Beyond a multiplicity of stigma: LGBTQ+ SURVIVORS of gender-based violence accessing services in the State of Utah

The experiences of domestic violence, sexual violence, and human trafficking survivors vary, particularly among LGBTQ+ survivors. Their lower rates of help-seeking behaviors have been linked to anti-LGBTQ+ bias in their communities, the threat of being "outed" while seeking help, and some shelter services rejecting transgender individuals from their systems. This study seeks to understand the specific barriers faced by LGBTQ+ survivors in the state of Utah, finding that stigma and discrimination continue to haunt survivors of violence. When specific needs related to mitigating fears of stigma and discrimination are not met by service providers, problems like rising rates of suicide, substance use, and homelessness become more visible within LGBTQ+ communities. This study employed mixed-methods data collection of surveys (N=293) and focus groups (N=8) to evaluate the needs of LGBTQ+ survivors of violence when accessing services, aiming to explore the role service-providing organizations play in availability of access, treatment, and recovery.

ii ABSTRACT The experiences of domestic violence, sexual violence, and human trafficking survivors vary, particularly among LGBTQ+ survivors. Their lower rates of help-seeking behaviors have been linked to anti-LGBTQ+ bias in their communities, the threat of being “outed” while seeking help, and some shelter services rejecting transgender individuals from their systems. This study seeks to understand the specific barriers faced by LGBTQ+ survivors in the state of Utah, finding that stigma and discrimination continue to haunt survivors of violence. When specific needs related to mitigating fears of stigma and discrimination are not met by service providers, problems like rising rates of suicide, substance use, and homelessness become more visible within LGBTQ+ communities. This study employed mixed-methods data collection of surveys (N=293) and focus groups (N=8) to evaluate the needs of LGBTQ+ survivors of violence when accessing services, aiming to explore the role service-providing organizations play in availability of access, treatment, and recovery. iii TABLE OF CONTENTS ABSTRACT ii INTRODUCTION 1 METHODS 5 RESULTS 8 DISCUSSION 17 REFERENCES 19 INTRODUCTION The consequences of not addressing violence experienced by LGBTQ+ members of the community include chronic long-term effects, such as mental illness, sexually transmitted infections, and substance abuse, and housing instability because of their abuse (Smith et al., 2012). Domestic violence, sexual violence, and human trafficking affect individuals in disparate manners — including trauma, circumstances, and available support systems. The services available to survivors are often used to support them as they adapt to and begin healing from their experiences (Gorde et al., 2004). Services available to survivors often work to address these long-term effects, including shelter housing, therapy services, and healthcare (Belknap et al., 2009). However, not all services provide these options and the number of LGBTQ+ survivors that access services are often lower than the national average, despite being at equal or higher risk of experiencing interpersonal violence (NCAVP, 2016). This study seeks to understand the specific barriers faced by LGBTQ+ gender-based violence survivors in the state of Utah, finding that stigma and discrimination continue to haunt survivors of violence. Gender-based violence (GBV) is an umbrella term to describe multiple forms of harm directed against women, girls, and gender minorities, where the violence is enacted to maintain gender inequalities. Gender-based violence is a global phenomenon where GBV includes, but is not limited to, domestic violence, forced marriage, sexual violence, rape, forced sexual economies, female genital mutilation, and human trafficking. A complex issue, gender-based violence movement has multiple beginnings (Fukushima, 2022). Gender-based violence is a harm that occurs due to systems of inequality, that for many is understood as the cause of gender inequality (Dobash & Dobash, 1979), 2 interacting with other forms of inequalities i.e., race and ethnicity (Crenshaw, 1991; Bernard, 2013). The deadly nature and the role of the state in maintaining gender-based violence was made visible in the early 1990s with global discussions regarding the disappearance and death of violence against women in Latin America (Fregoso & Bejarano, 2010) – referred to in English as femicide, and in Spanish as feminicidio. Gender-based violence such as intimate partner violence, sexual violence and human trafficking are typically researched as a heterosexual problem (Everhart & Hunnicutt, 2013). In the United States, over 1 in 3 women (37.3%) and nearly 1 in 3 men (30.9%) have experienced interpersonal violence in their lifetime (Smith et al., 2012), with rates of experienced violence often remaining higher in LGBTQ+ survivors (NCAVP, 2016). 2 in 5 men who have sex with men will experience intimate partner violence (Greenwood et al., 2002) and lesbians experience it at rates of 50% (NCAVP, 2006). 46% of bisexual women have been raped by an intimate partner, in comparison to 17% of straight women and 13% of lesbians have (CDC, 2010). 40% of gay men and 47% of bisexual men have experienced sexual violence other than rape, in comparison to 21% of straight men (CDC, 2010). Precise statistics on human trafficking are difficult to conclude, but it’s estimated that there were more than 40 million victims in 2016 (ILO, 2017). In Utah in 2020, the National Human Trafficking Hotline received 184 calls about 64 potential cases of human trafficking in the state (NHTH, 2021). LGBTQ+ survivors of violence are more likely to seek help from friends (Merrill & Wolfe, 2000; Renzetti, 1996; Guadalupe-Diaz, 2013), with law enforcement being the least trusted source for helping gender and sexual minoritized community members (Guadalupe-Diaz 2013). Research shows that LGBTQ+ survivors continue to face bias 3 when reporting to law enforcement (Herek et al., 1997). Help-seeking rates may be lower among LGBTQ+ survivors for numerous reasons, including fears of being “outed” as queer in their communities and of being discriminated against by service providers (NCAVP, 2016). In general, LGBTQ+ survivors also demonstrate lower intentions to seek help from family, general health clinics, and co-workers than from other resources (Calton, 2016). In a similar study, current students that were LGBTQ+ survivors indicated that they were less likely to disclose their experiences of violence in both formal and informal settings (Sylaska & Edwards, 2015). When LGBTQ+ survivors disclose their experiences and engage in help-seeking behaviors, they often face complications in accessing needed services — particularly housing and healthcare resources (Belknap et al., 2009). If LGBTQ+ survivors do engage in help-seeking behaviors and access these resources, they may face additional barriers like rejection from shelter services based on gender identity, social norms around masculinity, and lack of support from local organizations (NCAVP, 2016; Donne et al., 2017). Therefore, this thesis theorizes the stigma LGBTQ+ survivors experience when accessing services. Stigma involves social disapproval or mistreatment of a person based on a perceived departure from social norms. Experiencing or anticipating stigma can impact the way stigmatized individuals respond to and interact with their social context, including LGBTQ+ survivors of gender-based violence when seeking help from organizations. This thesis advances the theory about stigma and service access to further conceptualize a multiplicity of stigma. Multiplicity of stigma in the anti-violence response to LGBTQ+ survivors comprises the following: bias in access to care; barriers of shaming, shunning, and othering; misidentification and mislabeling; multiple levels of 4 furthering how survivors are deeply misunderstood and experience a culture of mistrust (Fukushima et al., 2020). Further conceptualizations of a multiplicity of stigma is central to understanding barriers LGBTQ+ survivors of violence experience when seeking services. And LGBTQ+ community members experience a complexity of oppression that cannot always be clearly defined due to their intersecting identities with race, sexuality, and other forms of identities. There are also health consequences to experiencing discrimination (Comstock, 1991). Calton et al., convey that there continues to be “limited understanding of the problem of LGBTQ IPV, stigma, and systemic inequities” (Calton et al., 2016). The Meyer (2003) minority stress model describes how stigmatization, homophobia, and rejection in unique, chronic, and socially based contexts can all contribute to negative physical and mental health outcomes. While past research has focused on the behaviors of LGBTQ+ survivors, it is essential to understand the systems that create barriers for survivors and how LGBTQ+ survivors experience stigmatizing behaviors from the response which prevents them from seeking out help or having their needs met. This study seeks to understand how available services and community perceptions continue to impact the ability of LGBTQ+ survivors of violence to access and receive support from service providing organizations and resources in Utah. Based on previous research, it is expected that stigma and service availability will be the greatest barriers LGBTQ+ survivors experience when helpseeking. 5 METHODS Design This study employed mixed methods (Venkatesh et al., 2013) which triangulates qualitative and quantitative data collection (Denzin & Lincoln 2013; Driscoll et al., 2007; Jick, 1979). The study design began with a larger project involving a needs assessment, ascertaining the needs for survivors of domestic violence, sexual violence, and human trafficking. A needs assessment is a “collection of data bearing on the need for services, products, or information” (Soriano, 2012, xiv). Quantitative data was collected through surveys (N=293) using Likert-scale and open-ended questions with a survey that was disseminated online and through social media. Qualitative data comes from open-ended focus group and interviews (N=41). Institutional Review Board approval was obtained on June 6, 2021. The survey was distributed to domestic violence, sexual violence, and human trafficking service providers and service-providing organizations. Instruments were designed by Dr. Annie Isabel Fukushima who had adapted instruments she used for a city-wide needs assessment in San Francisco in 2018. In January 2021, in consultation with community organizations the Utah Domestic Violence Coalition, Utah Coalition Against Sexual Assault, and Restoring Ancestral Winds, the instruments were revised to reflect questions that the community hoped to answer. Beginning in August 2021, the research team began recruiting participants for the surveys and September 2021 to recruit focus group participants and interviewees. Surveys were distributed to list-servs and on social media. The total possible number of participants is unknown, since the coalitions networks include 9 domestic violence 6 organizations across the state of Utah, federal agencies and coalitions coordinated in partnership with the Department of Child & Family Services, and tribal coalitions of the seven tribes with Restoring Ancestral Winds. Participants were invited to complete the survey and were asked to opt-in to potential focus group participation at the end of survey. Secondary outreach conducted through email was completed to community and governmental organizations to fill focus groups and interviews. Participants The survey was distributed to domestic violence, sexual violence, and human trafficking service providers and service-providing organizations. 293 participants completed the survey. A combined total of eight focus groups and interviews were conducted with 41 participants total during September and October 2021. The present paper focuses on the 35 survey respondents who self-identified as LGBTQ+ in the survey and any survey or focus group responses that discussed the experiences of LGBTQ+ survivors. To be eligible for the study, participants were service providers for survivors of domestic violence, sexual violence, and human trafficking in some capacity, whether that be through law enforcement, legal clinics, shelter service, or other professions that regularly engage with survivors. Recruitment was conducted through outreach to community organizations. Participants were asked to select their gender, sexuality, and race in the demographics section of the survey. Respondents were primarily female (n=185; 89%), heterosexual (n=170; 82% heterosexual), and white (n=179; 80%). 9% (n=19) of participants self-identified as male, 1% (n=2) gender non-conforming, and 1% other 7 (n=2). For sexuality, 19% (n=39) of respondents self-identified as LGBTQ+QA. 11% (n=25) of participants selected Hispanic/Latina/o, 9% (n=20) selected Alaskan Native or American Indian, Native Hawaiian or Pacific Islander, Asian, two or more races, or Black or African American. The average years of experience from respondents in their field was 9.5 years and nearly half (47%) self-identified as survivors. Measures A survey was used to measure participants’ demographics and feelings toward various aspects of their work, including questions on their organization’s financial resources, housing accessibility, and community perceptions of violence. Participants were asked to rate their experiences with those subjects on a scale from strongly agree to strongly disagree. For focus groups, a semi-structured guide was used to draw on participants’ experiences, beliefs, and attitudes toward various topics, including their work, service accessibility to survivors, and interactions between service providers. Study Context: Utah In 2015, the state legislature passed Utah’s first statewide LGBTQ+ nondiscrimination policies. This occurred seven years after the original bill was introduced and ensured that individuals could not be discriminated against based on their identity by employers and landlords, though exemptions were provided for religious entities. A 2019 survey showed that 77% of Utahns favor and 19% oppose implementing protections for LGBTQ+ individuals from discrimination, ranking Utah second in the country for supporting nondiscrimination laws with a percentage 8% higher than the national average (PRRI, 2019). 8 In the State of Utah, 3.7% of adults over the age of 18 are LGBTQ+, with Salt Lake City ranking seventh highest in terms of LGBTQ+ population percentage (4.7%) in the largest metropolitan areas in the United States (Williams, 2019; Gallup, 2015). Despite these numbers being greater than or comparable to percentages in states and cities across the U.S., as of 2017, only nine of the 19 intimate partner violence and domestic violence shelters in the state offered LGBTQ+ services (Hobday, 2017). RESULTS Of those surveyed 12% (n=35) identified as LGBTQ+. The majority of the LGBTQ+ participants had expertise in domestic violence or intimate partner violence (n=29; 83%) and sexual violence (n=23; 65%), with nearly half having expertise on violence against LGBTQ+ communities (n=16; 45%), gender-based violence and violence prevention. Table 1 displays the differences in LGBTQ+-identifying participants and the nonLGBTQ+ portion of the sample’s perceptions that various providers making a survivor of violence feel uncomfortable because of bias or discrimination contribute to the insufficiency of services. The contrast between the two groups of participants may indicate a higher awareness of bias in minoritized communities, potentially impacting the way services are designed and administered. Common themes that emerged in the focus groups reflected these concerns, including stigma or bias when accessing services, feelings of invisibility, and the homogenization of minoritized communities. 9 Table 1 Perceptions of Bias Contributing to Insufficient Services Variable LGBTQ+ % LGBTQ+ n Sample % Sample n Crisis line 25% 8 8.8% 17 Housing providers 47% 16 17% 38 Medical providers 63% 19 30% 54 Lawyers 43% 14 25% 48 Law enforcement 65% 19 49% 74 Awareness efforts 35% 12 18% 35 Current perceived insufficient services: Although all focus group and interview participants were asked a question that involved the LGBTQ+ community, not all participants provided commentary on their experiences working with those survivors. A common theme among responses of those who did speak on LGBTQ+ issues in service providing was LGBTQ+ individuals being afraid to access services due to anticipatory stigma. Bias, Stigma & Discrimination Stigma continues to be an ongoing issue for LGBTQ+ survivors of violence when accessing resources. A survivor’s inability to access resources can be derived from many sources, including a fear of or previous experience with discrimination (NCAVP, 2016). 1. Bias in services and access to care Participant responses indicated that LGBTQ+ survivors experience bias when seeking services. As a clinical manager explained, “There’s no question that there is a 10 stigma, there is—you know, all of it. And it’s so frustrating to—yeah, I mean, that’s really frustrating to see... And we had a lot of individuals that identified [as LGBTQ+], and just holy cow, they’re just not given the time of day, and it’s really not okay.” The stigma survivors of violence face stems not only from accessing services but occurs even before they begin to access resources. The clinical manager continues, “What happens is that those youths were basically shunned out of their homes, to the point that they literally could not reside there anymore; it was such a toxic place. And so, they weren’t kicked out, right? But they were shunned out.” While some survivors experience barriers and stigmatization when accessing services, their experiences also impact other institutions like healthcare settings. Another focus group participant who works in the healthcare industry expressed similar concerns about the resources available to LGBTQ+ survivors, focusing on the low number of reported cases from individuals identifying as transgender or intersex. “Probably the underserved population that, in some ways, I’m most concerned about getting healthcare care is LGBTQ,” the provider said, citing lower case rates among gender diverse individuals. “[...] But that population is not feeling comfortable receiving health care after sexual assault; our numbers should be much, much higher. We know that it’s a more vulnerable population and we, as a community, really need to figure out how to reach out to that LGBTQ population. Historically, they have been treated poorly by healthcare providers quite honestly, there’s lots of research about that. And so, I think that that, combined with other concerns they may have, they don’t seek health care afterwards, and I’m really 11 worried about that, and that’s something I would love to strengthen in our community.” This perspective mirrors the experiences of more than one in six LGBTQ+ adults that avoid healthcare due to anticipatory stigma (Casey et al., 2019) and the LGBTQ+ survivors of violence that are less likely to access services than the national average (NCAVP, 2016), a further indication that healthcare systems — particularly those serving survivors — are not adequately reaching or supporting these survivors. 2. Culture of mistrust For an LGBTQ+ survivor, fear may be a common emotion when seeking help. This fear impacts sexual and gender minorities’ abilities to access services. As described by an advocate: “We get a lot of calls about folks being afraid to reach out for services. But that’s not something – it really peaked in early 2017, post-election. And – but it’s resurfaced throughout the years anyway. It comes up – I think people just identifying they feel uncomfortable or unsafe accessing services that come up. The LGBT+ community — specifically trans folks — really get frightened about accessing services, they don’t feel safe.” – Advocate This manifestation of fear not only impacts a survivor’s ability to report abuse, but also affects their ability to access vital resources such as housing. For marginalized community members accessing resources, a fear of exclusion due to stigma and rising housing costs impacts survivors even when seeking out essential needs. 3. Shaming, shunning, and othering: identity abuse and being outed 12 The fear that LGBTQ+ survivors experience when accessing services is not isolated to stigma and discrimination, with interviewees detailing the fear that survivors face of being “outed.” In Utah, dominant religious ideologies can impact the ways that communities perceive LGBTQ+ individuals and thus heighten fear of others discovering their identities. When considering community perceptions of domestic violence, 42% (n=118) of survey participants noted that their communities believe domestic violence does not occur very often. Similar percentages were observed when participants were asked about community perceptions of human trafficking and sexual violence, with 46% (n=129) reporting that those in their community believe human trafficking never occurs in it. Because Utah community members tend to view issues through a heteronormative lens, the fear of being outed when seeking help impacts LGBTQ+ survivors. As one advocate said, “Just over the years that I have been providing victim services I feel a common thread is if I report this crime, I’m going to be outed to my work, to my neighbors, to my family even. Especially with older LGBTQ people. I really do see a difference in the older [population], I’m saying over 40 maybe. Because I think the stigma for them is hard, I hope, I’m just saying this in general so not specific people.” Abusers utilize LGBTQ+ identities and cultural stigma to continue to create a dynamic of dependence and further fear. This is demonstrated by the way survivors access services, where they are afraid that their identities will be used against them. As described by a victim advocate, this even impacts housing resources, when existing housing options in Utah are already scarce. 13 “They’re worried about housing. So, the person I was telling you about, she applied for a, I knew she could get this low-income housing voucher just because of her victimization. So, we’re working on it and then she’s kind of worried like, ‘well, what if they realize I was part of a lesbian relationship?’ and I said, ‘it really won't matter, it really won't.’ But her perception is that it would.” - Victim Advocate The perception of coercion in gender-based violence relationships continues to impact survivors beyond the relationship itself, affecting the way they approach services. 4. Discrimination and bias leads to institutional violence Due to the discrimination and bias the LGBTQ+ community faces, they are also impacted by the school-to-prison pipeline, where they may experience additional trauma. LGBTQ+ survivors are afraid to report to law enforcement, but also experience trauma when navigating justice systems. As described by a government worker, “Homeless youth that we’re dealing with that are transgender and LGBTQIA, they feel more marginalized in the community. But there aren’t safe spaces for them... When you're locked up and you're LGBTQIA, there’s even more oppression there. They won't use your surnames that you choose. They won't use names that you prefer. They’re not affirmative. In jail, prison, and in detention facilities they’re not affirmative. We’re not training spaces where harmed LGBTQIA show up to be affirmative. So, it’s just another place where there’s more trauma and more abuse and more vulnerability. I just had a transgender female come out of the male side of the prison. And she was supposed to complete an inpatient program on the men’s side of the prison where she was 14 being sexually harassed, almost assaulted by other prisoners and being shamed by the officers... It’s like, where are the safe spaces for an LGBTQIA child of color that’s fleeing a home where they reject him or her and then they show up at a space where they can be trafficked? It’s like adding insult to injury really.” As the government worker described, survivors of violence are currently being criminalized by the institutions that are intended to protect them. In addition to stigma interfering with LGBTQ+ survivors’ confidence in seeking help, service providers noted the lack of resources set up to support them, particularly when it comes to transgender survivors. The inability to support diverse communities including sexual and gender minorities impacts a survivor’s sense of safety and comfort level when accessing services. “So, LGBTQ+ and people who are transgender, I think, probably if they need to access resources, a lot of our organizations probably are not set up to be able to serve them in a way that’s going to honor them and help them feel safe, and so, I think we still have a long way to go there. ... They should be able to access all of our resources, but I think it gets to do they feel comfortable; are they being treated as a whole person by our staff? … I think it’s also important that we don’t say, ‘Well, there must be somewhere else that they can go,’ but really make our services accessible to them.” - Diversity Coordinator As stated by the diversity coordinator, the existence of organizations that open services to LGBTQ+ survivors do not have the same impact as organizations that actively support and ensure safety for these survivors. One area that participants noted as potential to 15 increase accessibility and safety for LGBTQ+ survivors is internal visibility among service-providing staff. 5. Invisibility The state of Utah and service-providing organizations are both diversifying, as well as the communities they serve. One advocate detailed how in order to provide services to transgender survivors, they need to partner with outside organizations to support them. A contributing factor to the invisibility that survivors experience in helpseeking is the invisibility that can be mirrored within organization staffs. As one interviewee conveyed, “I feel like we’re continuing to expand who our staff are, so folks feel like they have a place here and that they’re represented. … We definitely have gotten feedback in the past that our service — or even just our space — is not supportive of trans folks. And so, that’s something that we’ve actively tried to shift and improve on, but we’ve definitely seen an increase in male survivors, trans survivors as well.” - Clinician, Nonprofit The lack of visibility within service-providing organizations described by the clinician exacerbates the fears that survivors may have when seeking help from an organization that does not represent their identity. 6. Intersectional Identities & the Homogenization of Difference Understanding LGBTQ+ survivors of violence, however, is not isolated to active support of sexual and gender minorities. It also includes evaluating how intersectional identities of race, gender, nationality, sexuality, and class impact survivors’ experiences with services. LGBTQ+ survivors are facing stigmatization for their identities but may 16 also be experiencing racial oppression that can compound the barriers faced when accessing services — an issue that can be exacerbated by the diversity and composition of staffs at service-providing organizations making survivors feel unsafe. Despite some organizations in Utah having higher LGBTQ+ representation, one executive director recognizes that a lack of racial diversity and intersectionality may impact how effectively they can reach survivors in their community: “A lot of our staff is actually queer or are identifying LGBTQIA in some manner, which is really cool; and that representation, I think, means a lot; but the majority of us are pretty white... it can be re-traumatizing and it’s very Eurocentric; policies, in and of themselves, are oftentimes Eurocentric. So, we have a lot of work to do within our own agency to even have a diverse staff.” Concerns about the lack of intersectional identities in service-providing organizations were also highlighted by a crisis line worker, who conveyed their experiences hearing from individuals hesitant to access or avoiding services due to fear of stigma and for their personal safety: “I think people just identifying they feel uncomfortable or unsafe accessing services that come up. The LGBT+ community — specifically trans folks — really get frightened about accessing services, they don’t feel safe. People of color, I know this is something that has come up. I’ve talked with a few people who have identified as indigenous, African American, whatever – various identities that they’re like, ‘I just don’t feel comfortable accessing these whitewashed services. And I’m not going to, because it’s just not safe for me.’” 17 DISCUSSION In this study, a mixed methods design was employed to highlight the needs of survivors of violence as perceived by service providers such as therapists, healthcare workers, and law enforcement. The data used in this paper focused on LGBTQ+ survivors, hypothesizing that stigma and service availability would serve as primary barriers to those survivors accessing services. Based on the data collected through the survey, focus groups, and interviews, stigma and service availability do contribute significantly to LGBTQ+ survivors’ difficulties when attempting to access services. The level of concern among service providers for the quality of services available to LGBTQ+ survivors was significant across survey, focus group, and interview responses. In their responses, providers were particularly critical of diversity within organizations as well as overall inclusivity of their services. A notable area that falls under the issue of inclusivity is housing, which 47% of LGBTQ+ respondents and 17% of the remainder of respondents selected as being insufficient due to survivors experiencing bias when accessing the service. The issue of LGBTQ+ discrimination in housing that was raised by providers in this study is consistent across previous research, with transgender survivors frequently documenting discrimination when attempting to access emergency housing (NCAVP, 2016). The fear of being outed as LGBTQ+ when accessing resources was another common theme discussed by providers that supports the initial hypothesis, as anticipatory stigma based on previous experiences or perceived threat within organizations creates additional barriers for survivors. This finding is consistent with previous research found that the fear of being outed or discriminated against served as a deterrent for reporting 18 (NCAVP, 2016), in addition to research that found LGBTQ+ survivors are more likely to face rejection or lack of support from organizations (Donne et al., 2017). A limitation of this study is that it centers service providers and not the survivors that are accessing their services. While providers’ experiences are relevant to constructing a broad picture of the primary issues organizations have, it is also important to hear and incorporate feedback from LGBTQ+ survivors and their experiences. Providers contribute valuable insight into topics like funding and experiences working with survivors, the findings could be strengthened by including survivors’ perspectives. To that point, future research should involve surveying and interviewing survivors so that their experiences are contributing to overall understanding of the unique challenges they may face before, during, and after accessing services. While previous research has focused on overall barriers faced by LGBTQ+ survivors, the smaller scope of this study exposes the Utah-specific needs of the community and demonstrates how the social context of Utah impacts survivors’ likelihood to access services and comfort level in doing so. It contributes a deeper understanding of areas that individual organizations and the government can work to improve the services they provide, as well as how they approach working with LGBTQ+ survivors. 19 REFERENCES Belknap, J., Melton, H. C., Denney, J. T., Fleury-Steiner, R. E., & Sullivan, C. M. (2009). The Levels and Roles of Social and Institutional Support Reported by Survivors of Intimate Partner Abuse. Feminist Criminology, 4(4), 377–402. https://doi.org/10.1177/1557085109344942 Bernard, A. (2013). The Intersectional Alternative: Explaining Female Criminality. Feminist Criminology. 8 (1): 3–19. Black, M. C., Basile, K. C., Breiding, M. J., Smith, S. G., Walters, M. L., Merrick, M. T., Chen, J., & Stevens, M. R. (2011). The national intimate partner and sexual violence survey. Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/pdf/nisvs_report2010-a.pdf Calton, J.M. (2016) The impact of minority stress on LGBTQ individuals’ intentions to seek help for intimate partner violence. http://mars.gmu.edu/bitstream/handle/1920/10540/Calton gmu 0883E 11257.pdf?seque nce=1&isAllowed=y Casey, L.S., Reisner, S.L., Findling, M.G., Blendon, R.J., Benson, J.M., Sayde, J.M., & Miller, C. (2019).“Discrimination in the United States: Experiences of Lesbian, Gay, Bisexual, Transgender, and Queer Americans. Health Services Research 54: 1454–1466. https://doi.org/10.1111/1475-6773.13229 Comstock, G.D. (1991) Violence against Lesbians and Gay Men. Between Men - between Women: Lesbian and Gay Studies. New York: Columbia University Press. Crenshaw, Kimberlé. (1991) Mapping the Margins: Intersectionality and Women of Color. Stanford Law Review, 43(6): 1241–1299. 20 Denzin, N. K., & Lincoln, Y. S. (2002). In Handbook of Qualitative Research (pp. 699–714). essay, Sage. Driscoll, D., Appiah-Yeboah, A., Salib, P., & Rupert, D. (2007). Merging qualitative and quantitative data in mixed methods research: how to and why not. Ecological & Environmental Anthropology. 3. Dobash, R.P., Dobash, R.E., Wilson, M. & Daly, M., (1992) The Myth of Symmetry in Marital Violence. Social Problems, 39: 401–421. Dobner, J. (2015, March 27). LGBT anti-discrimination bill clears Legislature, on its way to Utah governor. The Salt Lake Tribune. https://archive.sltrib.com/article.php?id=2279279&itype=CMSID Donne, M. D., DeLuca, J., Pleskach, P., Bromson, C., Mosley, M. P., Perez, E. T., Mathews, S. G., Stephenson, R., & Frye, V. (2017). Barriers to and Facilitators of Help-Seeking Behavior Among Men Who Experience Sexual Violence. American Journal of Men’s Health, 12(2), 189–201. https://doi.org/10.1177/1557988317740665 Evashnee, N. & Nonhlanhla, M. Gender-Based Violence: The Lesbian and Gay Experience. Agenda: Empowering Women for Gender Equity No. 66. Gender-Based Violence Trilogy Volume 1,1: Domestic Violence (2005), pp. 34-38 Everhart, A. & Hunnicutt, G. (2013). Intimate partner violence among self-identified queer victims: Towards an intersectional awareness in scholarship and organizing surrounding gender-Based violence. Advances in Gender Research. 18. 67-88. 10.1108/S15292126(2013)000018A007. Fregoso, R.F. & Bejarano, C. (2010) Terrorizing Women: Feminicide in the Américas. Duke University Press. 21 Fukushima, A.I. (2022, Accepted). Gender-Based Violence; In S. Salari (Eds), Family Violence and Abuse: An Encyclopedia of Trends, Issues, and Solutions (pp. TBD), ABC-CLIO. Fukushima, A., Gonzalez-Pons, K., Gezinski, L. & Clark, L. (2020). Multiplicity of stigma: cultural barriers in anti-trafficking response. International Journal of Human Rights in Healthcare. ahead-of-print. 10.1108/IJHRH-07-2019-0056. Gallup, Inc. (2021, May 7). San Francisco metro area ranks highest in LGBT percentage. Gallup.com. https://news.gallup.com/poll/182051/san-francisco-metro-area-rankshighest-lgbt-percentage.aspx Gorde, M., Helfrich, C., & Finlayson, M. (2004). Trauma Symptoms and Life Skill Needs of Domestic Violence Victims. Journal of Interpersonal Violence. 19. 691-708. https://doi.org/10.1177/0886260504263871 Greenwood, G. L., Relf, M. V., Huang, B., Pollack, L. M., Canchola, J. A., & Catania, J. A. (2002). Battering victimization among a probability-based sample of men who have sex with men. American Journal of Public Health, 92(12), 1964–1969. https://doi.org/10.2105/ajph.92.12.1964 Guadalupe-Diaz, X. (2013). An Exploration of Differences in the Help-seeking of LGBQ Victims of Violence by Race, Economic Class, and Gender. Gay & Lesbian Issues and Psychology Review. 9, 15–33. Herek, G.M., Gillis, J.R., Cogan, J.C., Glunt, E.K. (1997) Hate crime victimization among lesbian, gay, and bisexual adults: prevalence, psychological correlates, and methodological issues. Journal of Interpersonal Violence. 12(2):195-215. doi:10.1177/088626097012002003 22 Hobday, T. (2017, July 20). Utah’s intimate partner violence sources, resources waning. QSaltLake Magazine. Retrieved April 10, 2022, from https://www.qsaltlake.com/news/2017/07/20/utahs-ipv-sources-resources-waning/ International Labour Office. (2017). Global estimates of modern slavery. https://www.ilo.org/wcmsp5/groups/public/@dgreports/@dcomm/documents/publication /wcms_575479.pdf Jick, T. D. (1979). Mixing qualitative and quantitative methods: triangulation in action. Administrative Science Quarterly, 24(4), 602–611. https://doi.org/10.2307/2392366 Merrill, G. & Wolfe, V. (2000). Battered gay men: an exploration of abuse, help seeking, and why they stay. Journal of Homosexuality. 39. 1-30. 10.1300/J082v39n02_01. Meyer I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674 National Coalition of Anti-Violence Programs (NCAVP). (2016). Lesbian, Gay, Bisexual, Transgender, Queer, and HIV-Affected Intimate Partner Violence in 2015. New York, NY: Waters, E. https://avp.org/wpcontent/uploads/2017/04/2015_ncavp_lgbtqipvreport.pdf National Coalition of Anti-Violence Programs. (NCAVP). (2007). Lesbian, gay, bisexual and transgender domestic violence in the United States in 2006. New York, NY: Fountain, K., & Skolnik, A. A. https://avp.org/wpcontent/uploads/2017/04/2006_NCAVP_DV_Report.pdf National Human Trafficking Hotline. (2021). Utah. https://humantraffickinghotline.org/state/utah 23 Public Religion Research Institute. (2022, March 17). Americans’ Support for Key LGBTQ Rights Continues to Tick Upward. PRRI. https://www.prri.org/research/americanssupport-for-key-lgbtq-rights-continues-to-tick-upward/ Renzetti, C. (1996). The poverty of services for battered lesbians. Journal of Gay & Lesbian Social Services. 4, 61-68. Schecter, S. (1982) Women and Male Violence: The Visions and Struggles of the Battered Women's Movement. South End Press. Smith, S.G., Chen, J., Basile, K.C., Gilbert, L.K., Merrick, M.T., Patel, N., Walling, M., & Jain, A. (2017). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010-2012 State Report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. 117-118, 126-127. https://stacks.cdc.gov/view/cdc/46305 Soriano, F. I. (2013). Conducting Needs Assessments. SAGE Publications. Sylaska, K., & Edwards, K. M. (2015). Disclosure experiences of sexual minority college student victims of intimate partner violence. American Journal of Community Psychology, 55(34) https://doi.org/10.1007/s10464-015-9717-z Venkatesh, V., Brown, S. A., & Bala, H. (2013). Bridging the qualitative-quantitative divide: guidelines for conducting mixed methods research in information systems. MIS Quarterly, 37(1), 21–54. http://www.jstor.org/stable/43825936 Williams Institute. (2019). LGBT data & demographics. Williams Institute. https://williamsinstitute.law.ucla.edu/visualization/lgbt-stats/?topic=LGBT#demographic 24 Name of Candidate: Mikaila Barker Date of Submission: May 5, 2022