8/13/2018 L GBT T r auma and Dome stic Viole nc e : Wha t c linic ia ns ne e d to know JOHN M. O’ BRI E N, PH.D. ME NT AL HE AL T H ASSOCI AT E S OF MAI NE 251 WOODF ORD ST . PORT L AND, ME 04103 AUGUST 17, 2018 L GBT T ra uma a nd Dome stic Viole nc e By the e nd of this wor kshop, pa rtic ipa nts will be a ble to: ide ntify a nd disc uss issue s o f re le va nc e to se xua l o rie nta tio n a nd/ o r g e nde r ide ntity disc uss the e xpe rie nc e s o f tra uma in L GBT c lie nts, inc luding mic ro - a g g re ssio ns. unde rsta nd the e xpe rie nc e s o f do me stic vio le nc e fa c e d b y me mb e rs o f the L GBT c o mmunity a nd wa ys to e ffe c tive ly inte rve ne imple me nt pra c tic a l skills fo r sc re e ning , a sse ssing a nd suppo rting L GBT c lie nts who a re e xpe rie nc ing tra uma a nd do me stic vio le nc e . L GBT T ra uma a nd Dome stic Viole nc e OVE RVIE W OF PRE SE NT AT ION 1
8/13/2018 L GBT T ra uma a nd Dome stic Viole nc e Ke y T e rms Se x ve rsus Ge nde r Ge nde r ide ntity/ Ge nde r e xpre ssio n Se xua l o rie nta tio n T ra nsg e nde r Cisg e nde r Co ming o ut He te ro se xua l privile g e Ho mo pho b ia Inte rna lize d Oppre ssio n (Ho mo pho b ia / Bipho b ia / T ra nspho b ia ) L GBT T ra uma a nd Dome stic Viole nc e Ke y T e rms: L GBT QQIP2SAA L e sb ia n Ga y Bise xua l T ra nsg e nde r Que e r Que stio ning Inte rse x Pa nse xua l 2 spirit Ase xua l Ally L GBT T ra uma a nd Dome stic Viole nc e History of L GBT Community Anc ie nt histo ry E uro pe a n histo ry Unite d Sta te s histo ry So do my la ws 1950’ s: Ma tta c hine So c ie ty/ Da ug hte rs o f Bilitis 1960’ s : Civil Rig hts a nd June 28, 1969 Stone wall Inn 1970’ s: Unite d Churc h o f Christ/ PF L AG/ Na tio na l L e sb ia n/ Ga y T a sk F o rc e / Huma n Rig hts Ca mpa ig n 1980’ s thro ug h to da y: ACT UP/ Que e r Na tio n/ Do n’ t Ask Do n’ t T e ll 2
8/13/2018 L GBT T ra uma a nd Dome stic Viole nc e Adole sc e nts Suic ida lity L GBT Yo uth De pre ssio n (SAMHSA, 2014) 4 to 5 time s mo re like ly to a tte mpt suic ide (Ahuja , 2016); inc re a se d risk o f suic ide risk o utc o me s (Sto ne , e t a l, 2014) I mpo rta nc e o f fa mily re spo nse (L e vy, Russo n & Dia mo nd, 2016) Culture a nd ne ig hb o rho o d (Dunc a n & Ha tze nb ue hle r, 2014) L GBT T ra uma a nd Dome stic Viole nc e Adole sc e nts Bullying De finitio n L GBT Yo uth a t inc re a se d risk b ut a lso re silie nc e (Ma rsto n, 2015; Pizmo ny-L e vy & K o sc iw, 2016)) L e g a l o ptio ns (K imme l, 2016) Sc ho o ls (Ma rsto n, 2015) Suppo rt Sa fe e nviro nme nt Ga y-Stra ig ht a llia nc e Pro te c t priva c y L GBT T ra uma a nd Dome stic Viole nc e Adole sc e nts Cybe rbullying : Ke y F inding s on Bullying / Ha ra ssme nt a nd Sa fe ty L GBT yo uth we re ne a rly thre e time s a s like ly a s no n-L GBT yo uth to sa y the y ha d b e e n b ullie d o r ha ra sse d o nline (42% vs. 15%) a nd twic e a s like ly to sa y the y ha d b e e n b ullie d via te xt me ssa g e (27% vs 13%). 1 in 4 L GBT yo uth (26%) sa id the y ha d b e e n b ullie d o nline spe c ific a lly b e c a use o f the ir se xua l o rie nta tio n o r g e nde r e xpre ssio n in the pa st ye a r, a nd 1 in 5 (18%) sa id the y ha d e xpe rie nc e d b ullying a nd ha ra ssme nt fo r the se re a so ns via te xt me ssa g e . (GL SE N, 2013). 3
8/13/2018 L GBT T ra uma a nd Dome stic Viole nc e Adole sc e nts Cybe rbullying : Ke y F inding s on Bullying / Ha ra ssme nt a nd Sa fe ty 1 in 3 (32%) L GBT re spo nde nts sa id the y ha d b e e n se xua lly ha ra sse d o nline in the pa st ye a r. 1 in 4 L GBT yo uth (25%) sa id the y ha d b e e n se xua lly ha ra sse d via te xt me ssa g e . L GBT yo uth we re fo ur time s a s like ly a s no n-L GBT yo uth to sa y the y ha d b e e n se xua lly ha ra sse d o nline (32% vs. 8%) a nd thre e time s a s like ly to sa y the y ha d b e e n se xua lly ha ra sse d via te xt me ssa g e (25% vs. 8%). (GL SE N, 2013). L GBT T ra uma a nd Dome stic Viole nc e Adole sc e nts Vio le nc e De finitio n a nd inc re a se d risk (CDC, 2017) Yo uth Risk Be havio r Sur ve y (CDC, 2015): L GB stude nts 10% we re thre a te ne d o r injure d with a we a po n o n sc ho o l pro pe rty 34% we re b ullie d o n sc ho o l pro pe rty 28% we re b ullie d e le c tro nic a lly 23% who ha d da te d o r we nt o ut with so me o ne during the 12 mo nths b e fo re the surve y ha d e xpe rie nc e d se xua l da ting vio le nc e in the prio r ye a r 18% ha d e xpe rie nc e d physic a l da ting vio le nc e 18% ha d b e e n fo rc e d to ha ve se xua l inte rc o urse a t so me po int in the ir live s. L GBT T ra uma a nd Dome stic Viole nc e Adole sc e nts Cybe r se lf-har m o r Digital se lf-har m Digital se lf-harm , a s it ha s b e e n te rme d, o c c urs whe n a n individua l c re a te s a n a no nymo us o nline a c c o unt a nd use s it to pub lic ly se nd hurtful me ssa g e s o r thre a ts to o ne ’ s se lf. the “ ano nymo us o nline po sting, se nding, o r o the rwise sharing o f hurtful c o nte nt abo ut o ne se lf .” Mo st c o mmo nly, it ma nife sts a s thre a ts o r ta rg e te d me ssa g e s o f ha te – the mo re e xtre me a nd ra re fo rms o f c yb e rb ullying . Hinduja & Pa tc hin, 2017 4
8/13/2018 L GBT T ra uma a nd Dome stic Viole nc e Adole sc e nts Cybe r se lf-har m or Digital se lf-har m 6% o f tho se who re spo nde d sa id the y ha d a no nymo usly po ste d so me thing o nline a b o ut the mse lve s tha t wa s me a n. Mo re b o ys a dmitte d to do ing it tha n g irls Co rre la te s o f dig ita l se lf-ha rm, b e ing no n-he te ro se xua l, e xpe rie nc ing b ullying a t sc ho o l o r b ullying o nline , using drug s o r pa rtic ipa ting in de via nt b e ha vio r, a nd ha ving de pre ssive tho ug hts a nd pa rtic ipa ting in o ff-line se lf-ha rm b e ha vio rs. Hinduju & Pa tc hin 2017; Pa tc hin & Hinduju, 2017 L GBT T ra uma a nd Dome stic Viole nc e Oppr e ssion Strug g le fo r Civil Rig hts I nc re a se d a c c e pta nc e o f L GBT pe o ple in the Unite d Sta te s o ve r the la st fo ur de c a de s Pro te c tio n fro m disc rimina tio n Ma rria g e I nc re a se d visib ility in pub lic o ffic ia ls, me dia I nc re a se d visib ility le a ds to inc re a se in ta rg e ting o f L GBT pe o ple O’ Brie n, 2017 L GBT T ra uma a nd Dome stic Viole nc e 5
8/13/2018 L GBT T ra uma a nd Dome stic Viole nc e Oppre ssion He a lth dispa ritie s Why impo rta nt? Histo ry o f a nti-L GBT b ia s in he a lthc a re No L GBT dise a se s b ut spe c ific he a lth dispa ritie s Mo re diffic ulty with a c c e ss to he a lthc a re a nd mo re like ly with unme t he a lth ne e ds Inc re a se d risk o f de pre ssio n, a nxie ty, suic ida l ide a tio n, sub sta nc e a b use Inc re a se d ra te s o f HIV a nd ST I’ s in g a y me n a nd MtFtra nsg e nde r individua ls L e sb ia ns a nd b ise xua l wo me n inc re a se d risk o f o b e sity, a sthma , smo king , drinking a s c o mpa re d to he te ro se xua l wo me n (F re dric kse n-Go ldse n, e t a l, 2013) L GBT T ra uma a nd Dome stic Viole nc e Oppr e ssion He a lth dispa ritie s L e ss pre va le nt in a re a s whe re the re is g re a te r suppo rt fo r sa me -se x ma rria g e (Ha tze nb ue hle r, F lo re x & Ga te s, 2017) L GB a dults (F re drikse n-Go lso n, e t a l., 2017) I nc re a se d risk o f we a ke ne d immune syste m, lo w b a c k/ ne c k pa in I nc re a se d risk o f disa b ility a nd me nta l distre ss. L e sb ia ns/ b ise xua l wo me n inc re a se d risk o f a rthritis, a sthma , he a rt a tta c k, stro ke , hig he r numb e r o f c hro nic c o nditio ns, a nd po o r g e ne ra l he a lth. Ga y/ b ise xua l me n inc re a se d risk o f c a nc e r a nd a ng ina , mo re like ly to b e c urre nt smo ke rs a nd e xc e ssive drinke rs. L GBT T ra uma a nd Dome stic Viole nc e Oppr e ssion Anti-L GBT vio le nc e Ha te c rime de finitio n Histo ry in the Unite d Sta te s Cha rlie Ho wa rd 1984 Re b e c c a Wig ht a nd Cla udia Bre nne r 1988 Sc o tt Ame dure 1995 Ma tthe w She pa rd 1998 Se a ttle 2013 6
8/13/2018 L GBT T ra uma a nd Dome stic Viole nc e Oppre ssion Anti-L GBT vio le nc e Re c e nt e ve nts Orla ndo , PUL SE nig htc lub June 2016 Che c hnya , April 2017 2017 sta tistic s 36 L GBT a nd HI V-a ffe c te d pe o ple murde re d so fa r this ye a r a s o f Aug ust 23, mo st e ve r 2015 Ma ine ha te c rime s L GBT T ra uma a nd Dome stic Viole nc e Ha te Crime s L GBT T ra uma a nd Dome stic Viole nc e Ha te Crime s: Ma ine 2016 7
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