ABSTRACT
Violence that occurs within intimate relationships, also referred to as intimate partner violence (IPV), domestic violence, dating violence, or partner abuse, is widely accepted as a national social crisis and preventable public health issue that affects millions of individuals in the United States. Although researchers have recently begun to give attention to this issue, there is a limited amount of data concerning its prevalence and clinical consequences within lesbian communities. This literature synthesis will provide a critical analysis of available research on IPV among lesbians in the United States. Understanding the circumstances surrounding IPV within lesbian communities will provide an opportunity to better address the myriad of negative health outcomes associated with both intimate partner violence and sexual minority status. Acquiring this information will allow researchers to better tailor response efforts to lesbian survivors of intimate partner violence. The finding of high rates of self-reported IPV victimization and perpetration among women in same-sex relationships defies the conventional notion that such violence solely afflicts heterosexual women.
TABLE OF CONTENTS
1.0Introduction
2.0BACKGROUND
3.0METHODS
4.0RESULTS
4.1PREVALENCE RATES OF VICTIMIZATION AND PERPETRATION of different forms of intimate partner violence among lesbians
4.2risk factors for ipv perpetration and consequences of sexual minority victimization experiences
5.0discussion
6.0conclusion
bibliography
List of tables
Table 1. Description of Primary Studies
1
1.0 Introduction
Violence that occurs within intimate relationships, also referred to as intimate partner violence (IPV), domestic violence, dating violence, or partner abuse, is widely accepted as a national social crisis and preventable public health issue that affects millions of individuals in the United States. Domestic violence against women has been considered for several decades to be a very serious public health problem (Krantz, 2002). The National Center for Injury Prevention and Control, Centers for Disease Control and Prevention defines intimate partner violence as physical, sexual, or psychological harm by a current or former partner or spouse in order to maintain control over their partner and their relationship (Breiding, Chen,and Black, 2014). Saltzman et al. (1999) continues to delineate the different forms in which an abusive person can commit violence: physical violence, sexual violence, threats of physical or sexual violence, and psychological or emotional violence. The World Health Organization (2012) expands on these definitions with the following:
IPV refers to any behavior within an intimate relationship that causes physical, psychological or sexual harm to those in the relationship, including but not limited to: physical violence, such as slapping, hitting, kicking and beating; sexual violence, including forced sexual intercourse and other forms of sexual coercion; emotional abuse, such as insults, belittling, constant humiliation, intimidation (e.g. destroying things), threats of harm, threats to take away children; controlling behaviors, including isolating a person from family and friends; monitoring their movements; and restricting access to financial resources, employment, education or medical care.
These seemingly blanket definitions further highlight the reality of intimate partner violence as a pervasive issue, as it can occur in and affect short or long-term relationships, between current or previous partners, among all age groups, and all socioeconomic, religious and cultural communities. Intimate partner violence has the potential to affect anyone.
In the United States, intimate partner violence is receiving attention as a preventable public health crisis that results in negative physical, psychological, social consequences for individuals as well as financial costs for society. The 2014 National Intimate Partner and Sexual Violence Survey revealed that 20 people per minute are victims of physical violence by an intimate partner in the United States, with nearly 1 in 2 women experiencing sexual violence victimization other than rape at some point in their lives and more than 1 in 2 women indicating a stalking incident before age 25 (Breiding, Smith, Basile, Walters, Chen, and Merrick, 2014). Further, 27% of women who have experienced sexual violence, physical violence, or stalking by an intimate partner later reported significant impacts including post-traumatic stress disorder and severe physical injury (Breiding, Smith, and Basile, et al., 2014).
Public discussion surrounding intimate partner violence arose in the 1970s and 1980s in [BJG1][Office2][Office3]part as a response to the numerous feminist and women’s rights movements, which began gaining speed during that time. Major social and political efforts were made to end the structural and cultural sexism that encouraged and allowed men to misuse their masculine privilege by abusing the women and children in their lives. As a result of these women’s liberation efforts, women survivors were given the space and encouragement to step forward and expose the details surrounding the conditions of daily life and subsequently seek help. The Battered Women’s movement started the proliferation of intimate partner violence research. These efforts influenced the development of some of the first resources for survivors of IPV including the origination of the nation’s first domestic violence shelters and crisis hotlines, both of which offered new resources for women and their children. Such support services provided an environment for researchers to evaluate the experiences of survivors and quantify the power and control used as a dynamic in abusive relationships.
The result of these women’s liberation efforts included an explosion of research on and funding for intimate partner violence and evidenced-based prevention and intervention efforts. Subsequently, it was discovered that although the reality that intimate partner violence has the potential to affect everyone, it does not affect everyone equally. Lipsky, Caetano, and Roy-Byrne (2009) utilized a retrospective cohort study to link the adult male-to-female IPV police records of women residing in a south central U.S. city with regional hospital discharge data. With respect to racial and ethnic disparities in police-reported intimate partner violence and risk of hospitalization among women, rates were 2-3 times higher among Black and Hispanic women when compared with White women, while hospitalization rates were higher among Black and White victims and lower among Hispanic victims (Lipsky, Caetano, and Roy-Byrne, 2009). Powers and Kaukkinen (2012) concluded that the rate of victimization for employed women is partly contingent on the victims’ race, discovering that employed non-White women are at a slightly increased risk of intimate partner assault when compared to employed White women. In a nationally representative sample of 1,421 persons in care for HIV and who reported having a spouse or primary relationship, bivariate analyses indicated that African Americans and Latinos had significantly elevated probabilities of being both perpetrators and victims of IPV when compared to Whites (Galvan, Collins, Kanouse, Burnam, Paddock, Beckman, and Mitchell, 2004). In a study of 71,764 individuals recruited to participate in the National Household Survey on Drug Abuse, Cunradi (2007) conducted separate analyses for men versus women by race and ethnicity. The odds of being in a relationship characterized as mutually violent were significantly elevated for both Non-Hispanic Black men as compared to White men and for Non-Hispanic Black women as compared to White women. These statistics suggest that that racial minority status may play a part in documented rates of IPV.
Similarly, an interesting disparity exists in male perpetration of intimate partner violence based on immigration status. When researchers examined 1,668 men from aged 18-35 who were recruited from community health centers and anonymously completed an automated, computer-assisted self-interview, recent immigrants (less than 6 years in the U.S.) were less likely to report IPV perpetration than non-recent immigrants (more than 6 years in the U.S.) and U.S. citizens (Gupta, Acevedo-Garcia, Hemenway, Decker, Raj, and Silverman, 2010). This data seems to suggest that the longer a man resides in the United States following immigration, the more likely he is to become a perpetrator of intimate partner violence. Wright and Benson (2010) noted that, despite the crime-promoting effects of economic disadvantage that many immigrant populations face, neighborhoods with greater concentrations of immigrants have lower levels of intimate partner violence. These apparently contradicting conclusions may suggest that men who immigrate to the United States may eventually assimilate to its notions of masculinity and incorporation of violence with respect to power and authority, eventuallyplacing themselves at higher risk for perpetrating intimate partner violence. This phenomenon was investigated by Bourgois (1996), whose research described how Puerto Rican men growing up in New York slums feel pressurized by models of masculinity and family of their parents' and grandparents' generations, and present-day ideals of successful manhood in the United States that emphasize material gain. In these circumstances, ideals of masculinity are reshaped to emphasize misogyny, so substance use, participation in crime, and violence against women become social norms in which men are violent towards women they can no longer control or economically support (Bourgois, 1996).
Poverty and associated socioeconomic stress are also key contributors to the prevalence of intimate partner violence. Until recently, the connection between intimate partner violence and persistent poverty had been largely ignored. Recent research indicates, however, that the two phenomena co-occur at high rates. A cross-sectional study of socioeconomic disparities in intimate partner violence against Native American women revealed that more than half of participants reported lifetime physical and/or sexual IPV,while past-year IPV prevalence was 42.8% among women scoring low on the socioeconomic index (Malcoe, Duran, and Montgomery, 2004). In a study that utilized data from the Project on Human Development in Chicago Neighborhoods, Wright and Benson (2010) concluded that older women with higher levels of education living in higher income households are less likely to experience IPV, while concentrated disadvantage and residential instability operated by increasing the likelihood of experienced partner violence. Sutherland, Sullivan, and Bybee (2001) took a community sample of 397 women from a mid-size urban area in the upper Midwest, about half of whom had been assaulted by an intimate partner. These women were interviewed about their income, experience of physical abuse, and physical health. Hierarchical multiple regression revealed that abuse was significantly more strongly associated with health symptoms at lower levels of income and overall findings suggested that abuse by an intimate partner or ex-partner negatively affects women's health and is especially detrimental to the health of low-income women (Sutherland, Sullivan, and Bybee, 2001).
As a result of the battered women’s movement’s efforts focus to illuminate the abuse of patriarchy, male power, and privilege, the investigative and historical understanding of domestic violence largely excluded lesbian communities. There was virtually no research or literature on IPV within the context of lesbian women until the late 1980s and early 1990s. Historically, however, most research concerning intimate partner violence did not specifically address sexual identity, sexual attraction, or sexual behavior along a spectrum. Rather, the traditional gender binary was typically the extent to which sexual orientation was investigated at this stage. Further, it was not uncommon for investigators to simply assume that bisexual and lesbian women were actually heterosexual, or to exclude altogether from their analysis transgender men and women, gay and bisexual men, and heterosexual-identified men who have sex with men.
The following literature review will discuss the available research surrounding the prevalence of intimate partner violence experienced and perpetrated by self-identified lesbians in the United States. Examining social, political, and health disparities experienced by this population in correlation with their risk factors for experiencing intimate partner violence can better inform current prevention and future intervention efforts. Both historically and currently, the majority of partner violence interventions focus on heteronormative populations and settings. Many are psychoeducational in nature, aimed at highlighting the issue as a public health crisis in order to decrease its stigma and promote increased knowledge surrounding the issue. In addition to heterosexuals, lesbian women face different sets of issues with respect to other sexual minority subpopulations (gay, bisexual, trans); therefore, this review recognizes that the distinct health disparities and risk factors unique to self-identified lesbian women should be acknowledged when considering future research and intervention efforts.
The central research question focuses on whatvictimization and perpetration prevalence data has been ascertained on this population, what factors influence the perpetrationof partner violence in lesbian women’s intimate relationships, and what IPV prevention programming needs to be implemented among lesbians as a result of these findings. What are the critical risk factors for IPV among lesbian women? What methodological issues could improve partner violence data among lesbian women? What future interventions could lead to improved prevalence rates for intimate partner violence among lesbian women? This literature review will touch on barriers to help-seeking behavior experienced by lesbian survivors of partner violence and efforts to reduce these barriers Important findings and similarities from the literature will be presented and will be analyzed. Recommendations for future interventions to lessen the impact of intimate partner violence among lesbians will be made based on the findings of the research discussed.
2.0 BACKGROUND
Research suggests that lesbian individuals experience significant health disparities that create both short and long-term health outcomes including high rates of psychiatric disorders and suicide (McLaughlin, Hatzenbuehler, and Keyes, (2010); Remafedi, French, Story, Resnick, and Blum, 1998). Homophobia, transphobia, stigma, and discrimination place members of this community at higher risk for cancer, sexually transmitted diseases, substance abuse, depression, and barriers to care (Peplau and Fingerhut, 2007). Research has established a positive correlation between drug and alcohol abuse and intimate partner violence (Cunradi, Caetano, and Schafer, 2002; El-Bassel, Witte, Wada, Gilbert, and Wallace, 2001; Hirsch, 2001). Higher rates of substance abuse as a response to minority stress among the LGBT community increases this population’s risk of experiencing IPV. Identifying and addressing the needs and challenges associated with lesbians in same-sex relationships is still ongoing, yet it is estimated nationally that lesbians and gay men report IPV and sexual violence over their lifetimes at levels equal to or higher than those of heterosexuals (Breiding, Chen, and Black, 2014). Although organizations have recently begun to give attention to this issue, there is a limited amount of research concerning the prevalence and clinical consequences of IPV within lesbian communities.
Research that identifies solely binary gender identity categories (only men and women) and assumes heterosexuality and cisgender identity as the norm does not accurately capture the variety of gender identities, sexual orientations, and relationship structures within lesbian, gay, bisexual, and transgender, and queer communities. Subsequently, efforts to address intimate partner violence among members of these various sub-populations are often neglected. Similar to the methodological path taken by researchers investigating intimate partner violence between men and women in heterosexual relationships, there appears to be two waves of intimate partner violence research as it pertains to sexual minorities. The first, which focuses on acknowledging the existence and identifying the prevalence of LGBT intimate partner violence along with assessing the need for research and the second, which focuses on delineating disparities among sub-populations and developing appropriate interventions.
Kelly and Warshafsky (1987) conducted nation-wide survey examining factors associated with gay and lesbian partner abuse and reported that about 47% of gays and lesbians have been victims of violent domestic relationships. Renzetti (1989) examined a nationwide sample of 100 battered lesbians recruited through women’s organizations and found that 74% reported 6 or more abusive incidents where pushing and shoving were the most common forms. 69% sought help from friends and 58% sought help from psychologists or social workers and reportedly found these resources more helpful than did those seeking friends’ help (Renzetti, 1989). A self-reported questionnaire administered to 1,925 lesbians from all 50 states revealed that 16% of respondents were physically abused by adult partners; 19% of these respondents reported abuse by females (Bradford, Ryan, and Rothblum, 1994). The National Violence Against Women Survey looked at survey data collected over a 1-year period between 1995 and 1996 from households with a telephone via random-digit dialing (RDD) in the 50 States and the District of Columbia. The survey found that 21.5% of men and 35.4% of women who reported a history of cohabitation with a same-sex partner had experienced physical abuse with that partner; the corresponding rates for men and women with a history of only opposite-sex cohabitation were 7.1% and 20.4%, respectively (Tjadenand Thoennes, 2000). A variety of other studies from this first wave of intimate partner violence among same-sex relationships indicate similar trends and conclude that 25% to 50% of lesbians are victims of domestic abuse (Brand and Kidd, 1986; Lie and Gentlewarrier, 1991; Lockhart, White, Causby, and Issac, 1994).
It is important to realize when reviewing this first wave of research on LGTB IPV that sampling methods were limited due to the fact that homosexual relationships at this time were still very much stigmatized, making participants hard to come by. Consequently, the samples that were taken reflect a predominantly White subject pool, giving an even more disproportionate view of partner abuse in same-sex relationships. The Lie and Gentlewarrier (1991) research relied on data taken from 1099 lesbians attending a women’s music festival in Michigan in 1995, for example. These limitations present a problem: once one finds information on victimized lesbians, there is an absence of lesbians of color in that research. The first wave of both heterosexual and lesbian research concerning intimate partner violence identified abuse in mostly middle to upper class white men and women from similar socioeconomic communities. The samples excluded bisexuals, lesbians of color, and so on. Other groups, particularly transgender individuals, whose gender identity is not concordant with their birth sex or who defy conventional gender classification, may suffer from an even greater burden of IPV. What was needed was a new paradigm through which to view the phenomenon of domestic violence in our society. This paradigm needs to have the ability to incorporate equally the issues of sexism, racism, homophobia, and heterosexism for a more encompassing understanding of domestic violence.