Each year, the National LGBTQ Health Conference brings scientists, public health professionals, and health care providers together to discuss issues that affect the health and well-being of the LGBTQ community.
During this year’s conference, which was held virtually on May 20 and 21, Zainab Nizam, M.P.H., delivered a poster presentation titled, “Queer Experiences with Sexual Violence.” As part of the discussion, Nizam―a fourth-year doctoral student and Second Century Initiative Fellow for Health Equity at Georgia State University School of Public Health―discussed the disproportionate risk that gender and sexual minority communities face with sexual violence, how narratives that pathologize LGBTQ communities and trauma can perpetuate harm, and the need for additional research on the topic.
While interviewing with Terri Wilder, Nizam elaborated, “We have limited surveillance research that indicates that gender and sexual minorities, as measured, experience higher risk for a bunch of negative health outcomes compared to their heterosexual and sex-normative counterparts.”
Terri Wilder: Why do you think there is such narrow reporting on who can experience sexual violence?
Zainab Nizam: I think it’s less that people think, “Queer folks don’t experience sexual violence,” and more that heterosexual cisgender people, especially in medical or health research, don’t think about queer people very much at all.
If you look at the history of queer inclusion in research, criminalization and pathologization were basically the authoritative narrative in research for being queer or trans through the late 1900s and into the early 2000s. So it’s a very short history in which academic institutions have regarded queer folks as a population to be researched with dignity and as full people, instead of as a population that needs correcting. I think a lot of the real research still walks a pretty fine line with that distinction.
Wilder: Can you give a definition of what you mean by sexual violence in your research?
Nizam: There are lots of definitions of sexual violence, but for this study we defined it as any act that a participant felt was sexual in nature that was committed against them without their ongoing consent.
That opens it up to their interpretation of whether or not it was sexual. So, it could be things that were included like touching of genitalia, an explicit and traditionally recognized sex act, or something that felt very sexual to them but was not overtly sexual in the way that we might see on TV or hear about in normalized stories. I believe this definition is similar to the broad definition that the CDC gives.
When you get into more sexual violence research, the definitions become more and more nuanced, with things like classifying the severity of acts and classifying acts as completed or not completed. We really wanted to steer clear from that for this because sexual violence can feel and look so differently to different people, and because we were exploring experiences that we felt weren’t represented or [that hadn’t been] given a voice so far.
This ended up being helpful because I had multiple participants tell me afterwards that they had been worried that their experience didn’t count; that what they’d experienced wasn’t severe enough. That’s something that we really didn’t want to be gatekeepers of.
Wilder: At your gut level, what really stuck out to you as you were interviewing folks for your research?
Nizam: [On a personal level] I was really nervous before starting this study because I identify as queer and nonbinary, and I have had experiences with sexual assault in my own life. I was nervous that this was going to be a triggering experience for me.
What I found was this was maybe the most empowering thing I’ve ever done for myself. It was incredible to talk to people, hear their stories, and to receive the gift of their vulnerability and their intense desire to help others.
[On the research side], part of what we don’t know with experiences of violence for queer folks is―When is it happening? Who is perpetrating the acts of violence? A lot of times we get into this trap of thinking of queer identity as an on/off switch; I either am or I am not. But in reality, identity is fluid and changes with circumstances as you grow.
So one of the interviews that struck me [involved] participants talking about having experiences of sexual trauma before they had ever started thinking about their own sexual or gender identity. And after processing that sexual trauma with a therapist, partner, or friend, finding space to think more freely about their own sexuality.
So we had participants who were able to realize or acknowledge their own queerness in the wake of an assault that occurred earlier in their lives—which kind of flips the script on this idea that we have about queerness inviting violence.
Wilder: Can you share some of the main takeaway points that the research showed?
Nizam: Yes. One thing that is important for medical providers and social workers is that they’re going to be the person to whom someone either discloses violence or discloses that they have experienced violence and are living with the after-effects.
In terms of disclosing violence, I’ve heard so much about the importance of a person’s reception to that, especially from an authority figure. A quote from one of our participants is, “I tried to tell my teacher. I was like, ‘Can you just separate us?’” referring to a student that the person was seated next to. “And she refused. She was like, ‘Maybe she shouldn’t be so gay, and then she wouldn’t have any problems with this student.’ I feel like I’m less likely to report things that happen to me because of that experience.” For disclosing violence, I think that’s especially important because the reception we get can change our willingness to discuss something more. And it can be a really sensitive topic.
Of course, some people are comfortable talking about that or asking for what they need. But our reception can make us kind of aware of whether or not we’re going to get help.
Wilder: It feels like the teacher in that quote was blaming the person. “Because you identify as queer, this is your fault.”
Nizam: Yes, exactly. That was an extreme incident of a teacher blaming a young student for their identity and essentially punishing them for that identity and inviting violence on that student. Because the teacher felt that the student deserved it. We hope that was an extreme instance, but it is probably something that does happen frequently, especially in places where identity is still criminalized or seen as something that should be punished.
Wilder: That speaks to the basic foundation that people don’t have an understanding of sexuality and gender identity. We’re in this powerful time where people are feeling safe to come out with their identities at a younger age. The common person in public may not understand these nuances of identity or when we feel safe or unsafe to share who we are.
Nizam: That’s so true. As a queer person, I really struggle with this dissonance between how we get people to understand us. Like a cohesive narrative that is unimpeachable. [Because] you can’t attack the way a person is born, but the condemnation of queerness is often that you’re choosing to live this lifestyle.
So there’s this desire to be intelligible to the people who contribute to our oppression. But there are also limits to that; with intelligibility comes limitations, and we’re so varied that it would be impossible to understand a whole population and to really see them for the nuanced ways they exist.
Wilder: What are the next steps for this research?
Nizam: This study was limited in gender, class, and racial diversity, so I think the next steps for this research could include bigger, more diverse studies that encapsulate more lived experiences; quantitative studies that try to tease out causal pathways between factors related to identity and violence with more nuance; and using queer or gender theory to restructure the assumptions we make about queer identity, especially when we’re creating things like measurement tools for gender and sexuality.
For me, this research is for my dissertation. [In the future], I’m hoping to tackle a small quantitative study that looks at identity change over time in relation to experiences of violence. And I’m hoping that this study will be one of many that says we need to look at gender and sexuality in different ways.