Partner Violence in Transgender Populations: Context, Risk, and Health Impact

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PROJECT SUMMARY/ABSTRACT Intimate partner violence (IPV) is a severe public health problem that can lead to physical injury, mental health issues, economic impairment, HIV/STI transmission risk, and even homicide. Existing literature suggests that transgender (trans, i.e. individuals whose gender is different from their sex assigned at birth) people are heavily impacted by IPV, with lifetime prevalence estimates ranging from 18% to 47%, and are at heightened risk of IPV as compared to non-transgender individuals. IPV against trans individuals often takes on unique dimensions because trans individuals face unique vulnerabilities for IPV. For instance, abusers may undermine a trans partner's self esteem by attacking their gender identity, or blackmail them by threatening to “out” their identity to others. Additionally, trans people are likely to face discrimination and abuse when seeking help from domestic violence shelters, police, or medical providers. Research on IPV among trans individuals is at a nascent stage, and all studies have estimated the prevalence of IPV using brief measures of lifetime IPV that were developed and validated with non-transgender heterosexual populations that do not consider unique forms of trans-specific IPV or only make ad-hoc adjustments. There is an urgent need to better understand the context of, risks for, and health impact of IPV in transgender populations. The proposed study aims to advance our understanding of the unique experience and impact of IPV across diverse trans communities and to develop the first scale validated to measure the experience of IPV among trans individuals. This study will first use qualitative methods to describe the forms of IPV that occur in the relationships of trans men and women, better understand typologies of IPV in these populations, and to examine perceived links between IPV, discrimination and oppression, and negative health outcomes. In the quantitative phase, these data will be used to inform an online survey administered to 700 trans adults (350 trans men and 350 trans women) to quantify associations between IPV and demographic factors, partner characteristics, stigma and discrimination. The study will also examine how IPV is associated with negative physical and mental health outcomes, and to psychometrically validate a trans-specific IPV scale. Elucidating the unique form, function, and impact of IPV among different populations of transgender individuals will inform clinical practice and lead to future trans-competent violence prevention and response interventions. The development of a validated IPV scale will substantially advance IPV research in trans communities, which has relied on pre-existing measures of IPV designed for cisgender, heterosexual populations. This deliverable will also be immediately useful for IPV screening of trans individuals in primary care, mental health, and violence response provider settings.