(WITHDRAWN) Contextualizing Intimate Partner Violence Histories of Sexual Minority Women

Background: Intimate partner violence (IPV) is a prevalent public health concern experienced by as many as one in three U.S. women over their lifetime. A growing body of literature indicates that sexual minority women – those who identify as lesbian, gay, or bisexual; experience same-gender sexual attraction; and/or who have same-gender sexual partners – are more likely than their completely heterosexual counterparts to experience IPV. However, research has largely been quantitative and cross-sectional, leaving much to be understood about the contexts of women’s abusive relationships. The purpose of this study was to identify whether sexual minority women experienced IPV in relationships with men, women, or nonbinary partners, and whether and how stressors related to sexual orientation shaped risk for IPV.

Methods: We conducted in-depth, face-to-face interviews with women (n=25) ages 18 to 34 seeking care from sexual and reproductive health clinics in Western Pennsylvania who met the following inclusion criteria: 1) they had ever had sex with women; and 2) they had experienced physical or sexual IPV in their lifetime. Interviews -- which addressed relationship histories, sexualities, adverse childhood experiences, and care seeking – were audio-recorded and transcribed verbatim. We conducted thematic analysis, using structural codes to address main research questions and open coding to allow additional themes to emerge. Study procedures were approved by institutional review boards at University of Pittsburgh and Michigan State University.

Results: Participants described their sexual orientation in one of three ways: gay, lesbian or bisexual; heterosexual with attraction to women but “could never date women;” or heterosexual and engaged in hookups with women at the prompting of a male partner. Importantly, participants did not always disclose their relationships with women without the probing of the study interviewer. Women primarily experienced physical and sexual IPV in relationships with men and emotional abuse in relationships with women. While women-perpetrated physical or sexual IPV was not common, participants described their experiences with men and women differently. Participants were more likely to describe IPV perpetrated by men as physically violent, including the use of weapons. In contrast, they described IPV perpetrated by women to be less physically violent and more coercive. Participants described stressors related to sexual orientation that shaped participants’ same-gender relationships: being at different stages in the coming out process, partner discordance in same-gender sexual attraction, and internalized homonegativity. There were notable contextual factors that emerged across participants experiences, including homophobic family environments, histories of adverse childhood experiences, and substance use (by participants themselves, by their partners, and by their families).

Conclusions and Implications: While sexual minority women are disproportionately burdened by IPV, they are more likely to experience this form of violence in their relationships with men, not women. Findings from this unique care-seeking sample of ‘mostly heterosexual’ women suggest that clinicians working with sexual minorities would benefit from asking about women’s relationship histories and the contexts of their relationships, refraining from making assumptions about their experiences, to inform clinical decision-making.