Experiences of Minority Stress and Intimate Partner Violence Among Homosexual Women in Turkey

Abstract

Intimate partner violence (IPV) has been recognized as an important public health problem over the past two decades, and increased attention to violence in intimate relationships has been given to heterosexual couples. Although the vast majority of literature has determined the rate of IPV among lesbian, gay, bisexual couples, and relationship quality, few studies investigated how stress specific to living as a lesbian or bisexual woman might correlate with IPV in these relationships. For this reason, the purpose of this descriptive study was to determine the experiences of minority stress and IPV among homosexual women (n = 149) in Turkey. Data were collected using convenience and snowball sampling. Participants completed an interviewer-administered survey. Results indicated that victimization and perpetration of all the forms of IPV occur but the most prevalent was perpetration (66.4%) and victimization (63.1%) of psychological violence. The mean score of participants’ total level of outness was found 4.78 ± 2.15 (0-10). Most participants (74.5%) reported being often exposed to discrimination in the public area and reported moderate level of internalized homophobia (2.72 ± 0.87). Participants’ level of outness associated with psychological (Victimization r = .319, p = .00; Perpetration r = .421, p = .00), physical (Victimization r = .184, p = .025; Perpetration r = .209, p = .010), and sexual (Victimization r = .263, p = .001; Perpetration r = .372, p = .00) violence perpetration and victimization. It is also founded that there was relation between internalized homophobia level and sexual violence perpetration (r = .164, p = .045)/victimization (r = .189, p = .021). These findings demonstrate a need for health care staff to be aware of the prevalence of IPV and minority stress that affected this population. Mental health of homosexual individuals is under the risk due to minority stress and IPV experiences. Furthermore, this finding illustrated that need for additional empirical research improved interpersonal relationship among these women. Also, policies need to be developed to reduce the minority stress experienced by these individuals and provide integration with the society.

Keywords

domestic violence GLBT violence against GLBT anything related to domestic violence dating violence

Introduction

Intimate partner violence (IPV) is defined as an “action such as the psychological harassment, sexual coercion, physical aggression and/or economic abuse between couples” (World Health Organization [WHO], 2010). IPV, which has been identified as a public health problem that leads to long-term, serious physical and mental health problems, has become an increasingly important social phenomenon that transcends culture, geography, and ethnicity (Black et al., 2011; Blackwell, Ricks, & Dziegielewski, 2004). This issue has been extensively studied by many professionals, including those in the fields of health care, law enforcement, and the government (Pepper & Sand, 2015). In many countries, government resources are used in an attempt to prevent IPV in heterosexual relationships (Balsam & Szymanski, 2005; Chong, Mak, & Kwong, 2013). Nonetheless, same-sex IPV is often ignored and/or minimized, and it is not addressed in cultures where same-sex relationships are less accepted (Balsam & Szymanski, 2005; Chong et al., 2013). However, the focus on same-sex IPV in the relevant literature has increased (Edwards & Sylaska, 2013; Rohrbaugh, 2006; Trotman, 2013). The lifetime prevalence of IPV (rape, physical violence, or stalking) is 44% for lesbian women, 61% for bisexual women, and 35% for heterosexual women (Black et al., 2011). Being exposed to IPV may lead to physical and mental health problems, such as depression, anxiety, low self-esteem, suicide attempts, gastrointestinal disorders, substance abuse, sexually transmitted diseases, or unwanted pregnancy (WHO, 2010). Lesbian and bisexual women have also reported more fear than heterosexual women; they worry about their safety and they have possible symptoms of posttraumatic stress disorder due to IPV (Walters, Chen, & Breiding, 2013). These problems can result in hospitalization, disability, or death (Black et al., 2011).

Although the correlations and predictors of IPV, including the power dynamics and the cyclic nature of the violence, are similar in heterosexual and same-sex relationships (Bucci, 1995; Chong et al., 2013; Hellemans, Loeys, Buysse, Dewaele, & De Smet, 2015), stress due to the minority status of lesbian, gay, bisexual, and transgender (LGBT) individuals, as well as some dynamics that are specific to members of this community, should be considered to cause IPV. These individuals may experience additional stressors related to their sexual orientation that increase inter- and intrapersonal conflict and societal stigma, such as suffering discrimination, which can be reflected in their intimate relationships (Chong et al., 2013; Hellemans et al., 2015).

A perspective specific to LGBT individuals, in particular, may be helpful in understanding same-sex IPV perpetration or victimization (Balsam & Szymanski, 2005; C. Brown, 2008). One view is that minority stress (MS) is responsible for IPV in same-sex couples. MS has been defined as “psychosocial stress derived from minority status” (Meyer, 1995, 2003; Wong, Schrager, Holloway, Meyer, & Kipke, 2014). According to Meyer (1995, 2003), the components of MS are internalized homophobia, experiences of discrimination (expectations of rejection, discrimination, and actual prejudice events), and being out. Most previous studies on MS have investigated negative mental health outcomes due to the correlation between negative identity feelings, depression, and low self-esteem (Hequembourg et al., 2008; King et al., 2008; Meyer, 2003; Meyer & Northridge, 2007; Wong et al., 2014; Yalcınoglu & Onal, 2014).

According to Meyer (1995, 2003), internalized homophobia occurs when LGBT individuals consciously or unconsciously accept society’s negative attitudes about homosexuality. The internalization of socially approved homophobia by sexual minorities also leads to poor self-worth and decline in self-esteem (Meyer, 1995; Dispenza, 2012; Lehavot & Simoni, 2011). The feelings of shame and worthlessness associated with internalized homophobia can cause problems in interpersonal relationships (Meyer, 1995, 2003).

Many studies have reported on the relationship between internalized homophobia and psychological IPV (Bartholomew, Regan, White, & Oram, 2008; Lewis, Milletich, Derlega, & Padilla, 2014), physical IPV (Balsam & Szymanski, 2005; Edwards & Sylaska, 2013; Lewis, Mason, Winstead, & Kelley, 2017; Milletich, Gumienny, Kelley, & D’Lima, 2014; Stephenson & Finneran, 2017), and sexual IPV (Balsam & Szymanski, 2005; Edwards & Sylaska, 2013; Hershow et al., 2021; Pepper & Sand, 2015; Stephenson & Finneran, 2017). LGBT individuals can project their negative feelings about their orientation onto their partners (Frost & Meyer, 2009). Facing these negative feelings is likely to decrease the satisfaction and quality of intimate relationship (Rostosky & Riggle, 2017). Thus, internalized homophobia can lead to problems related to ambivalence, relational conflict, misunderstandings, and discrepant goals (Frost & Meyer, 2009).

MS can also arise from experiences with one’s coming out process, which is described as the process of recognizing, accepting, and expressing one’s sexual orientation to others (DiPlacido, 1998). Each of the MS components can trigger others. For example, discrimination or rejection expectations may affect when, and to whom, one may reveal or hide one’s same-sex relationship. Societal discrimination and hiding one’s sexual identity can reinforce the internalized homophobia of an individual that identifies as being LGBT or who has a partner of the same sex. Finding ways to deal with prejudice and its effects, especially when negative coping strategies increase stress, LGBT couples experience and respond to MS as a dyad (Rostosky & Riggle, 2017). C. Brown (2008) has argued that the most important factor concerning IPV among same-sex couples is often the daily stress they encounter living as members of a socially sanctioned minority group in heterosexist and homophobic societies.

LGBT individuals sometimes do not disclose their sexual orientation for fear of stigmatization and discrimination. It has been reported that perpetrators of partner abuse use this fear (Ard & Makadon, 2011; Renzetti, 1992). In intimate relationships, perpetrators can restrain their partners from seeking help from family, friends, police, or institutions (Ard & Makadon, 2011). As LGBT individuals become more visible in society, they become targets of anti-homosexual violence and discrimination (W. Brown, 2001; Reis & Saewyc, 1999). Many LGBT individuals experience psychological or physical trauma from being exposed to hate speech, hate crimes, or bullying in schools and hospitals (Ard & Makadon, 2011; Meyer, 2003). Studies have shown that homophobic discrimination and hiding sexual orientation were related to the physical IPV (Edwards & Sylaska, 2013; Houston & McKirnan, 2007; Lewis et al., 2017; Rostosky & Riggle, 2017). A positive correlation has also been found between psychological IPV and internalized homophobia (Edwards & Sylaska, 2013). Moreover, stigmatization has been correlated with the lifetime prevalence of IPV (Carvalho, Lewis, Derlega, Winstead, & Viggiano, 2011).

Although IPV experiences are similar for LGBT and heterosexual individuals (M. J. Brown & Groscup, 2009; Chong et al., 2013), homophobia and gender role stereotypes reveal myths and prejudices about same-sex relationships (Island & Letellier, 1991; Potoczniak, Murot, Crosbie-Burnett, & Potoczniak, 2003). The limited number of studies investigating IPV in same-sex relationships have focused on IPV in lesbian and bisexual women. Assumptions that women do not commit physical violence, that physical violence against men is not possible, and that this type of violence is more easily managed in same-sex relationships than heterosexual relationships have reduced the importance of same-sex IPV (Renzetti, 1992; Steele, Everett, & Hughes, 2020; Whitton, Dyar, Mustanski, & Newcomb, 2019). Furthermore, unlike most heterosexual women, women who are members of sexual minority groups face many additional stressors due to the stigma related to their sexuality and sexual orientation in a society that does not approve of their relationships (Balsam & Szymanski, 2005; Fingerhut, Peplau, & Ghavami, 2005; Brown, 2008; Messinger, 2011). In particular, gender inequalities grounded in culture should also be added to the current list of MS components.

In Turkey, studies have focused on attitudes toward LGBT individuals and the problems they encounter (Akhan & Barlas, 2013; Guney, Kargi, & Corbacı Oruc, 2004; Kabacaoglu, 2012; Karakaya, 2016; Mitrani Akdas, 2008; Kaos GL, 2015; Ozturk & Kindap, 2011; Yalcınoglu & Onal, 2014). These studies have emphasized that LGBT individuals are exposed to negative attitudes and homosexuality is unacceptable in Turkey where Islamic traditions are commonly upheld. However, it is important to note that there is still no published research on MS experiences and IPV in a Turkish population. In Turkey, attitudes toward sexual orientation range from positive to negative. While there are still no legal and penal regulations for LGBT individuals, homosexuality is not prohibited. However, LGBT individuals are exposed to stigma and discrimination in many social and institutional settings such as hospital and school. This leads to psychological problems (low self-esteem, loneliness, depression, anxiety) that adversely affect the lives of LGBT individuals in Turkey. Although one study (Okutan, Buyuksahin Sunal, & Sakalli Ugurlu, 2016) has investigated the relationship between internalized homophobia and relationship satisfaction, investigating the IPV problem in relation to MS has not yet been studied.

The current study contributes to the literature by examining IPV among lesbian women in the context of MS in Turkey, in which the traditional societal norms are considered to be sexist. Thus, it aimed to describe the experiences of MS and IPV among lesbian women. In particular, it investigated how the internalized homophobia, “outness level,” and experiences of discrimination are associated with IPV in this group of women.

It is believed that the results of this study will help identify the MS and interpersonal violence experienced by lesbians who are already exposed to negative discrimination in society. It is also thought that the suggestions emerging from the study’s findings will create awareness in health care professionals and provide protection and support for lesbians who are at risk in terms of their mental health. The study also seeks to provide a deeper understanding of the stereotypes/myths about violence in same-sex relationships and assess interpersonal violence from a variety of perspectives. Toward that end, this study sought to answer three research questions:

Research Question 1: What are the MS and IPV experiences of lesbians in Turkey?

Research Question 2: Which personal characteristics affect MS and IPV?

Research Question 3: What are the correlations between perpetration or victimization of IPV and MS (disclosure, perception of prejudice, or discrimination toward LGBT individuals, and internalized homophobia) in lesbians?

Method

Sample and Procedure

This cross-sectional descriptive study was conducted between September 2016 and March 2017. Prospective participants were recruited from email lists of LGBT organizations as well as news items posted on LGBT websites and online dating websites in Turkey. To reach diverse members of the target population, we contacted a range of LGBT organizations as well as other civil society organizations such as Lambda Istanbul. Purposive sampling (i.e., selecting participants who fit the objectives of the study) was used to select lesbians from the sampling venues, including social groups, and outdoor areas (e.g., parks, cafes, bookstores) in Istanbul. To enhance the number of participants, snowball sampling was also used.

To be eligible for the study, the participants needed to meet the following inclusion criteria: (a) be at least 18 years of age, (b) self-identified as a lesbian, and (c) reported being in a current or previous same-sex partner relationship. Participants signed a written informed consent form after the study procedure was explained to them. Participants were told that the survey was about same-sex relationships and MS and it contained personal questions about their behavior; their responses would remain anonymous, and it would take 30 min to complete the survey. During administration of the questionnaire, the voluntary nature of participation in the study was emphasized, and the participants were told that it was important for them to be frank and honest in their responses. The research protocol was reviewed and approved by the Istanbul University Social and Human Sciences Ethics Committee (2016/137).

The sample consisted of 149 lesbians. Their average age was 25, with a range of 18 to 60 years. Overall, the participants reported a high level of education: approximately 77% (n = 115) had a college degree, or higher.

Measures

Demographic questionnaire

The authors of this article designed a demographic questionnaire, which included information, such as age; education level; occupation; income level; parents’ parenting style; area of residence; the person with whom the respondent lives; cigarette, alcohol, and substance use status; and relationship status. Relationship status was assessed by asking whether the participants were currently in a relationship, the length of their current relationship, and their relationship with a member of the opposite sex at any point in their lifetime.

MS indicators

Internalized homophobia was assessed using the “Lesbian Internalized Homophobia Scale (LIHS)” developed by Szymanski and Chung (2001). It was translated into Turkish by Ozturk and Kindap (2011). The LIHS consists of 52 items that are rated using a 7-point Likert-type scale (1 = never agree to 7 = fully agree). Four subscales were included in the Turkish version: (a) “Connection with Lesbian Community (CLC),” (b) “Public Identification as a Lesbian (PIL),” (c) “Attitudes Toward other Lesbians (ATOL),” and (d) “Personal Feelings and Moral/Religious Attitudes Toward Lesbians (PFMRTL).” The mean rating for all items was used to create a total scale score and a subscale score, with higher scores indicating more internalized homophobia. The items had good internal consistency (Cronbach’s α = .92).

Experiences of discrimination were assessed by asking the participants whether they experienced frequent problems due to their sexual orientation and whether they experienced discrimination. These questions were used to determine the situation and the participants’ thoughts related to perceived discrimination (e.g., people treat me badly because they know or guess I’m a lesbian.) The situation and the participants’ thoughts related to perceived discrimination were determined using the visual analog scale (VAS; 0-10 mm).

Outness was conceptualized as an individual’s relative amount of disclosure about his or her sexual orientation to family members, heterosexual friends, lesbian/gay friends, and coworkers. Thus, outness included attitudes about the importance of being out and the fear of exposure. In this study, the participants’ coming out experiences were assessed by asking them to identify the age at which they recognized and accepted their sexual orientation, the age at which they concealed their sexual orientation, and their attitudes about the importance of being out and their level of outness. The level of outness was assessed as the extent to which the participants had disclosed their sexual orientation to others. Each question focused on a specific individual to whom the participants had disclosed their sexual orientation (e.g., a mother). The level of outness and the attitudes about the importance of being out were determined using VAS (0-10 mm). Higher scores indicate greater disclosure of sexual orientation.

IPV

The revised Conflict Tactic Scale (CTS2) was used to assess the extent of domestic violence that was experienced and perpetrated by the participants. The CTS2 includes two questions for each item, assessing the actions done by and to the participant (Straus, Hamby, Boney-McCoy, & Sugarman, 1996). It was translated into Turkish by Aba and Kulakac (2016). The CTS2 consists of 78 items that are rated using an 8-point Likert-type scale (0 = never happened and 1 = once to 6 = more than 20 times within the past several years and 7 = it has not happened in the past year, but it happened before). The Turkish version of the CTS2 contains five subscales: “negotiation, psychological violence, physical violence, sexual violence, and injury.”

IPV prevalence and annual frequency were calculated for this scale. Prevalence was determined based on whether the participant was subjected to at least one or more violent behaviors in the previous year. Thus, the frequency of violent behavior is not considered in the calculation of prevalence; rather, it is determined by whether the participant was a victim or perpetrator of violent behavior. Responses ranging from 1 to 6 were coded as “YES = 1” and responses ranging from 0 to 7 were recoded as “NO = 0.” After creating this dichotomous code, the subscale responses were further evaluated. A “YES” response to any of the items in each of the subscales indicates that violence occurred; a “NO” response to any of the items in the subscales indicates that no violence occurred.

To calculate the frequency of violence, the responses were coded as 7 and 0 = 0, 1 = 1, 2 = 2, 3 = 4, 4 = 8, 5 = 15, and 6 = 25. Then, the average score of the subscales was calculated, and the frequency of being exposed to or perpetrating violence for each subscale was measured. Consequently, the scale is not evaluated based on the total score. The items had good internal consistency (Cronbach’s α = .95).

To determinate lesbian-specific tactics of psychological aggression in IPV, VAS was used for prevalence in the previous year, and yes–no questions were used to determine the lifetime prevalence. This section consisted of eight questions. These items included “I threatened to tell my partner’s employer, family, or others that she is lesbian”; “I forced my partner to show physical or sexual affection in public, even though she didn’t want to,” “I used my partner’s age, race, class, or religion against her,” and “I told my partner she deserves what she gets because she is a lesbian.” As with the rest of the CTS2 items, parallel items that read “My partner did this to me” followed each LGBT-specific item, and the participants were asked to indicate the tactics that were used. To determine the prevalence of LGBT-specific tactics, “Never happened” and “It has not happened in the past year, but it happened before” responses were coded as 0 = No. Any value in the VAS indicating the prevalence of the tactic in the previous year was coded as 1 = Yes. After creating this dichotomous code, a “YES” response to any of the items in LGBT-specific tactics items indicated that there is violence; a “NO” response indicated that no violence occurred. To calculate the frequency of occurrence in the previous year, the average of the responses of the VAS markers was calculated using descriptive statistics.

Data Analysis

We conducted descriptive analyses of the sample demographic characteristics, outness level, internalized homophobia, discrimination experiences, and IPV. The Kolmogorov–Smirnov test was used to assess the normality distribution. The data did not fit the normal distribution. Demographic differences in the participants’ characteristics, MS, and IPV outcomes were examined using the Mann–Whitney U and Kruskal–Wallis tests (nonparametric tests for continuous variables; i.e., internalized homophobia and discrimination experiences). Spearman’s rank correlation coefficient was used to determine the relationship between the descriptive statistics and the continuous variables. For all analyses, p < .05 was used to define the statistical significance. The data were evaluated using the IBM SPSS 20 for IOS package software program.

Results

Sample Characteristics

Half of the participants (51.7, n = 77) lived in a city, 33.6% (n = 50) lived in a city, 12% (n = 18) lived in a village or town, and 2.7% (n = 4) lived abroad. Most (58.4%, n = 87) of the participants reported being employed full-time, and 62.4% (n = 93) stated that their economic status was moderate. Slightly less than half of the participants (45%, n = 67) indicated that they have authoritative parents, and 40.3% (n = 60) reported living with their family.

In terms of relationship status, 65.3% (n = 98) of the participants were currently in an intimate relationship ( $\bar{M}$ minimum 1 to maximum 84 months), and almost all of them (89.9%, n = 134) had never been in an intimate relationship with the opposite sex. Approximately three quarters of the participants (72.5%, n = 108) were smokers, 73.8% (n = 110) consumed alcohol, and very few (7.4%, n = 11) used drugs.

Most of the participants (70.5%, n = 105) reported that they had been victimized for any type of intimate relationship violence in the previous year. Of those, the most frequent type of victimization was psychological (63.1%, n = 94), physical (42.3%, n = 63), sexual (38.3%, n = 57), and LGBT-specific abusive responses (28%, n = 42). The perpetration rates for any type of IPV were similar to the victimization rates.

MS Experiences

The MS experiences of the participants are presented in Table 1. The mean age of first self-identification as a lesbian was 13 (SD: 4.69), with a range of 3 to 30 years. The mean age of first accepting of oneself as a lesbian was 17 (SD: 3.64). The mean score of the participants’ total level of outness was 4.78 ± 2.15, and the highest level of outness was found in their disclosure of their sexual orientation to their friends (7.86 ± 2.65).

Table 1.

Participants’ Minority Stress Experiences (n = 149).

Minority Stress Indicators		M	±SD	n	%
Age of first noticing one was lesbian		13	4.69
Age of first accepting of oneself as a lesbian		17	3.64
Age of first told someone that they were lesbian		17	3.01
Person who disclosed the sexual orientation first time	Family			38	25.5
Person who disclosed the sexual orientation first time	Friend			111	74.5
Outness level
Family		4.55	3.14
Friends		7.86	2.65
Coworkers, neighbors, and so on		2.53	2.61
Unfamiliar persons		4.20	3.56
Total outness		4.78	2.15
Perceived discrimination experiences
Subjective perceptions related to sexual orientation discrimination
People act like I’m not as good as they are because they know or guess I am lesbian		3.82	3.10
People act less respectfully me than other people because they know or guess I am lesbian		3.67	3.19
People act less politely me than other people because they know or guess I am lesbian		3.71	3.27
People insult or give a name because they know or guess I am lesbian		3.48	3.14
People threaten or harass because they know or guess I am lesbian		3.52	3.28
People trust me less than other people because they know or guess I am lesbian		2.84	3.08
People are revolted at me because they know or guess I am lesbian		3.17	3.29
People don’t behave warmly because they know or guess I am lesbian		3.06	2.91
People don’t want to spend time with me because they know or guess I am lesbian		3.08	3.08
Total		3.37	2.54
General perceptions related to sexual orientation discrimination
Discrimination experiences restrain from having quality and productive life		7.51	3.51
Discrimination experiences make life difficult		8.20	2.92
Total		7.85	3.02
Internalized homophobia
Connection with the Lesbian Community (CLC)		2.76	1.06
Public Identification as a Lesbian (PIL)		3.32	1.22
Personal Feelings, Moral and Religious Attitudes Toward Lesbianism (PFMRTL)		2.05	1.00
Attitudes Toward Other Lesbians (ATOL)		2.67	1.01
Lesbian Internalized Homophobia Scale (LIHS) total score		2.72	0.87

Most of the participants (74.5%) reported often being exposed to discrimination in a public area (e.g., street, cafe) due to their sexual orientation. While the majority suffered from derogatory gestures and glances in social environments, 29.5% of the participants were excluded from family events, 21.5% were unable to use to health services, and only a small number (4.7%) had to leave school. The mean score of subjective perceptions about discrimination was 3.37 ± 2.54.

The mean score of the LIHS scale for the participants was 2.72 ± 0.87, indicating that most of them reported a moderate level of internalized homophobia. Furthermore, the highest mean score among the subscales was 3.32 ± 1.22 in the PIL subscale.

The effect of personal characteristics on MS

It was found that level of subjective perceptions related to sexual orientation discrimination was higher for participants with a lower level of education (Z_mnu = −2.889/p = .004). The participants’ area of residence had an effect on the internalized homophobia score. Participants who lived in a city had a statistically significant higher mean score on the LIHS scale (X_kw = 7.784/p = .020) than participants who lived in the other areas. Economic status had an effect on the participants’ level of outness (X_kw = 6.264/p = .044) and internalized homophobia (X_kw = 19.848/p = .000). Participants with a higher economic status indicated lower levels of internalized homophobia than those with a middle or low economic status. Participants who lived with a partner had a higher outness level than participants who lived alone (X_kw = 12.155/p = .002; Table 2).

Table 2.

The Effect of Personal Characteristic on Minority Stress (n = 149).

Demographic Variables	Outness Level	Perceived Discrimination Experiences	LIHS
Education level^a
High school diploma or GED (n = 34)		93.76*
College or more (n = 115)		69.45*
Homeland^b
Village-county (n = 18)			65.89*
City (n = 50)			88.83*
Metropolitan-abroad (n = 81)			68.49*
Economic status^b
Low (n =11)	96.45*		100.68**
Middle (n = 87)	68.17*		84.07**
High (n = 51)	82.03*		53.98**
Person who living with^b
Single (n = 37)	72.23*
Family or friends (n = 93)	69.55*
Partner (n = 19)	107.08*
Parenting style^a
Authoritative (n = 67)		59.20*	67.10*
Nonauthoritative (n = 82)		87.91*	81.45*
Cigarette use^a
Yes (n = 108)		79.49*
No (n = 41)		63.17*
Alcohol use^a
Yes (n = 110)	80.46*	83.78**
No (n = 39)	59.60*	50.24**
Subtance use^a
Yes (n = 11)	111.77*
No (n = 138)	72.07*

Note. LIHS = Lesbian Internalized Homophobia Scale; GED = General Educational Development.

Mann–Whitney U test was used for binary variables.

Kruskal–Wallis test was used for multiple variables.

p < .05. **p < .005.

It was shown that parenting style had an effect on subjective perceptions related to discrimination (Z_mnu = −4.003/p = .00) and internalized homophobia (Z_mnu = −2.019/p = .043). The participants with nonauthoritative parents had higher levels of subjective perceptions related to discrimination and internalized homophobia.

The effect of personal characteristic on IPV

Education level (Perpetration X_kw = −2.173/p = .030; Victimization X_kw = −2.452/p = .014) and economic status (Perpetration X_kw = 6.642/p = .040; Victimization X_kw = 7.204/p = .027) had an effect on the participants being a perpetrator or a victim of sexual violence. Participants with a high level of education and a high economic status more often reported perpetration and victimization of sexual IPV. Parenting style had an effect on the participants’ perpetration and victimization experiences for all types of IPV. Participants whose parents had a nonauthoritative parenting style more often reported that they were perpetrators and victims of IPV than participants whose parents had an authoritative parenting style (p > .005; Table 3).

Table 3.

The Effect of Personal Characteristic on Intimate Partner Violence Experiences (n = 149).

Demographic Variables	Victimization				Perpetration
Demographic Variables	Psychological Violence	Physical Violence	Sexual Violence	Inquiry	Psychological Violence	Physical Violence	Sexual Violence	Inquiry
Education level^a
High school or GED (n = 34)			60.87*				62.66*
College or more (n = 115)			79.18*				78.65*
Economic level^b
Low (n = 11)			102.73*				101.05*
Middle (n = 87)			75.02*				75.11*
High (n = 51)			69.45*				69.20*
Parenting style^a
Authoritative (n = 67)	61.75*	58.66**	64.22**	69.74*	57.61**	61.10**	66.52*	69.04*
Nonauthoritative (n = 82)	85.83*	88.35**	83.80**	79.30*	89.21**	86.36**	81.93*	79.87*
Cigarette use^a
Yes (n = 108)		78.18*					78.73*
No (n = 41)		64.98*					65.17*
Alcohol use^a
Yes (n = 110)							79.64*
No (n = 39)							61.91*
Subtance use^a
Yes (n = 11)		99.64*						93.77*
No (n = 138)		73.04*						73.50*

Note. GED = General Educational Development.

Mann–Whitney U test was used for binary variables.

Kruskal–Wallis test was used for multiple variables.

p < .05. **p < .005.

Correlation between MS and IPV

The correlation between the MS of the participants and IPV is presented in Table 4. The outness level of the participants was found to be positively related to being perpetrators and victims of psychological and sexual violence at a significant level in intimate relationships (p < .005) and it was also positively correlated with victimization and perpetration of physical IPV(p < .05). Participants with a higher level of outness reported more perpetration and victimization for all types of IPV. The participants’ subjective perceptions about discrimination were found to be positively correlated (r = .173/p = .034) with being the victim of psychological violence. A positive correlation was found between the level of internalized homophobia and victimization and perpetration of sexual violence (Perpetration r = .164/p = .045; Victimization r = .189/p = .021).

Table 4.

Relationship Between Minority Stress and Intimate Partner Violence (n = 149).

	Outness Total	Perceived Discrimination Experinces	LIHS Total
Perpetration
Psychological violence	.421**	.114	.037
Physical violence	.209*	.097	−.023
Sexual violence	.372**	.069	.164*
Injury	.158	.182	.001
Victimization
Psychological violence	.319**	.173*	.026
Physical violence	.184*	.145	−.002
Sexual violence	.263**	.105	.189*
Injury	.159	.99	−.049

Note. LIHS = Lesbian Internalized Homophobia Scale.

p < .05. **p < .005. Spearman’s rank correlation.

Discussion

It is hoped that the outcomes of this study, which was conducted to determine the experiences of MS and IPV among lesbians, who are objectified and trivialized by being categorized as “other” and “stranger” will help improve their ability to more successfully integrate into society, preserve their human rights without hiding, and reveal the dynamics that motivate the violence in their intimate relationships. The current study aimed to explore the experiences of MS and IPV among lesbians. In this context, the results of the research will be discussed in three subsections.

Participants’ Experiences of MS and IPV

The study results show that the average age at which the participants realized their sexual orientation for the first time was 13.20 ± 4.69; the average age at which they came out was 17.29 ± 3.01. In the relevant literature, the age of at which LGBT individuals come out varies between the ages 19 and 24 (Feldman, 2012; Kabacaoglu, 2012; Morris, Waldo, & Rothblum, 2001).

The majority the participants in this study first shared their sexual orientation with their friends. A similar result was seen in a study conducted with LGBT individuals (Legate, Ryan, & Weinstein, 2012) where the participants first revealed their sexual orientation to their friends, followed by their families. Coming out is a process that begins when an individual realizes his or her sexual orientation (usually in adolescence) and is satisfied with this revelation. Factors, such as gender roles, religious beliefs, and family values, lead to delaying the acceptance of sexual orientation for LGBT individuals. This finding is also compatible with the results reported in previous studies (Feldman, 2012; Houston & McKirnan, 2007; Kabacaoglu, 2012; Morris et al., 2001; Savin-Williams & Dube, 1998).

In the present study, participants were most often exposed to discrimination in public areas, where they encountered disturbing gestures and staring. Other discrimination experiences were ranked as exclusion from the family and being unable to benefit from health services. Having to leave school was less common. These results are consistent with the findings reported in relevant literature (Lambdaistanbul LGBTI Solidarity Association 2006; Mays & Cochran, 2001). In fact, in Turkey, LGBT individuals are still exposed to discrimination in many areas of society and in many institutions.

The highest means for the PIL subscale indicate that the participants found it difficult to manage their sexual orientation identities. The PFMRTL subscale determines an individual’s attitudes toward his or her sexual orientation (self-accusation, tolerating, etc.). In this study, the lower mean PFMRTL scores in comparison with the scores for the other subscales suggest that the participants have a positive attitude toward their sexual orientation. Overall, these findings demonstrate that, despite the high rates of victimization related to sexual orientation among lesbians, many display resilience and they do not internalize these negative experiences, as evidenced by the generally low levels of internalized homophobia in the current study.

Based on the high scores for the CLC subscale and the high rates of discrimination in the public sphere, the need to belong somewhere and to fit into the sociocultural structures embedded in a community should be considered. However, the effect that the environment in which an individual is raised has on the development of their mental health should not be ignored.

Effect of the Differences in the Personal Characteristics on the Experiences of MS and IPV

It is also important that the current study measured the effects that the participants’ personal characteristics had on MS and IPV. Future research studies are needed to better understand the factors that may mediate or moderate these effects on MS and IPV.

Participants growing up with nonauthoritative parental attitudes reported that they had negative perceptions about discrimination and a high level of internalized homophobia. This means that the effect of individual adoption of parental attitudes during the development process might shape an individual’s perceptions about and attitudes toward sexual orientation. Nonauthoritative parental attitudes could lead to not accepting individual differences. This tendency is commonly seen in the sociocultural structure of countries in which most of the inhabitants are Muslims. However, participants growing up with a nonauthoritative parenting style reported a high rate of victimization and perpetration for all types of IPV in their intimate relationships. Families are important in the formation of an individual’s personality, and individuals exposed to domestic violence are known to use violence to resolve conflicts in their interpersonal relationships (Coleman, 1994; Lie, Schilit, Bush, Montagne, & Reyes, 1991; McKenry, Serovich, Mason, & Mosack, 2006). From the perspective of disempowerment, individuals that are subjected to domestic violence often resort to violence as a way to resolve conflicts (Bucci, 1995; McKenry et al., 2006). To support this perspective, Milletich et al. (2014) also found that there was a correlation between family of origin and perpetration of violence.

Another result of our study was the high level of internalized homophobia of the participants who live in a city and also have low economic status. Although the gay rights movement in Turkey is active and the number of LGBT individuals in society is increasing, better acceptance of same-sex relationships is still limited to big cities. The high level of internalized homophobia of people who do not live in a city could be due to their inability to receive the social support that is more often afforded to LGBT people who live in big cities and also because they have to hide their identities in a more restricted environment. It was also found that participants with a low economic status and high education levels were often both victims and perpetrators of sexual violence in intimate relationships. These findings suggest that power imbalance has an impact on the prevalence and frequency of IPV (Milletich et al., 2014; Steele et al., 2020). Previous studies have reported that individuals with feelings of inadequacy engage in violence to gain power (McKenry et al., 2006; Rohrbaugh, 2006).

The Correlation Between IPV and MS Experiences

Previous studies have revealed a significant correlation between the level of outness and IPV (Carvalho et al., 2011; Edwards & Sylaska, 2013; Kelley, Lewis, & Mason, 2015). The findings of the current study also support this phenomenon. In contrast, in their frequently cited study of relevant literature, Balsam and Szymanski (2005) found that there was no correlation between the level of outness and IPV. It is thought that the differences between the study results may be due to cultural diversity. Although some studies have shown that the level of outness of LGBT individuals is not related to IPV, not disclosing one’s sexual orientation appears to be an obstacle to seeking help if one is a victim of IPV (Ard & Makadon, 2011; Sylaska & Edwards, 2015). Perhaps, disclosing or not disclosing one’s sexual orientation is not the problem; rather, after coming out process, an individual’s internal dilemmas or the conflicts experienced in his or her environment, such as feeling ambivalent, make him or her vulnerable to IPV.

This study found a negative correlation between the perceptions of discrimination and IPV. It may be that same-sex couples are better equipped to cope with experiences of sexual orientation discrimination that occur outside of the dyadic relationship than with internal beliefs, which may be more hidden. Being in a relationship might be a protective factor against homophobia. It is also believed that exposure to discrimination may lead LGBT individuals to view their intimate partner as a safe haven to cope with the negative situation they experience (Rostosky & Riggle, 2017). It is also important that the current study measured the occurrence of discriminatory events and the perceived impact of those events.

Although the sociocultural context of homophobia and heterosexism plays a role in the lives of all lesbians, individual experiences affect this context differently. In the present study, internalized homophobia was associated with lifetime victimization and perpetration of sexual violence by a female partner. It might be that women who have been treated badly by a same-sex partner hold more negative beliefs about homosexuality, in general. Conversely, women who have internalized more negative beliefs about homosexuality can be more likely to remain in abusive relationships because they may believe that they deserve the abuse.

In addition to the theoretical implications, the findings from the current study have implications for decreasing MS and implementing IPV prevention programs. Although some of the components (e.g., assertiveness communication skills training) of existing partner violence prevention programs developed for heterosexuals are relevant to members of the LGBT community, the findings of the current study suggest that partner violence prevention programs for LGBT individuals should integrate techniques (developing positive self-esteem, anger and stress management, increasing social support networks, and providing role models) to reduce MS, which could, subsequently, lead to less IPV.

Limitations

This study has some limitations that need to be considered in future research. Most importantly, the use of cross-sectional data limits our study’s ability to draw conclusions about causality. The majority of the respondents had a university degree or higher, which does not correspond to the average level of education in Turkey and it was also used that nonprobability sample method; hence, the sample was not representative.

The study’s participants included individuals who were aware of their sexual orientation accepted their sexual orientation, experienced the coming out process, received support from LGBT associations, and found opportunities to socialize in LGBT places; however, we were unable to reach out to all possible groups of lesbian women in Turkey. Low societal visibility, stigmatization, and discrimination make it difficult to collect data in research conducted with LGBT individuals. The discrimination experienced by the lesbians who participated in this study may differ from lesbians in other cities because the data were collected in Istanbul, a city with more activities associated with LGBT associations and more opportunities to engage in an LGBT-focused social life.

As a stigmatized group, being a victim/perpetrator of IPV can lead to the fear of a second stigmatization. Within the scope of the research, the participants’ answers to the survey questions may have reflected social desirability and bias, so the outcome is dependent on sociocultural limitations.

Given the context of the CTS2, which is a widely used scale (a pattern of gender symmetry), it might be possible to reveal a definitive answer for partner violence in intimate relationships in this study. The results should be treated with caution as there is no clear distinction between perpetrator and victim with the couple. Future research on same-sex IPV should be convenient to clearly differentiate which behaviors on IPV correspond to the participant or his or her partner. Although several important types (psychological, physical, sexual, injury) of IPV were determined in this study, economic IPV was not investigated. Future research should examine the economic IPV especially conducted with older population.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Cemile Hurrem Ayhan Balik

Author Biographies

Cemile Hurrem Ayhan Balik, MSc, is a research assistant and PhD candidate in the Department of Psychiatric and Mental Health Nursing at the Istanbul University–Cerrahpasa.

Hulya Bilgin, PhD, is an associate professor in the Department of Psychiatric and Mental Health Nursing at the Istanbul University–Cerrahpasa. Her research focuses on interpersonal violence, violence in clinical settings, work safety, and aggression in addition to contributing factors, psychiatric and mental health nursing, and interventions.

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