Alcohol-Related Intimate Partner Violence among Transgender and Gender Diverse Adults

Overview

Intimate partner violence (IPV) among adults is a serious public health problem. IPV includes psychological, physical, and sexual aggression, which occur each year at rates of approximately 80%, 20%, and 15%, respectively1-3. With the exception of sexual IPV, which is more frequently perpetrated by cisgender men4, rates of IPV are similar for cisgender men and women and is remarkably stable across time4,5. One of the most robust correlates of IPV is alcohol6,7. Theoretical and empirical literatures document that alcohol increases the risk for IPV perpetration and victimization8,9, and IPV victimization increases the risk for alcohol use10,11. Research is clear that adults who identify as a gender minority (i.e., transgender and gender diverse [TGD]) are at greater risk for IPV relative to their cisgender peers12. TGD people are 2.2 and 2.9 times more likely to experience physical and sexual IPV, respectively, than cisgender people.13 Research also demonstrates that TGD adults report more alcohol use than their cisgender peers14,15. Despite this increased risk for IPV and drinking, there is no published research on the associations between alcohol and IPV among TGD adults, hindering knowledge of risk factors to target in IPV programs for TGD adults. Theoretical models of IPV (e.g., alcohol Myopia16, I3 model17) state that the presence of negative situational and distal factors increase the chances that alcohol will lead to IPV. This is due to the threshold for IPV being reduced by the presence of negative situational and distal factors, which is then compounded by alcohol18. Self-medication models propose that traumatic experiences, such as IPV victimization, increase the risk for drinking to cope with negative affect19. These theories have received empirical support in cisgender populations, although virtually no research has examined their relevance to IPV in TGD populations. Minority stress models20 hypothesize that factors specific to TGD people may increase (e.g., internalized transphobia; discrimination) or decrease (e.g., TGD-specific social support and community connectedness) the risk for alcohol-related IPV. Thus, TGD-affirming investigations of alcohol-related IPV among TGD adults should examine the impact of minority stress factors. In addition to IPV, TGD populations experience high levels of other traumas, including high rates of childhood abuse21 and posttraumatic stress symptoms22, both strong predictors of alcohol23,24 and IPV25,26. As the threshold for IPV is reduced by the presence of childhood abuse and trauma symptoms, it is theoretically plausible these factors would interact with alcohol to predict IPV. Given the high rates of trauma experienced by TGD adults, examining fluctuations in trauma symptoms and childhood abuse history as moderators of the alcohol-IPV relationship will provide critical information for future intervention and prevention programs. The proposed study will examine relations between alcohol and IPV (psychological, physical, and sexual) perpetration and victimization among 130 TGD young adults. Incorporating the minority stress model into existing theories of IPV (i.e., I3 model), our study will also consider the impact of gender minority stress and protective factors (e.g., discrimination, internalized transphobia, TGD-specific social support) on the relationships between alcohol and different forms of IPV. We propose to use a 60-day daily diary design in which alcohol, minority stress, and IPV will be examined. In the first ever research of its kind, the proposed study will provide the most rigorous investigation of alcohol related IPV to date among TGD adults. The specific aims are to: Aim 1: Examine whether alcohol temporally increases the risk for IPV. Hypothesis 1: The odds of IPV perpetration and victimization will be increased on alcohol use days and heavy drinking days as compared to non-drinking days. Aim 2: Examine whether IPV temporal