Violence and Trauma Experienced by Lesbians, Gays and Bisexuals

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Boston College
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Despite the significant increase in awareness about gays and lesbians in the society, individuals with same-sex orientation continue to experience trauma due to their sexual orientation. Throughout their lives, gay, lesbian, and bisexual persons experience a lot of violence in their communities. These forms of violence include violent crimes from heterosexual individuals who consider gay life as a violation of societal norms (Roberts, Austin, Corliss, Vandermorris, & Koenen, 2010). As such, negative attitudes have been instrumental in fomenting violence in the gay community (Moskowitz, Rieger, & Roloff, 2010). However, violence towards gay individuals does not come from heterosexual persons alone. According to Roberts et al. (2010), lesbian, gay, bisexual (LGB) persons also mete out violence against one another on a daily basis. This paper will explore consequences of assault on sexual orientation minorities and evidence-based interventions that can be pursued to address the effects of assault on victims.

Part 1: The Consequences of Assault on Gays, Lesbians, and Bisexuals

Violence against individuals with minority sexual orientations over the years has been well-documented (Modi, 2014). Assault is a common form of abuse that LGB persons experience. Assault has been described as the physical attack (or threat of attack) on LGB persons and is mostly manifested in the form of homophobic attacks and intimate partner violence (Fernandez, 2011).

Homophobic individuals hold stereotypes towards LGBs, hence do not like them (Moskowitz, Rieger, & Roloff, 2010).Feelings of dislike are often expressed in the form of attitudes which, in turn, influence the behavior of heterosexuals towards same-sex oriented persons. Behavior is sometimes manifested in open hostility towards LGB persons (Roberts et al., 2010). The attack carried out by Omar Mateen on a gay nightclub in Orlando, Florida, on June 12, 2016, is an example of an assault motivated by hate towards people with minority sexual orientations.

On the other hand, intimate partner violence is committed by LGB persons against their intimate partners. One researcher describes Intimate partner violence (IPV) as violence perpetrated by a current or former intimate partner such as spouse, boyfriend, girlfriend or ex-spouse. Intimate violent acts include acts of physical aggression, sexual assault, and psychological abuse and controlling behavior (Modi, 2014). Sexual assault is a common form of IPV and researchers have shown that it is a major public health problem in America and in the world (Rothman, 2011; Fernandez, 2011; Moskowitz et al., 2010).

Assault is a pervasive problem in many societies. For instance, hate crimes on the basis on of sexual orientation are the third-highest in the United States after those that are based on race and religion (Kaysen, Lostutter, & Goines, 2005). Sexual assault is also a major public health problem in the world. According to Fernandez (2011), approximately 13 percent of women and 3 percent of men worldwide, experience sexual assault in their lifetime. In the US, 17 percent of women and 2-3 percent of men report having had experiences of sexual assault (Rothman, 2011). Women experience most of the effects of assault with statistics indicating that 3 in 10 women experience assault or intimate violence and this is common in male-dominant societies where masculinity is emphasized, and superiority over women is widely tolerated. The sexual assault rate among Native American women is double the rate in other racial groups. Moreover, a growing body of evidence also indicates that GLB youth form the largest portion of the targets of bullying and physical violence (Modi, 2014; Moskowitz et al., 2010). However, Jolly (2014) and Roberts et al. (2010), report that the problem of sexual assault is more prevalent in LGB persons than heterosexuals. Stated in another way, an LGB person is more vulnerable to assault compared to heterosexual individuals.

As demonstrated by a number of studies, assault is a major health problem in the United States and the world as a whole (Modi, 2014; Moskowitz et al., 2010; Rothman, 2011; Fernandez, 2011).It takes forms such as hate attacks, sexual assault, negative messages towards a sexual minority, and rape by intimate partners, among others(Rothman, 2011). It is a problem motivated by complex attitudes stemming from what certain groups of people in society consider as appropriate or unacceptable. Since it takes a long time for attitudes to change, assault on LGB persons may take a long time be accepted as a moral transgression in many societies. Owing to complexity in the manner in which it thrives in society and the far-reaching nature of consequences of assault, it can be concluded that this is a complex issue whose solution may not be determined soon.

The consequences of assault are enormous and are borne by the victims, their families, and nations. For instance, victims of violence against gay persons form an enormous health cost to families of victims and nations. For example, the economy loses the contribution of victims to economic activities due to absence from paid work with statistics showing that the US economy suffers 8 million days of paid work every year to assault and violence related to intimate relationships alone(Modi, 2014).

Apart from death, such physical attacks make LGB people feel vulnerable in the context of the wider society due to their perceived abnormality (Fernandez, 2011; Moskowitz et al., 2010).One study investigating the effects of assault and related violence on victims find that LGB youth who have been bullied or physically attacked have a higher risk of substance abuse and suicide compared to those that do not experience assault (Rothman, 2011). These eventualities not only affect the lives of the victims but also put a strain on their families in terms of treatment resources. Studies carried on women and men show that sexually assaulted LGB persons experience negative long-term health consequences which include higher prevalence rates of suicide attempts, depression, and substance abuse compared to men and women who have not experienced assault. The mentioned problems are higher in LGB women compared to men (Hequembourg, Parks, Collins, & Hughes, 2014).A combination of the mentioned effects significantly lowers the general quality of life of the affected persons.

Most victims who abuse substances due to depression caused by assault have a higher risk of developing posttraumatic stress disorder (Fernandez, 2011). Often, internalized homophobia aggravates the experiences of LGB individuals thereby increasing their changes developing PSTD. Internalized homophobia is the process where victims of assault absorb negative messages regarding their victimhood and sexual minority into self-perceptions (Hequembourg et al., 2014). This pattern of thoughts encourages feelings of self-dislike which, in turn, degenerates into a mental disorder. In this regard, evidence suggests men are less likely to report cases of sexual assault compared to women (Rothman, 2011). As a result, internalized feelings of dislike are more severe compared to women hence the higher the risks of developing posttraumatic stress disorder in men.

Part 2: Strategies of Intervention Plan

Supportive counseling has been identified as one of the most effective ways of dealing with victims of assault, including cases related to sexual assault and hate crimes. One study conducted on the perceptions among survivors on the effectiveness of supportive counseling finds that supportive counseling is the most effective evidence-based intervention in addressing the trauma of sexual assault (Artime & Buchholz, 2016).

Cognitive processing therapy is also frequently used in treating trauma. Evidence-based research findings show that is it is an effective intervention when compared with other approaches except for supportive counseling therapy. Indeed, a comparative research conducted by Nixon (2012) regarding the efficacy of supportive counseling and cognitive processing therapy found that the two interventions are equally effective in reducing symptoms at posttreatment phase.

Cognitive processing therapy identifies the challenges faced by the victim when they attempt to process trauma-related information (Vickerman & Margolin, 2009). This treatment entails interventions such as psychoeducation and cognitive approaches. Cognitive processing therapy also involves extracting beliefs from patients about the implications of the trauma they are going through in their lives. In the end, the therapy has to handle trauma-triggering issues such as safety, power, trust, esteem, and intimacy. A process that mitigates the enumerated aspects of trauma effectively has been found to be very effective in addressing the symptoms of stressful experiences such as sexual assault (Artime & Buchholz, 2016; Vickerman & Margolin, 2009).

A number of studies have shown the effectiveness of supportive counseling in treating victims of assault (Vickerman & Margolin, 2009; Nixon, 2012; Artime & Buchholz, 2016).It is a standard approach used to support victims whose stress levels have degenerated into mental disorders. One study found that people with psychiatric disorders such as posttraumatic stress disorders (PSTD)seek medical attention in hospitals because they lack appropriate interventions in social settings (Duncan & Hatzenbuehler, 2014).According to Vickerman and Margolin (2009), counseling support helps trauma victims by mitigating the effects of anxiety, depression, fear, and loss of self-esteem. Invariably, therapists seek to re-engineer the negative thoughts of victims through the provision of positive alternatives to processing information related to the assault experiences.

Among LGB persons, it is critical that counseling support recognizes the settings in which assault takes place (Artime & Buchholz, 2016). As such, consideration of socio-context factors such as neighborhoods in which victims live can be useful in enhancing the effectiveness of counseling support as a mitigation strategy. As explained by Duncan and Hatzenbuehler ( 2014), this is because trauma resulting from assault of gay persons is not exacerbated only by the negative patterns of thoughts among the victims themselves but also the social environments (such as family, peer groups, neighbors, and the community) in which the victims spend their lives on a daily basis.

Determining the choice Between Cognitive Processing Therapy and Supportive Counseling

The choice of therapy in addressing LGB issues is influenced by the nature of the complications that the said persons exhibit (Artime & Buchholz, 2016). As indicated in the previous paragraphs, victims of assault such as hate crimes and sexual assault experience episodes of depression, anxiety, PTSD, and anger. Enhancement of the cognitive skills of the victims can be effective in addressing psychological distress among LGB persons hence the preference for cognitive processing therapy in such cases (Duncan & Hatzenbuehler, 2014; Kaysen, Lostutter, & Goines, 2005).It should be noted, however, that cognitive processing therapy is not a cure-it-all approach but the best available option in addressing extreme cases of trauma such as PSTD (Artime & Buchholz, 2016).

On the other hand, support counseling is preferable in cases where the severity of the symptoms is relatively low. Here, the victims can internalize the counsel of a therapist on how to deal with anxiety, depression, and stress, among other symptoms. It is also a multi-dimensional in the sense that it can be used to treat patients alongside other interventions (Kaysen, Lostutter, &...

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