Abstract
This cross-sectional study documented between-group differences in risk factors associated with sexual victimization histories in an ethnically and racially diverse sample of transgender emerging adults (N = 248, ageM = 22.61 years). The sample was recruited using the Internet-based CloudResearch platform to answer questionnaires assessing predictors for recent experiences of intimate partner violence (IPV). Participants were categorized into four groups based on cross-classified self-reports of child sexual abuse (CSA) and recent sexual IPV, prior to the use of multivariate analysis of variance to evaluate mean score differences for past-year substance use, minority stressor, and relationship functioning variables. Participants reporting sexual IPV reported higher scores for all substance use variables, while transfeminine participants reported significantly higher scores for alcohol use problems and negative consequences related to substance use. Participants reporting both CSA and sexual IPV also reported the highest scores for everyday discrimination. Participants who experienced sexual IPV also reported the highest scores for internalized sexual stigma. Sexual revictimization among transgender adults occurs in the context of harmful patterns of substance use and several minority stressors. Our findings have implications for healthcare or counseling services for transgender emerging adults who have experienced multiple forms of victimization, substance use problems, and minority stressors, including the importance of trauma-informed and integrated intervention services, and specialized training for service providers.
Pervasive public health threats experienced by transgender people include the multiple forms of interpersonal violence to which they are disproportionately exposed (Reisner, Poteat, et al., 2016; Wirtz et al., 2020). Analyses of the U.S. Transgender Survey data (Messinger et al., 2022) revealed that almost 70% of the sample reported experiencing one or more forms of violent victimization, including lifetime intimate partner violence (IPV; 55.2%) and lifetime nonpartner sexual assault (41.0%). These findings are supported by data from the National Crime Victimization Survey that documented an interpersonal victimization rate four times higher among transgender compared to cisgender respondents (86.2 vs. 21.7 per 1,000) (Flores et al., 2021). The purpose of the present study, guided by the Sexual Minority Alcohol-Related Intimate Partner Violence Perpetration Model (Shorey et al., 2019), was to describe multivariate differences in risk factors for IPV drawn from this model, between groups of transgender emerging adults defined by (a) their lifetime sexual victimization experiences and (b) their transgender identity. This information is essential to tailor interventions for victimization-related trauma or harmful substance use among transgender adults (Glynn & van den Berg, 2017; Shipherd et al., 2019).
Transgender persons are substantially more likely to experience gender-based violence, which includes forms of sexual victimization (Wirtz et al., 2020). In their systematic review, Schneeberger et al. (2014) provided estimates of median prevalence rates for child sexual abuse (CSA) in transgender populations using both probability (20.7%) and nonprobability (33.5%) samples. In a national sample of adolescent Internet users, transgender youth reported the highest rate (82%) of sexual harassment (Mitchell et al., 2014). Transgender adolescents are also at substantially higher risk for sexual coercion and assault both in and outside the context of dating relationships (Dank et al., 2014; Norris & Orchowski, 2020). Data from the National College Health Assessment-II documented significantly higher rates of multiple forms of sexual victimization among transgender emerging adults compared to cisgender men and women (Griner et al., 2020). Transgender adults are also 2.5 times more likely to experience sexual IPV, compared to their cisgender counterparts (Peitzmeier et al., 2020).
Accumulating evidence suggests that substantial proportions of sexual minority persons experience lifetime sexual revictimization, for example, sexual victimization during both childhood and adulthood (Heidt et al., 2005; Whitton et al., 2019). The present study, guided by the Sexual Minority Alcohol-Related Intimate Partner Violence Perpetration Model (Shorey et al., 2019), was conducted to determine what risk factors are associated with a typology of patterns of lifetime sexual victimization, including during childhood and in intimate relationships. This model, which draws on Alcohol Myopia Theory (Steele & Josephs, 1990), as well as Minority Stress Theory (Meyer, 2003) and the I3 metatheory of interpersonal aggression (Finkel & Hall, 2018), highlights how specific factors interact to increase the likelihood of IPV among sexual minority dyads. While the generalizability of the model to gender minority adults is unknown, it provides a conceptual framework to pursue our inquiry. Specifically, the probability of IPV is determined by risk factors that mark underlying processes such as: (a) factors that provoke negative behaviors (instigation), for example, dysfunctional interactions with a partner; (b) factors that enhance negative responses (impellance), for example, minority stressors; and (c) factors that influence whether an aggressive response is expressed or not (inhibition), for example, substance use.
Factors associated significantly with risk for victimization, including sexual victimization, among sexual minority persons have been identified, (e.g., Edwards et al., 2015; McGeough & Sterzing, 2018). However, application of the Shorey et al. (2019) model to data collected from transgender emerging adults presents an opportunity to enhance our current understanding of factors associated with sexual victimization among transgender persons, including potential differences between persons who identify as transmasculine or transfeminine. These are important gaps in the available research and practice literatures, that reflect existing disparities in healthcare for diverse groups within the larger transgender community (Reisner, Radix, & Deutsch, 2016; Velasco et al., 2022). Comparisons of groups of transgender persons based on their experiences of sexual victimization during childhood and adulthood are likely to generate important data regarding differences in multivariate patterns of variables associated with sexual victimization. This strategy was implemented by Heidt et al. (2005) to describe between-group differences in mental health symptoms among sexual minority adults based on sexual victimization status.
The Present Study
The present cross-sectional study is intended to describe between-group differences in an Internet-recruited sample of transgender emerging adults, grouped by their experiences of CSA and adult sexual IPV, as well as by transgender identity, in risk factors for sexual IPV, guided by the model of Shorey et al. (2019). Multivariate group differences were examined using multivariate analysis of variance (MANOVA) for three sets of variables: (a) past-year substance use involvement, (b) minority stressors, and (c) intimate relationship functioning. We hypothesized that transgender emerging adults who reported more extensive sexual victimization experiences would also report higher mean scores for indicators of substance use involvement, minority stressors, and dysfunctional intimate relationships. We also hypothesized that transfeminine participants would report higher scores for one or more of the risk factor domains related to IPV experiences, due to existing research documenting higher rates of specific forms of IPV among transfeminine persons, compared to transmasculine persons (Goldenberg et al., 2018; Kattari et al., 2022).
Methods
Participants
This study included a sample of emerging adults (N = 248) who identified as transgender, recruited via the Internet through a CloudResearch managed project. The participants reported a mean age of 22.61 years (SD = 3.06 years). Participants reported that they identified as Black/African-American (n = 55, 22.2%), White (n = 152, 61.3%), Asian, Pacific Islander or Desi (n = 10, 4.0%), Native American or First Nation (n = 3, 1.2%), Biracial or Multiracial (n = 12, 4.8%), or another racial group (n = 16, 6.5%). Participants included 60 persons (24.3%) who identified as Latine. Participants identified as either transgender male (n = 172, 69.4%) or transgender female (n = 76, 30.6%). With regard to sexual identity, participants reported that they identified as: Heterosexual (n = 28, 11.3%), Lesbian/Queer (n = 21, 8.5%), Gay/Queer (n = 66, 26.6%), Bisexual (n = 76, 30.6%), Pansexual (n = 34, 13.7%), Asexual (n = 7, 2.8%), Sexually Fluid or Flexible (n = 11, 4.4%), or another sexual identity (n = 3, 1.2%).
Measures
Self-Reported Sexual Victimization
Several items were used to classify participants with regard to their experiences of sexual victimization. One item from the Adverse Childhood Experience Questionnaire (Felitti et al., 1998) was used to determine if participants experienced sexual victimization prior to age 18 years: “Did an adult or person at least 5 years older than you ever touch or fondle you or have you touch their body in a sexual way or attempt or actually have oral, anal or vaginal intercourse with you?” Recent sexual IPV was assessed using two items from the Composite Abuse Scale (Revised)—Short Form (CASR-SF; Ford-Gilboe et al., 2016): “Made me perform sex acts that I did not want to perform” and “Forced or tried to force me to have sex.” All three items were scored dichotomously, either (1) Yes or (0) No. A positive response on either item from the CASR-SF indicated that the study participant experienced recent sexual IPV. Dichotomous indicators of sexual victimization during childhood and sexual IPV were cross-classified to form a four-part sexual victimization categorization scheme.
Substance Use Involvement Variables
Alcohol Use Disorders Identification Test
The self-report version of the 10-item Alcohol Use Disorders Test (Babor et al., 1992) was used to assess past-year alcohol-related harm. Most items on this screener (e.g., “How often during the last year have you had a feeling of guilt or remorse after drinking?”) are scored from (0) Never to (4) Daily or almost daily except for two items that are scored (0) No, (2) Yes, but not in the last year or (4) Yes, during the last year. Item scores are summed for a total score of 0 to 40 and used to assign individuals to alcohol use risk categories: (0–3) Low Risk, (4–9) Risky, (10–13) Harmful, or (14+) Severe. In our sample, the Alcohol Use Disorders Identification Test (AUDIT) had excellent internal consistency (α = .90).
Drug Abuse Screening Test
The Drug Abuse Screening Test (DAST-10) (Skinner, 1982) was used to assess past-year drug use involvement. The 10 items on this self-report screener (e.g., “Do you abuse more than one drug at a time?”) are scored (1) Yes or (0) No and are summed to create a total score ranging from 0 to 10, with higher scores indicating greater drug use involvement. The total score can also be used to assign risk classifications to individuals, that is, (0) No problems reported, (1–2) Low Level, (3–5) Moderate Level, (6–8) Substantial Level, or (9–10) Severe Level. In our sample, the DAST-10 had high internal consistency (α = .83).
Short Inventory of Problems
The 17-item self-report Short Inventory of Problems (SIP-R) (Kiluk et al., 2013) was used to assess negative consequences due to substance use involvement during the past 90 days. Each item (e.g., “My physical health has been harmed by my drinking or drug use.”) is rated (0) Never, (1) Once or a few times, (2) Once or twice a week, or (3) Daily or almost daily. Item scores can be summed for a total score, as well as domain scores for five areas of substance use-related consequences (i.e., physical, social, intrapersonal, interpersonal, and impulse control). The SIP-R has significant correlations with measures of addiction severity, readiness to change, and treatment retention, as indicators of concurrent and predictive validity (Kiluk et al., 2013). In our sample, the SIP-R had excellent internal consistency (α = .96).
Minority Stressors
The Nebraska Outness Scale
The 10-item self-report Nebraska Outness Scale (NOS) (Meidlinger & Hope, 2014) was used to measure two related constructs: disclosure and concealment of sexual orientation. Each subscale (i.e., the NOS-D & NOS-C) was assessed by 5 items. The stimulus item for NOS-D is, “What percentage of the people in this group do you think are aware of your sexual orientation?” while the stimulus item for NOS-C is, “How often do you avoid talking about topics related to or otherwise indicating your sexual orientation when interacting with members of these groups?” Each group (members of your immediate family, members of your extended family, people you socialize with, people at your work/school, strangers) is rated on an 11-point format, from 0% to 100%. In our sample, both the NOS-D (α = .77) and the NOS-C (α = .79) demonstrated acceptable internal consistency.
Everyday Discrimination Scale
The Everyday Discrimination Scale (EDS) (Williams et al., 1997) was used to measure perceived unfair or discriminatory treatment by others in the context of everyday social situations. This widely used scale includes the stimulus item, “In your day-to-day life, how often do any of the following things happen to you?” to measure the frequency of nine discriminatory actions (e.g., “You are threatened or harassed,” “People act as if they are afraid of you”). Each action is rated from (1) Never to (6) Almost every day. In the present study, the EDS had excellent internal consistency (α = .92).
Felt Stigma
Participants’ awareness and expectancies regarding community manifestations of sexual stigma were measured via three items from Herek (2009). Sample items include: “Most people where I live think less of a person who is gay” and “Most people where I live would not want someone who is openly gay to take care of their children.” Each statement was rated using a five-point Likert scale that ranged from (5) Strongly agree to (1) Strongly disagree. For each item, the word “gay” was replaced by the word “transgender.” In the present study, the internal consistency of the three items was modest (α = .60).
Internalized Sexual Stigma
Participants’ degree of agreement with indicators of sexual stigma reflective of their self-perceptions was measured using the Revised Internalized Homophobia Scale (IHP-R; Herek et al., 2009). The nine items were modified slightly to be congruent with transgender identity. Sample items included: “I wish I weren’t transgender” and “I feel that being transgender is a personal shortcoming for me.” Items were rated using a five-point Likert scale that ranged from (1) Disagree strongly to (5) Agree strongly. In the present study, the internal consistency of the nine items was excellent (α = .90).
Relationship Functioning
Relationship Satisfaction
Participants’ global satisfaction with their primary intimate relationship was assessed using the Couples Satisfaction Index (CSI-4; Funk & Rogge, 2007). This measure contains three six-point Likert scale items assessing (a) warmth and comfort, (b) degree of reward, and (c) satisfaction with a current intimate relationship. Items include “How rewarding is your relationship with your partner?” and “In general, how satisfied are you with your relationship?” scored from (0) Not at All to (6) Completely. This measure also contains one seven-point Likert scale item assessing global degree of happiness with the relationship. Responses are summed across items to form a total score, ranging from 0 to 21. In the present study, the internal consistency of the four items was excellent (α = .93).
Partner Respect
Participants’ respect for their primary intimate relationship partner was assessed using the Respect Towards Partner Scale (Hendrick & Hendrick, 2006). This measure consists of six items that measure multiple aspects of partner respect, with each rated on a five-point Likert scale, from (1) Strongly Agree to (5) Strongly Disagree. Sample items include, “I am interested in my partner as a person” and “I honor my partner.” Items are averaged to form a mean score. The internal consistency coefficient was high for this scale (α = .85) in our study.
Relationship Quality
Participants’ global ratings of the quality of their current primary intimate relationships were assessed using the Abbreviated Dyadic Adjustment Scale (DAS-7; Hunsley et al., 2001). This seven-item measure has three items that ask about the extent of agreement in specific areas (e.g., “Aims, goals, and things believed important” or “Philosophy of life”) that are rated on a six-point scale, from (5) Always Agree to (0) Always Disagree. The DAS-7 also includes three items about the frequency of shared activities such as, “Calmly discuss something together” or “Work together on a project”, rated from (0) Never to (5) More Often Than Once a Day. This measure also contains one seven-point Likert scale item assessing the degree of overall happiness with the relationship. Responses are summed across items to form a total score, ranging from 0 to 36. The internal consistency coefficient was good for this scale (α = .78) in our study.
Relational Aggression and Victimization
Participants’ experiences of aggression and victimization in the context of recent romantic or sexual relationships were assessed using two scales from Linder et al. (2002). Each scale contained five items, with a seven-point Likert response format ranging from (1) Never to (7) Always. Items used to assess relational aggression included, “I try to make my romantic partner jealous when I am mad at him/her” and “I give my romantic partner the silent treatment when s/he hurts my feelings in some way.” Items used to assess relational victimization included, “My romantic partner has threatened to break up with me in order to get what s/he wants” and “When my romantic partner is mad at me, s/he won’t invite me to do things with our friends.” Internal consistency coefficients were high for both relational aggression (α = .89) and relational victimization (α = .91) for our sample.
Procedures
Data were collected using questionnaires that were distributed using the Qualtrics platform to transgender emerging adults. Participant recruitment to complete the study questionnaire occurred through a CloudResearch managed project. Data collection occurred from September 21st through November 28th, 2022. Potential participants were screened using the following inclusion criteria: (a) age 18 to 29 years; (b) alcohol consumption during the past year; and (c) current transgender male or transgender female identity. Data quality safeguards included: using participants from the CloudResearch Approved Group; limiting geolocations to inside the US; blocking duplicate submissions from the same IP addresses; and reviewing all completed surveys to screen for completion times less than 50% of the estimated 20-minute completion time, nonrandom missing data, inconsistent responses, straight-lined, or other systematic patterns of responses (e.g., Christmas tree responses). There were 570 responses to the Transgender Emerging Adult Survey, resulting in 248 completed validated surveys and 82 completed but rejected surveys. Prior to beginning the questionnaire in Qualtrics, participants provided informed consent. Participants were compensated $10.00 for a completed survey. As part of a debriefing script, all participants were provided information regarding nationally available resources for domestic violence and substance use problems.
Analytic Plan
The analytic plan proceeded in three steps. First, univariate descriptive statistics were used to examine the distributional characteristics of all variables included in multivariate analyses. Second, sexual victimization variables for childhood and adulthood were cross-tabulated to create a four-part categorization scheme for subsequent MANOVA models. Third, three MANOVA models were conducted to evaluate the main effects of (a) sexual victimization category and (b) transgender group (i.e., transmasculine, transfeminine) on mean scores for variable sets representing: past-year substance use involvement, minority stressors, and relationship functioning. Multivariate patterns of significant between-group differences in substance use, minority stressors, and relationship functioning across sexual victimization categories and transgender groups were documented to inform service provision or counseling initiatives for victimized transgender emerging adults. All analyses were conducted using IBM SPSS Statistics, Version 29.0 (IBM Corporation, 2022).
Results
Descriptive Analyses
Table 1 summarizes data regarding the distributional characteristics of the 13 dependent variables included in MANOVA models for our sample of transgender emerging adults. The findings of our cross-sectional study are comparable to other studies of violent victimization of transgender adults (e.g., Messinger et al., 2022). The majority (54.8%) of the transgender emerging adults in our study reported a lifetime history of sexual abuse and 19.4% reported both CSA and revictimization by a romantic or sexual partner. More generally, 30.6% of participants (n = 76) reported that an intimate partner “forced or tried to force me to have sex” and 26.6% (n = 66) reported that a partner “made me perform sex acts that I did not want to perform.” Participants reported experiencing a mean of 3.64 types of IPV. In addition, over half of our sample of emerging adults reported clinically significant substance use problems, that is, AUDIT scores of 10 or higher (n = 129, 52.0%), or DAST-10 scores of 6 or higher (n = 67, 27.1%). The cross-classification of the dichotomous CSA variable and the dichotomous sexual IPV variable yielded four groups of transgender adults based on their sexual victimization experiences: Never Sexually Victimized (n = 112, 45.2%), CSA Only (n = 41, 16.5%), Adult Sexual IPV (n = 46, 18.5%), and CSA and Adult Sexual IPV (n = 48, 19.4%). This classification scheme provided the four sexual victimization groups for subsequent MANOVA models.
Distributional Characteristics of Study Variables.
Note. N = 248; AUDIT = alcohol use disorders identification test total score; DAST-10 = drug abuse screening test total score; SIP-R = short inventory of problems total score; NOS-D = Nebraska outness scale-disclosure mean score; NOS-C = Nebraska outness scale-concealment mean score.
Multivariate Analyses
Substance Use
Table 2 summarizes total past-year substance use involvement scores for risky alcohol use (AUDIT scores), risky drug use (DAST-10 scores), and negative consequences of substance use (SIP-R scores) by sexual victimization group. There was a significant multivariate pattern of between-group differences in total past-year substance use scores by sexual victimization group (Pillai’s Trace = .17, F[9, 717] = 4.74, p < .001). There was also a significant multivariate pattern of between-group differences in total past-year substance use scores by transgender group (Pillai’s Trace = .04, F[3, 237] = 3.29, p = .021). Significant differences existed for between sexual victimization groups for AUDIT scores (F[3, 239] = 3.25, p = .023), DAST-10 scores (F[3, 239] = 8.45, p < .001), and SIP-R scores (F[3, 239] = 6.41, p < .001). Participants reporting sexual revictimization via IPV reported higher mean scores on the AUDIT than participants with no history of sexual victimization (15.96 vs. 11.19). Participants who reported sexual revictimization via IPV (M = 5.04) or sexual IPV in adulthood (M = 4.22) reported higher scores on the DAST-10 than participants with no history of sexual victimization (M = 2.65). Participants who reported sexual revictimization via IPV (M = 21.25) reported higher scores on the SIP-R than participants with no history of sexual victimization (M = 12.09) or participants who reported CSA only (M = 11.98). Compared to transmasculine participants, transfeminine participants reported significantly higher mean total scores for the AUDIT (15.00 vs. 11.46), F(1, 239) = 9.49, p = .002 and the SIP-R (17.43 vs. 13.58), F(1, 239) = 4.98, p = .027. All statistical interactions between sexual victimization group and transgender group for past-year substance use involvement scores were nonsignificant.
Mean Substance Use, Minority Stress, and Relationship Functioning Variable Scores by Sexual Victimization Groups.
Note. N = 248; AUDIT = alcohol use disorders identification test total score; DAST-10 = drug abuse screening test total score; HSD = Honestly Significant Difference; SIP-R = short inventory of problems total score; NOS-D = Nebraska outness scale-disclosure mean score; NOS-C = Nebraska outness scale-concealment mean score.
p < .05; **p < .01; ***p < .001. Means with different letter subscripts are significantly different from one another via Tukey HSD test p < .05.
Minority Stressors
Table 2 summarizes mean minority stress variable scores by sexual victimization group. There was a significant multivariate pattern of between-group differences in mean minority stress variable scores by sexual victimization group (Pillai’s Trace = .14, F[15, 714] = 2.27, p = .004) but not by transgender group (Pillai’s Trace = .04, F[5, 236] = 1.86, NS). Significant between-group differences were documented for the EDS, F(3, 240) = 5.71, p < .001 and the IHP-R, F(3, 240) = 4.13, p = .007. All statistical interactions between sexual victimization group and transgender group for mean minority stress variable scores were nonsignificant. Participants who reported sexual revictimization via IPV (M = 4.00) reported higher scores on the EDS than participants with no history of sexual victimization (M = 3.11) or participants who reported CSA only (M = 3.35). Participants who reported sexual revictimization via IPV (M = 2.42) or who reported sexual IPV in adulthood only (M = 2.49) reported higher scores on the IHP-R than participants who reported CSA only (M = 1.90).
Relationship Characteristics
Table 2 also summarizes mean relationship characteristics variable scores by sexual victimization group. The multivariate pattern of between-group differences in mean relationship characteristics variable scores was not significant for either sexual victimization group (Pillai’s Trace = .07, F(15, 714) = 1.10, NS) or transgender group (Pillai’s Trace = .04, F[5, 236] = 1.82, NS). All statistical interactions between sexual victimization status and transgender group for mean relationship characteristics variable scores were also nonsignificant.
Discussion
The findings of the present study provided partial support for each of the hypotheses evaluated using a multivariate data analytic strategy. Specifically, more extensive lifetime experiences of sexual victimization among transgender emerging adults were associated with higher mean scores for substance use involvement variables, and two important minority stress variables, but not with indicators of relationship functioning. In addition, participants who identified as transfeminine, compared to those who identified as transmasculine, reported higher mean scores for problem alcohol use and negative consequences related to substance use, but not for either minority stressor or relationship functioning variables. The multivariate analytic strategy implemented in this study documented complex associations among sexual victimization, minority stressors, and harmful patterns of substance use (e.g., Rimes et al., 2019; Testa et al., 2012; Whitton et al., 2019). Our findings highlighted the importance of screening transgender emerging adults for lifetime traumas, including IPV, as well as a range of co-occurring individual and social factors that may interact to increase the probability of IPV among transgender persons (Shorey et al., 2019). Comprehensive screening initiatives are critical in efforts to address health disparities experienced by transgender persons, which may vary substantially across this heterogeneous population (Feldman et al., 2016; Wylie et al., 2016).
Our findings, documenting multivariate patterns of between-group differences among transgender emerging adults, based on the extensiveness of their sexual victimization experiences, provide initial information on the generalizability of the model of Shorey et al. (2019) to sexual IPV among transgender emerging adults. The present study also replicates, in a sample of transgender emerging adults, risk factors for IPV victimization identified in samples of sexual minority adults including: internalized sexual stigma and expectations of discrimination (Berke et al., 2023; Carvalho et al., 2011) and harmful substance use (Duncan et al., 2018; Eaton et al., 2008; Kelly et al., 2011). An additional innovative feature of the present study is the identification of a significant difference between transmasculine- and transfeminine-identified participants with regard to a multivariate pattern of risky substance use. This group difference may increase vulnerability to sexual IPV, highlighting an important source of heterogeneity within a larger transgender population.
Our findings highlighted a confluence of risk factors, in particular for transfeminine-identified emerging adults, that exacerbate their risk for experiences of sexual IPV. It is critical that our findings be used to reduce risk for future sexual IPV among transgender emerging adults, drawing on IPV risk reduction strategies used by other vulnerable groups. While conceptualizations of IPV among sexual or gender minority clients may be distorted by heteronormative perspectives (Kar et al., 2023), there are several strategies for IPV risk reduction that appear to apply to transgender emerging adults. For example, the enhancement of social support systems and community connectedness can serve a protective function against internalizing problems and potentially reduce the likelihood of additional victimization experiences (Garthe et al., 2020). Economic support programs provide for a vulnerable person’s basic needs so that greater financial independence enables that person to leave an abusive relationship (Matjasko et al., 2013). This form of support is particularly relevant to the economic circumstances of many transgender emerging adults, who often experience transphobia, familial rejection, and economic marginalization (Mizock & Hopwood, 2018). Standard safety planning protocols may be tailored to accommodate the unique lived experiences and IPV forms reported by transgender individuals (Sherman et al., 2023). Efforts to reduce the likelihood of violence in the intimate relationships of transgender emerging adults may also focus on improving couple communication and conflict management skills. Such efforts are likely to be engaging if they focus on content relevant to the experiences and dynamics of participating couples (Cook-Daniels, 2015).
The findings of our study have implications for provision of healthcare services and counseling to transgender emerging adults who have experienced lifetime sexual victimization and revictimization by romantic or sexual partners. First, our findings highlight the importance of a trauma-informed perspective for healthcare service delivery to transgender or gender nonconforming clients in order to improve their engagement and the effectiveness of services received (Elze, 2019; Scheer & Poteat, 2021). Second, the experience of sexual IPV in the context of ongoing substance use and minority stressors emphasizes the importance of multidimensional assessments and targeted efforts to interrupt one or more processes that initiate or maintain sexual IPV episodes (e.g., Lewis et al., 2017). Third, practitioners who counsel transgender clients to address the trauma associated with sexual IPV and other forms of violence must have sufficient familiarity with the heterogeneity of this population to flexibly engage potential barriers to help-seeking, including minority stressors (e.g., internalized stigma, rejection expectancies, and discrimination experiences) and shame (Calton et al., 2016). Fourth, the ability of service providers to address the impact of sexual IPV on the health and mental well-being of transgender clients depends in large part on their understanding of the relational contexts of IPV, gender and power dynamics, as well as structural factors that promote violence in interpersonal relations (Akande et al., 2022; Barrett & Sheridan, 2017; Ford et al., 2013).
Our study documented important multivariate between-group differences among transgender emerging adults, based on their lifetime experiences of CSA and sexual IPV. These findings must be interpreted with care due to methodological limitations in the study. First, the amount of information used in the categorization scheme was limited and did not include details regarding perpetrators, the acts perpetrated, or the extensiveness of sexual abuse. Second, our study was cross-sectional and the paths of influence among variables such as sexual IPV, minority stress, and substance use cannot be determined. Third, all data collected in the study were self-report and susceptible to all of the potential biases of self-report methods. Fourth, our sample was collected in collaboration with an Internet-based platform (i.e., CloudResearch), a decision that may limit the generalizability of our findings, as may the self-selected nature of our sample. Despite these limitations, our study generated innovative data about factors associated with the sexual victimization experiences of transgender emerging adults. In addition, the heterogeneity of those relations may be used to tailor healthcare services or trauma-informed counseling to address health and mental health disparities in this population.
Footnotes
Author Contributions
Jonathan G. Tubman conceptualized the study, supervised study implementation and data collection. All authors participated in manuscript writing, data interpretation, text revisions, and approved the final version of the manuscript. All authors agree to be accountable for the accuracy and integrity of the content of the manuscript.
Availability of Data
Data are available upon request from the first author.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research and/or authorship of this article: Data collection for the present study was supported by seed award funding from the College of Arts and Sciences and the Department of Psychology at American University.
Ethics Approvals
The Institutional Review Board of the host university approved the study that collected the data used in this manuscript.
Consent to Participate
Participants provided active informed consent to participate in the study.
