Abuse in Same-Sex Relationships: How Can Family Doctors Help?
article by Caffyn Jesse, 2012
Domestic violence threatens the health of up to one in three people. Those in same-sex relationships face psychological and physical abuse in the same proportions as those in heterosexual relationships, but there has been limited research on the problem in this population. There are less tools and established protocols for health care providers. The Lambda Foundation and GLOSSI (Gays and Lesbians of SSI) sponsored a talk by Dr. Christina Romulus, who presented the results of her groundbreaking study on how family doctors can help address the problem of domestic violence with patients in same-sex relationships.
Dr. Romulus noted that there is a great need to educate both patients and doctors on what abuse is. Beyond physical violence, abuse can operate in emotional, social, financial and sexual spheres of people’s relationships. Victims tend to minimize the abuse and its impact.
Dr. Romulus found that doctors can use simple, open questions like “How safe do you feel in your relationship?” and “How supported do you feel by your partner?” to explore the possibility of abuse in relationships. Doctors then need to be ready with an appropriate response to a disclosure, which could include referrals to community resources, and seeing the patient for a series of counseling appointments. Survey respondents noted that simply talking about the abuse helped them to feel empowered. They did not discuss the situation with their doctor when she or he failed to ask, or when the victim did not feel important enough.
Doctors have special considerations when dealing with domestic violence in the lives of the GLBT (Gay Lesbian Bisexual and Transgender) population. There may be a dearth of resources for GLBT patients contending with abuse. Lesbians and trans women are welcomed into emergency shelters serving abused women, but there are no transition houses serving men, and specialized counseling services are limited. Here family doctors play an even more important role in helping their patients gain safety. Domestic violence is the third-largest health care problem affecting gay men, after HIV and substance abuse.
Domestic violence and its disclosure can be complicated by homophobia. Victims can be bullied by homophobic stereotypes or threatened with unwanted disclosure of their sexual orientation, even when the abuser is the victim’s intimate partner. Victims may be reluctant to disclose negative aspects of their relationships for fear of encountering a homophobic response, or further stigmatizing an already-stigmatized group.
Dr. Romulus is a family physician working in downtown Vancouver. She has been selected to receive the Lambda Foundation Dr. Gary Gibson Award in recognition of her research. Salt Spring Islanders may remember Dr. Gibson, who was an active volunteer in many island organizations between moving to Salt Spring in 2002 and his sudden death in 2008.