011; Miles-Johnson 2016a, b; Redfern 2014; Wolff and Cokely 2007). Consequently, police agencies, organizations, and individual officers have failed in their efforts to tackle the lack of trust and confidence transgender people have in the police. For example, in the US, UK, and Australia, numerous police organizations have been criticized for not engaging in community outreach programs or community policing initiatives or involving members of the transgender community in the creation of policing policy or operational guidelines which officers can refer to when engaging professionally with transgender people (see Alliance for a Safe and Diverse DC 2008; Berman and Robinson 2010; Edelman 2014; Heidenreich 2011; Miles-Johnson 2016a, b; Redfern 2014; Wolff and Cokely 2007). Many of the negative perceptions police have towards transgender people stem from notions of masculinity within police culture that can influence perceptions of social identity and police reactions to minority group members (Miles-Johnson 2016a, b). For example, police culture purposefully distances itself from femininity because the culture is rooted in hegemonic masculinity and gender expression based on traditional heteronormative behaviors linked to normative identities of men and women (Panter 2018). Aspects of police work are heavily influenced by notions of hegemonic masculinity (Panter 2018), whereby displays of exaggerated masculinity underpin police practice and characteristics of police work (see Westmarland 2001). The effects of machismo (or aggressive masculinity) in police culture implemented

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towards the transgender community is also based on traditional police cultural ethics that gender identity difference is linked to ‘sexual deviance’ such as homosexuality (Miles-Johnson 2016a, b). These normative notions of heterosexuality and ideals of heterosexual masculinity inform police practices and social interactions within policing (see Miles-Johnson 2013a, b, 2016a, b). It is this traditional ideology that is pervasive in police culture and negatively impacts the interaction of police and transgender people and deters help-seeking. If machismo and displays of transphobia are not addressed by police agencies, the transgender community will continue to have negative and biased opinions towards police officers and policing practices. This is important since minority groups like the transgender community (similar to many other minority groups) have beliefs about the police that are not necessarily based on personal experience of police victimization, but rather based on the knowledge of other people’s positive or negative experiences with the police (see Dario et al. 2019; Hodge and Sexton 2018; Miles-Johnson 2016a, b; Pickles 2019, Simpson 2018). In this way, any interaction with police officers is presumed to lead to negative outcomes for transgender people.

Slow Changes, Recognition, and Acceptance Police have consistently been criticized for targeting transgender peoples’ gender expression under procedurally unfair police practices (see Dario et al. 2019; Hodge and Sexton 2018; Miles-Johnson 2016a, b; Pickles 2019; Simpson 2018). As stated, research analyzing transgender peoples’ experiences with police engagement consistently suggest transgender people are often instantly and negatively judged by police, and simultaneously stigmatized accordingly (see Alliance for a Safe and Diverse DC 2008; Berman and Robinson 2010; Edelman 2014; Heidenreich 2011; Miles-Johnson 2016a, b; Redfern 2014; Wolff and Cokely 2007). In many instances, the hostility displayed towards transgender people, as well as the stigma and associated judgments awarded to transgender people, are based on an officer’s assumption that the transgender person may be a “street prostitute,” and as such, a criminal and immoral (see Nuttbrock 2018). This type of hostility is deeply connected to prejudice about sexuality and homosexuality and is usually associated with prejudices about particular gender practices, and visibility and violation of gender norms. Although there is a minority of transgender people who do engage in sex work and are, therefore, more likely to enter the criminal justice system as victims or perpetrators of crime experience (e.g. transgender sex workers experience increased incidences of both physical assault and rape than other non-transgender sex workers), the majority of transgender people do not engage in sex work, yet they are treated by officers in ways that are influenced by negative police perceptions of transgender people thus undermining protections usually offered to other members of the community (Miles-Johnson 2016a, b; Nuttbrock 2018). In light of these revelations, police organizations are becoming increasingly aware that transgender people’s perceptions of law enforcement are less than optimal. Police organizations have implemented outreach programs and community liaison officers

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to interact with members of the transgender community. Unfortunately, many of these programs do not last (Miles-Johnson and Pickering 2018) and in some cases, police liaison officers may further the divide when resources are lacking, or liaisons become deployed to general or operational duties policing (Miles-Johnson 2019). Police organizations are also making changes to the way they police minority group members. Many Western police organizations have embraced the idea of training their officers to recognize diversity and equality and have implemented police engagement strategies to tackle officer discrimination and inequality of officer treatment towards transgender people (Miles-Johnson 2019). However, it appears that members of the transgender community remain reticent in their interactions with police. Regardless of changes in the social, political, and legal history of the relationship between police and the transgender community, the lack of trust from transgender people towards police remains problematic. Police abuse of transgender people has been widely reported across many nations and typically includes transphobic abuse and violence, and homophobic abuse and violence (see Dario et al. 2019; Hodge and Sexton 2018; Miles-Johnson 2016a, b; Pickles 2019; Simpson 2018). For transgender people of color, this type of treatment has also included racial and ethnic slurs, which often intersect in terms of policing (see Bith-Melander et al. 2010; Singh and McKleroy 2011). In many instances, police abuse of transgender people has escalated into physical or sexual abuse, and sometimes death (Singh and McKleroy 2011). For example in the US in 2008, transgender woman Duanna Johnson was physically beaten by police officers after she refused to respond to anti-transgender slurs spoken to her by arresting officers, and in 2019, officers beat a group of transgender women while being held in custody in Meerut, Uttar Pradesh, India. Previous research by Miles-Johnson (2013a, b, 2016a, b) indicates that members of the LGBTIQ+ community, and specifically members of the transgender community, are less likely than heterosexual and cisgender people to contact police during times of victimization, and there is a perceived (and at times experienced) lack of support from other agencies and service providers during times of victimization. Indeed, differences between transgender people and cisgender people and their likelihood of reporting crime to the police (based on notions of police transphobia, transmisogyny, and homophobia and perceptions of negative police interaction) raise questions about transgender peoples’ intention to not report (or underreport) specific types of crime to the police (see Dario et al. 2019; Hodge and Sexton 2018; Miles-Johnson 2016a, b; Pickles 2019; Simpson 2018).

Policing IPV in the Transgender Community Intimate partner violence is a complex and sensitive issue. Research indicates that many cisgender victim-survivors of IPV do not report to police, with some reports suggesting that almost 50 percent of incidents of IPV are unreported annually (HMIC 2014). Reasons for cisgender victim-survivors of IPV not reporting include: fear of retaliation; embarrassment and shame; intensified controlling behavior from the

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perpetrator; pressure from other family members or members of the community to not report the crime; isolation from other support agencies; and a lack of trust or confidence in police (HMIC 2014). While there is a lack of research examining transgender peoples’ experiences of IPV in relation to policing and police response, some studies suggest IPV perpetrated in the transgender community is underreported because of the paucity of the police response to IPV incidents involving transgender people (such as non-recognition of transgender IPV or under-policing of transgender IPV) and as previously stated, the frequency in which police are the perpetrators of general violence enacted towards transgender people (see Dario et al. 2019; Hodge and Sexton 2018; Miles-Johnson 2016a, b; Pickles 2019; Simpson 2018). While this is highly problematic and under-addressed by many police organizations, police agencies in many Western nations (such as in the US, UK, Canada, and Australia) recognize the need to provide appropriate policing responses to transgender people during incidents of IPV as well as training, resources, and community partnerships when policing transgender victim-survivors of IPV (Ovenden et al. 2019). IPV responses constitute a core part of police work and comprise a considerable proportion of the overall crime responses law enforcement officers make regarding police-citizen encounters (see Natarajan 2016). For example, in London, England the Metropolitan police receive an emergency call relating to IPV every 30 s (ONS Report 2017). Yet, policing of IPV and police responses to cases of IPV are fraught with an array of multifarious issues that place police officers in situations where they are expected to: recognize victim-survivors and perpetrators of IPV, provide safety for victim-survivors of IPV (thereby not placing them at further risk of IPV), and provide adequate services to victims of IPV. Officers are also expected to collect appropriate and accurate evidence at the scene (or after) the incident of IPV, treat the victim-survivor of IPV in a manner which reflects the seriousness of the crime and recognize the victimization experienced, and keep other people involved in the incident (such as family members or children) safe (see Franklin et al. 2019; Messinger and Roark 2019; Russell and Sturgeon 2019). Similar to IPV experienced in heterosexual relationships, no two incidents of IPV in transgender relationships or experienced by transgender people are the same. Transgender IPV may occur in similar or different ways to incidents of IPV experienced by cisgender victim-survivors (in cisgender heterosexual relationships). Reporting of incidents of transgender IPV may also share similarities with the way cisgender incidents of IPV are reported. For example, some transgender victims of IPV may make initial contact with police from a domestic setting such as their home or in the home of a friend or relative (see Broderick 2011; LangenderferMagruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013). Victim-survivors of transgender IPV may also make initial contact with police at a police station while others may be directed to make contact with police through another service provider or responder to the incident such as a concerned friend, relative, neighbor, or police contact initiated by an ambulance officer, hospital worker, social worker, etc. (see Broderick 2011; Langenderfer-Magruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013).

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Reasons regarding why there is a lack of reporting of transgender IPV as opposed to cisgender IPV must also be acknowledged since research suggests numerous individual and structural barriers affect transgender people and their interaction with the police during times of IPV, that impede their access to support (see Franklin et al. 2019; Messinger and Roark 2019; Miles-Johnson 2016a, b; Russell and Sturgeon 2019; Saxton et al. 2018). Barriers include a lack of money to access services; fear of discrimination from service providers; and the potential need to disclose transgender status to service providers (see Broderick 2011; Langenderfer-Magruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; StilesShields and Carroll 2015; Walters et al. 2013). It is vital (regardless how police involvement occurs) that responding officers engage the incident appropriately and treat transgender victim-survivors of IPV in a proper manner (Franklin et al. 2019; Messinger and Roark 2019; Miles-Johnson 2016a, b; Russell and Sturgeon 2019; Saxton et al. 2018). Similar to heterosexual relationships, the first time a transgender victim of IPV contacts the police may be the first time (but not always) a transgender person has experienced IPV; therefore, police must respond appropriately and understand the specific responses (and requirements) transgender victim-survivors of IPV need (see Franklin et al. 2019; Messinger and Roark 2019; Russell and Sturgeon 2019). Research by HMIC (2014) also suggests senior officers within police organizations have a profound effect on the attitudes of officers assigned to respond to incidents of IPV, therefore senior officers must reinforce the need for respectful and appropriate engagement with members of the transgender community during times of IPV, particularly since transgender victims of IPV frequently report that they are not always believed by responding officers or that their reports were not taken seriously by a responding officer. The majority of IPV calls made to the police, however, are those stemming from heterosexual (heteronormative) relationships, where victim-survivors and perpetrators of IPV are more easily recognized (based on stereotypes/prototypes) under heteronormative assumptions of behavior (Morgan et al. 2018). In this way, IPV is typically associated with or about, violence perpetrated by men against women (in heterosexual relationships) where both partners are presumed to be cisgender (Morgan et al. 2018). While there are similar challenges to officers when responding to transgender and cisgender incidents, responding to IPV involving transgender people presents unique challenges. Transgender IPV can involve different forms of social and/or psychological abuse such as the “outing” of a transgender victim-survivors transgender status by officers (Langenderfer-Magruder et al. 2016). These can include a misplaced focus by service providers regarding victim and perpetrator status of transgender individuals involved in IPV and limitations imposed by gender-specific services offered to victim-survivors of IPV (Langenderfer-Magruder et al. 2016). It also shapes stereotypes regarding gender and normative expectations of behavior associated with the gender of transgender individuals experiencing IPV as either a victim or perpetrator, and increases a lack of awareness regarding typologies of IPV such as physical, sexual, and psychological violence (see Broderick 2011; Langenderfer-Magruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields

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and Carroll 2015; Walters et al. 2013). For many officers, responding to an incident of IPV involving a transgender person (or people) could be the very first time they engage or interact with a member of the transgender community making it difficult to determine whether officers in this situation would be able to adequately recognize and respond to the IPV incident in this context (Langenderfer-Magruder et al. 2016). Responding appropriately to situations of transgender IPV also applies to police officers or civilians employed by law enforcement agencies that receive or handle caller-responses to incidents of IPV. The way a front-desk/control-room officer or police agency employee handles an incident of transgender IPV could influence the way a general duties officer responds in-person to a transgender victim-survivor of IPV (see Franklin et al. 2019; Messinger and Roark 2019; Russell and Sturgeon 2019). The type of attitude the first point-of-contact within law enforcement has towards the transgender community, as well as their perception and awareness of the transgender community (especially their ability to recognize the transgender status/identity of the victim of IPV), is vital when assessing the incident of IPV. To carry out this role effectively, front-desk staff/control-room staff/officer(s) in charge must receive ongoing awareness training regarding recognition and response to transgender victims of IPV, thereby helping to build trust and confidence in victimsurvivors of transgender IPV (see Franklin et al. 2019; Messinger and Roark 2019; Russell and Sturgeon 2019). In addition, tailored police recording systems which allow front-desk staff/control-room staff/officers in charge to appropriately record the transgender identity of the victim can help specify the types of IPV experienced by transgender people and assess risk in relation to transgender victims of IPV, which are vital if police organizations are going to respond to and recognize IPV in the transgender community (Langenderfer-Magruder et al. 2016).

Active Measures and Perceptions of Law Enforcement A great deal of progress has been made regarding police response to IPV such as police organizations training officers to respond to and recognize different types of IPV. Specialist IPV units have been created within police organizations to expertly investigate IPV, and partnerships have been created with IPV victim/perpetrator support groups and IPV survivor networks, thus allowing interagency collaborations for recognition of IPV (see Franklin et al. 2019; Messinger and Roark 2019; MilesJohnson 2016a, b; Russell and Sturgeon 2019; Saxton et al. 2018). Critics such as Langenderfer-Magruder et al. (2016) argue, however, that many police officers lack the skills to engage appropriately with transgender victim-survivors of IPV regardless of whether or not the incident involves overt (such as physical abuse) or covert (such as psychological and coercive) forms of violence (see Franklin et al. 2019; Messinger and Roark 2019; Miles-Johnson 2016a, b; Russell and Sturgeon 2019; Saxton et al. 2018). For example, research by Russell and Sturgeon (2019) found police officers were not trained adequately to respond to members of the transgender community appropriately. Similar to police responses to cisgender incidents of IPV, Russell and Sturgeon (2019) argue that many officers arrive unprepared when responding to an

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IPV crime involving a transgender person or have a lack of information regarding the transgender victim-survivor or perpetrator of IPV. Research, albeit scarce (see Broderick 2011; Langenderfer-Magruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013), suggests that the quality of service a victim-survivor of transgender IPV receives is entirely dependent upon (in this order): 1. the awareness of the attending officer and the specific needs of the transgender victim and; 2. their ability to recognize the different contexts and situations where transgender IPV can occur.

Police Training to Improve Awareness and Response to IPV and Risk While there have been progressive social transformations regarding public perceptions of transgender people, research suggests institutions continue to be plagued by levels of bias towards transgender people, often reflected in systematic and structured ways throughout police organizations (Miles-Johnson 2016a, b; Miles-Johnson et al. 2018). To solve the problem, policing response (or lack thereof) to victimsurvivors of transgender IPV, starts with officers being given the right mentoring from senior field officers and appropriate academy or on-going police training in this area (Langenderfer-Magruder et al. 2016). Research conducted in the UK (see Stonewall Housing ‘ROAR’ report 2014) states that many transphobic police officers were found to ridicule transgender victim-survivors of IPV; often questioning the gender of the transgender individual (“Is that a girl or a boy”), thereby victimizing transgender people because officers were not given adequate training regarding transgender awareness or IPV in relation to the community. Evidence also suggests that many officers are not adequately trained to differentiate between perpetrators and victims of IPV when an incident involves members of the transgender community (HMIC 2014). This leads to a clear variation in the ways in which police arrest perpetrators of transgender IPV or those suspected of a transgender victim-related IPV crime, with perpetrators of transgender IPV being less likely than perpetrators of cisgender IPV to be arrested for the same type of crime (HMIC 2014). Police, therefore, play a pivotal role in the protection of transgender survivors of IPV, as well as performing a crucial part in the outcome of justice regarding successful prosecution of perpetrators of transgender IPV under the law (HMIC 2014). As many police organizations around the world slowly begin to implement training packages aimed at equipping officers to engage appropriately with members of the wider cisgender community during times of IPV, specific programs educating police officers about the importance of appropriate interaction and engagement with transgender people when responding to incidents of IPV are virtually non-existent. The few that do exist include training programs for officers regarding operational procedures and guidelines when interacting with members of the transgender community in an official capacity (see Miles-Johnson 2016a, b). Many of these generalized

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awareness training programs may even include appropriate terminologies used when addressing members of the transgender community, safety, searching, and custody issues when arresting, as well as detaining and/or segregating transgender people as they enter the criminal justice system (Miles-Johnson 2016a, b). While maintaining the safety and dignity of transgender individuals during police interaction and engagement is important, it is also vital that police officers understand the different types of victimology transgender victim-survivors experience during times of IPV. That way, any potential bias an officer may have towards members of the transgender community or heteronormative stereotypes associated with cisgender incidents of IPV can be addressed. Appropriate prosecution of a perpetrator of transgender IPV is only one measure of successful police response to incidents of transgender IPV and, similar to cisgender IPV, police must be effectively trained to identify the level of ‘risk’ associated with the victim of transgender IPV (Langenderfer-Magruder et al. 2016). Adequate training will enable officers responding to incidents of transgender IPV to take suitable action to keep a transgender victim-survivor of IPV safe from further harm, thereby protecting the victim-survivor and ensuring they are supported throughout the criminal justice process (Langenderfer-Magruder et al. 2016). In the UK, some police agencies (such as the Greater Manchester Police) have implemented training programs instructing officers to use a specific coding system, which enables responding officers to better capture and record incidents of transgender IPV; thus facilitating better prosecutorial rates of perpetrators of transgender IPV while simultaneously clearly identifying a transgender victim-survivor on all electronic police records and reporting systems (HMIC 2014). The recording system also has the potential to reflect the specific experience of transgender victims concerning incidents of IPV and potential future risk of IPV, thereby enhancing police capability for referral support and prosecution of perpetrators (HMIC 2014). Intimate partner violence risk training and identification of IPV with transgender individuals is an important aspect to consider when analyzing police response to IPV. In order to safeguard transgender victim-survivors of IPV, police organizations (and individual officers) need to be trained well to get risk assessment right the first time so appropriate referrals can be made, and the proper support and specialist services can be accessed to reduce the likelihood of future incidents of transgender IPV occurring (see Franklin et al. 2019; Messinger and Roark 2019; Miles-Johnson 2016a, b; Russell and Sturgeon 2019; Saxton et al. 2018). Transgender IPV risk training and identification will also enable police organizations and individual officers to gather intelligence regarding perpetrator and victim-related behavior and enable police organizations to better train officers to understand the impact of IPV on transgender victim-survivors of this crime (HMIC 2014). Being trained and having the appropriate risk assessment tools and processes to identify and recognize transgender IPV will also assist responding officers to react appropriately, thereby increasing the perceptions of trust a victim-survivor of transgender IPV will have in police and the criminal justice system (HMIC 2014). Putting these safeguards in place means that the responding officer(s) must fully understand, and be aware of, the types of IPV experienced by transgender people

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to gauge levels of risk as well as understand what risk means to different gender identities within the transgender community (Langenderfer-Magruder et al. 2016). It also means that the responding officer(s) must be able to assess risk in relation to understanding how transgender perpetrator and victim-survivor roles may differ or be similar to those experienced by cisgender people, and how the different types of relationships/partnerships that transgender people engage in (such as transgender/transgender or transgender/cisgender relationships) may heighten or lessen levels of risk associated with transgender IPV (see Broderick 2011; LangenderferMagruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013). Tick-box responses by police officers or police organizations in relation to checking boxes for having trained officers in risk assessment and transgender IPV (based on cisgender incidents and or notions of IPV) may severely undermine the professional judgment and professional practice a police organization can instill in its officers, and may diminish an individual officer’s capabilities to make a decision about the level of risk (and actions required) when attending and responding to an incident of transgender IPV (Longobardi and Badenes-Ribera 2017). Without effective risk assessment training, officer discretion in such situations may adversely affect an officer’s discretionary judgment regarding what constitutes an incident of IPV (see Broderick 2011; LangenderferMagruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013). It is therefore crucial that police organizations assess their working responses and practices regarding officers’ assessment of risk relating to incidents of transgender IPV, to identify weaknesses in the risk assessment process, and to determine whether the specific needs (and risk related factors) relating to transgender victims of IPV are understood in relation to keeping victims safe.

Recruitment of Transgender Law Enforcement Officers and Personnel Another solution to solving the problem regarding police training, transgender IPV, police response to victim-survivors, and risk assessment may be for police organizations to strategically recruit members of the transgender community in both police and civilian-police employee roles. While there is a small body of literature that has examined the experience of transgender police officers working within different police organizations (see Panter 2018), there is very little research that examines the perceptions of transgender and cisgender police officers towards transgender people during times of IPV. Although recruitment of transgender people into policing and police-related work may not be a panacea solving all transgender-policing related problems, there is research which suggests that strategic recruitment of minority group members into police organizations does improve police-minority group member relations (see Loftus 2010; Miles-Johnson and Pickering 2018; Shjarback et al. 2017).

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Gaps in Our Knowledge In Western countries such as the US, UK, Australia, and Canada, police work traditionally recruited working-class males (Novich et al. 2018). While many police organizations in the 21st century are moving away from such traditional modes of recruitment toward becoming more inclusive and diverse police organizations, the reality of policing is that it is still a profession dominated by white, working-class, heterosexual men (Novich et al. 2018). The strategic and ongoing recruitment processes many police organizations currently undertake to specify the enlistment of minority group members to employ more culturally diverse people and individuals from specific racial and ethnic groups (Loftus 2010; Shjarback et al. 2017). As the majority of Western police organizations are embracing the idea of recruitment of diverse officers, there is little research that examines transgender identities within police organizations, how transgender officers police members of the transgender community, or how they engage with victim-survivors of IPV during times of victimization (see Broderick 2011; Langenderfer-Magruder et al. 2016; Longobardi and Badenes-Ribera 2017; Miles-Johnson 2016a, b; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013). Studies are also needed to examine the overall effects of these strategic recruitment drives, and how this may affect policing and police response to other crime types. Research from the US, however, suggests that the strategic recruitment of diverse officers and its effects on policing is not as simple as it appears. Chrobot-Mason and Aramovich (2013) describe workplace diversity as a “double-edged sword”: it has the potential for both positive and negative outcomes. When diversity is well managed and the workplace supports and values its diverse personnel, employees from all backgrounds will feel included and believe their ideas and opinions matter (Chrobot-Mason and Aramovich 2013). Conversely, when the work environment fails to support a diverse workforce, negative outcomes such as an increase in harassment, discrimination, and intergroup conflicts will occur; particularly if members of an organization do not identify with, or understand, the needs of another group they are charged with helping (Chrobot-Mason and Aramovich 2013). Certainly, this has been argued in terms of changing police practice with policing minority group members such as the transgender community (see Miles-Johnson 2016a, b). The public promotion of inclusion of transgender people into police organizations may reduce barriers to reporting incidents of IPV by transgender individuals, but this is an area of research that is non-existent in the extant literature. It is argued that the strategic inclusion of transgender people into police organizations may better equip police agencies to engage in complex problem-solving and tactical-thinking regarding police engagement with transgender people (Miles-Johnson 2016a, b; MilesJohnson and Pickering 2018) and better equip officers to respond to specific crime types pertinent to the experiences of transgender people. The reality of current policing, however, is that police agencies typically comprise of larger numbers of cisgender officers than transgender officers and, from a police perspective, the lack of officers who self-identify openly/publicly as transgender raises questions about how

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police organizations can increase cisgender officers’ abilities to meet the needs of transgender people (Miles-Johnson 2016a, b; Panter 2018). Certainly, the recruitment of transgender officers into police agencies may have a positive effect on police-transgender community engagement and levels of trust regarding reporting and responding to, IPV crime. However, it cannot be assumed that transgender officers will be more accepting of other members of the transgender community or that they will necessarily better police other members of the transgender community than cisgender officers (Panter 2018). But, given the complexity of experience, the specific needs transgender people have when engaging with police, and the unique experience transgender victim-survivors have during incidents of transgender IPV, the strategic inclusion of transgender people into policing and police work sends a positive message to the transgender community that police organizations are aware of the vulnerability of transgender people, and (when experiencing crime types such as IPV), police officers and police organizations will respond appropriately.

Conclusion Across the globe, police agencies have sought to build rapport with a ride range of minority groups, yet relationships between police and members of the transgender community have been tense due to real or perceived discriminatory police practices. Policing is one of the most complex and difficult jobs in any society; police officers must simultaneously balance legitimate and conflicting behaviors while still being guided by the law and professional expertise. Transgender people, however, have frequently criticized the police for being unaware of their specific needs during times of engagement. Subsequently, mistrust in the police poses an ongoing problem for police organizations expected to engage with transgender people, who generally lack trust due to historical (and ongoing) social and institutional discrimination (MilesJohnson 2016a, b). Stereotyping of transgender people by police officers negatively reinforces social opinions about transgender people because the social structure of most Western societies upholds the notion that members of the majority or dominant group (such as the police), have the potential to reinforce or enforce the value systems and ideologies of society upon all minority groups members (see Alliance for a Safe and Diverse DC 2008; Berman and Robinson 2010; Edelman 2014; Heidenreich 2011). Also, police have the discretionary power to deliver policing techniques upon transgender people that are influenced by officers’ value systems and ideologies, thereby determining how police officers interact with members of the transgender community (see MilesJohnson 2013b, 2016a, b; Redfern 2014; Wolff and Cokely 2007). This is problematic since police organizations around the world have been criticized for allowing officers to police citizens in this way, and for collectively policing citizens under identityrelevant policing techniques; typically resulting in transgender people being treated unfairly.

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Certainly, research determines that the police have treated members of minority groups, such as the transgender community, with indifference and insensitivity due to antipathy towards minority group members. Police attitudes towards minority groups such as the transgender community are formed by aspects of police culture, police training, and experience, thus negative and positive encounters will result in corresponding attitudes from police towards members of the transgender community (and conversely from members of the transgender community towards police). Policing has always been implicated in processes of inclusion and exclusion, and pre-existing or emerging senses of difference and alienation between police organizations and groups of people considered “other” or “different”. Policing transgender people, therefore poses an ongoing problem to police organizations since notions of exclusion and the sense of difference transgender people have in terms of their perceived or outward identity difference, form barriers between police officers and members of the transgender community (see Alliance for a Safe and Diverse DC 2008; Berman and Robinson 2010; Edelman 2014; Heidenreich 2011; Miles-Johnson 2013b; Redfern 2014; Wolff and Cokely 2007). The lack of awareness police officers’ have regarding the specific needs of the transgender community during times of IPV victimization, and the expectations transgender victim-survivors of IPV have regarding negative notions of police interaction (and a lack of professionality that police officers will show towards transgender victim-survivors of IPV) is one domain which lacks systematic inquiry. Discrimination towards recognition of transgender IPV is still pervasive across the globe, and indicative of the general pattern of discrimination displayed towards transgender people on an institutional, societal, and individual level (see Broderick 2011; Langenderfer-Magruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013). It has been a persistent struggle for transgender victim-survivors of IPV to confidently engage with police during times of victimization and to obtain provision of appropriate treatment, suitable referrals, and a level of risk assessment which enhances protective services offered by police because police officers and police organizations discriminate in their levels of professionalism displayed towards transgender victim-survivors of IPV (see Broderick 2011; Langenderfer-Magruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013). This type of social discrimination occurs frequently in the lives of transgender individuals and the lives of transgender victim-survivors of IPV. This is not to say that police organizations across the globe are not aware of the situation since many police organizations have implemented law enforcement programs specifically tailored towards training officers to appropriately police transgender individuals, and many law enforcement organizations are strategically recruiting diverse individuals into policing in an attempt to diversify forces and include other members of society (Miles-Johnson 2019; Miles-Johnson et al. 2018). Some police organizations (albeit not many), in an effort to bolster transgender individuals’ confidence in the police regarding the way they perceive police interaction and IPV, have implemented policing programs which train officers to assess risk and IPV, employ crime recording systems which allow responding officers to specify incidents of transgender IPV and

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specify the details of the victim-survivor (and perpetrator) of transgender IPV. Yet, no other public-service agency has the capacity to antagonize transgender people in the same way as police organizations since it is the traditional styles of policing that organizations rely heavily on (as well as traditional notions of law enforcement), which alienate transgender people; particularly when those traditional notions of law enforcement or police engagement are not appropriate for, or tailored towards, transgender IPV (Miles-Johnson 2016a, b). Incidents of poor law-enforcement about lack of response and recognition of transgender IPV, negative outcomes of policing such as police brutality, and notions of normative gender performance when responding to transgender victim-survivors of IPV have consistently undermined the relationship between transgender people and the police. Thus, the tense relationship between police and transgender people is underscored by real and perceived discriminatory police practices during times of IPV such as stigma related to gender identity and normative notions of behavior. It is also accentuated by negative perceptions of transgender people and a lack of understanding regarding the specific needs of transgender people when entering the criminal justice system as well as police discretion, bias, and prejudice displayed towards members of the transgender community (see Alliance for a Safe and Diverse DC 2008; Berman and Robinson 2010; Edelman 2014; Heidenreich 2011; Miles-Johnson 2013b, 2016a, b; Redfern 2014; Wolff and Cokely 2007). Over policing or under policing of transgender victim-survivors of IPV and mistrust of transgender victim-survivors of IPV and their related experiences also underlines police practice, resulting in unfair treatment of transgender victim-survivors of IPV as a result of social and institutional alienation (see Broderick 2011; LangenderferMagruder et al. 2016; Longobardi and Badenes-Ribera 2017; Ovenden et al. 2019; Stiles-Shields and Carroll 2015; Walters et al. 2013). In addition, unfair or unclear police policies regarding appropriate engagement with transgender victim-survivors of IPV; inappropriate and unclear operational guidelines regarding policing of transgender IPV; stereotypes of behavior applied to transgender victim-survivors regarding victim/perpetrator roles associated with cisgender heteronormative notions of IPV; and a lack of understanding or awareness of the types of relationships transgender people have and or are involved in, uniquely shape the experience transgender victim-survivors have during incidents of IPV (Langenderfer-Magruder et al. 2016). To date, across much of the literature regarding IPV and the transgender community, there exists a lack of knowledge regarding how police officers interact with, and/or respond to, transgender people during this type of victimization. Across the globe, there is also a paucity of literature regarding prevalence rates of IPV within the transgender community, with only a cluster of studies suggesting that transgender people experience higher rates of IPV than cisgender people (see Decker et al. 2018; Langenderfer-Magruder et al. 2016; Reuter et al. 2017; Whitton et al. 2016; Valentine et al. 2017). Law enforcement research linking police practice and operational response to transgender IPV is also lacking in the extant literature examining policing of specific crime types and officer response to minority groups within those specific crime types. What is needed is targeted research which examines these areas generally, and in relation to the prevalence and experience of transgender people

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who experience IPV (Langenderfer-Magruder et al. 2016). Research in this area also needs to determine the experiences of transgender victim-survivors of IPV; specifically, when the transgender victim-survivor of IPV is a parent and or a caretaker of children; when the transgender victim-survivor of IPV lives in a rural or remote area; when the transgender victim-survivor of IPV is a member of an Indigenous community; when the transgender victim-survivor of IPV has a physical and/or mental disability; and when the transgender victim-survivor of IPV is not open or “out” about their transgender status (or if the transgender individual’s partner is not open or “out” about having a transgender partner) (Langenderfer-Magruder et al. 2016). Importantly, evidence-based data collected to determine how police officers interact with members of the transgender community during incidents of IPV is severely lacking as well (Langenderfer-Magruder et al. 2016). For police officers and police organizations to respond appropriately to transgender IPV, this needs to change.

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Toby Miles-Johnson is a policing scholar and Senior Lecturer in the School of Justice, Faculty of Law, Queensland University of Technology. Toby’s research and work has been cited and discussed within the 2017 US report: An Evidence-Assessment of the Recommendations of the President’s Task Force on 21st Century Policing, in association with the International Association of Chiefs of Police; George Mason University; and The Laura and John Arnold Foundation. Toby’s work and research has contributed to key areas on ‘Police Training’ and ‘Policing Diverse Communities’ within this report. For an academic outside of the US this is a significant achievement. His current research considers inclusion and diversity within police organisations, police officer perceptions of LGBTIQ+ IPV, and police officer perceptions of recruitment, retention, deployment and promotion. His research interests include: Policing, Policing Diversity, Policing Minority Groups, Policing and Same-Sex Domestic Violence, and Threat and Victimisation Policing.

Index

A Abuse, 3–6, 13, 14, 16–21, 23–25, 37, 39–42, 48, 54, 58, 62, 64, 69–73, 75, 76, 78– 81, 92, 100–102, 111, 113–119, 121– 128, 130–132, 139–143, 145, 148, 149, 151, 153, 162, 166, 180, 183– 185, 187, 188, 196–209, 211, 228, 229, 231, 238, 239, 241–248, 258, 260–265, 268–270, 273, 281, 285, 289, 291, 292 Action, 3, 6, 76, 77, 146, 199, 206, 208, 211, 212, 215, 230, 258, 294, 295 Ageism, 24, 241, 251

B Batterer intervention, 7, 184, 195, 199, 201– 203, 205, 208, 210, 211, 213, 214 Batterer intervention programs, 7, 48, 178, 179, 181–185, 188, 189, 195, 196, 198, 200, 202–214, 216 Bi-invisibility, 112 Biphobia, 63, 116–118, 120, 124, 131, 132, 145, 187, 233 Bisexual, 4, 7, 12–21, 23, 25, 26, 47, 56, 59, 60, 71, 94, 96, 97, 111–132, 139, 140, 147, 164, 170, 177, 180, 185, 186, 228, 231–233, 237–240, 243–250, 259, 260, 266, 268, 270, 284

C Caregiver stress, 240, 241 Community readiness model, 231 Criminal justice, 6, 7, 63, 80, 127, 177, 238, 249, 257–259, 261, 262, 270, 271, 273, 274, 285, 286, 288, 294, 299

D Discretion, 8, 79, 257, 258, 273, 295, 299 Domestic abuse, 48, 100, 128, 152, 187, 207, 238, 239, 241, 245 Domestic violence, 3, 25, 60, 64, 69, 71, 73, 74, 80, 103, 113, 114, 117, 120–122, 127, 128, 143, 144, 146, 147, 149, 150, 178, 181, 183, 186, 188, 195– 197, 203, 204, 207, 214, 227–231, 240, 246, 264, 267, 269

E Elder abuse, 23, 24, 237–241, 246, 248–250 Emergency shelters, 121, 245–247, 249– 251, 264, 265 Equality, 5, 6, 8, 39, 40, 42, 103, 113, 196, 200, 289

F Feminist theory, 6, 37, 39, 40, 42, 43, 45, 47, 48, 53, 55, 56, 58, 61, 63–65, 73, 74, 77, 80, 82, 113, 179, 203

G Gay, 4, 12, 13, 15–21, 23, 45–47, 60, 71, 80–82, 96, 97, 114, 127, 131, 139, 141, 148, 164, 169, 180, 185, 186, 204, 213, 215, 227, 231, 232, 237– 239, 241, 243, 246, 248–250, 259, 260, 262, 264–266, 268–272, 284 Gender, 4–6, 12–26, 38–41, 43–46, 48, 58– 65, 70, 73–82, 91–103, 113, 114, 116–118, 121, 122, 125, 127, 129– 131, 139, 141, 142, 144, 145, 148,

© Springer Nature Switzerland AG 2020 B. Russell (ed.), Intimate Partner Violence and the LGBT+ Community, https://doi.org/10.1007/978-3-030-44762-5

305

306

Index

149, 151, 153, 161, 163–165, 169, 170, 177, 178, 181, 183–185, 187– 189, 196–200, 202, 205, 208, 213– 216, 230, 231, 233, 238–241, 249, 251, 258–262, 265, 266, 268, 269, 271, 272, 283, 284, 286–288, 291, 293, 299 Gender identity, 6, 8, 12, 13, 15–17, 19–21, 23, 24, 26, 58, 59, 61, 63, 91, 94– 98, 100–104, 132, 139, 144, 146, 151, 153, 166, 168–170, 181, 237, 239, 241–243, 245–248, 250, 257, 262, 264, 266, 270, 271, 273, 282–286, 288, 295, 299 Gender roles, 5, 6, 63, 73, 77, 80–82, 97, 196, 197, 200, 208, 215–217, 262 Gender symmetry, 58, 70–72, 74–76, 83

242, 245, 246, 248, 250, 259, 260, 262, 264, 265, 269–272, 284 LGBT+, 3–8, 257, 259–264, 266, 267, 270– 274 LGBT adults, 237, 239–244, 248 LGBTIQ+, 281–283, 289 LGBTQ, 4, 12–16, 19, 20, 22–27, 45, 48, 53–56, 58, 60, 61, 63, 64, 117, 121, 126, 128, 152, 178, 179, 181–190, 196, 198, 200, 203, 204, 209, 213, 229, 231, 260, 266, 269, 270 LGBTQ+, 7, 91, 96 LGBTQ communities, 7, 13, 15–17, 26, 48, 128, 180, 182, 184–187, 189, 190, 198, 204, 231, 233 LGBTQ individuals, 6, 12–16, 20, 23, 24, 26, 27, 58, 61, 63, 65, 182, 183, 200

H Health disparities, 141, 142, 149, 170, 181 Hegemony, 227, 234 Help-seeking barriers, 139, 140, 142, 143, 145, 146, 148, 151, 154 Heteronormative bias, 139, 167, 181, 263, 273 Heteronormativity, 5, 46–48, 63, 74, 81, 183 Heterosexism, 45, 61, 62, 81, 141, 142, 145, 146, 148, 151, 187, 230, 241, 263

M Minority stress model, 112, 164

I Intersectionality, 6, 37, 39–43, 47, 48, 53, 55, 56, 116, 130, 183 Intimate Partner Violence (IPV), 3–8, 11– 27, 37–39, 41, 42, 45, 47, 48, 53–65, 69–83, 92, 93, 100–103, 111–132, 139–154, 161–171, 177–190, 195– 200, 202–210, 213–216, 229–234, 237–251, 257–274, 281, 282, 286, 289–300

L Law enforcement, 4, 7, 16, 74, 80, 102, 103, 127, 144, 146, 149, 150, 178, 195, 199, 203, 210, 231, 245, 248– 251, 263, 265–267, 269, 271–273, 282–288, 290, 292, 295, 298, 299 Lesbian, 4, 5, 12, 13, 15–21, 23, 25, 26, 45– 47, 56, 59–61, 71, 73, 80–82, 96, 114, 120, 121, 127, 128, 131, 139, 140, 164, 180, 185, 186, 197, 204, 213, 217, 228, 230–232, 237–239, 241,

O Older adults, 7, 23, 237–241, 243, 247–250 Older LGBT adults, 237–251

P Perpetrator treatment, 39, 179, 189 Personal-based violence, 189 Police, 8, 41, 45, 62, 69, 71, 76, 79, 103, 127, 128, 146–150, 179, 182, 202, 245, 250, 251, 258, 259, 262, 266–274, 281–300 Policing, 8, 266, 281–284, 287–290, 293, 295–299 Policy, 5–8, 27, 37, 39, 42, 45, 48, 53, 55, 79, 80, 103, 104, 113, 127, 144, 145, 148, 149, 152, 162, 168–170, 178, 185, 186, 188–190, 195, 196, 199, 202, 203, 205, 206, 215, 231, 233, 234, 250, 261, 267, 272–274, 283, 287, 299 Prevention, 3, 5, 7, 11, 22, 79, 140, 151, 161, 162, 164–168, 170, 171, 177, 180, 184, 189, 209, 231, 250, 257, 267 Public health, 53, 143, 151, 161, 171, 177, 241, 251, 261, 273

S Sex and gender minority health, 177, 178, 184, 185, 188

Index Sexual and gender minority, 12, 139–154, 161–171 Sexual minorities, 4–8, 12, 13, 15, 19, 21– 23, 25, 53, 57, 59, 62–64, 97, 98, 111, 113–122, 124, 126, 127, 129, 130, 132, 141, 142, 144–148, 162– 164, 167, 169, 170, 183, 228, 242, 245, 251, 260–264, 267, 270, 272 Sexual minority stress, 241, 251 Social ecological model, 168 Social isolation, 14, 144, 237, 240, 243, 268

307 T Transgender, 4, 7, 8, 12, 13, 15, 16, 20, 21, 25, 26, 39, 42, 47, 58, 61–64, 92, 97, 98, 100, 102, 103, 116, 131, 139, 142, 145–150, 153, 180, 181, 185, 186, 231–233, 237–240, 243– 246, 248–250, 260, 264–266, 268, 271, 281–300 Trans people, 91–94, 96–104, 231 Trans prejudice, 7, 92–104 Treatment interventions, 37, 41, 48, 178, 179, 181, 187–189