Page 241 - Cultural Competence in Health Education

Culture and Sexual Orientation 219

transphobic laws and procedures, and coming out to family members, friends, and
coworkers.
In addition to depression and substance abuse, domestic violence is also problem-
atic in LGBT communities. According to a 2001 study, 2,183 LGBT persons reported
domestic violence to the National Coalition Against Domestic Violence. Forty - three
percent of the domestic violence survivors were lesbians, 49 percent were male, and

4 percent identified as transgender (National Coalition Against Domestic Violence,
2003). Although domestic violence centers on power and control in LGBT relation-
ships, as it does in heterosexual relationships, it also has unique elements when it
occurs in LGBT relationships. One of the major ways abusers control victims is
through the victims ’ fear that their abusers will “ out ” them (disclosing their LGBT
identity to family, friends, coworkers, and so forth). This results in LGBT people not
reporting domestic violence. Another reason that LGBT people do not report domestic
violence is fear of a homophobic and transphobic legal system, where same - sex rela-
tionships are not afforded the same legal rights as opposite-sex relationships. This can
become a tool used by the batterer, who may repeatedly tell the victim that he or she
will never be helped by the legal system. There are several institutional barriers to
obtaining domestic violence services as well. For example, crime victims ’ compensa-
tion (CVC) programs provide services only to legally married couples. Because LGBT
people cannot legally marry in the majority of the states in the United States, they are
often denied these services (Baernstein et al., 2006).
Along with domestic partner violence, external anti - LGBT violence and hate
crimes also harm the health of LGBT people. It is estimated that up to 80 percent of
hate crimes toward LGBT individuals are never reported to authorities (Public Health —
Seattle and King County, 2004). Violence resulting from hate crime, domestic violence,
suicide, and other forms of physical, sexual, emotional, and environmental violence
takes a heavy toll on the LGBT population. Between one - quarter and one - third of all
LGBT individuals have experienced domestic violence. LGBT individuals are more
than four times as likely as the general population to have attempted suicide (Public
Health — Seattle and King County, 2004).
Additionally, not all state reporting systems use sexual orientation and gender
identity as reporting categories for hate crimes. Therefore it is hard to get accurate
statistics about hate-crimes rates. However, we know that anti - LGBT crimes do exist
and that the threat of hate crimes can affect people ’ s stress levels and mental health.
This issue goes beyond the LGBT community and becomes everyone ’ s responsibility.
Hate crimes affect the mental health of the victim, his or her family, and all societal
members.

HEALTH ISSUES OF LGBT YOUTHS
Adolescence is a difficult time regardless of sexual orientation; however, a growing

body of research on LGBT youths indicates that they have health problems and needs
that are different from those of heterosexual youths (Lock & Steiner, 1999). The most

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