1. Karen Harper COH 617

2. -Domestic violence occurs at roughly the same rates in same-sex and opposite-sex relationships -Between one in four and one in three people in same-sex relationships report experiencing domestic violence. By comparison, one in four heterosexual women report experiencing domestic violence. -Domestic violence includes physical, emotional, sexual, and spiritual abuse. The victim often feels isolated, afraid, and guilty. -Domestic violence can occur in any relationship regardless of race, ethnicity, or socioeconomic status. Reference: Domestic Violence in the LGBT Community: A Fact Sheet. Retrieved from https://www.americanprogress.org/issues/lgbt/news/2011/06/14/9850/dome stic-violence-in-the-lgbt-community/ on January 18, 2016. https://www.americanprogress.org/issues/lgbt/news/2011/06/14/9850/dome stic-violence-in-the-lgbt-community/ Prevalence of DV in the LGBT Community

3. DV in same-sex relationships presents challenges specific to the LGBT population and its history of being marginalized by society at large. -Batterers may threaten to “out” the victim to family, friends, or coworkers. This adds to the sense of isolation from support systems that many in the LGBT community experience. -Victims in same-sex relationships may be more reluctant to report the abuse since doing so means “outing” themselves to authorities -Victims in same-sex relationships are more likely than heterosexual women to fight back, which may lead p0lice to conclude that the fight was mutual and not domestic violence -Abusers may threaten to take away children. Until recently, many states did not allow same-sex couples to adopt (this is now only true in Mississippi, while some other states have statutes stating that if a social worker’s religious beliefs conflict with placing a child with a same-sex couple, they can decline to do so) Population-specific Considerations

4. -Authorities may lack the knowledge or experience in dealing with same-sex domestic violence. Police may erroneously assume that two men or two women are roommates and thus the partners do not receive referrals for appropriate services. -While there are often shelters available to women who are victims of DV, few shelters and resources exist for male victims, which may make it harder for them to leave an abusive relationship -Many states do not have laws explicitly protecting victims of DV in same-sex relationships. -Some people may be afraid to report DV, fearing that it makes the greater LGBT community look bad, or that people will assume that DV in one same- sex relationship means that all such relationships are dysfunctional. Reference: Domestic Violence in the LGBT Community: A Fact Sheet. Retrieved from https://www.americanprogress.org/issues/lgbt/news/2011/06/14/9850/domestic- violence-in-the-lgbt-community/ on January 18, 2016. https://www.americanprogress.org/issues/lgbt/news/2011/06/14/9850/domestic- violence-in-the-lgbt-community/ Population-specific Considerations (continued)

5. -Educate and raise awareness among law enforcement officials about violence between same-sex couples -Require medical staff to regularly screen for domestic violence regardless of the patient’s sexual orientation. Anytime abuse is suspected, providers need to ask the patient about it and must not assume that domestic violence isn’t a possibility because the patient appears to live with a “rooommate.” -Prevention educators must be comfortable talking about LGBT issues and accepting of trans identities. -If youth feel supported when they come out as LGBT they may be more likely to discuss abuse in relationships with trusted adults -National organizations and state and local health departments should collect data with an adequate sample size on domestic violence in same- sex relationships Primary Prevention Strategies

6. -Work with LGBT communities to do a community needs assessment and identify barriers, resources, and unmet needs to help prevent violence -Schools should include domestic violence as part of the health education curriculum, using either gender-neutral language or language that includes LGBT youth -Agencies considering implementing LGBT-specific prevention programs should consider partnering with LGBT organizations such as community centers or bookstores. The program may be more successful if it is held at an organization the LBGT community already knows and trusts. References: Guide for Transformative Prevention Programming: Sexual Violence & Individuals Who Identify as LGBTQ. Retrieved from http://www.nsvrc.org/sites/default/files/Publications_NSVRC_Guides_Transform ative-Prevention-Programming.pdf on January 18, 2016. http://www.nsvrc.org/sites/default/files/Publications_NSVRC_Guides_Transform ative-Prevention-Programming.pdf New York State Office for the Prevention of Domestic Violence. Retrieved from http://www.opdv.ny.gov/whatisdv/lgbtqdvinfo.pdf on January 18, 2016. http://www.opdv.ny.gov/whatisdv/lgbtqdvinfo.pdf Primary Prevention (continued)

7. -One study showed that primary care providers who regularly screened patients with a history of being abused had some success in reducing the number of subsequent incidents. Patients were given referral cards to keep in their wallets with numbers to call if they felt unsafe or needed shelter. More research needs to be done on whether this approach would also work for LGBT victims as they are often afraid to admit to abuse and may fear discrimination if they come out to their PCP, police, or shelter staff. -The same study also showed success when a case management model was implemented. A nurse case manager followed up with both victims and abusers regularly over a 12-month period. Abusers rated themselves lower on aggression than those who did not participate in case management, and victims also reported fewer incidents of violence. Reference: Mcfarlane, J., Groff, J., O'brien, J., & Watson, K. (2006). Secondary Prevention of Intimate Partner Violence. Nursing Research, 52-61. Retrieved January 18, 2016, from http://journals.lww.com/nursingresearchonline/Abstract/2006/01000/Second ary_Prevention_of_Intimate_Partner_Violence_.7.aspx Secondary Prevention Strategies

8. -Ongoing community-based support services should be made available to victims. For the LGBT community, this may take the form of case management or support groups at a local LGBT community center or other gathering place. Reference: Mcfarlane, J., Groff, J., O'brien, J., & Watson, K. (2006). Secondary Prevention of Intimate Partner Violence. Nursing Research, 52-61. Retrieved January 18, 2016, from http://journals.lww.com/nursingresearchonline/Abstract/2006/01000/Sec ondary_Prevention_of_Intimate_Partner_Violence_.7.aspx Secondary Prevention (continued)

9. -More support services, especially for gay, bisexual, and transgender men, need to be available. Currently there are very few domestic violence shelters willing to accept male victims of domestic violence, whether they are heterosexual or not. -Gay, bisexual, and other men who have sex with men are at increased risk for suicide. Any man involved in a domestic violence situation should be thoroughly screened for depression and suicidality. -In cases where domestic violence is chronic and recurring, the legal system must be involved. A victim’s advocate with sensitivity to LGBT issues can be appointed to help the victim navigate the system and access resources. Batterer’s intervention programs should also address same- sex relationships. Reference: Gay and Bisexual Men’s Health: Suicide and Violence Prevention. Accessed from http://www.cdc.gov/msmhealth/suicide-violence- prevention.htm on January 18, 2016.http://www.cdc.gov/msmhealth/suicide-violence- prevention.htm Tertiary Prevention Strategies

11. -The discrimination faced by LGBT individuals has been evident in legal policy and societal attitudes against them. This causes LGBT victims of domestic violence to be afraid to seek help for fear of “outing” themselves. We must continue to raise awareness of the prevalence of DV within the LGBT community. -Until widespread policy changes and attitudes toward LGBT people change for the better, domestic violence will continue to be an underreported problem in this community. -LGBT youth need to feel accepted and be taught that dating violence is not OK -Prevention programs should partner with local LGBT organizations as the community is more likely to trust and participate in them. Conclusions