Home > Public Resources > Trauma Blog > 2022 - September LGBTQIA+ Issues: Domestic Violence in the LGBTQ+ Community: A Silent Pandemic Truc Vi Duong, MD, and Gino Mortillaro, MD September 29, 2022 The history of violence against the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community has been originally tied to the notion of disparate identities. Stereotypes permeate popular perception associating homosexuality with criminal activity, mental illness, and deviance. These views, despite some progress in awareness about the LGBTQ+ community, have resulted in a continued cycle of ridicule, harassment, discrimination, trauma, and even death.1 Among all forms of violence faced by the LGBTQ+ community, domestic violence is often overlooked. In September 2017, the British LGBTQ+ charity Stonewall found that one in five LGBTQ+ people have faced a hate crime in the previous year, an upward trend of 78% in comparison to 2013.2 LGBTQ+ communities have seen a rapid increase in homophobia and transphobia in daily life, which can lead to a negative effect on mental well-being. Half of LGBTQ+ people (52%) reported experiencing depression, and one in eight LGBTQ+ people reported suicidal attempts in 2016.2 Domestic violence (DV) or intimate partner violence (IPV) is a serious preventable public health problem that happens within the context of romantic relationships, involving acts of physical, sexual, emotional, and psychological abuse or controlling behaviors.3,4 According to the Centers for Disease Control and Prevention (CDC), over 43 million women and 38 million men have reported experiencing IPV in their lifetimes.5 Consequences of IPV can range from physical injuries to serious mental illnesses (for example, PTSD, depression, anxiety, substance use) and even death. Traditionally, research into this public health problem has focused on heterosexual relationships and neglected the LGBTQ+ community, although, in recent years, the literature has become increasingly inclusive.3,6,7 The CDC estimated that in the U.S. general population, 35% of heterosexual women experienced any type of IPV (rape, physical violence, and/or stalking) in their lifetime, compared with 31.9-43.8% of lesbians and approximately 52-61.1% of bisexual women in 2010.8,9 On the other hand, the CDC reported that 29% of heterosexual men had experienced any type of IPV in their lifetime, compared to 26-26.9% of gay men and 19.6-37.3% of bisexual men. Additionally, the lifetime prevalence of severe physical violence is 23.6% for heterosexual women, 29.4% for lesbians, and 49.3% for bisexual women.8,9 Approximately 13.9% of heterosexual men and 16.4% of gay men experienced severe physical violence in intimate relationships.8,9 A report in 2010 states that the lifetime prevalence of IPV in transgender individuals is around 45%.10 Research has consistently found that LGBTQ+ people are at least at the same rate or more likely to be victims of IPV than their heterosexual counterparts, and they face additional challenges when trying to escape their abusers.4,6,11,12 Previous experiences with violence and discrimination, combined with a community's inability to adequately respond, can lead LGBTQ+ victims to be less likely to seek assistance when experiencing IPV.13 LGBTQ+ victims of domestic violence often feel pressured to stay in abusive relationships because of the mixed perceptions that they don't have similar legal protections and social acceptance as heterosexual couples.11,14 The higher rate of homelessness among LGBTQ+ individuals due to family rejection15 also places this population at an increased risk of IPV. Due to the common assumption that IPV is a male-perpetrated, heterosexual experience, LGBTQ+ IPV shelter services are rare to non-existent in many areas.13 In some cases, transgender women are legally fenced from receiving help at violence against women organizations due to the belief that their presence could create an unsafe environment for cisgender female survivors.16 Discussion surrounding IPV in the LGBTQ+ population has been generally avoided due to fear that it will further stigmatize this minority group and challenge the effort to reinforce the notion that LGBTQ+ relationships are healthy and non-pathological.16 Some abusers even take advantage of the notion that domestic violence can only happen in a heterosexual relationship to convince their partners that abuse is not violent if it happens between two women or two men. Violence within LGBTQ+ relationships is sometimes “sexified”; for example, people might assume the perpetrator is always the more masculine partner.17 Persistent stereotypes about domestic violence as an act committed by a more masculine partner may contribute to LGBTQ+ victims feeling concerned that they will not be understood or believed when disclosing the abuse. Additionally, LGBTQ+ victims and perpetrators of IPV often share the same social network.18 Therefore, IPV survivors have expressed fears that information shared to mutual friendship connections may be taken lightly and could make its way back to the perpetrators.18 IPV victims tend to seek support from friends and families instead of seeking professional help.19 Consequently, the risk of isolation and rejection from friends and family make it more challenging for IPV victims to separate from abusers in the LGBTQ+ community. The fear of “outing” someone or oneself is unique in the LGBTQ+ community and can pose a threat to LGBTQ+ individuals and act as a barrier to seeking help.11,16 LGBTQ+ people who are still “in the closet” might not want to risk losing love and respect from family and friends if others discover they are IPV victims in non-heterosexual relationships.11 Hence, LGBTQ+ IPV victims may be reluctant to ask for professional help due to the fear of confidentiality breaches and/or potential discrimination from providers.11,16 The LGBTQ+ community is at a higher risk for domestic violence than their heterosexual counterpart because of a lack of resources, protections, and discrimination, particularly in states that do not have anti-discrimination laws. With the rapidly increasing rate of IPV worldwide due to the current COVID-19 pandemic, it is even more crucial for organizations to make an effort to mitigate the risks of this silent pandemic. Compared to the general population, LGBTQ+ people face additional barriers distinctive to their sexual orientation while trying to leave their abusers. These are several recommendations to target those barriers: Raise awareness regarding the elevated prevalence of IPV in the LGBTQ+ community and their unique difficulties while leaving abusers Provide education that this public health problem does not pathologize non-heterosexual relationships or their sexual orientation or gender identity Increase funding for LGBTQ+-friendly shelters/safe housing options11,15 Develop legal protections addressing IPV in the LGBTQ+ community11,14,16 Increase health care providers’ competency and sensitivity to LGBTQ+ violence issues11,16 Screen for IPV regardless of sexual orientation or gender identity Here are suggestions for future research: Conduct research to assess the effectiveness of programs devoted to reducing the prevalence of IPV among LGBTQ+ people11 Study domestic violence prevalence in other marginalized identity subgroups such as non-binary or intersex individuals Explore the impact of racial minority stress on IPV in the LGBTQ+ community About the Authors Dr. Gino Mortillaro was born and raised in New Orleans, Louisiana, where he previously competed for USA Gymnastics as a professional gymnast prior to pursuing his medical education. He stayed in New Orleans to complete his college and medical schooling at Tulane University before moving to Boston to complete his residency and fellowship with Harvard Medical School at the Harvard South Shore and Boston Children’s Hospital programs, respectively. Throughout his education, Dr. Mortillaro has had the opportunity to spearhead development of LGBT+ focused educational initiatives and research aimed to reduce the health disparities for this patient population. Currently, Dr. Mortillaro is a partner physician in the Kaiser Permanente Healthcare System in Southern California where he serves as core faculty for the residency and fellowship programs as well as an associate clinical professor at the Kaiser Permanente School of Medicine. His research interests are varied, but his particular focuses include large scale database mining studies, gender and sexual minority mental health, borderline personality disorder, and the interface of media and mental health. In his spare time, Dr. Mortillaro enjoys spending time with his husband and two dogs as well as traveling and playing volleyball. Dr. Truc Vi Huynh Duong was born in Vietnam. She immigrated to the U.S. at the age of 17 and initially resided in Portland, Oregon. Dr. Duong went to the University of Portland to complete her Bachelor of Science degree in biochemistry before earning her Doctor of Medicine degree in Rochester, Michigan. Too tired of the snow, Dr. Duong moved back to the West Coast to finish her general psychiatry residency in Visalia, California. She is currently a second-year Child & Adolescent Psychiatry Fellow at Kaiser Permanente, Fontana, California. Her research interests mainly focus on early childhood trauma, LGBTQ+, cultural psychiatry, and intimate partner violence. Dr. Duong was selected as a 2022-2023 SAMHSA Minority Fellow by the American Psychiatric Association. Through this honored fellowship program, Dr. Duong will receive federal funding to develop and execute a project using YouTube videos to target the public health issue of increasing domestic violence and substance use during the COVID-19 pandemic in the Asian community. In her free time, Dr. Duong enjoys singing karaoke, watching thriller movies, playing pickleball, and spending time with her girlfriend and two cats. References Dworkin SH, Yi H. LGBT Identity, Violence, and Social Justice: The Psychological Is Political. Int J Adv Couns. 2003;25(4):269-279. doi:10.1023/B:ADCO.0000005526.87218.9f Bachmann CL, Gooch B. Hate Crime and Discrimination. Published online 2017. Accessed June 10, 2022. Graham LM, Jensen TM, Givens AD, Bowen GL, Rizo CF. Intimate Partner Violence Among Same-Sex Couples in College: A Propensity Score Analysis. J Interpers Violence. 2019;34(8):1583-1610. doi:10.1177/0886260516651628 Reuter TR, Newcomb ME, Whitton SW, Mustanski B. Intimate Partner Violence Victimization in LGBT Young Adults: Demographic Differences and Associations with Health Behaviors. Psychol Violence. 2017;7(1):101-109. doi:10.1037/vio0000031 The Centers for Disease Control and Prevention. Preventing Intimate Partner Violence.; 2021. Accessed June 10, 2022. Langenderfer-Magruder L, Whitfield DL, Walls NE, Kattari SK, Ramos D. Experiences of Intimate Partner Violence and Subsequent Police Reporting Among Lesbian, Gay, Bisexual, Transgender, and Queer Adults in Colorado. J Interpers Violence. 2016;31(5):855-871. doi:10.1177/0886260514556767 Whitfield DL, Walls NE, Langenderfer-Magruder L, Clark B. Queer Is the New Black? Not So Much: Racial Disparities in Anti-LGBTQ Discrimination. J Gay Lesbian Soc Serv. 2014;26(4):426-440. doi:10.1080/10538720.2014.955556 Walters ML, Chen J, Breiding MJ. The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Findings on Victimization by Sexual Orientation.; 2013. Accessed June 10, 2022. Goldberg NG, Meyer IH. Sexual Orientation Disparities in History of Intimate Partner Violence. J Interpers Violence. 2013;28(5):1109-1118. doi:10.1177/0886260512459384 Roch A, Ritchie G, Morton J. Out of Sight, Out of Mind?: Transgender People’s Experiences of Domestic Abuse.; 2010. Brown TNT, Herman JL. Intimate Partner Violence And Sexual Abuse Among LGBT People: A Review of Existing Research.; 2015. Stephenson R, Finneran C. Minority Stress and Intimate Partner Violence Among Gay and Bisexual Men in Atlanta. Am J Mens Health. 2017;11(4):952-961. doi:10.1177/1557988316677506 Ard KL, Makadon HJ. Addressing Intimate Partner Violence in Lesbian, Gay, Bisexual, and Transgender Patients. J Gen Intern Med. 2011;26(8):930-933. doi:10.1007/s11606-011-1697-6 LGBT Domestic Violence Fact Sheet.; 2011. Accessed July 1, 2022. Waters E, Misclevitz C, Diamond K, et al. Lesbian, Gay, Bisexual, Transgender, Queer,and HIV-Affected Hate Violence in 2016.; 2016. www.ncavp.org Barrett BJ. Domestic Violence in the LGBT Community. In: Encyclopedia of Social Work. NASW Press and Oxford University Press; 2015. doi:10.1093/acrefore/9780199975839.013.1133 HRCStaff. Common Myths about LGBTQ Domestic Violence. The Human Rights Campaign. Published October 18, 2017. Accessed June 10, 2022. https://www.hrc.org/news/common-myths-about-lgbtq-domestic-violence Turell SC, Herrmann MM. “Family” Support for Family Violence: Exploring Community Support Systems for Lesbian and Bisexual Women Who Have Experienced Abuse. J Lesbian Stud. 2008;12(2-3):211-224. doi:10.1080/10894160802161372 Wong JWH, La V V, Lee SE, Raidoo S. The ALOHA Study: Intimate Partner Violence in Hawai’i’s Lesbian, Gay, Bisexual, and Transgender Community. Vol 79.; 2020.