Differences in Rape Acknowledgment and Mental Health Outcomes Across Transgender, Nonbinary, and Cisgender Bisexual Youth

Preliminary Prevalence Estimates of Sexual Exploitation as Measured by the Sexual Experiences Survey-Victimization (SES-V) in a National US Sample

The new Sexual Experiences Survey-Victimization (SES-V) was designed to capture a larger range of sexual exploitation and to be applicable to more diverse populations than prior measures. This study represents the first administration of the SES-V in a national sample of adults (N = 347). Participants were recruited from a crowdsourcing platform and selected to reflect the national distribution in terms of age, sex, and race/ethnicity. Rates of sexual exploitation since age 14 were very high in this sample (90%), providing evidence that the SES-V was successful in capturing experiences on the low end of the severity continuum. Using the items corresponding to the FBI definition of rape, 60% of women and 29% of men endorsed rape on the SES-V. Compared to men, women reported higher rates of sexual exploitation overall, and higher rates of every type of sexual exploitation except technology-facilitated. The new SES-V also asks participants to estimate the number of separate instances of four types of sexual exploitation that they have experienced; results provided support for the value of these incident estimates in understanding the scope of sexual exploitation. Finally, this study evaluated new sexual acts and exploitative tactics that were added to the SES-V and found that they demonstrated utility and validity. These findings offer preliminary support for the validity and functionality of the SES-V, although the high prevalence of sexual exploitation on the SES-V is discussed as both a strength and limitation. Future research should evaluate prevalence and demographic differences in a larger national sample.

Universal Sexual Violence Intervention Effects in a Cluster-Randomized Trial: Moderation by Sexual Orientation

Sexual minority (e.g., gay/lesbian, bisexual, and queer) students are more likely than their heterosexual peers to experience sexual violence (SV) during college. Interventions that prevent SV and improve SV care-seeking behaviors for sexual minority students are lacking. Giving Information for Trauma Support and Safety (GIFTSS) is an evidence-based universal SV intervention implemented by providers during college health and counseling visits. Compared to controls, GIFTSS participants reported greater self-efficacy to use SV harm reduction strategies and SV disclosure during clinical visits. However, GIFTSS' effectiveness for sexual minority participants is unknown. The current study examines whether sexual orientation moderates GIFTSS' effects on numerous SV-related outcomes (i.e., to test whether intervention effects at 4 and 12 months differed based on sexual orientation). Across 28 college campuses in Pennsylvania and West Virginia, 2,291 students participated in a two-arm cluster-randomized controlled trial. We used mixed models with two- and three-way interaction terms to test whether sexual orientation modified GIFTSS' effects at 4- and 12-month follow-up on participants': SV recognition; knowledge of and self-efficacy to enact SV harm reduction strategies; intentions to intervene; knowledge of and self-efficacy to use SV-related services; SV disclosure during visits; and recent SV exposure. Overall, 22.1% of participants were sexual minorities (n = 507). Sexual orientation moderated GIFTSS effectiveness as indicated by significant three-way interaction (p = .01) at 12-month follow-up, and knowledge of SV services decreased for heterosexual participants (β = -.23) but increased for sexual minority participants (β = .23). Our study indicates that universal provider-based education may promote greater knowledge of SV services among sexual minority than heterosexual participants, and population-specific interventions are needed that reduce sexual minority students' SV exposure, service utilization, and other critical aspects of SV prevention on university campuses.Clinical Trial Registration: Registry name: College Health Center-based Alcohol and Sexual Violence Intervention (GIFTSS), Registration number: NCT02355470, Web link: https://clinicaltrials.gov/ct2/show/NCT02355470, Deidentified individual participant data will not be made available.

Labeling Victimization Experiences and Self as Predictors of Service Need Perceptions and Talking to Police

Theoretical frameworks suggest that how victims of violence against women (VAW) label their experiences and selves shapes their help-seeking intentions and behaviors. Quantitative studies assessing this relationship have focused on sexual assault and have neglected self-labels, thus this study adds to the research by including multiple forms of VAW and both experience-labels (e.g., "abuse") and self-labels (e.g., "victim"). Data came from a community-based sample of 1,284 adult, female victims of physical intimate partner violence, sexual assault, and/or stalking. These women participated in a state-wide phone survey in 2020 to determine victimization prevalence and were selected for the present analyses based on their victimization experiences. Bivariate analyses and multivariate logistic regression models were used to determine whether experience- and self-labels predicted the likelihood of perceiving the need for legal services, victim services, shelter or safe housing, and/or medical care, as well as talking to police. Both applying a label to one's experiences with VAW and applying a label to oneself in relation to those experiences approximately doubled the odds of perceiving a need for formal services. The significance of self-labels seemed to be driven by the "survivor" label, as using a "victim" label was not related to need perceptions, but a "survivor" label doubled or tripled the odds of perceiving a need for formal services. Applying a label to one's experiences with VAW almost doubled the odds of talking to the police, and, again, use of the "survivor" self-label significantly increased the odds of talking to the police. These findings confirm the importance of labeling one's victimization experiences and self, and indicate that greater attention be paid to the labels that victims use and how the use of labels might be improved so that they are more likely to seek and attain meaningful help and services.

Sexual Victimization Outcomes and Adjustment Among Bisexual Women: A Review of the Quantitative Literature

Bisexual women experience worse mental health outcomes than lesbian and heterosexual women, which may be explained by greater rates of sexual violence among bisexual women. The current comprehensive literature review aimed to synthesize research on mental health and substance use outcomes related to lifetime sexual violence among bisexual women. A comprehensive literature search was conducted within the PsycINFO and Medline databases (final search conducted in August, 2021). Inclusion criteria required articles to examine a mental health or substance use correlate/outcome of lifetime sexual victimization experiences among bisexual women. Fifteen studies met inclusion criteria and were reviewed. Results indicate that there are significant gaps in this literature, including limited research on psychological distress outcomes. Most notably, there is a limited focus on the experiences of bisexual women specifically and the role of bisexual minority stress. Findings indicate that lifetime sexual victimization experiences are linked with increased posttraumatic stress, depression, and alcohol (and other substance) use and consequences. It appears that bisexual women are vulnerable to cumulative victimization, which may further exacerbate outcomes. Clinicians working with bisexual women should provide bisexual-affirmative care, help bisexual women access positive social supports, and build more effective coping strategies for managing post-trauma distress. Future research on outcomes of violence among bisexual women would benefit from contextualizing adjustment following sexual assault within a bisexual minority stress-informed approach for a more comprehensive understanding of this process.

Measuring the Prevalence of Interpersonal Violence Victimization Experience- and Self-Labels: An Exploratory Study in an Alaskan Community-Based Sample

Purpose

How victims of violence against women (VAW) label their experiences and selves can be important for help-seeking, but descriptive research on the prevalence of experience- and self-labels among VAW victims is limited. This study sought to fill some of the gaps in this quantitative literature using new measurement tools.

Method

The current study used quantitative survey data from a weighted sample of 1694 community-based women in Alaska who had experienced VAW (determined using behaviorally specific items) to measure the prevalence of a variety of labels these victims could apply to their experiences and selves.

Results

Generally, victims of specific forms of violence had minimal agreement on the terms they used to label their experiences. The most commonly endorsed label was 28.5% of those who had experienced alcohol or drug involved sexual assault applying the label rape to their experiences. Across all victims, the most commonly endorsed self-label was survivor, with one-quarter to one-third endorsing this label, depending on the subsample. Roughly one-tenth used the self-label victim across all subsamples.

Conclusion

VAW service providers should consider labels used to promote services and how to increase awareness about which behaviors constitute VAW; policymakers should improve the accessibility of healthcare so that labeling oneself or one's experiences in a certain way is not a prerequisite of help-seeking; and researchers should continue exploring how to measure experience- and self-labels with minimal priming of participants and greater specificity to the actual experiences with violence.

Unacknowledged and missed cases of sexual victimization: A comparison of responses to broad versus behaviorally specific questions

From the beginning of systematic research on sexual victimization, it has been recognized that a substantial proportion of women report nonconsensual sexual experiences meeting the defining criteria of rape in response to behaviorally specific items, but do not acknowledge their experience as rape in response to broad questions about whether they have ever been raped. Recent studies suggest that rates of unacknowledged rape may be as high or even higher among men than among women. This study examined rates of unacknowledged female and male victims of rape and sexual assault by comparing responses to behaviorally specific items of the Sexual Aggression and Victimization Scale (SAV-S) with responses to broad questions using the labels of sexual assault and rape (SARA) in 593 participants (303 women) in Germany. As predicted, more women and men were classified as rape victims based on behaviorally specific items than on the basis of the broad rape item. The rates of unacknowledged rape were about 60% for women and 75% for men. The gender difference was not significant. Against our prediction, no significant differences in acknowledgement of sexual assault were found in relation to coercive strategy and victim-perpetrator relationship. Few cases of rape and sexual assault identified by the SARA items were missed by the behaviorally specific questions. The implications for establishing prevalence rates of rape and sexual assault and for comparing victims and nonvictims in terms of vulnerability factors and outcomes of sexual victimization are discussed.

A Quantitative Intersectional Exploration of Sexual Violence and Mental Health among Bi + People: Looking within and across Race and Gender

Young bisexual people report disparities related to mental health and sexual violence compared to their heterosexual and gay/lesbian peers. However, the majority of research in these areas does not employ an intersectional design, despite evidence that health outcomes vary by race and gender within bi + populations. The goal of this paper is to provide an intersectionally-informed exploration of the prevalence of sexual violence among a diverse sample of 112 bi + people age 18-26, as well as descriptive data on stigma, mental health, and social support. Most (82%) of participants reported at least once experience of sexual violence since the age of 16. Sexual violence was positively associated with sexual stigma, anxiety, depression, and suicidality. Nonbinary participants reported greater prevalence of violence, exposure to stigma, and worse mental health outcomes relative to cisgender participants. Nonbinary BIPOC participants reported higher levels of anxiety and depression than cisgender BIPOC participants.

Sexual Violence and Mental Health among Young Bi+ and Lesbian Women and Gender Minoritized People

Introduction

Sexual minoritized people report worse mental health and are at risk of sexual violence compared to their heterosexual peers.

Method

We conducted a survey to explore sexual stigma, sexual violence, and mental health among 326 bi+ and lesbian women and gender minoritized people age 18-25.

Results

Mental health did not differ by sexual identity; sexual stigma and violence were associated with negative mental health symptoms, as were identifying as BIPOC, as trans or nonbinary, or having less formal education.

Conclusion

Sexual stigma and violence are related to mental health among young bi+ and lesbian women and gender minoritized people.

Gender violence perpetrated against trans women

ABSTRACT Objectives: to identify scientific evidence on gender violence perpetrated against trans women. Methods: integrative review, carried out in June 2020, without time frame, in the Scopus, MEDLINE, Embase, CINAHL, WoS, PsycInfo and LILACS databases. The controlled descriptors of DeCS, MeSH and their entry terms were used: “Transgender People”, “Transgender”, “Gender Identity”, “Transsexuality”, “Gender Violence”, “Aggression”, “Sexual Offenses”, “Rape”, “Violence”, “Domestic Violence”. The presentation and synthesis of the results were presented in the PRISMA-2009 flowchart. Results: the final sample, consisting of 16 articles, identified different types of violence (sexual, physical, verbal, psychological and financial), perpetrated by family members, strangers, police officers, intimate partners, health professionals, acquaintances, or friends. Conclusions: trans women suffer violence and social exclusion that result from stigma and discrimination due to gender identity and result in unrestricted damage to physical health.

Trauma Symptoms Resulting From Sexual Violence Among Undergraduate Students: Differences Across Gender and Sexual Minority Status

Experiencing sexual violence is an important risk factor for trauma symptoms, and these symptoms significantly impair psychosocial functioning. Sexual and gender minority university students are more likely than their heterosexual and cisgender peers to experience sexual violence (e.g., sexual harassment, unwanted sexual contact, or sexual coercion) while attending university, but research on the consequences of these experiences is needed to inform service provision to these vulnerable populations. Using a large-scale study of university-based sexual violence in Quebec, the current study examined how gender and sexual minority status were associated with the severity of trauma symptoms among students who experienced sexual violence (N = 1,196). Findings indicated that compared with their cisgender peers, gender minority students experienced significantly higher levels of trauma symptoms as a result of sexual violence, controlling for the severity of sexual violence behaviors experienced and other variables. Among cisgender women, but not cisgender men, sexual minority identity was also associated with higher levels of trauma symptoms, controlling for severity of sexual violence behaviors experienced and other variables. Furthermore, gender of perpetrator and amount of sexual violence moderated the associations between sexual identity and trauma symptoms among cisgender women. These findings not only suggest that gender minority and some sexual minority university students are more likely to experience sexual violence, but that they are also more likely to experience negative psychological sequelae as a consequence of these experiences. Ultimately, these findings may suggest the need for services that are more supportive of the specific needs of gender and sexual minority students with regard to sexual violence.

Mental Health and Substance Use Diagnoses and Treatment Disparities by Sexual Orientation and Gender in a Community Health Center Sample

Purpose: This study assessed disparities in screener- and provider-identified mental health and substance use diagnoses and treatment attendance by sexual orientation and gender in an urban community health center focused on sexual and gender minority individuals. Methods: Using an electronic data query (October 2015 to October 2018), computerized screening results assessing likely depression, anxiety, alcohol use disorder (AUD), and substance use disorder (SUDs); provider diagnoses; and treatment initiation related to mental health and substance use were compared across sexual orientation (heterosexual, gay/lesbian, bisexual, and other) and gender categories (men and women, inclusive of cisgender and transgender individuals; N = 24,325). Results: Bisexual and other-identified individuals were more likely to screen positive for depression and anxiety, followed by gay/lesbian women, compared with heterosexual individuals and gay men (χ² = 463.22, p < 0.001 and χ² = 263.36, p < 0.001, respectively). Of those who screened positive for AUDs, women were less likely to be diagnosed by a professional (χ² = 63.79, p < 0.001) and of those who screened positive for either alcohol or other SUDs, women were less likely to attend one or more substance use-related behavioral health appointments, regardless of sexual orientation (contingency coefficient = 0.14, p < 0.001). Conclusion: This community health center study identified a need for increased mental health services for bisexual and other-identified individuals and increased assessment and initiation of substance use treatment for women, including sexual minority women.

Valid for who? A preliminary investigation of the validity of two sexual victimization questionnaires in men and sexual minorities

The #MeToo movement illuminated vast numbers of people who experienced sexual violence, but the exact scope and impact, especially among under-studied populations (e.g., men and sexual minorities) is unclear, due in part to measurement issues. Our objective was to compare the validity of two measures of sexual violence victimization: The Sexual Experiences Survey - Short Form Victimization (SES-SFV) and The Post-Refusal Sexual Persistence Scale - Victimization (PRSPS-V). Participants were 673 college students who first completed the Rape Empathy for Victims (REM-V) and then the SES-SFV and PRSPS-V (counter-balanced). We found strong evidence of convergent validity for the PRSPS-V with correlations ranging from r = .57 - 88. Convergent validity correlations were strongest for sexual minority women (r = .88) and weakest for heterosexual men (r = .57). We also found evidence of differential validity for the SES-SFV and PRSPS-V. For heterosexual women, rape empathy was correlated to victimization on both questionnaires (r = .25 - .29). However, for heterosexual men, only scores on the SES-SFV were correlated with rape empathy for victims (r = .19). For sexual minorities there appeared to be differences between PRSPS-V only victims and those who reported victimization on both questionnaires in rape empathy (F = 2.65, p = .053). These results provide researchers a starting point for improving these questionnaires to collect more accurate data that helps improve the ability to detect cases of sexual victimization and thus, prevent and heal sexual victimization, especially in understudied populations such as men and sexual minorities.

Young Bisexual People's Experiences of Sexual Violence: A Mixed-Methods Study

Bisexual people are at an increased vulnerability for sexual victimization in comparison to heterosexual people, as well as gay and lesbian people. As the majority of first sexual violence experiences happen prior to age 25 for bisexual women, young bisexual people are particularly vulnerable. Despite consistent evidence of this health disparity, little is known about what factors might increase young bisexual people's risk for sexual victimization, or how they access support post-victimization. The current study addresses this gap through a mixed-method investigation of young bisexual people's experiences of sexual violence with a sample of 245 bisexual people age 18-25. Quantitative results indicate that bisexual stigma significantly predicts a greater likelihood of reporting an experience of sexual violence. Qualitative findings support that while not all participants felt bisexual stigma related to their experience of sexual violence, some felt negative bisexual stereotypes were substantial factors. Interview participants found connecting with other survivors, particularly LGBTQ+ and bisexual survivors, to be beneficial. Some participants encountered barriers to accessing support, such as discrimination in schools. Sexual violence researchers should consider bisexual stigma as an important factor, and support services the potential positive impact of bisexual-specific survivor support.

Bisexual Women’s Experiences of Stigma and Verbal Sexual Coercion: The Roles of Internalized Heterosexism and Outness

In the current study, we examined how bisexual women’s unique experiences of sexual identity stigma might elevate their risk for verbal sexual coercion. Online survey data were collected from 350 self-identified bisexual women. Hayes PROCESS macro was used to test moderated-mediation and mediation analyses. Results indicated that anti-bisexual experiences (from both heterosexual and lesbian/gay individuals) were associated with greater internalized heterosexism (i.e., internalization of negative societal attitudes and stereotypes about one’s minority sexual orientation), which in turn was associated with increased odds of experiencing verbal sexual coercion. We did not find moderating effects of outness, such that internalized heterosexism mediated the relation between anti-bisexual experiences and verbal sexual coercion regardless of bisexual women’s levels of outness. Findings suggest that anti-bisexual experiences and internalized heterosexism are associated with bisexual women’s elevated risk for experiencing verbal sexual coercion. There is a need for targeted sexual violence prevention and risk reduction efforts that take into account the unique experiences and vulnerabilities of bisexual women in victimization risk. Results also highlight the need for campaigns that reduce sexual orientation-related stigma at the population level in order to prevent negative health outcomes among bisexual women.

Discrepant Responding across Measures of College Students' Sexual Victimization Experiences: Conceptual Replication and Extension

Sexual violence victimization affects approximately 1 in 5 college women and 1 in 6 college men; however, rates of sexual victimization vary widely, in part due to measurement issues. The present study is the first to compare the Sexual Experiences Survey-Short Form Victimization (SES-SFV) to a measure of sexual victimization designed to capture gender differences, the Post-Refusal Sexual Persistence Scale-Victimization (PRSPS-V). Prior research has compared the perpetration versions of these questionnaires and found large discrepancies. College students (N = 673: 367 women, 298 men, 8 gender minority) were surveyed. The SES-SFV identified 260 cases of sexual victimization whereas the PRSPS-V identified 330 cases; this discrepancy was largest for men. While percent agreement between the two measures ranged from 79.9-92.0%, kappa estimates indicated that agreement was in the weak to moderate range. Kappa estimates tended to be poorer for men than women. These results highlight poor precision in the measurement of sexual violence victimization, even when using well-established measures. The PRSPS-V identified more cases and may be less gender biased. We discuss how differences in questionnaire structure, item structure, and operationalization of consent may account for discordance between the SES-SFV and PRSPS-V even when controlling for item content.