A Mixed Methods Study of Barriers to Help-Seeking for Intimate Partner Aggression in the LGBTQIA+ Community

Cañete M., Reis E., Moleiro C.

Kanougiya S., Sivakami M., Daruwalla N., Osrin D.

Abstract Background Help-seeking for intimate partner violence (IPV) requires women to disclose their experiences. For policymakers, low help-seeking threatens the United Nations Sustainable Development Goals (SDGs) of gender equality, good health, and wellbeing. In India, the Prevention of Domestic Violence Against Women Act (PWDVA 2005) was implemented in 2006. Using two rounds of the India National Family Health Survey (NFHS), one before and one after implementation, we examined the prevalence, pattern, and sociodemographic and socioeconomic factors associated with formal help-seeking for IPV. Methods We used univariable and multivariable logistic regression models to assess the prevalence of help-seeking for IPV in the past 12 months and examined associations with different forms of IPV and sociodemographic factors. Results The proportion of ever-married women aged 15–49 years who reported physical, sexual, or emotional IPV in the last 12 months increased from 23% in NFHS-3 (2005–2006) to 25% in NFHS-4 (2015–2016). In both surveys, few women sought help. Informal sources of help were preferred over formal sources, which declined from NFHS-3 to NFHS-4 (any help: 24.5 to 13.8%; informal help: 24.1 to 13.4%; and formal help: 1.2 to 1.1%). Women from lower castes and women with children were less likely to seek formal help. Over the two surveys, the odds of formal help-seeking for sexual IPV in the past 12 months remained similar (NFHS-3 aOR 1.9, 95% CI 1.4, 2.5. NFHS-4 aOR 1.9, 95% CI 1.4, 2.6). The odds were slightly higher for emotional IPV (NFHS-3 aOR 2.5, 95% CI 1.8, 3.3. NFHS-4 aOR 2.7, 95% CI 2.0, 3.7) and spousal control (NFHS-3 aOR 2.0, 95% CI 1.4, 3.0. NFHS-4 aOR 2.3, 95% CI: 1.4, 3.7). Conclusions Low disclosure and help-seeking impact a country’s social, cultural, economic, and political progress. The PWDVA did not appear to result in increases in help-seeking among women in India who experienced IPV. Further work is needed to understand barriers to help-seeking in the presence of public policy efforts to support women affected by IPV. These may include poor implementation and enforcement of Policy, as well as normalization and justification of gender-based violence. We recommend a deeper understanding of help-seeking across all systems to establish a barometer of help-seeking. An increase in formal or informal help-seeking is an indicator of reduced tolerance of IPV and the enabling environment of the PWDVA 2005 for tracking progress toward the SDGs of gender equality and the eradication of all forms of gender-based violence and discrimination.

Sardinha L., Maheu-Giroux M., Stöckl H., Meyer S.R., García-Moreno C.

Intimate partner violence against women is a global public health problem with many short-term and long-term effects on the physical and mental health of women and their children. The Sustainable Development Goals (SDGs) call for its elimination in target 5.2. To monitor governments' progress towards SDG target 5.2, this study aimed to provide global, regional, and country baseline estimates of physical or sexual, or both, violence against women by male intimate partners.This study developed global, regional, and country estimates, based on data from the WHO Global Database on Prevalence of Violence Against Women. These data were identified through a systematic literature review searching MEDLINE, Global Health, Embase, Social Policy, and Web of Science, and comprehensive searches of national statistics and other websites. A country consultation process identified additional studies. Included studies were conducted between 2000 and 2018, representative at the national or sub-national level, included women aged 15 years or older, and used act-based measures of physical or sexual, or both, intimate partner violence. Non-population-based data, including administrative data, studies not generalisable to the whole population, studies with outcomes that only provided the combined prevalence of physical or sexual, or both, intimate partner violence with other forms of violence, and studies with insufficient data to allow extrapolation or imputation were excluded. We developed a Bayesian multilevel model to jointly estimate lifetime and past year intimate partner violence by age, year, and country. This framework adjusted for heterogeneous age groups and differences in outcome definition, and weighted surveys depending on whether they were nationally or sub-nationally representative. This study is registered with PROSPERO (number CRD42017054100).The database comprises 366 eligible studies, capturing the responses of 2 million women. Data were obtained from 161 countries and areas, covering 90% of the global population of women and girls (15 years or older). Globally, 27% (uncertainty interval [UI] 23-31%) of ever-partnered women aged 15-49 years are estimated to have experienced physical or sexual, or both, intimate partner violence in their lifetime, with 13% (10-16%) experiencing it in the past year before they were surveyed. This violence starts early, affecting adolescent girls and young women, with 24% (UI 21-28%) of women aged 15-19 years and 26% (23-30%) of women aged 19-24 years having already experienced this violence at least once since the age of 15 years. Regional variations exist, with low-income countries reporting higher lifetime and, even more pronouncedly, higher past year prevalence compared with high-income countries.These findings show that intimate partner violence against women was already highly prevalent across the globe before the COVID-19 pandemic. Governments are not on track to meet the SDG targets on the elimination of violence against women and girls, despite robust evidence that intimate partner violence can be prevented. There is an urgent need to invest in effective multisectoral interventions, strengthen the public health response to intimate partner violence, and ensure it is addressed in post-COVID-19 reconstruction efforts.UK Department for International Development through the UN Women-WHO Joint Programme on Strengthening Violence against Women Data, and UNDP-UN Population Fund-UNICEF-WHO-World Bank Special Programme of Research, Development, and Research Training in Human Reproduction, a cosponsored programme executed by WHO.

Rodríguez D.G., Murtagh B.

Braun V., Clarke V.

Santoniccolo F., Trombetta T., Rollè L.

Same-Sex Intimate Partner Violence (SSIPV) is a complex issue that can be severely damaging. When involved in SSIPV, victims and perpetrators sometimes choose to seek help. The help-seeking process, however, can be difficult. Experiences of help-seeking seem to vary and may be positive or negative depending on several factors, some of which appear to be specific to lesbian, gay, and bisexual (LGB) people involved in a same-sex relationship. A systematic review of the literature has been conducted across four databases following the PRISMA statement guidelines. Out of 410 screened abstracts, 78 articles were selected for full-text review. Following the inclusion and exclusion criteria, 21 studies were included in the current review. Thematic analysis was conducted on these studies and results were discussed by three reviewers. Help-seekers tended to use informal sources of help, perceived to be ambivalently helpful. Formal sources tended to be utilized sparingly, except for counselors. Many formal sources were perceived to be unhelpful, and most of the studies identified several barriers to services that prevented effective help. Formal and helpful sources were perceived as knowledgeable and sensitive about LGB themes. While existing research is limited, formal services that can provide effective care for SSIPV appear scarce. Barriers to services seem widespread, limiting accessibility. Existing services would benefit from increasing their knowledge and sensitivity on SSIPV-specific themes. The development of policies, programs, and interventions that aim to provide effective help is needed, as well as more research.

Messinger A.M., Kurdyla V., Guadalupe-Diaz X.L.

Research finds that transgender survivors of intimate partner violence (IPV) often face transphobia-related barriers to reaching help. Due partially to a dearth of larger datasets supporting multivariate analyses, it is unclear whether sociodemographic factors can further hinder transgender help-seeking. Addressing these gaps, logistic regression secondary data analyses were conducted with 15,198 transgender IPV survivors from the nationally-representative 2015 U.S. Transgender Survey. Odds of seeking help from survivor agencies were significantly greater for survivors who are trans men, assigned-female-at-birth genderqueer, Alaska Native or American Indian, poorer, transphobia victims, and victims of any IPV type, especially controlling IPV. In addition, odds of not seeking help due fearing transphobic responses were significantly greater for survivors who are trans women, asexual or bisexual, poorer, younger, undocumented, childless, ever homeless, transphobia victims, or victims of any IPV type, particularly sexual IPV. Implications for future research and population-specific service provision are discussed.

Harden J., McAllister P., Spencer C.M., Stith S.M.

Intimate partner violence (IPV) is a worldwide issue that, although often thought of as a very gendered and heteronormative crime (male perpetrators and female victims within heterosexual relationships), occurs in all kinds of relationships. The purpose of this study is to examine and raise awareness of how IPV operates within female same-gender relationships. Researchers utilized a narrative inquiry framework, as well as thematic analysis, in order to conduct a qualitative synthesis of articles that examined IPV in female same-gender relationships. Articles were identified through database searches for studies published between 2000 and 2019 using key search terms. Studies were included if they were qualitative in nature (including direct quotes from participants), examined IPV within female same-gender relationships, and were written in English. A total of 19 studies were included in the qualitative synthesis. Findings were categorized as barriers to help and support, themes within experiences of IPV, or recommendations for helping professionals. Themes within categories included, among others, a lack of framework to identify abuse; mistrust of law enforcement; power dynamics related to parenthood, race, and gender presentation; and fears of contributing to heterosexism. Findings from this study can serve to better inform helping professionals about considerations to keep in mind when working within lesbian, gay, bisexual, transgender, plus various additional sexual minorities’ communities and survivors of female same-gender violence.

Dixon L., Wride A.

The heterogeneity of people who aggress against an intimate partner is well established, and classification systems have long been produced to describe core differences between these people. However, typologies have failed to inform treatment and sophisticated theoretical explanations about the causes of intimate partner aggression (IPA). Recent theoretical research suggests that classification systems can be meaningful in informing explanations and treatment of offending behavior if they are derived from units of classification that are well suited to the task of explanation. This paper critiques a commonly used typology that aims to inform the explanation of IPA, the Holtzworth-Munroe and Stuart (1994) typology. Measured against recent theoretical developments, the classification system is found to be lacking in its ability to effectively inform explanation and treatment. The value of deriving a classification system based on the goals of human functioning to inform an inclusive approach to the explanation and treatment of IPA is thus considered. The implications of rethinking the way classification systems of intimate partner abuse are developed for prevention of this public health issue is also contemplated.

Donovan C., Barnes R.

Despite growing research into domestic violence and abuse (DVA) in lesbian, gay, bisexual and/or trans (LGB and/or T) people’s relationships, LGB and/or T people remain largely invisible in DVA policy and practice. Research evidence indicates that they primarily seek help from privatised sources such as counsellors/therapists and friends. The gap in knowledge about LGB and/or T victims/survivors’ help-seeking reflects and reinforces the success of neoliberal trends in privatising social problems by promoting self-care and individual responsibility. Using qualitative data from a mixed-methods UK study, this article offers an ecological analysis of LGB and/or T victims/survivors’ help-seeking decisions and barriers, demonstrating how cisgendered heteronormativity and LGBT invisibility permeate help-seeking at individual, interpersonal and socio-cultural levels. The conclusion argues for LGBT DVA to be recognised as a social problem rather than a private trouble. Recommendations are offered for necessary steps towards better recognising and supporting LGB and/or T victims/survivors.

Laskey P., Bates E.A., Taylor J.C.

The traditional view of intimate partner violence (IPV) is that the perpetrator is male and the victim is female (Dobash, Dobash, Wilson & Daly, 1992). As a result of this, most research into victimisation experiences appears to be conducted with female victims of IPV (Morin, 2014), and research with male victims, and victims from the LGBTQ+ community is less common. The main aim of the current research was to conduct a systematic literature review to synthesise the literature base of IPV victimisation experiences to ascertain how abuse is experienced, and the effects of that abuse. The secondary aim was to investigate the prevalence of different victim groups, across gender and sexuality, in current research studies. The review highlighted that victims of IPV experience several different types of abuse and the negative mental and physical health outcomes associated with that abuse are significant. Additionally, it was found that the large majority of research studies included in the review were conducted with female victims in opposite-sex relationships, and were quantitative and cross-sectional in nature. The implications of these findings are discussed and suggestions for future research are put forward.

Salomaa A.C., Matsick J.L.

In this article, we review basic research on sexual orientation for a clinical scientist-practitioner audience. We present contemporary and evolving approaches to defining and measuring sexual orientation, and we provide suggestions for how to translate psychological theory into best practices (i.e., how to select appropriate sexuality measures in both research and clinical settings). Our focus is on evaluating currently available measures of sexual orientation in terms of comprehensiveness and feasibility: How thoroughly are components of sexuality captured and how feasible it is to use such measures in research and clinical settings? Basic research in sexuality has progressed beyond our current clinical practices and should be used as a guide to more responsibly conceptualize participants and clients. While we determine that the current options are far from perfect, the critical clinician will find that contemporary measures of sexual orientation prove more useful than more simplistic predecessors. This review will elucidate best strategies for translating sexual orientation research and theory into clinical practice and provide clinicians and researchers alike with theoretically grounded support for tools of measurement and assessment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Rollè L., Giardina G., Caldarera A.M., Gerino E., Brustia P.

Over the past few decades, the causes of and intervention for Intimate Partner Violence (IPV) have been approached and studied. This paper presents a narrative review on IPV occurring in same sex couples, that is, same sex IPV (SSIPV). Despite the myth that IPV is exclusively an issue in heterosexual relationships, many studies have revealed the existence of IPV among lesbian and gay couples, and its incidence is comparable to (Turell, 2000) or higher than that among heterosexual couples (Kelley et al., 2012; Messinger, 2011). While similarities between heterosexual and lesbian, gay, and bisexual (LGB) IPV were found, unique features and dynamics were present in LGB IPV. Such features are mainly related to identification and treatment of SSIPV in the community and to the need of taking into consideration the role of sexual minority stressors. Our findings show there is a lack of studies that address LGB individuals involved in IPV; this is mostly due to the silence that has historically existed around violence in the LGB community, a silence built on fears and myths that have obstructed a public discussion on the phenomenon. We identified the main themes discussed in the published studies that we have reviewed here. The reviews lead us to the conclusion that it is essential to create a place where this subject can be freely discussed and approached, both by LGB and heterosexual people.

Lelaurain S., Graziani P., Lo Monaco G.

Abstract. Intimate partner violence (IPV) is a global social concern: many women are affected by this phenomenon and by the difficulty of putting an end to it. This review of the literature aims to identify help-seeking facilitating and inhibiting factors in response to IPV. It was carried out on the PsycINFO and Medline databases using the following keywords: “intimate partner violence,” “domestic violence,” “help-seeking,” and “help-seeking barrier.” Ninety out of 771 eligible publications were included on the basis of inclusion criteria. The results highlight that (1) research on this phenomenon is very recent and underdeveloped in Europe, (2) theoretical and conceptual frameworks are poorly developed and extended, (3) there is a significant impact of violence characteristics (e.g., severity, type) on help-seeking, and (4) help-seeking is a complex and multifactorial process influenced by a wide range of factors simultaneously individual and social. To conclude, these findings lead us to propose a psychosocial conceptualization of the help-seeking process by indicating how the levels of explanation approach in social psychology can be applied to this field of research in order to increase our understanding of this phenomenon.

Shelton S.Z.

Since the foundations of the contemporary anti-violence movement in the 1960s and 1970s, advocates have sought to establish a critical understanding of domestic violence that we can use to direct our efforts for social change. Yet many advocates and advocacy organizations continue to rely on a problematic narrative of sameness that marginalizes and erases diverse victims' experiences and needs. In this article, I conduct a critical discourse analysis of the National Coalition Against Domestic Violence Web site to identify outcomes of this narrative for the inclusivity of advocacy efforts. I argue that despite the organization's numerous claims to represent diverse victims' experiences, Web site content reveals that its purportedly general account of domestic violence normalizes the experiences of a small group of victims-namely, heterosexual, cisgender women. Further, the Web site's content greatly limits the potential for thinking about and discussing violence across difference. I conclude with recommendations for changes in advocacy practices.