Out On The Couch
As a mental health professional, you may be familiar with some of the issues faced by teens who identify as LGBTQIA+: bullying, harassment, rejection, and physical and emotional violence. One lesser known and often undiscussed issue is teen dating violence (TDV). Violence against LGBTQIA+ teens is usually categorized as a hate crime–but much of the harm experienced by this population is inflicted by a dating partner. February has been designated as TDV awareness month, and each year, we acknowledge the millions of teens who endure violence in their dating relationships. This article looks specifically at LGBTQIA+ youth, who are often omitted from statistics.
TDV is a significant public health and social justice issue (Murray, King & Crowe, 2016). It is, in fact, the most common form of youth violence, and recent statistics have estimated that roughly 1.5 million U.S. high school students experience TDV each year (LoveisRespect.org, 2015). When these issues are not addressed adequately and early on, they can lead to intimate partner violence later in life (LoveisRespect.org, 2015). Since violent behaviors often begin between 6th and 12th grade (Louisiana Department of Justice, 2015), school administrators, mental health providers, and others who interact with teens should be aware of the warning signs of TDV. Additionally, they should become familiar with best practices to meet the needs of youth. These include acquiring an understanding of how dating violence affects young people who identify as LGBTQIA+ and gaining familiarity with the available resources.
The Centers for Disease Control estimate that about 10% of high school students have reported experiencing physical or sexual dating violence (CDC, n.d). While there are many studies that examine TDV, the unfortunate reality is that most of these studies fail to take into account the sexual orientation or gender identity of the respondents (Dank, Lachman, Zweig & Yahner, 2014). For this reason, accurate data on LGBTQIA+ TDV is still largely unknown (Dank, Lachman, Zweig & Yahner, 2014). Some studies have suggested that LGBTQIA+ youth have greater odds of experiencing violence and victimization within intimate relationships than their non-LGBTQIA+ peers (Dank, Lachman, Zweig & Yahner, 2014); rates of cyber and psychological dating abuse as well as physical abuse are significantly higher among LGBTQIA+ young people (Zweig, Dank, Lachman & Yahner, 2013).
The adolescent years are generally a time in which identities are developed and the pursuit of intimacy is negotiated. This developmental period can be filled with uncertainty, anxiety, and a rush of unfamiliar emotions (Espelage, Merrin & Hatchel, 2018). For LGBTQIA+ youth, adolescence can entail significant social isolation and victimization because their dating practices are often deemed socially unacceptable. As a result, these teens are less likely to talk about their dating experiences for fear of further victimization (Espelage, Merrin & Hatchel, 2018). When these teens do open up about negative dating experiences, they are more likely to receive dismissive and demeaning responses (Marrow, 2004, as cited in Espelage, Merrin & Hatchel, 2018). Espelage, Merrin and Hatchel (2018) suggest that the best approach for addressing the needs of LGBTQIA+ youth is to understand their unique experiences with intimate partner violence, and the association between these events and future adverse mental health outcomes.
Teen Dating Violence Statistics
Many therapists are woefully unaware of how common teen dating violence is. Approximately 1.5 million high school students in the U.S. report being intentionally hit or physically harmed in the last year by someone with whom they were romantically involved (Murray, King, & Crowe, 2016), while one in three young people are reported to be in an abusive or unhealthy relationship (Gellar, 2018). Meantime, one in 10 teenagers involved in romantic relationships report being nonconsensually kissed or touched, or physically forced to have sexual relations with their partner (CDC, n.d.). These statistics are even more striking among LGBTQIA+ teens: nationwide, 17.8% of gay, lesbian, and bisexual high school students–in comparison to 5.4% of heterosexual students–reported being forced to have sex (Kann, et al., 2016). A 2013 study conducted by the Urban Institute Justice Policy Center found that 23% of lesbian, gay, bisexual, transgender, and queer youth, as compared to 12% of heterosexual youth, have experienced sexual coercion (Zweig, Dank, Lachman & Yahner, 2013). Affirmative therapists, especially those who work with adolescent populations, need to be aware of this problem in order to properly assess their clients and create safety plans.
Types of Teen Dating Violence
TDV extends far beyond physical abuse–it also includes financial, digital, sexual, mental, and emotional abuse (LoveisRespect.org, 2017). Financial abuse involves using money as a form of control. In financially abusive relationships, the abuser may coerce their partner to use their credit card or debit card; withhold money, thus requiring their partner to beg for allowances; or control what their partner can buy and how their money can and should be spent (LoveisRespect.org, 2017). Financial abuse often begins with subtle acts; these are generally warning signs that should not be ignored.
Digital abuse is becoming more common between teens, though the warning signs are often dismissed. In this type of dynamic, the abusive partner may dictate who their partner can and should be friends with on social media; request passwords to access accounts; constantly text and require immediate responses; pressure their partner to send explicit photographs; and look through their partner’s phone or emails to keep tabs (LoveisRespect.org, 2017). In LGBTQIA+ relationships, digital abuse can also entail an abuser publicly posting relationship status without consent, thereby outing their partner, who may not be ready to disclose their sexual orientation (LoveisRespect.org, 2017).
Emotional and mental abuse in LGBTQIA+ relationships can differ greatly from the ways in which they show up in heterosexual and cisgender relationships. In most relationships, mental and emotional abuse occurs when the abuser constantly puts down their partner, makes threats of harm, or constantly accuses the other person of cheating. The abusive person may assume control of their partner’s behaviors and actions (LoveisRespect.org, 2017). Meantime, in LGBTQIA+ relationships specifically, the abuser may also use tactics involving fear, shame, and threats of loss of community to control their partner. If the abuser is aware that their partner feels any shame about their sexual orientation or gender identity, they may use this to exert power and control in the relationship (LoveisRespect.org, 2017). Additionally, if the abuser is aware that their partner belongs to a religious community or a traditional family structure, the abuser may use the fear of outing their partner to assume control or cause them to lose their support system.
Limitations in the Laws
At the school level, many of the laws currently implemented fail to provide adequate protection for LGBTQIA+ youth. Quite frankly, some of the laws have done the opposite of protecting them, instead putting them at significant risk (Lenson, 2015). One law currently in place is referred to as “No Promo Homo,” and nine states have implemented it. The law requires school officials to take a neutral stance on sexual and gender identity, and prohibits any discussion or services to promote the well-being of LGBTQ students (Lenson, 2015). 22 states have implemented laws requiring school boards to include curricula on TDV, but none of these provide guidance on sexual minority dating violence (Plichta, 2018). At the clinical level, the American Academy of Pediatrics outlines their recommendation for the assessment for intimate partner violence, but these recommendations do not include guidelines for sexual minorities (Plichta, 2018).
Given the gaps in the research, the lack of adequate reporting of TDV statistics affecting LGBTQIA+ youth, and the necessity for development of best practices to address the concerns of this population, mental health providers and school officials are in an optimal position to begin meeting these needs. TDV is a developmental stepping stone in the pathway toward adult intimate partner violence (Dank, M., Lachman, Zweig & Yahner, 2014), which can lead to poor mental health outcomes such as increased rates of depression, alcohol and drug abuse, and suicidal ideation among survivors. Prevention and early identification are key, as the primary risk factor for future victimization is early victimization (Plichta, 2018). Further research is needed for a better understanding of the circumstances that place LGBTQIA+ teens at higher risk for dating violence and the consequences of this type of abuse. Such research will assist with the development of prevention and intervention programs that specifically target the current and future needs of this population.
Learn More About LGBTQIA Clients
Center for Disease Control and Prevention. (N.D.). Preventing teen dating violence. Retrieved from:https://www.cdc.gov/violenceprevention/intimatepartnerviolence/teendatingviolence/fastfact.html
Dank, M., Lachman, P., Zweig, J. M., & Yahner, J. (2014). Dating violence experiences of lesbian, gay, bisexual, and transgender youth. Journal of youth and adolescence, 43(5), 846-857.
Espelage, D. L., Merrin, G. J., & Hatchel, T. (2018). Peer victimization and dating violence among LGBTQ youth: The impact of school violence and crime on mental health outcomes. Youth violence and juvenile justice, 16(2), 156-173.
Gellar, L. (2018). Dating Violence Affects 1 in 3 Teenagers. This Is What You Can Do To Help. Retrieved from: https://articles.aplus.com/a/5-common-signs-teen-dating-violence?no_monetization=true
Kann, L., Olsen, E. O. M., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., … & Thornton, J. (2016). Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9–12—United States and selected sites, 2015. Morbidity and Mortality Weekly Report: Surveillance Summaries, 65(9), 1-202.
Louisiana Department of Justice. (2015). Know more about teen relationship violence. Retrieved from:https://www.ag.state.la.us/Files/Shared/Documents/Know_More_About_Teen_Rel_Violence_11_13_2015.pdf
Luo, F., Stone, D. M., & Tharp, A. T. (2014). Physical dating violence victimization among sexual minority youth. American journal of public health, 104(10), e66-e73.
Murray, C. E., King, K., & Crowe, A. (2016). Understanding and addressing teen dating violence: implications for family counselors. The Family Journal, 24(1), 52-59.
Plichta, S. B. (2018). Translating research to practice for sexual minority youth affected by intimate partner violence. Journal of Adolescent Health, 62(6), 647-648.
Pride Surveys. (2017). Teen Dating Violence Awareness: Facts, Signs, Prevention. Retrieved from: https://www.pridesurveys.com/index.php/blog/teen-dating-violence-awareness/#_ftn8
Types of Abuse – loveisrespect. (2017). Retrieved from https://www.loveisrespect.org/is-this-abuse/types-of-abuse/
Zweig, J. M., Dank, M., Lachman, P., & Yahner, J. (2013). Technology, teen dating violence and abuse, and bullying. Washington, DC: Urban Institute.
Written by: Muria Nisbett, LCSW
Edited by: Manny Kemphues, MA. AMFT
As we recognize October as national domestic violence awareness month, and we hold vigil for the 24 people per minute who experience rape, physical violence or stalking by an intimate partner in the United States (NDVH, 2019), let’s not forget the voices of those who may not have been included in these statistics and whose stories are still untold. According to the CDC, intimate partner violence (IPV) refers to physical, sexual, or psychological harm inflicted by a current or former partner or spouse (CDC, n.d.). For the LGBTQIA+ community, however, there is also an additional form of violence known as identity abuse (Woulfe & Goodman, 2019). Identity abuse takes place when a perpetrator threatens to out a survivor to family and/or an employer or restricts their access to supportive LGBTQIA+ communities (Woulfe & Goodman, 2019). “Identity abuse emphasizes LGBTQIA+ survivors’ marginalized position and denigrates an aspect of their identity that is already threatened by internalized, interpersonal, cultural, and structural heterosexism and gender oppression” (Woulfe & Goodman, 2019). This form of abuse is not formally recognized in the definition of intimate partner violence which further highlights the disconnect in the global understanding of how intimate partner violence affects sexual and gender minorities.
Discussions around intimate partner violence have been largely centered on the idea that perpetrators are males and victims are females, with both parties being heterosexual. However, research has indicated that intimate partner violence affects LGBTQIA+ relationships at the same or higher rates as heterosexual relationships (Cannon & Buttell, 2015). The National Intimate Partner and Sexual Violence Survey conducted by the Center for Disease Control found that 29 percent of heterosexual men have experienced rape, physical violence, or stalking by an intimate partner, compared to 37 percent of bisexual men. The same survey found that 61 percent of bisexual women, as compared to 35 percent of heterosexual women, have experienced the same (NCAVD, 2018). There are only a handful of studies that compare the prevalence of intimate partner violence in transgender and cisgender couples, but one study indicated that 31.1% of transgender people compared to 20.4% of cisgender people surveyed had ever experienced IPV in their lifetime (Brown & Herman, 2015). These numbers indicate that LGBTQIA+ individuals may be at an increased risk of IPV and may be in need of additional services and appropriate resources.
Access to Care
For many LGBTQIA+ survivors of sexual assault, the decision to seek care is often affected by the discrimination that continues to affect sexual and gender minorities. This ongoing discrimination makes them hesitant to seek help from law enforcement, hospitals, shelters, or rape crisis centers, which are the very resources that are supposed to help them (HRC, n.d.). The National Coalition of Anti-Violence Program surveyed victim advocates and found that 85 percent reported that they have worked with an LGBTQ+ survivor who was denied services based on their sexual orientation or gender identity (HRC, n.d.). This affects access to quality care. LGBTQ+ survivors of intimate partner violence report high rates of help-seeking through informal resources such as family, friends, and associates (Calton, Cattaneo & Gebhard, 2016). Not surprisingly, the healthcare system has been deemed less than helpful when it comes to meeting the needs of LGBTQIA+ IPV survivors.
In the helping professions, training on same gender IPV continues to fall short when compared to the training on heterosexual IPV. Many healthcare providers are not equipped to meet the needs of sexual expansive communities largely due to homophobic, biphobic, and transphobic attitudes. They tend to refute the seriousness of the violence based on the assumption that women are not violent to each other and that men can protect themselves. Additionally, male perpetrators in relationships with women were considered more dangerous and serious than perpetrators of any gender in same-sex relationships. Healthcare providers have been said to assess heterosexual female IPV survivors in a different manner that they assess a LGBQ+ survivor (Rollè, Giardina, Caldarera, Gerino & Brustia, 2018).
Mental and sexual health implications
Intimate partner violence can lead to poor sexual and mental health outcomes for survivors. IPV is associated with lower levels of sexual satisfaction, greater likelihood of sexual dysfunctions, and sexual distress in cisgender women (Hellemans, Loeys, Buysse, Dewaele & De Smet, 2015). Aggression towards an intimate partner has also been strongly associated with a range of mental health problems. One study reported that lesbian IPV survivors reported significantly higher rates of daily stress, increased depression, and high rates of alcohol abuse (Hellemans, et al., 2015). A subsequent study conducted on 817 men who have sex with men found that IPV survivors were more likely to report depression, bipolar disorder, and other mental health disorders (Hellemans, et al., 2015).
While there are many barriers to care for LGBTQIA+ survivors of IPV, there are some resources available to assist and provide appropriate care. Additionally, there are many organizations that provide affirmative training for mental health professionals to ensure that they can provide the highest level of care to their LGBTQIA+ clients. The American Psychological Association also outlines 21 practice guidelines for working with LGBTQIA+ clients to ensure the provision of affirmative care (APA, 2012). Below are some organizations that provide trainings and resources for care.
- FORGE is a national transgender anti-violence organization that works with transgender survivors of sexual assault, domestic and dating violence, and stalking. They can be reached at their helpline 414-559-2123 or online.
- The Network/La Red is a survivor-led social justice organization that works to end partner abuse in lesbian, gay, bisexual, transgender, SM, polyamorous, and queer communities. They can be reached at their toll-free hotline 800-832-1901, or online at tnlr.org.
- Loveisrespect.org serves to engage, educate, and empower young people to prevent and end abusive relationships. They can be reached by phone or text at 1-866-331-99474 (24/7) or Text “loveis” to 22522.
- The Trevor Project is a non-judgmental hotline with LGBTQ-sensitive trained counselors you can contact through a call, text, or chat during a mental health crisis and/or when experiencing suicidal thoughts. They can be reached on their hotline at 1-866-488-7386. You can also chat online on their website at thetrevorproject.org/get-help-now/#tt.
- Trans Lifeline is a 24/7 hotline staffed by transgender people for transgender people. Trans Lifeline is primarily for assistance with crisis, from struggling with gender identity to thoughts of self-harm. They can be reached at 1-877-565-8860.
- The GLBT National Help Center provides telephone, online chat, and email peer support for many issues such as bullying, workplace issues, HIV/AIDS anxiety, coming out, relationships, safer sex, and more. They can be reached on their hotline at 1-888-843-4564, or for online peer support chat at glbthotline.org/chat.html.
- The LA LGBT Center is one of the few in the country that offers mental health services, including survivor groups and court-approved batterer intervention, and legal services specifically designed for LGBTQIA+ community members. For more information, go to lalgbtcenter.org/health-services/mental-health/intimate-partner-domestic-violence
This is not an exhaustive list, but it is intended some provide resources that can be accessed during an emergency.
Learn More About Working with LGBTQ Clients
American Psychological Association. (2012). Guidelines for psychological practice with lesbian, gay, and bisexual clients. The American Psychologist, 67(1), 10.
Brown, T., & Herman, J. (2015). Intimate partner violence and sexual abuse among LGBT people. Los Angeles, CA: The Williams Institute.
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.
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.
Center for Disease Control and Prevention. (N.D.). Intimate partner Violence. Retrieved from: https://www.cdc.gov/violenceprevention/intimatepartnerviolence/
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.
Human Rights Campaign. (N.D.). Sexual assault and the LGBTQ community. Retrieved from: https://www.hrc.org/resources/sexual-assault-and-the-lgbt-community
National Coalition Against Domestic Violence. (2018). Domestic violence and the LGBTQ community. Retrieved from: https://ncadv.org/blog/posts/domestic-violence-and-the-lgbtq-community
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
Woulfe, J., & Goodman, L. (2019). Weaponized oppression: Identity abuse and mental health in the lesbian, gay, bisexual, transgender, and queer community.. Psychology of Violence. 10.1037/vio0000251.