Sexual violence & individuals who identify as LGBTQ Research Brief The publications below examine sexual violence — in the form of hate or bias-motivated crimes, intimate partner violence, childhood sexual abuse, and adult sexual assault — against victims who identify as lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ). Sexual assault is extremely damaging to the health and wellbeing of victims who identify as LGBTQ. The studies examined in this brief found correlations between sexual assault victimization and high-risk sexual behaviors, mood disorders (i.e., depression), and suicide attempts among individuals who identify as LGBTQ. In the absence of accessible LGBTQ-affirming services, victims may encounter barriers to post-assault services due to homophobia and transphobia. Additionally, intersections between systems of inequality and discrimination such as homophobia, transphobia, misogyny, ableism, and racism may heighten risks and challenges for diverse subsets of the LGBTQ population. This research brief can assist sexual assault advocates, LGBTQ community advocates, mental health professionals, and medical personnel in understanding the issues confronting survivors who identify as LGBTQ. Accessible and affirming post-assault services are crucial for all survivors regardless of sexual orientation or gender identity, requiring service providers to be knowledgeable about LGBTQ issues. Gentlewarrior, S., & Fountain, K. (2009). Culturally competent service provision to lesbian, gay, bisexual and transgender survivors of sexual violence. Retrieved from VAWnet, National Online Resource Center on Violence Against Women: http://new.vawnet.org/Assoc_Files_VAWnet/AR_LGBTSexualViolence.pdf Aims: This article highlights disproportionate rates of sexual assault against individuals who identify as LGBTQ and stresses the importance of LGBTQ-affirming, culturally competent services for sexual assault survivors. Methods: Gentlewarrior and Fountain explore multiple research papers on sexual assault against LGBTQ people published in the 1990s and 2000s. Key results: • Due to societal oppression of individuals and communities who identify as LGBTQ, some may be reluctant to disclose their sexual orientation or gender identity to service providers and researchers, making accurate statistics on the LGBTQ community challenging to obtain. • Sexual violence against individuals who identify as LGBTQ has been perceived as a violent attempt to oppress those who are challenging social norms around gender and sexuality. • Many studies that have focused on individuals who identify as LGBTQ have found this population has been subjected to sexual harassment, with high rates reported in academic settings. For example, Fineran’s (2002) research suggests a correlation between sexual harassment victimization and increased rates of suicide attempts and missed school time among gay, lesbian, and bisexual students. • Although research is limited, several studies found that respondents who identify as LGBTQ reported higher rates of childhood sexual abuse than heterosexual respondents. Childhood sexual victimization among gay, lesbian, and bisexual survivors has been correlated with psychopathologies (i.e., psychological distress, mood disorders), substance abuse, and high-risk sexual behaviors. However, research indicates that childhood sexual abuse does not influence sexual orientation. • Several studies indicate that sexual violence can be a dimension of hate or bias-motivated crimes against adults who identify — or are perceived to be —LGBTQ. For instance, Dunbar ”Sexual harassment between same-sex peers: Intersection of mental health, homophobia, and gays and lesbians are more likely to experience sexual assault, sexual harassment, physical assault and stalking compared to other groups typically targeted for hate crime victimization. This article, as well as ”Victim experiences in hate crimes based on sexual orientation” (2002) indicate that such hate crimes are less likely to be reported to the authorities than other types of hate crimes, due to perceived homophobic and transphobic bias in the criminal justice system. • Service providers may encounter additional challenges when trying to promote safety and community reconnection for survivors of sexual assault who identify as LGBTQ. Survivors who identify as LGBTQ struggle not only with the aftermath of sexual assault, but with systematic oppression and discrimination. Thus, culturally competent, LGBTQ-affirming services are crucial. • The authors offer recommendations for providing LGBTQ-affirming services to survivors of sexual assault who identify as LGBTQ, such as utilizing LGBTQ-affirming practice models, professional development opportunities, and information dissemination. Summary: Numerous studies over the past two decades indicate that members of the LGBTQ community suffer disproportionate rates of sexual victimization compared to the general population. Affirming and culturally competent services are essential to assist individuals who identify as LGBTQ who have histories of childhood sexual abuse, adult sexual assault, sexual harassment, and hate crime victimization. Application: This article can help sexual assault advocates, medical personnel, and mental health professionals understand the challenges facing survivors of sexual assault who identify as LGBTQ and the importance of providing sensitive services to this population. Additionally, service providers can use this information to confront possible latent homophobia and transphobia in their organizations. Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., & Keisling, M. (2011). Injustice at every turn: A report of the National Gender Discrimination Survey. Retrieved from The National Gay and Lesbian Task Force: http://www.thetaskforce.org/downloads/reports/reports/ntds_full.pdf Aims: This study documents wide-reaching discrimination and violence against individuals who identify as transgender and gender non-conforming in the U.S. Methods:This stuy drew data from 6,436 individuals who identify as transgender and gender non-conforming in 50 states, three U.S. territories, and the District of Columbia. Respondents completed a 70-question survey designed by a team of advocates, transgender leaders, researchers, lawyers, and other stakeholders. Key results: • Respondents who identified as transgender or gender non-conforming during grades K-12 reported significant rates of harassment (78%), physical assault (35%), and sexual violence (12%). Respondents who identified as American Indian, Asian, Black, and multiracial experienced higher rates of sexual violence than K-12 students of other races. More than half (51%) of respondents who were harassed, physically assaulted, or sexually assaulted because of the gender expression in K-12 reported having attempted suicide. • The overwhelming majority (90%) of respondents reported harassment and mistreatment at work, or felt compelled to take actions that negatively affected their well-being or career. Sexual assault at work of undocumented immigrant respondents reporting sexual assault at work. American Indian, Black, and Hispanic participants reported the highest rates of sexual assault at work. • Almost one-fifth (19%) of respondents reported experiencing homelessness at some point in their lives. Of respondents who tried to access a homeless shelter, 22% were sexually assaulted by residents or staff. Respondents who identified as American Indian, Black, and Hispanic, as well as those who were undocumented, reported higher rates of sexual assault by shelter residents or staff. • Among respondents who reported incarceration, 15% reported being sexually assaulted while in jail or prison. Respondents who identified as Americans Indian, Black, and Hispanic reported the highest rates of sexual assault while incarcerated. • Nearly half (46%) of respondents reported being uncomfortable seeking police assistance. Of those who interacted with police, 2% reported being sexually assaulted by police, with percentages higher for respondents who identified as Black or Hispanic. • A small percentage of respondents reported unequal treatment (5%), verbal harassment or disrespect (4%) or physical assault (1%) when seeking services at rape crisis centers. • A total of 11% of respondents reported engaging in prostitution. Respondents were more likely to engage in prostitution if they had been incarcerated, physically assaulted at school, driven out of school due to harassment, fired because of transphobic bias, or subjected to hiring discrimination. Black and Hispanic respondents reported the highest rates of prostitution. • A total of 41% of respondents reported attempting suicide, with markedly higher rates for those who had experienced sexual assault (64%), physical assault (61%), school harassment and bullying (51%), and job loss because of transphobic bias (51%). • Respondents who had been sexually assaulted because of transphobic bias reported higher rates of HIV infection (10%). Summary: In a study of 6,436 individuals who identified as transgender and gender non-conforming, significant percentages of respondents reported having experienced discrimination and violence. Transgender and gender non-conforming people reported high rates of harassment, physical assault, and sexual assault in a variety of settings including, but not limited to, schools, workplaces, prisons, and homeless shelters. Sexual victimization was correlated with higher rates of HIV infection and attempted suicide among respondents. Sexual assault rates were higher among people of color, suggesting intersections between transphobia and racism. Application: This study illustrates the serious problems facing transgender and gender- nonconforming people. Stakeholders may consider promoting anti-violence prevention efforts, anti-discrimination policies, and public awareness of transphobic discrimination and violence (including sexual violence). Primary prevention programs intended to prevent sexual assault may consider teaching participants about homophobia, transphobia, and sexual assault as a hate crime. Additionally, stakeholders in the criminal justice, sex offender management, and prison systems may wish to explore innovative secondary and tertiary prevention efforts geared toward perpetrators of sexual hate crimes. Additionally, the study pointed to possible intersections between transphobia and racism, given that people of color reported high rates of sexual victimization. For this reason, service providers and LGBTQ advocates should consider extending outreach to transgender and gender non-conforming communities of color. Also, because respondents reported considerable violence and harassment in grades K-12, service providers should consider directing outreach and services to youth who identify as transgender and gender non-conforming. Finally, because of reported correlations between involvement in prostitution and experiences of transphobic violence and discrimination, service providers may wish to collaborate with prostitution outreach programs to assist this specific population. Researchers should further examine violence (including sexual assault) experienced by transgender and gender non-conforming people during involvement in prostitution. Heintz, A. J., & Melendez, R. M. (2006). Intimate partner violence and HIV/ STD risk among lesbian, gay, bisexual, and transgender individuals. Journal of Interpersonal Violence, 21, 193-208. doi:10.1177/0886260505282104 Aims: This study examined the relationship between intimate partner violence (including sexual violence) among individuals who identified as lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) and safe sex practices. Methods: Researchers drew data from surveys completed by 58 adult clients of a community- based organization that provides services to victims of intimate partner violence who identify as LGBTQ. Subjects completed a survey with questions about intimate partner sexual victimization, safer sex practices, and safer sex negotiation. The majority of respondents (72%) identified as gay or bisexual men. Women who identified as lesbians constituted 19% of respondents and individuals who identified as transgender made up 9% of participants. Key results: • Nearly all respondents (98%) had experienced verbal abuse by a former or current intimate partner, and 71% had experienced physical violence by a partner. Nearly half (41%) of respondents replied that an intimate partner had forced them to have sex, and 10% indicated that a partner had forced them to have sex with another person. • Only half of respondents who reported being sexually assaulted by a partner also reported that their partner used safer sex measures. • Regarding safer sex negotiation, 32% of respondents said that they are not using protection with their partner to avoid problems, while 28% admitted that it would be unsafe to negotiate because they fear their partner’s response. • Respondents who reported that they had been forced to have sex with their partner were 10.3 times more likely to report that they used no safer sex practices, because they feared their partner’s response to safer sex negotiation. • Nineteen percent of respondents were subjected to sexual violence by their partner as a result of requesting safer sex practices, 21% were subjected to physical violence, and 32% were subjected to verbal abuse. Summary: In a study of 58 adults who identified as LGBTQ and sought services at a community organization focused on domestic violence, researchers found that nearly half of respondents reported sexual assault by an intimate partner. Sexual assault by an intimate partner was correlated with failure to use safer sex practices out of fear of the partner’s response. These results suggest that intimate partner sexual assault among LGBTQ couples may result in reluctance to negotiate safer sex, thereby increasing victims’ risk of sexually transmitted (STI) and HIV infections. Application: This study can alert service providers (including domestic violence advocates, sexual assault advocates, and LGBTQ community organizations) to sexual violence as a dimension of intimate partner violence in abusive LGBTQ relationships. Additionally, by illustrating the relationship between intimate partner violence and risk of STI/HIV, this study can encourage reproductive health service providers and public health professionals to extend outreach to the LGBTQ community. National Coalition of Anti-Violence Programs. (2010). Hate violence against the lesbian, gay, bisexual, transgender and queer communities in the United States in 2009. Retrieved from http://www.avp.org/documents/NCAVP2009HateViolenceReportforWeb.pdf Aims: This report seeks to collect statistics and information about homophobic and transphobic hate or bias-motivated crimes reported to 15 member organizations of the National Coalition of Anti-Violence Programs (NCAVP) in 2009. Methods:NCAVP gathered crime data on 2,181 hate or bias-motivated crime victims reported to 15 member organizations in 12 states. Hate or bias-motivated crime incidents included verbal, physical, and sexual attacks on individuals who identify as lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ), people perceived to be LGBTQ, or property. Key results: • Of 2,181 reported LGBTQ hate crime victims, information was available on the sexual orientation of 1,640 victims. Of those 1,640, 49% identified as gay, 28% as lesbian, 10% as heterosexual, 7% as bisexual, 3% as queer2% as questioning or unsure, and 1% under a self-identified term. • Of 1,983 victims whose gender identity was known, 52% identified as male, 32% as female, 11% as male-to-female transgender, 3% as female-to-male transgender, 1% as questioning, 0.6% as intersex, and 0.4% as genderqueer. • Of the victims whose disability status was known, 31% identified as living with a disability. • People of color were overrepresented as hate crime targets compared to the demographics of the general population. •Sexual assault (74 reported incidents), assault without weapons (262 reported incidents), assault with weapons (137 reported incidents), robbery (49 reported incidents) and vandalism (111 reported incidents) were the most commonly reported hate crimes. In 2009, 74 hate-related sexual assaults were reported, compared to 138 in 2008. • Among 1,142 perpetrators whose gender identity was known, the vast majority (77%) were cisgender1 males, followed by (23%) cisgender females. • The total number of hate crime victims who reported to NCAVP in 2009 decreased by 12% since 2008. The total number of incidents reported decreased slightly (by 7%) from 2008. Given cuts in NCAVP member program staff and budgets, the authorship speculates that these statistics probably do not reflect an actual decrease in homophobic and transphobic hate crimes, but rather a decrease in program capacity to meet community needs. • Recommendations for stakeholders include increasing local, state, and federal funding for anti-violence efforts, enhancing institutional support for hate crime research and reporting, and taking legislative steps to address homophobic and transphobic hate crimes. With regard to sexual assault-related legislation, NCAVP urges implementation of the Prison Rape Elimination Act so as to enhance protections for LGBTW inmates. NCAVP also encourages legislators to reformsexual assault laws so as to be more inclusive of LGBTQ hate crime victims. 1 Cisgender refers to a person who was assigned female at birth and is comfortable living and presenting as female, or someone who was assigned male at birth and is comfortable living and presenting as male. It provides a name for a gender identity that society considers to match with or to be appropriate for one’s sex. For more information on terminology, see the NSVRC’s Talking about gender & sexuality: Sexual violence & individuals who identify as LGBTQ. Summary: A total of 2,181 homophobic and transphobic hate or bias-motivated crimes were reported to 15 member programs of the NCAVPin 2009. Sexual assault, physical assault with and without weapons, robbery, and vandalism were the most commonly reported hate crimes. In cases where the gender identity of perpetrators was known, the overwhelming majority of perpetrators were cisgender males, followed by cisgender females. NCAVP provides recommendations to stakeholders for addressing homophobic and transphobic hate crimes, including crimes with a sexual violence component. Application: Since most reported hate or bias-motivated crime perpetrators were cisgender1 males, stakeholders should be aware of intersections between patriarchy and cisgender privilege in the motivations of sexual hate or bias crime perpetrators. Service providers may wish to target this particular population in hate crime prevention efforts. Additionally, stakeholders and researchers should be aware of the intersections of LGBTQ status and other identity variables (i.e., race, disability status) with regard to hate or bias-motivated crime victimization. Advocates should consider devoting attention to these at-risk LGBTQ communities for services and education related to hate crimes and sexual assault. Regarding additional research, the authorship acknowledges that most of the hate or bias- motivated crime data was self-reported by victims who contacted member organizations for assistance. This study should be supplemented with other research utilizing population-based samples to provide a well-rounded view of hate crime victimization rates. Rothman, E. F., Exner, D., & Baughman, A. L. (2011). The prevalence of sexual assault against people who identify as gay, lesbian, or bisexual in the United States: A systematic review. Trauma, Violence & Abuse, 12, 55-66. doi:10.1177/1524838010390707 Aims: This article reviews 75 studies on sexual victimization among individuals who identify as gay, lesbian, or bisexual (GLB) in the U.S. to determine the prevalence of sexual violence in the GLB population. Methods: The authors reviewed 71 articles on 75 studies on the prevalence of sexual violence against individuals who identify as GLB, published between 1989 and 2009. The authors examined data on lifetime sexual victimization, childhood sexual abuse, adult sexual assault, intimate partner sexual assault, and sexual assault as a dimension of hate or bias- motivated crime. This review drew data from population-based and census studies (in which all individuals in a particular geographic area had equal probability of being selected) as well as non-probability studies (in which individuals in a geographic area have an unequal probability to being selected). Key results: • Reported prevalence of child sexual abuse ranged from 15% to 76% for women who identified as lesbian or bisexual and 4% to59% for men who identified as gay or bisexual. • Reported prevalence of adult sexual assault ranged from 11% to 53% for women who identified as lesbian or bisexual and 11% to 45% for men who identified as gay or bisexual. • Reported prevalence of intimate partner sexual assault ranges from 2% to 45% for women who identified as lesbian or bisexual, and from 10% to 57% for men who identified as gay or bisexual. • Reported prevalence of sexual assault as a hate crime ranged from 1% to 12% for women who identified as lesbian or bisexual, and from 3% to 20% for men who identified as gay or bisexual. • Reported prevalence of lifetime sexual assault ranged from 16% to 85% among women who identified as lesbian or bisexual, and from 12% to 54% among men who identified as gay or bisexual. When these statistics are considered alongside lifetime sexual assault prevalence among the general population (11% to 17% for females; 2% to 3% for males), they suggest that individuals who identify as GLB may be at increased risk for sexual victimization. Summary: In a review of 75 studies on sexual victimization of individuals who identify as gay, lesbian, and bisexual, researchers found significant rates of lifetime sexual assault, childhood sexual abuse, adult sexual assault, intimate partner sexual assault, and hate crime-related sexual assault among respondents who identified as GLB. When lifetime sexual victimization rates for individuals who identify as GLB are compared to those of the general population, they suggest that individuals who identify as GLB may face increased risk for sexual violence. Application: The statistics demonstrated in this review suggest that sexual assault advocates should consider extending outreach and adapt services to survivors who may identify as gay, lesbian, and bisexual, given the high prevalence of sexual victimization among members of these communities. Primary prevention programs that focus on intimate partner violence and dating violence should consider including content geared toward participants who identified as LGBTQ. Also, sexual assault primary prevention programs in general should consider adding content on homophobia, transphobia, and sexual assault as a hate crime. Additionally, service providers who serve the LGBTQ community should consider the benefits Conclusion of providing trauma-informed care and screen for prior sexual victimization when appropriate. Because this study provides only general data, it should be supplemented with studies on distinct groups within the LGBTQ community, including but not limited to different geographic, racial, ethnic, and age groups. Regarding future research, the authors suggest additional studies should directly compare the prevalence of sexual victimization among individuals who identify as LGBTQ to that among heterosexual people. Additionally, comparing the prevalence of sexual victimization among transgender people to that of cisgender people may shed light on the overall sexual assault risks of the LGBTQ community. Finally, many of the studies using non-probability methods produced higher sexual victimization rates than studies using population-based or census methods. The authors suggest additional research to determine whether population-based studies underestimate the prevalence of sexual violence, or if non-probability studies overestimate its prevalence. Conclusion The research examined above indicates that sexual violence is an important concern for individuals and communities who identify as LGBTQ. Indeed, individuals who identify as LGBTQ appear to be at higher risk for sexual victimization than the general population, and may encounter barriers to services because of homophobia and transphobia. Intersections between various forms of oppression may exacerbate these challenges, making it important to address LGBTQ sexual victimization alongside sexism, racism, ableism, and other variables. Additional research should utilize population-based and census methods to compare LGBTQ sexual victimization rates to those of heterosexual and cisgender populations. Additionally, future research can explore protective and risk factors for sexual victimization and post-assault recovery among individuals who identify as LGBTQ, as well as the nature of the relationship between sexual orientation and sexual assault. National Sexual Violence Resource Center and Pennsylvania colaition Against Rape 2012. All rights reserved. This document was supported by Cooperative Agreement #5VF1CE001751-03 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC This project is supported by Grant No. 2010-SW-AX-0019 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women.