Quality of life among LGBTQ+ survivors of IPV: an exploratory sequential mixed method approach
Creators: name: Shayesteh Ast, Roxanna
Publisher: name: No Publisher Supplied
Year: 2023

description: IPV is internationally recognized as a serious violation of human rights and a public health issue (Council of Europe, 2018) and is often defined as behaviors in an intimate relationship that lead to sexual, physical, or psychological harm or discomfort (CDC, 2018). Although IPV often refers to physical, sexual, and psychological abuse, in this study, it is used more broadly to include physical, psychological, sexual, financial, and identity abuse as unique strategies to inflict harm and discomfort in an intimate relationship. Research on the experiences of LGBTQ+ survivors of IPV is growing, but our understanding of how IPV victimization impacts the quality of life of LGBTQ+ survivors is limited. Further, LGBTQ+ experiences are often understood when compared to that of cisgender-heterosexual survivors, and little attention has been given to exploring the within-group differences and similarities of cisgender and transgender and gender diverse (TGD) queer survivors of IPV. As such, the objective of this dissertation was to better understand the experiences of LGBTQ+ survivors of various forms of IPV (physical, emotional, sexual, financial, and identity abuse), the impact of IPV on quality of life, and ways in which other factors such as support, and representation influence the lives of LGBTQ+ survivors. This dissertation used exploratory sequential mixed method design and primary data collected via interviews and online surveys. Data collection for this project was partially funded by the Melissa Institute for Violence Prevention and Treatment. The data was collected between June 2021-August 2022. A total of 30 LGBTQ+ survivors of IPV from across the United States were interviewed for the qualitative strand. Additionally, 242 LGBTQ+ survivors from across the United States completed an online survey in the quantitative strand. All interviews and surveys were in English. The data from the interviews were used to better understand the lived experience of LGBTQ+ survivors as it related to their IPV victimization and the ways in which it impacted their quality of life. Six themes were identified during this strand: 1) decreased mental well-being, 2) loss of confidence and self-esteem, 3) physical toll on the body, 4) difficulty seeking new intimate relationships, 5) loss of friends and family ties, and 6) living in a constant state of fear. Furthermore, participants in the qualitative strand discussed at length how media representation, family support, lack of access to queer spaces, and other issues shaped their IPV victimization prior to, during, and after the relationship. The second strand of the study was informed by the findings from the qualitative strand. Overall, 242 participants completed the online survey and responded to questions related to IPV, overall quality of life and four quality of life subscales (physical health, psychological health, quality of relationships, and environmental health), questions related to support, outness, perceptions of media representation, and best ways to address IPV in the LGBTQ+ community. Results from this strand of this study suggested that TGD survivors scored lower on all QoL measures compared to their cisgender counterparts. Further, though no moderation effect was found for support and outness, perceptions of media representation moderated the association between gender identity (cis vs. TGD) and the subscales of relationship health, environmental health, and physical health for survivors of this sample, highlighting the importance of accurate and positive representation of queer relationships, especially for TGD individuals. Additionally, data from this strand of the study revealed that LGBTQ+ survivors believe the best way to address IPV in the community is by offering a positive representation of queer relationships in media, training health care and service providers to offer affirmative care to LGBTQ+ survivors, and inclusive sex education for everyone. Finally, the results from the qualitative and quantitative strands of the study were integrated and presented in a joint display to highlight areas of convergence and divergence. Overall, the results from the quantitative strand aligned with the findings from the qualitative strand though there were some areas of divergence, such as differences in how environmental health was perceived, the role of identity (cis vs. TGD), and the role of social support in mitigating the impacts of IPV. Overall, these findings can inform future research, practice with IPV survivors, and policies for LGBTQ+ survivors. These findings highlight the importance of developing a positive and accurate representation of queer relationships as well as offering affirming care to LGBTQ+ survivors and training practitioners who have the knowledge and skills to work with the LGBTQ+ community. These findings also provide further evidence that the LGBTQ+ community at large, and LGBTQ+ survivors, in particular, have diverse experiences, needs, and resources. When creating programs and services for this community, it is important to be mindful and informed of the context within which many LGBTQ+ survivors, especially TGD survivors, must operate and navigate.