Sexual Violence & Individuals Who Identify as LGBTQ Annotated Bibliography The articles, reports, and films listed in the bibliography explore sexual violence against individuals who identify as lesbian, gay, bisexual, transgender, and queer (LGBTQ) from a variety of angles, including lifetime sexual victimization, intimate partner violence, sexual violence as hate/bias crimes, and service provisions for survivors. It lists articles that dispel common myths about individuals who identify as LGBTQ and sexual violence. GENERAL Balsam, K. F., Rothblum, E. D., & Beauchaine, T. P. (2005). Victimization over the life span: A comparison of lesbian, gay, bisexual, and heterosexual siblings. Journal of Consulting and Clinical Psychology, 73, 477-487. doi:10.1037/0022-006X.73.3.477 Retrieved from http://www.apa. org/pubs/journals/features/ ccp-733477.pdf This article explores lifetime victimization among a primarily European American sample of 557 lesbian/gay, 163 bisexual, and 525 heterosexual adults. Lesbian, gay, and bisexual (LGB) participants also recruited one or more siblings for participation in the study (81% heterosexual, 19% LGB). Sexual orientation was a significant predictor of several victimization variables. Compared with heterosexual participants, LGB participants reported more childhood psychological abuse and childhood physical abuse by parents or caretakers, as well as more childhood sexual abuse. Respondent also reported more partner psychological and physical victimization in adulthood, as well as more sexual assault experiences in adulthood. Gartrell, N. K., Bos, H. M., & Goldberg, N. G. (2011). Adolescents of the U.S. National Longitudinal Lesbian Family Study: Sexual orientation, sexual behavior, and sexual risk exposure. Archives of Sexual Behavior, 40, 1199– 1209. doi:10.1007/s10508-0109692- 2 Retrieved from http:// www.springerlink.com/content/ d967883qp3255733/fulltext.pdf Using the Kinsey scale (a self-assessment measurement of lifetime sexual experiences) this study charted the experiences of 78 adolescents of mothers who identified as lesbian. The adolescent subjects were asked if they had ever experienced verbal, emotional, physical, or sexual abuse and by whom. Adolescent respondents also reported their sexual identity on the Kinsey scale, between exclusively heterosexual and exclusively homosexual. No respondents reported physical or sexual victimization by a parent or other caregiver. Regarding sexual orientation, 0% of girls and 5.4% of boys self-rated as predominantly-to-exclusively homosexual, while 18.9% of the adolescent girls and 2.7% of the adolescent boys self-rated in the bisexual spectrum. This research suggests that boys and girls reared in families with parents who identify as lesbian are less likely than their peers to experience abuse by a parent or caregiver and daughters are more likely to describe their sexual orientation as bisexual. Rothman, E. F., Exner, D., & Baughman, A. L. (2011). The prevalence of sexual assault against people who identify as gay, lesbian, or bisexual in the United States: A systematic review. Trauma, Violence, & Abuse, 12, 55-66. doi:10.1177/1524838010390707 In a review of 75 studies published between 1989 and 2009 on sexual victimization of individuals who identify as lesbian, gay, and bisexual (LGB), researchers found significant rates of lifetime sexual assault, childhood sexual abuse, adult sexual assault, intimate partner sexual assault, and hate crime-related sexual assault among respondents. When lifetime sexual victimization rates for individuals who identify as LGB are compared to those of the general population, they suggest that individuals who identify as LGB may face increased risk for sexual violence. Todahl, J. L., Linville, D., Bustin, A., Wheeler, J., & Gau, J. (2009). Sexual assault support services and community systems: Understanding critical issues and needs in the LGBTQ community. Violence Against Women, 15, 952-976. doi:10.1177/1077801209335494 This study examines the relationship between community attitudes toward individuals who identify as LGBTQ and community responses to victims of sexual violence. The study drew data from 130 online survey responses and focus group interviews with 14 subjects; a majority of online survey respondents felt that the local community, including law enforcement, was ill-equipped to handle sexual assault cases in the LGBTQ community. Most respondents agreed that sexual violence is a problem in the LGBTQ community, and that sexual violence responses specifically tailored to the LGBTQ community are necessary. Focus group participants identified low community awareness and support for victims who identify as LGBTQ as a problem. White, B. H., & Kurpius, S. E. (2002). Effects of victim sex and sexual orientation on perceptions of rape. Sex Roles, 46, 191-200. doi:10.1023 /A:101961792015503600025/ 02/0300-0191/0 This study examined the relationship of sex, gender role attitudes, and sexual orientation to perceptions of victims of sexual violence. A total of 168 male and 220 female undergraduate students responded to a fictional scenario that depicted the rape of a heterosexual male or female, a gay man, or a woman who identified as a lesbian. Male respondents tended to assigned more blame to victims than female respondents. Additionally, male respondents were more likely to assigned greater blame to male victims than female victims. Acceptance of traditional gender roles was correlated with greater victim blame and negative attitudes toward gay men and lesbians, which in turn was correlated with greater blame being assigned to gay and lesbian victims. Wisconsin Coalition Against Sexual Assault. (2003). Lesbian, gay, bisexual, transgendered (LGBT) populations and sexual assault. Retrieved from http://www.wcasa.org/file_open.php?id=151 This information sheet provides a brief introduction to LGBTQ communities and what forms of sexual assault occur in these communities. The information sheet provides statistics on same-sex sexual assault and sexual violence against individuals who identify as LGBTQ, while addressing commonly asked questions about perpetration, victimization risks, and barriers faced by victims who identify as LGBTQ. VICTIMS WHO IDENTIFY AS GAY OR BISEXUAL MEN Fenaughty, J., Braun, V., Gavey, N., Aspin, C., Reynolds, P., & Schmidt, J. (2006). Sexual coercion among gay men, bisexual men and takatapui tane in Aotearoa/New Zealand. Retrieved from the University of Auckland (New Zealand): https://researchspace.auckland. ac.nz/bitstream/handle/2292/2399/ final%20report.pdf?sequence=1 This study draws upon interviews with 23 men who identify as gay or bisexual on sexual coercion against men who have sex with men. Respondents discussed the dynamics of sexual assault, the relationship between sexual assault and alcohol and drugs, disclosure, reporting, STDs (including HIV), and cultural considerations for the indigenous communities of New Zealand. Parsons, J. T., Bimbi, D. S., Koken, J. A., & Halkitis, P. N. (2005). Factors related to childhood sexual abuse among gay/bisexual male internet escorts. Journal of Child Sexual Abuse, 14, 1-23. doi:10.1300/J070v14n02_01 This article examines relationship between childhood sexual victimization and sexual behaviors among 46 gay or bisexual male escorts. Most respondents identified as caucasian (67.4%), followed by Latino (15.2%), African-American (10.9%), or Asian/Pacific Islander (6.5%). More than a quarter of men (28.3%) reported some history of child sexual abuse (CSA). Respondents who reported childhood sexual victimization were more likely to report unprotected sex with work-related partners and internalized homophobia. Finally, men of color who took part in the study were eight times more likely to report childhood sexual victimization. Interventions for male escorts who have experienced childhood sexual abuse should include strategies for safer sex with work partners and addressing internalized homophobia. Sivakumaran, S. (2005). Male/male rape and the “taint” of homosexuality. Human Rights Quarterly, 27, 1274–1306. doi:10.1353/hrq.2005.0053 Sivakumaran argues that homophobia and male-on-male rape are linked, regardless of the sexual orientation of the perpetrator or victim. This link, conceived as the “taint” of homosexuality regarding male-on-male rape, has lead to the silence surrounding this form of sexual violence. The author emphasizes the difference between male-on-male rape and rape among individuals who identify as gay or bisexual men, as the former is rape of a male victim by a male perpetrator and the latter involves the rape of a man who identifies as gay or bisexual. Sivakumara urges both the queer movement and the feminist movement to confront the issue of male-on-male rape and discuss issues of gender, feminization, power, and dominance. VICTIMS WHO IDENTIFY AS LESBIAN OR BISEXUAL WOMEN Bernhard, L. A. (2000). Physical and sexual violence experienced by lesbian and heterosexual women. Violence Against Women, 6, 68-79. doi:10.1177/10778010022181714 In a study of 136 women who identified as lesbian and 79 heterosexual women, significantly more lesbians (51%) than heterosexual women (33%) reported having experienced nonsexual physical violence. Additionally, 54% of respondents who identified as lesbian and 44% of heterosexual respondents reported having experienced sexual violence. Most women reported passive strategies for risk reduction, including avoidance, talking to someone, and doing nothing. Girshick, L. B. (2002). Woman-to-woman sexual violence: Does she call it rape? Boston, MA: Northeastern University Press. This book discusses women-to-woman sexual violence, including intimate partner sexual assault, acquaintance sexual assault, and sexual harassment. Girshick discusses woman-to-woman sexual violence in the context of societal homophobia, biphobia, and misogyny, emphasizing the need for services relevant to this subset of victims. Gold, S. D., Dickstein, B. D., Marx, B. P., & Lexington, J. M. (2009). Psychological outcomes among lesbian sexual assault survivors: An examination of the roles of internalized homophobia and experiential avoidance. Psychology of Women Quarterly, 33, 54-66. doi:10.1111/j.1471-6402.2008.01474.x This study explored the relationship between internalized homophobia, experiential avoidance, and psychological symptom severity among 72 survivors of sexual assault who identified as lesbian. The study found that internalized homophobia was associated with both experiential avoidance and greater severity of post-traumatic stress disorder symptoms. Additionally, experiential avoidance mediated the relation between post-traumatic stress disorder symptom severity and internalized homophobia. VICTIMS WHO IDENTIFY AS TRANSGENDER Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., & Keisling, M. (2011). Injustice at every turn: A report of the National Gender Discrimination Survey. Retrieved from the National Gay and Lesbian Task Force: http://www.thetaskforce.org/ downloads/reports/reports/ntds_full.pdf In a study of 6,436 individuals who identify as transgender or gender non-conforming, significant percentages of respondents reported having experienced discrimination and violence. Participants reported high rates of harassment, physical assault, and sexual assault in a variety of settings including schools, workplaces, prisons, and homeless shelters. Sexual victimization was correlated with higher rates of HIV infection and suicide attempts among respondents. Sexual assault rates were higher among people of color, suggesting intersections between transphobia and racism. Pennsylvania Coalition Against Rape. (2007). Understanding the transgender community: A technical assistance bulletin for sexual assault counselors and advocates. Technical Assistance Bulletin, 4(2), 1-3. http://www.pcar. org/sites/default/files/TAB_2007_Summer_ Understanding_Transgendered_Community. pdf This bulletin introduces readers to commonly used terms and labels in the transgender community. The bulletin discusses survivors of sexual violence who identify as transgender and the importance of providing culturally competent services to transgender victims. VICTIMS WHO IDENTIFY AS TWO-SPIRIT Balsam, K., Huang, B., Fieland, K. C., Simoni, J. M., & Walters, K. L. (2004). Culture, trauma, and wellness: A comparison of heterosexual and lesbian, gay, bisexual, and two-spirit Native Americans. Cultural Diversity and Ethnic Minority Psychology, 10, 287-301. doi:10.1037/1099-9809.10.3.287 In a study of 179 adults who identified as Native American and Alaska Native, 25 identified as lesbian, gay, bisexual, and two-spirit (collectively categorized as two-spirit), while 154 identified as heterosexual. Respondents identifying as two-spirit respondents reported higher rates of childhood physical abuse, childhood sexual abuse, and lifetime sexual assault compared to heterosexual respondents. These individuals were also more likely than heterosexual respondents to report having received mental health care and having used illicit drugs. The authors discuss the intersections of homophobia and racial oppression among individuals who identify as Native American and Alaska Native, LGB, and two-spirit. Lehavot, K., Walters, K. L., & Simoni, J. M. (2009). Abuse, mastery, and health among lesbian, bisexual, and two-spirit American Indian and Alaska Native women. Cultural Diversity and Ethnic Minority Psychology, 15, 275–284. doi:10.1037/a0013458 In a study of 152 women who identified as American Indian and Alaska Native and lesbian, bisexual, or two-spirit, 85% of respondents reported sexual victimization, and 78% reported experiencing physical assault. Sexual and physical victimization were correlated with worse overall physical and mental health, as well as a diminished sense of mastery or control. Simoni, J. M., Walters, K. L., Balsam, K. F., & Meyers, S. B. (2006). Victimization, substance use, and HIV risk behaviors among gay/ bisexual/two-spirit and heterosexual American Indian men in New York City. American Journal of Public Health, 96, 2240-2245. doi:10.2105/AJPH.2004.054056 In a study of 71 men who identified as American Indian in New York, NY, 51 identified as heterosexual and 20 identified as gay, bisexual, or two-spirit (classified collectively as two-spirit). Respondents who identified as two-spirit reported higher rates of intimate partner sexual abuse than heterosexual respondents (10% versus 0%), as well as sexual assault by someone other than a partner (55% versus 6%). They also reported greater lifetime involvement in HIV risk behaviors. While limited by its small sample size, the study suggests that possible correlation between victimization and high-risk behaviors should be explored. VI. INTIMATE PARTNER SEXUAL ASSAULT Hardesty, J. L., Oswald, R. F., Khaw, L., & Fonseca, C. (2011). Lesbian/bisexual mothers and intimate partner violence: Help seeking in the context of social and legal vulnerability. Violence Against Women, 17, 28-46. doi:10.1177/1077801209347636 Mothers involved in same-sex relationships face unique challenges when seeking services after experiencing intimate partner violence. Service providers such as law enforcement or medical professions may fail to validate their experiences, leaving them vulnerable and underserved. The authors conducted interviews with 24 women who identified as lesbian or bisexual who were either in or had left same-sex relationships marked by intimate partner violence. Increasing severity of violence and the effects of violence on their children influenced respondents’ definitions of the situation. Respondents’ decisions to seek formal help were shaped by the availability of support from informal networks and perceived homophobic and biphobic stigma. National Coalition of Anti-Violence Programs. (2010). Lesbian, gay, bisexual, transgender and queer domestic/intimate partner violence in the United States in 2009. Retrieved from http://www.avp.org/documents/2009DVIPVREPORTFINAL2. pdf This report documents violence experienced by individuals who identify as lesbian, gay, bisexual, transgender and queer (LGBTQ) within domestic and intimate partner relationships, reported in the United States in 2009. The report provides an overview of findings related to LGBTQ intimate partner violence and explores the systemic, interpersonal and individual factors that may limit survivors' access to critical services and support. Porter, J. L., & Williams, L. M. (2011). Intimate violence among underrepresented groups on a college campus. Journal of Interpersonal Violence, 26, 3210-3224. doi:10.1177/0886260510393011 This study investigates the incidence of physical abuse, psychological abuse, and sexual violence, among underrepresented groups in a random sample of 1,028 college students. The study found statistically significant associations between physical and psychological abuse, students who were deaf or hard of hearing students, and students who identified as lesbian, gay, or bisexual. Students who identified as lesbian, gay, or bisexual, as well as students from certain racial and ethnic groups, showed a significantly higher risk for sexual abuse. Students who identified as lesbian, gay, or bisexual, students from certain racial and ethnic groups, and female students were significantly more likely to experience rape. VII. HATE AND/OR BIAS-MOTIVATED CRIMES Herek, G. M., Gillis, J. R., & Cogan, J. C. (1999). Psychological sequelae of hate-crime victimization among lesbian, gay, and bisexual adults. Journal of Consulting and Clinical Psychology, 67, 945-951. doi:10.1037//0022-006X.67.6.945 2,259 Sacramento-area residents who identified as lesbian, gay, or bisexual completed a questionnaire about their victimization experienced. Approximately 25% of male respondents and 20% of female respondents reported having experienced some form of victimization because of their sexual orientation (i.e., sexual assault, physical assault, robbery, or property crime). Hate crimes were less likely to have been reported to law enforcement than non-bias crimes. Survivors who identified as lesbian or gay reported significantly more symptoms of depression, anxiety, and posttraumatic stress than other crime victims. These findings demonstrate the importance of acknowledging the needs of hate-crime survivors’ needs in both service provision and public policy. Rose, S. M., & Mechanic, M. B. (2002). Psychological distress, crime features, and help-seeking behaviors related to homophobic bias incidents. American Behavioral Scientist, 46, 14-26. doi:10.1177/0002764202046001003 A study of 290 individuals who identified as lesbian, gay, or bisexual explored crime features, psychological distress, and help-seeking behaviors related to homophobic bias incidents. Nearly three-quarters of respondents (73%) reported that they had been the target of at least one homophobic incident. Respondents who had experienced homophobic sexual assaults reported significantly more post-traumatic stress symptoms than victims of other bias acts or non-victims. Homophobic sexual assaults also were more likely to involve a previous bias incidents, a known perpetrator, or multiple perpetrators. These results suggest that certain types of bias crimes, such as sexual assault, result in greater psychological distress for victims. VIII. SEXUAL ASSAULT IN PRISON AGAINST INDIVIDUALS WHO IDENTIFY AS LGBTQ Baus, J., Hunt, D., & Williams, R. (Directors). (2006). Cruel & unusual [Motion picture]. New York, NY: Outcast Films. Cruel and Unusual explores the experiences of women who identified as transgender in U.S. prisons. The subjects of this document report being denied hormone therapy, put in solitary confinement, and experiencing sexual assault from male prisoners and guards while incarcerated. Several of the women in Cruel and Unusual have waged legal struggles for the right to access counseling and hormone therapy while in prison. Coolman, A., Glover, L., & Gotsch, K. (2005). Still in danger: The ongoing threat of sexual violence against transgender prisoners. Retrieved from Just Detention International: http://www.justdetention.org/pdf/stillindanger. pdf This document discusses the legal implications of the 1994 Farmer v. Brennan ruling – in which the Supreme Court held that prisoner rape is constitutionally unacceptable -- for prisoner claims of Eighth Amendment violations as well as conditions for transgender prisoners. First-person accounts by individuals who identified as transgender shed light on sexual violence during incarceration. Just Detention International. (2009). Call for change: Protecting the rights of LGBTQ detainees. Retrieved from http://www.just detention.org/pdf/CFCLGBTQJan09.pdf This article discusses incarcerated individuals who identified as lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) and the vulnerability to sexual assault behind bars, the mental health aftermath of prison sexual abuse, and laws pertaining to prison sexual violence. Just Detention International offers recommendations for raising prisoner awareness, promoting prisoner safety, screening and training correctional facility staff, and responding effectively to sexual violence against incarcerated individuals who identify as LGBTQ. Ware, W. (2010). Locked up & out: Lesbian, gay, bisexual & transgender youth in Louisiana’s juvenile justice system. Retrieved from The Equity Project: http://www.equityproject.org/pdfs/ Locked-Up-Out.pdf This report discusses the challenges faced by youth who identify as lesbian, gay, bisexual, and transgender (LGBT) in the Louisiana juvenile justice system, including physical violence and sexual assault, as well as the lack of LGBT-specific resources available to them. The report suggests policy and programming solutions for Louisiana to ensure safe environments for youth in state care. It also proposes that advocates for racial justice, juvenile justice, and LGBT rights come together more effectively and collaboratively in the future, to ensure justice and equitable treatment for all Louisiana's youth. IX. HOMELESSNESS Cochran, B. N., Stewart, A. J., Ginzler, J. A., & Cauce, A. M. (2002). Challenges faced by homeless sexual minorities: Comparison of gay, lesbian, bisexual, and transgender homeless adolescents with their heterosexual counterparts. American Journal of Public Health, 92, 773-777. doi:10.2105/AJPH.92.5.773 In a study of 375 youth homeless (ages 13-21) 84 youth identified as lesbian, gay, bisexual, and transgender (LGBT). Homeless adolescents who identified as LGBT alongside those of 84 heterosexual adolescents revealed that homeless adolescents who identified as LGBT reported higher rates of sexual victimization, physical victimization, psychopathology, and substance abuse than their heterosexual counterparts. Lowrey, S. (Ed.). (2010). Kicked out. Ypsilanti, MI: Homofactus Press. Kicked Out is a collection of autobiographical essays by runaway, throwaway, and homeless youth who identify as lesbian, gay, bisexual, and transgender (LGBT). Contributors describe the physical violence, sexual assault, homophobia, and transphobia they endured at home and on the streets, as well as opportunities they encountered that allowed them to build stable lives. The book concludes with an article by Nick Ray of the National Gay and Lesbian Task Force Policy Institute, featuring statistics on homeless youth who identify as LGBT, the current state of services for this distinct population, and policy recommendations for stakeholders. Ray, N. (2006). Lesbian, gay, bisexual and transgender youth: An epidemic of homelessness. Retrieved from the National Gay and Lesbian Task Force: http://www.thetaskforce.org/downloads/ HomelessYouth.pdf This report discusses homeless, runaway, and throwaway youth who identify as lesbian, gay, bisexual, and transgender (LGBT) and critical issues facing this population (including mental health issues, substance abuse, sexual victimization, and involvement in the criminal justice system). The author explores federal and community responses to youth who identify as LGBT and provides policy recommendations for serving this population. X. PHYSICAL AND MENTAL HEALTH Balsam, K. F., Lehavot, K., & Beadnell, B. (2011). Sexual revictimization and mental health: A comparison of lesbians, gay men, and heterosexual women. Journal of Interpersonal Violence, 26, 1798-1814. doi:10.1177/0886260510372946 This study charted prevalence and mental health correlates of sexual revictimization among 871 adults who identified as lesbians, gay men, or heterosexual women. Childhood sexual abuse was correlated with higher rates of adult rape for all three groups. Additionally, respondents who reported experiencing both childhood sexual abuse and adult rape had higher levels of psychological distress, suicidality, alcohol use, and self-harm behaviors, compared to respondents who reported experiencing only one type of victimization or no victimization. Respondents who reported any sexual victimization were more likely to report recent drug use than those who had not experienced sexual victimization. Brennan, D. J., Hellerstedt, W. L., Ross, M. W., & Welles, S. L. (2007). History of childhood sexual abuse and HIV risk behaviors in homosexual and bisexual men. American Journal of Public Health, 97, 1107-1112. doi:10.2105/AJPH.2005.071423 This study examined the prevalence and frequency of childhood sexual abuse and its relationship to high-risk sexual behaviors among a sample of 134 men who identified as gay or bisexual. Results showed that 15.5% of respondents reported experiencing childhood sexual abuse. Subjects who reported experiencing sexual abuse regularly were more likely to have engaged in transactional sex, use sex-related drugs (i.e., methamphetamine, ecstasy) and be HIV positive. Childhood sexual abuse was not correlated with unsafe sex practices or sexually-transmitted infections. Heintz, A. J., & Melendez, R. M. (2006). Intimate partner violence and HIV/STD risk among lesbian, gay, bisexual, and transgender individuals. Journal of Interpersonal Violence, 21, 193-208. doi:10.1177/0886260505282104 This study looked at the relationship between intimate partner violence (including sexual violence) and safe sex practices among individuals who identified as lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ). Researchers drew data from surveys completed by 58 adult clients of a community-based organization that provides services to victims of intimate partner violence who identified as LGBTQ. Subjects completed a survey with questions about intimate partner sexual victimization, safer sex practices, and safer sex negotiation. Nearly half (41%) of respondents replied that an intimate partner had forced them to have sex, and 10% indicated that a partner had forced them to have sex with another person. Only half of respondents who reported being sexually assaulted by a partner also reported that their partner used safe sex measures. Respondents who reported that they had been forced to have sex with their partner were 10.3 times more likely to report that they used no safe sex practices because they feared their partner's response to safer sex negotiation. These results suggest that intimate partner sexual assault among LGBTQ couples may result in reluctance to negotiate safer sex; thereby increasing victims’ risk of STD and HIV infections. Hughes, T. L., Johnson, T., & Wilsnack, S. C. (2001). Sexual assault and alcohol abuse: A comparison of lesbians and heterosexual women. Journal of Substance Abuse, 13, 515-532. doi:10.1016/S0899-3289(01)00095-5 This article explores the relationship between sexual victimization and alcohol abuse among women who identified as either heterosexual (N = 57) or lesbian (N = 63). The authors found childhood sexual abuse was associated with lifetime alcohol abuse among both groups. However, adult sexual assault was associated with alcohol abuse among respondents who identified as heterosexual only. Kalichman, S. C., Gore-Felton, C., Benotsch, E., Cage, M., & Rompa, D. (2004). Trauma symptoms, sexual behaviors, and substance abuse: Correlates of childhood sexual abuse and HIV risks among men who have sex with men. Journal of Child Sexual Abuse, 13, 1-15. doi:10.1300/J070v13n01_01 The authors explore the relationship between childhood sexual abuse and HIV-related risk behavior among men who have sex with men (MSM). In a study of 647 MSM, researchers found that men with a history of childhood sexual abuse are more likely to barter sex for drugs or money, engage in high-risk sexual behavior, experience intimate partner violence, and report being HIV-positive. Nemoto, T., Bodeker, B., & Iwamoto, M. (2011). Social support, exposure to violence and transphobia, and correlates of depression among male-to-female transgender women with a history of sex work. American Journal of Public Health. 101, 1980-1988. doi:10.2105/AJPH.2010.197285 Researchers studied 573 male-to-female transwomen with a history of exchanging sex for money or drugs, seeking information on racial and ethnic differences in social support as well as exposure to violence and transphobia. More than half of participants who identified as Latina and white reported being depressed. More than half of respondents reported having suicidal thoughts, with higher rates among participants who identified as African-American and white. Additionally, half of all respondents reported experiencing physical assault, and 38% reported sexual victimization before age 18. White and African American participants reported more frequent experiences with transphobia than other respondents. Ratner, P. A., Johnson, J. L., Shoveller, J. A., Chan, K., Martindale, S. L., Schilder, A. J., … Hogg, R. S. (2003). Non-consensual sex experienced by men who have sex with men: Prevalence and association with mental health. Patient Education and Counseling, 49, 67-74. doi:10.1016/S0738-3991(02)00055-1 Retrieved from the British Columbia Centre for Excellence in HIV/AIDS: http://cfenet. ubc.ca/vanguard/publications_journal/ MSM&MentalHealth.Ratner2002.pdf In a study of 358 adult men who have sex with men in the Greater Vancouver area, researchers found a correlation between lifetime sexual victimization (including involvement in juvenile prostitution) and onset of psychopathologies, including alcohol abuse, suicidal thoughts, suicide attempts, and mood disorders such as depression and bipolar disorder. Roberts, A. L., Austin, S. B., Corliss, H. L., Vandermorris, A. K., & Koenen, K. C. (2010). Pervasive trauma exposure among U.S. sexual orientation minority adults and risk of post traumatic stress disorder. American Journal of Public Health, 100, 2433-2441. doi:10.2105/AJPH.2009.168971 Drawing data on 34,653 adults from the National Epidemiologic Survey on Alcohol and Related Conditions, researchers found that respondents who reported any same-sex sexual partners over their lifetime reported higher rates of childhood maltreatment and interpersonal violence (including sexual assault) than those with no same-sex attraction or partners. The risk of post-traumatic stress disorder onset was higher among respondents who identified as lesbian, gay, bisexual and respondents who identified as heterosexual but reported having partners of the same gender. Saewyc, E., Skay, C., Richens, K., Reis, E., Poon, C., & Murphy, A. (2006). Sexual orientation, sexual abuse, and HIV-risk behaviors among adolescents in the Pacific northwest. American Journal of Public Health, 96, 1104-1110. doi:10.2105/AJPH.2005.065870 The authors examined data on sexual abuse, sexual orientation, and HIV risk behaviors from 5 school-based cohorts studied between 1992 and 2003. Adolescents who identified as lesbian, gay, and bisexual (LGB) reported higher rates of sexual abuse than heterosexual respondents, as well as higher prevalence of HIV risk behaviors (i.e., risky sexual behaviors, injection drug use). The authors emphasized the need for greater community awareness of sexual violence against LGB youth and the health needs of this population. X. SERVICES Ciarlante, M., & Fountain, K. (2010). Why it matters: Rethinking victim assistance for lesbian, gay, bisexual, transgender, and queer victims of hate violence & intimate partner violence. Retrieved from the National Center for Victims of Crime: http://www.ncvc.org/ ncvc/AGP.Net/Components/documentViewer/ Download.aspxnz?DocumentID=47632 This report, which draws data from a 2009 survey of victim assistance providers and lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) anti-violence programs, discusses gaps in LGBTQ-specific crime victim services recommends strategies for improving service accessibility. The 2009 survey found that LGBTQ victims (including hate crime victims and intimate partner violence victims) do not have consistent access to culturally-competent victim services. The report recommends increased support for LGBTQ-focused training, education for service providers and first responders, and additional research on the needs of victims who identify as LGBTQ and the prevalence of crime against LGBTQ communities. Cook-Daniels, L. (2006). Seeing past the “L”: Addressing anti-male bias in sexual assault services for the “LGBT” community. Retrieved from Forge: http://forge-forward.org/wp- content/docs/Anti-Male_Bias_SeeingpasttheL. pdf In this article, the author argues that advocates for victims of sexual assault who identify as lesbian, gay, bisexual and transgender (LGBT) need to self-assess to make sure that they are addressing the needs of both female and male victims. The author explains that in order for the needs of all victims to be met, advocates need to address the anti-male bias within LGBT and broader sexual assault service programs. The author offers simple tips for self-assessment and ways to ensure that one’s own agency is open to all victims. Gentlewarrior, S., & Fountain, K. (2009). Culturally competent service provision to lesbian, gay, bisexual and transgender survivors of sexual violence. Retrieved from VAWnet: the National Online Resource Center on Violence Against Women: http://new.vawnet.org/Assoc_Files_VAWnet/ AR_LGBTSexualViolence.pdf Research over the past two decades suggests that LGBTQ persons suffer disproportionate rates of sexual victimization compared to the general population. Affirming and culturally competent services are essential to assist LGBTQ victims of childhood sexual abuse, adult sexual assault, sexual harassment, and hate crimes. Lunine, B. (2008) Transitioning your services: Serving transgender victims of domestic violence, sexual assault and stalking. Retrieved from the Transgender Law Center: http://www.transgenderlawcenter.org/pdf/ LunineSummer2008.pdf Lunine offers recommendations to increase the accessibility of domestic violence, sexual assault, and stalking services and prevention programs so that they can effectively serve transgender communities. The author discusses issues surrounding the relationship between transgender clients and law enforcement, legal issues with housing agencies, service agencies, safety planning and support groups, and how to make offices transgender-friendly. Mottet, L., & Ohle, J. M. (2003). Transitioning our shelters: A guide to making homeless shelters safe for transgender people. Retrieved from the National Gay and Lesbian Task Force: http://www.thetaskforce.org/ downloads/reports/reports/Transitioning OurShelters.pdf This guide offers suggestions to homeless shelter administrators and other service providers who seek to make shelters safe and welcoming for transgender persons. The guide introduces readers to transgender issues and discusses shelter policy, legal issues, transgender health matters, and physical and sexual violence against transgender people. Munson, M. (2006). Practical tips for working with transgender survivors of sexual violence. Retrieved from Forge: http://www.forge- forward.org/handouts/Trans_survivor_tips.pdf The author argues that due to society’s investment in a gender binary and sexuality conformity, there are multiple reasons that transgender people may be at an increased risk for sexual victimization. The article offers 10 tips for working with transgender survivors of sexual violence, including suggestions related to training, language, policies, disclosure, and body dysphoria. Smith, C., & Cleveland, A. E. (2010, Winter). Sexual assault nurse examiner (SANE) protocol for working with lesbian, bisexual, gay, transgender, intersex, & queer survivors of sexual violence. Connections, XIII, 17. Retrieved from http://wcsap.org/sites/www. wcsap.org/files/uploads/documents/ StrategiesforSupportingLGBTIQ2010.pdf Smith and Cleveland argue that it is imperative that sexual assault nurse examiners (SANEs) understand the unique needs of patients who identify as lesbian, bisexual, gay, transgender, intersex, and queer (LBGTIQ) when providing post-assault services. Appropriate, sensitive and effecting nursing care requires the SANE to be knowledgeable about specific issues of identity, infection and pregnancy risk, medical care and safety. XI. DISPELLING MYTHS ABOUT SEXUAL VIOLENCE & INDIVIDUALS WHO IDENTIFY AS LGBTQ Jenny, C., Roesler, T. A., & Poyer, K. L. (1994). Are children at risk for sexual abuse by homosexuals? Pediatrics, 94, 41-44. In a study of 269 cases of suspected child sexual abuse (CSA) referred to a children's hospital sexual abuse clinic, only two offenders were tentatively identified as being gay or lesbian adults. In the majority (82%) of cases, the accused perpetrator was a partner of one of the child's relatives. Researchers found no evidence from this study that children are at a greater risk of sexual abuse by adults who identify as LGBTQ than by other adults. Stevenson, M. R. (2001). Public policy, homosexuality, and the sexual coercion of children. Journal of Psychology & Human Sexuality, 12(4), 1-19. doi:10.1300/J056v12n04_01 Stevenson reviews the literature related to the erroneously presumed association between homosexuality and the sexual abuse of children as it relates to public policy. The article refutes the assumption that the public embraces the myth that gay men sexually abuse children, stresses the distinction between sexual behavior and sexual orientation, and reviews research concerning childhood sexual abuse and sexual identity development in boys. The author argues that sexual orientation is a poor predictor of sexual interest in or sexual abuse of children. Furthermore, most gay men studied did not experienced sexual abuse as children. In short, empirical research had not demonstrated that a relationship between childhood sexual abuse and adult sexual orientation exists. Stevenson, M. R. (2002). Understanding child sexual abuse and the Catholic Church: Gay priests are not the problem. Angles: The Policy Journal of the Institute for Gay and Lesbian Strategic Studies, 6(2), 1-6. This article dismantles the myth that gay priests lie at the root of the Catholic clergy abuse crisis. Stevenson clarifies psychiatric diagnoses and terms related to pedophiles and argues that it is pedophile priests, not homosexual priests, who perpetrate child sexual abuse. National Sexual Violence Resource Center and Pennsylvania colaition Against Rape 2012. All rights reserved. This document was supported by Cooperative Agreement #5VF1CE001751-03 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC This project is supported by Grant No. 2010-SW-AX-0019 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women.