Abstract
Many college students who have been victimized develop negative physical or mental health effects, for which they need help or information to manage or resolve, yet, they may be faced with barriers to seeking information or services. These barriers are likely exacerbated and/or different for LGBTQ+ students. Few studies have examined help-seeking among LGBTQ+ college students, and there is a dearth of research exploring information-interest, such as wanting information on violence prevention as it relates to gender and sexual identity, and how victimization may differentially impact this form of help-seeking. Thus, the current study fills this gap by exploring how being interested in, receiving, and being interested in but not receiving sexual assault/relationship and violence prevention information differ across sexual and gender identity and whether being a nonheterosexual or transgender/nonbinary+ victim influences these behaviors. Findings show that nonheterosexual and transgender/nonbinary+ college students have greater interest in receiving information. At the multivariable level, violence prevention information models suggest similar effects across gender and sexual identity. In models examining sexual assault/relationship violence prevention, the effect of sexual victimization on interest in receiving information is strongest for nonheterosexual students, but heterosexual students who have been sexually victimized had the highest probability of being interested in but not receiving information. The effect of intimate partner violence victimization on receiving information is slightly stronger for heterosexual students. In light of these findings, it may be beneficial for colleges/universities to provide additional trainings/information focused on general violence prevention and to work toward implementing training modules and information in less heteronormative ways.
Introduction
A growing body of research shows that those in the LGBTQ+ (i.e., lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender identities not including heterosexual, cisgender males and females) community have a higher risk of interpersonal victimization than others (Chen et al. 2020; Edwards et al. 2016; Griner et al. 2017; Hughes et al. 2010; Kahle 2020). Similar risks are found when studying college student samples (Snyder et al. 2018). For example, transgender students face greater odds of victimization compared to male students and have higher odds of experiencing victimization aside from emotional intimate partner violence (IPV) compared to female students (Griner et al. 2017).
Given their high risk for victimization, LGBTQ+ people may have greater interest in information and assistance than others, but LGBTQ+ victims may face barriers in getting the assistance they need. Much research on help-seeking focuses on reporting to formal and informal sources or seeking services. With specific reference to LGBTQ+ victims, this research demonstrates that LGBTQ+ victims are less likely to seek certain forms of help and face barriers in reporting their victimizations. For example, research shows that LGBTQ+ individuals are less likely to report their victimization to police than their non-LGBTQ+ counterparts (Daigle and Hawk 2021; Felix et al. 2020; for exceptions see Flores et al. 2021; Langenderfer-Magruder et al. 2016) and are often faced with discrimination, disbelief, and lack of resources when they disclose (Brown 2008; Parry and O'Neal 2015; Scheer and Baams, 2021). LGBTQ+ victims have been found to seek help in other ways.
Some research shows that disclosure rates of victimization are high, but that LGBTQ+ victims report telling friends or therapists/counselors at higher rates compared to family (Kurdyla et al. 2019). Others have found that LGB victims are more likely to disclose their victimization to informal sources, such as counselors, when compared to others (Felix et al. 2020). These findings may support the differential use of formal and informal resources postvictimization for LGBTQ+ persons.
Given these differences in victimization rates and disclosure between LGBTQ+ and non-LGBTQ+ victims, it is likely that other forms of help-seeking, such as being interested in violence prevention information, may also differ. LGBTQ+ victims may be more interested in victimization prevention information than non-LGBTQ+ victims for several reasons. First, having high victimization rates may be indicative of wanting preventative information. It is also possible that LGBTQ+ individuals experience heightened mental health issues, which could be tied to information-interest (Liu et al. 2019; Oswalt and Wyatt 2011; Przedworski et al. 2015). Victimization may also exacerbate these mental health issues for LGBTQ+ persons and increase their interest in help/information. Thus, it is important to identity instances where LGBTQ+ persons may be interested in receiving violence prevention information but are not receiving this information.
Despite possible needs for increased assistance, members of the LGBTQ+ community may also be less prone to seek out or receive victimization information/help. Indeed, LGBTQ+ victims may face substantial barriers, such as relationship (e.g., outing threats, fear of homophobic reactions), institutional (e.g., hegemonic masculinity, community isolation/denial), and legal (e.g., fear negative police response, antigay/lesbian policies) barriers to help-seeking (Parry and O'Neal 2015). Further, minority stress theory (Meyer 1995) suggests that LGBTQ+ people may face discrimination and sexual stigma that inhibits their ability to receive help. If true, it is expected that nonheterosexual and transgender/nonbinary+ victims will indicate greater interest in receiving violence and sexual assault/relationship violence prevention but not receive it.
Nonheterosexual and transgender/nonbinary+ college students may experience additional barriers to information-seeking. For instance, Mennicke et al. (2020) found that lesbian, gay, bisexual, or other nonheterosexual students felt less connection to their institution and less institutional support compared to heterosexual students, which may reduce information-seeking among college student victims. Although campus violence awareness trainings/programs have increased in number in the last few decades (Brown et al. 2015), they are predominantly heteronormative, meaning that LGBTQ+ students may feel institutionally excluded from these curriculums and/or not feel the victimization information applies to them (Worthen and Wallace 2017). Thus, it is important to understand if certain campus groups are more likely to be interested in and receive violence prevention information because prevention and intervention efforts should be targeted and tailored to those most in need.
Current Study
Little is known about interest in and actually receiving violence prevention information among LGBTQ+ college student victims and even less is known about differences across sexual and gender identity groups. Our study adds to the literature by examining information interest and receipt (i.e., interest in receiving, having received, and interest in but not receiving violence and sexual assault/relationship violence prevention information). Two questions are addressed: (1) What differences exist in information interest and receipt across sexual and gender identity? (2) Are nonheterosexual and transgender/nonbinary+* victims (across three victimization types) more likely to have interest in, receive, and have interest in but not receive information regarding violence and sexual assault/relationship violence prevention than heterosexual and cisgender victims?
Methods
Data and sample
The American College Health Association administers the National College Health Assessment IIc (ACHA-NCHA IIc) in the Fall and Spring (ACHA, 2021). Since its first administration in 2000, three versions have been implemented. The Spring 2019 data are used, which include survey responses for 67,972 students across 98 postsecondary institutions (i.e., public, private, 2-year, 4-year, or above). Schools self-select into the study, but only institutions that surveyed all students or used random sampling methods were included (ACHA 2019). After accounting for listwise deletion, the total analytical sample was 62,676. Table 1 presents characteristics for the total sample, nonheterosexual students, and transgender/nonbinary+ students. Students who identified as being asexual, bisexual, gay, lesbian, pansexual, queer, questioning, same gender loving, or having another sexual identity were considered nonheterosexual (coded as 1 and coded as 0 otherwise).
Sample Characteristics
IPV, intimate partner violence; SA, sexual assault.
Students who indicated being a trans man, trans woman, genderqueer, agender, gender fluid, nonbinary, or another gender identity were considered nonbinary+ (coded as 1 and coded as 0 otherwise). † Approximately 53% of students were interested in, 45% had received, and 25% were interested in but did not receive violence prevention information. Similarly, about 57% of students were interested in, 77% had received, and 9% were interested in but did not receive sexual assault/relationship violence prevention information. During the previous 12 months, 18% reported violent, 11% reported sexual, and 11% reported IPV victimization. University of Tennessee at Chattanooga's Institutional Review Board made a “not human subjects research” determination.
Measures
Dependent variables
One item was used to create a violence prevention information-interest measure. Students were asked if they were interested in receiving information about violence prevention from their college/university (1 = yes, 0 = no). One item was used to create a sexual assault/relationship violence prevention information-interest variable. Students were asked if they were interested in receiving information about sexual assault/relationship violence prevention from their college/university (1 = yes, 0 = no).
Students were asked if they had received information about violence prevention from their college/university (1 = yes, 0 = no). Students were asked if they had received information about sexual assault/relationship violence prevention from their college/university (1 = yes, 0 = no). A measure to indicate student interest but no receipt of violence prevention information was created. This measure is critical as it demonstrates that there are students who were interested in receiving violence prevention and/or sexual assault/relationship violence prevention information but did not receive it from their university/college (i.e., their need was not met). Students who were interested in violence prevention but did not receive this information were coded as 1 and 0 otherwise. A measure to indicate student interest but no receipt of sexual assault/relationship violence prevention information was created. Students who were interested in but did not receive this information were coded as 1 and 0 otherwise.
Independent variables
Violent victimization reflects if a student experienced physical assault or verbal threats during the past 12 months (1 = yes, 0 = no). Sexual victimization during the past 12 months was created from four items (i.e., sexual touching, sexual penetration, attempted sexual penetration, and sex while drinking alcohol—items indicating “without consent”). Persons who experienced any of these were coded as 1 and 0 if not. To measure IPV, students were asked “if they had been in an intimate/coupled (partnered) relationship within the past 12 months that was emotionally abusive, physically abusive, or sexually abusive (ACHA 2019). Those who indicated experiencing any of these were coded as 1 and 0 otherwise.
We include a set of variables that have been correlated with victimization, sexual/gender identity, and information- and help-seeking within the literature. Specifically, these measures may be associated with increased minority stress, motivated offender exposure, and may constrain information interest and receipt. Mental health reflects a self-reported diagnosis or treatment for any of 12 disorders (i.e., anorexia, anxiety, attention deficit and hyperactivity disorder, bipolar disorder, bulimia, depression, obsessive compulsive disorder, panic attacks, phobia, schizophrenia, substance abuse or addiction, other mental health condition; 1 = yes, 0 = no). Binge drinking was coded as 1 for those who indicated they had drunk five or more drinks in a sitting within the last 2 weeks and coded 0 otherwise.
An illicit drug use measure reflects self-reported past 30-day use of 11 types of illicit drugs (i.e., cocaine, methamphetamine, other amphetamines, sedatives, hallucinogens, anabolic steroids, opiates, inhalants, MDMA (ecstasy), other club drugs, other illegal drugs) with those who indicated any use coded as 1, and those who reported no use of any drugs coded as 0. Marijuana use reflects, within the past 30 days, how many days students used marijuana (1 = at least 1–2 days; 0 = never used or have used but not in past 30 days). A disability status measure is included to capture if a student reported having one of five disabilities (i.e., deaf/hard of hearing, mobility/dexterity, partially sighted/blind, speech or language disorder, other disability; 1 = yes, 0 = no). Students who reported that they were a member of a social fraternity or sorority were coded as 1 and nonmembers were coded as 0.
We include a categorical measure of year in school that reflects if students were 1st year (referent category), 2nd year, 3rd year, 4th year, 5th or more, in a graduate/professional program or in a nondegree seeking/other program. Race/ethnicity was coded as (1) White—referent, (2) Black, (3) Hispanic or Latino/a, (4) Asian or Pacific Islander, and (5) another race/ethnicity (i.e., American Indian, Native Hawaiian, or Alaskan Native, Biracial or Multiracial, and Other). A birth sex variable reflects what sex students indicated they were assigned at birth, with females coded as 0 and males as 1.
Analytic Plan
The data were analyzed in several steps using Stata 16 and SPSS 27. Multivariable logistic regression models were run for each dependent variable (i.e., interest in receiving information, receiving information, and interest in but not receiving information on violence prevention and sexual assault/relationship violence prevention) with its corresponding victimization type(s) included. For example, when examining interest in receiving violence prevention information, violent victimization is included in the model. An interaction term was included in each model to examine the effect of sexual and gender identity and victimization type on having interest in, receiving, and having interest in but not receiving violence prevention and sexual assault/relationship violence prevention information. Robust standard errors are used to account for the clustering of students within schools.
Results
Results from the multivariable analyses are presented in Tables 2 and 3. Table 2 shows results from models examining interest in receiving information, receiving information, and interest in but not receiving information on violence prevention. Two interaction terms (i.e., sexual identity × violent victimization; gender identity × violent victimization) were included to examine if victimization is related to these outcomes differently for nonheterosexual and transgender/nonbinary+ students. Although violent victimization is associated with a 42% increase in the odds of interest in receiving and a 37% increase in the odds of interest in but not receiving violence prevention information among heterosexual and cisgender people (violent victimization main effect), it is not significantly related to receiving violence prevention information. The main effect of gender identity was not significant in any model.
Logistic Regression Models Predicting Received/Interest Information on Violence Prevention
p < 0.05, **p < 0.01, ***p < 0.001.
CI, confidence interval; OR, odds ratio.
Logistic Regression Models Predicting Received/Interest Information on Sexual Assault/Relationship Violence
p < 0.05, **p < 0.01, ***p < 0.001.
The main effect of sexual identity shows that among those who have not been violently victimized, being nonheterosexual increases the odds of interest in and interest in but not receiving violence prevention information, but it is associated with reduced odds of receiving violence prevention information. Interaction terms were not significant in any model, demonstrating that violent victimization is similarly related to these outcomes regardless of sexual or gender identity.
Table 3 shows results for models examining three different sexual assault/relationship violence prevention information variables. Experiencing sexual and IPV victimization are included as covariates, and the interactions between sexual victimization, IPV victimization, sexual identity, and gender identity are examined. Experiencing a sexual victimization is related to an increase in the odds for interest in, receiving, and interest in but not receiving sexual assault/relationship violence prevention information (for heterosexual and cisgender people). Experiencing IPV is related to increased odds of interest in and interest in but not receiving sexual/relationship violence prevention information and experiencing IPV is related to decreased odds for receiving sexual assault/relationship violence prevention information (for heterosexual and cisgender people). Similar to the violent victimization models, the main effect for gender identity and its interactions were nonsignificant. Interaction terms for sexual identity were significant in three models.
Predicted probabilities (not in table) reveal that the probability of being interested in information among those who are heterosexual and who have been sexually victimized is 0.679 compared to 0.739 for those who are nonheterosexual and who have been sexually victimized. The predicted probability for wanting but not receiving information is 0.114 among those who are heterosexual and have been sexually victimized compared to 0.112 among those who are nonheterosexual and have been sexually victimized. The interaction term for sexual identity and IPV is only significant in the model examining receiving information. The predicted probability of receiving information is 0.751 among those who are heterosexual and have been an IPV victim compared to 0.743 among those who are nonheterosexual and have experienced IPV victimization. ‡
Discussion
Being interested in and receiving victimization prevention information can be viewed as a form of help-seeking. Little is known about information interest and receipt among nonheterosexual and transgender/nonbinary+ college students compared to their cisgender and heterosexual peers and how victimization relates to this form of help-seeking. The current study adds to the literature by comparing interest in, receipt of, and interest in but not receiving sexual assault/relationship and violence prevention information among nonheterosexual, transgender/nonbinary+, cisgender, and heterosexual victims of violence, sexual assault, and IPV. Supporting the assertions of minority stress theory, descriptive statistics show that nonheterosexual and transgender/nonbinary+ students tend to show more interest in receiving violence prevention and sexual assault/relationship violence prevention information. Two key findings emerged at the multivariable level.
First, in the models examining interest in violence prevention, neither gender identity nor sexual identity significantly interacted with sexual or IPV victimization in predicting interest in, receipt of, or interest in but no receipt of violence prevention information. Thus, victimization did not elevate the odds of this type of help-seeking for transgender/nonbinary+ or nonheterosexual individuals as expected. Second, when considering sexual assault/relationship violence prevention information, sexual identity did appear to interact with victimization. Those who were nonheterosexual and experienced sexual victimization had the highest probability of being interested in receiving information. In the model examining receiving and interest in but not receiving sexual assault/relationship violence prevention information, those who were heterosexual and experienced sexual victimization had the highest probability of being interested in but not receiving information; however, the probabilities were similar as compared to nonheterosexual victims.
For these two models, victims (regardless of sexual identity) were less likely to receive and more likely to want but not receive sexual assault/relationship violence prevention information. Thus, it appears that the effect of victimization is similarly related to information interest and receipt across gender identity, but nonheterosexual students may not be getting sexual assault/relationship violence prevention information when controlling for other factors connected to victimization and help-seeking. Further, victims are more likely to be interested in receiving information, but are less likely to receive this information, even when interested. Our findings suggest that transgender/nonbinary+ and nonheterosexual victims may have different needs and may be differentially receiving sexual assault/relationship violence prevention information. Future research should consider investigating victimization and information-seeking behaviors separately for these groups.
These findings have implications for which groups to target for resources and services. LGBTQ+ individuals often have higher rates of receiving mental health services (Baams et al. 2018; Cochran and Mays 2000; Kerr et al. 2013), so they may already be receiving the information that they need. It could also be that some of the sampled campuses have been focusing their outreach efforts more on transgender/nonbinary+ students and/or have LGBTQ+ campus resource centers, but they should also be mindful of targeting outreach to nonheterosexual students specifically. In addition, as highlighted within our descriptive statistics, campus prevention programs often focus on sexual violence or IPV prevention, but campus violence curriculums should also provide general violence prevention information regarding safety precautions from other crime types.
The insignificance of many of the interaction terms was unexpected because it contrasts prior literature on service provision for LGBTQ+ individuals (Felix et al. 2020; Kurdyla et al. 2019; Williams et al. 2005). As noted, research suggests that LGB and transgender individuals are more likely to be willing to disclose victimization experiences to counselors/therapists (Felix et al. 2020; Kurdyla et al. 2019). Thus, it may be that nonheterosexual and transgender/nonbinary+ victims have already sought out violence prevention information from their service providers, which may explain the lack of differences across groups. We initially thought that nonheterosexual and transgender/nonbinary+ victims would not be interested in or receive violence or sexual assault/relationship information because campus providers may lack the required cultural competency to treat them.
Indeed, it is possible that victims in marginalized sexual and gender identity groups are not differentially interested in receiving or receive sexual assault/relationship violence prevention from their campus because they do not view their campus as a safe space or likely to provide culturally competent information. However, our findings provide some evidence that universities may be making positive strides in outreach. Nevertheless, future research should focus on the relationship between information interest, sexual identity, gender identity, and victimization. Future research may benefit from exploring these relationships using multilevel modeling to see if school characteristics influence students' desire for and receipt of violence prevention information. In addition, it would be beneficial to qualitatively examine interest in and receipt of violence prevention information among members of varying sexual and gender identity groups.
Despite several contributions from our study, there are also limitations. The ACHA-NCHA II Spring 2019 data do not have direct measures to assess help-seeking postvictimization. Rather, we explore general help-seeking behaviors via information interest, receipt, and interest but no receipt. The general violence prevention variable also does not define “violence prevention,” which may have led to various interpretations of the phrase by participants. These data are also cross sectional, which means that we cannot establish time order between information interest/receipt and victimization, but we do find that victims are more likely than nonvictims to indicate interest in and receipt of information.
Future research using longitudinal data would be beneficial to determining time order and possible causality among the information-interest and receipt measures as they relate to victimization. Moreover, while this is a national sample, the schools included in these data self-select to participate. Thus, the findings cannot be generalized to all U.S. universities/colleges.
Conclusion
Our study finds that although nonheterosexual and transgender/nonbinary+ college students were more interested in receiving information in comparison to heterosexual and cisgender students at the univariate level, the effects of sexual and gender identity, at the multivariable level, were similar across all victimization types for information interest and receipt. At the univariate level, it appears that colleges are doing well in providing sexual assault/relationship violence prevention information to their students. However, college students, in general, may benefit from additional information and/or trainings related to other types of violence prevention, and LGBTQ+ students may benefit from these being presented in nonheteronormative ways. Universities/colleges should pay special attention to educating students on how and where to seek violence prevention information for multiple types of violence.
Footnotes
Authors' Contributions
Conceptualization (equal), writing original draft (K.P.H. and C.A.D.), major editing (L.E.D. and K.P.H.), rewriting draft (equal), methodology (K.P.H. and L.E.D.), formal analysis (K.P.H.), results (K.P.H. and L.E.D.), and discussion (equal).
Author Disclosure Statement
No competing financial interests exist.
Funding Information
No funding was received for this article.
