Perceptions of Contexts of Intimate Partner Violence Among Young,Partnered Gay,Bisexual and Other Men Who Have Sex With Men in the United States

Abstract

There has been a growth in research illustrating that gay, bisexual, and other men who have sex with men (GBMSM) experience intimate partner violence (IPV) at rates that are comparable to those among heterosexual women. However, the majority of research on IPV among same-sex male couples has focused on adults, and research on the experience of IPV among younger men (those aged under 18), remains at a nascent stage, despite knowledge that IPV is often common among younger men. This article adds to the growing body of literature on IPV among young GBMSM (YGBMSM) through of an analysis of qualitative data from in-depth interviews (IDI) with GBMSM aged 15–19 (n = 30) in romantic relationships partnerships. The study sought to explore issues of relationship development, relationship contexts, and understandings of IPV. More than one-half of the sample reported experiencing some form of IPV in their current or past relationships. Participants described a range of experiences of IPV, including physical IPV, emotional IPV, sexual IPV, and controlling behaviors. Emotional IPV in the form of negative comments and controlling behaviors such as jealousy were the most commonly reported forms of violence behaviors. Although few participants reported experiencing physical or sexual IPV, several discussed concerns about giving, and partners’ acknowledging, sexual consent. Antecedents to IPV included wanting or feeling pressured to participate in normative development milestones, short-lived relationships, and societal stigma. Interventions that develop content on IPV and that reflect the lived realities of YGBMSM who are experiencing their first relationships are urgently needed. Study findings also support the need for training teachers, health care providers, and parents to identify signs of IPV and provide them with the knowledge and skills to talk to YGBMSM about relationships and violence to reduce IPV.

Keywords

domestic violence GLBT male victims sexual assault sexuality

Introduction

Over the past 20 years, there has been a significant paradigm shift in intimate partner violence (IPV) research, growing from a recognition that IPV exists in relationships with people of all genders and sexualities, and is not restrained to the traditional cisgender, heterosexual female victim and male perpetrator model. A critical element of this paradigm shift has been a growth research illustrating that gay, bisexual and other men who have sex with men (GBMSM) experience IPV at rates that are substantially higher than experienced by cisgender heterosexual men, and rates that are comparable to those among cisgender heterosexual women (Finneran & Stephenson, 2013, 2014). Estimated prevalence for experiencing IPV among GBMSM ranges from 12% to 45% for physical IPV (Stephenson et al., 2010). This is particularly important given the known greater prevalence of HIV among GBMSM and the now consistent evidence demonstrating a link between IPV and risk for HIV acquisition and transmission (Edwards et al., 2015; Greenwood et al., 2002; Kalichman et al., 2001; Stall et al., 2003; Stults et al., 2015). In one systematic review on the associations between IPV and health outcomes among GBMSM, Buller et al. (2014) found that being a victim or survivor of IPV was associated with increased odds of substance use, being HIV positive, reporting depressive symptoms, and engagement in condomless anal sex.

Unique Antecedents of IPV Among Gay, Bisexual and Other Men Who Have Sex With Men

An emerging body of literature has focused on understanding the unique factors that shape the experience of IPV for same-sex male couples. In a survey of 1,075 GBMSM in Atlanta, Finneran and Stephenson (2014) reported that many of the antecedents for IPV identified by studies of opposite-sex cisgender couples also emerged as significant antecedents for IPV among same-sex male couples, including general life stressors such as substance misuse, jealousy, and financial stress (Bell & Naugle, 2008; Wilkinson & Hamerschlag, 2005). Despite these similarities, Finneran and Stephenson’s (2014) also illustrated that there were a number of antecedents to IPV that were specific to same-sex male couples, including one or both partners not having disclosed their sexual identity to family or friends, disagreements regarding sexual positioning, and threats to masculinity created by both men striving to be the dominant male in the relationship.

One unique antecedent for IPV identified for sexual minorities is the exposure to sexuality-based discrimination and stigma. Minority stress theory (MST) suggests that experiences of discrimination and victimization are a primary driver of negative outcomes for sexual minorities (Meyer, 2003). IPV among GBMSM has been attributed to excess stress experienced by sexual minorities from sexuality-based stigma and discrimination (Dyer et al., 2012; Stephenson & Finneran, 2017). Stephenson and Finneran (2017) found that internalized heteronormativity, sexual minority-specific discrimination, and experiences of racism were each significantly associated with increased odds of reporting both the experience and perpetration of IPV among a sample of GBMSM. Similarly, in a sample of Black GBMSM, Dyer et al. (2012) found an association between stress and depression symptoms, sexual compulsiveness, and the experience of IPV. Several other studies have identified correlations between internalized heteronormativity and perpetration of physical IPV, sexual IPV, and emotional/psychological IPV (Balsam & Szymanski, 2005; Burgard et al., 2012). Experiences of minority stress can evoke feelings of anxiety, shame, and victimization, resulting in self-devaluation, predisposing GBMSM to experiences or perpetration of IPV.

IPV Among Young GBMSM

There has been a substantial number of studies focused on IPV among young women (Dardis et al., 2017; Edwards et al., 2014; Edwards et al., 2016). Additionally, the majority of research on IPV among GBMSM has focused on adult populations; however, research on the experience of IPV among younger GBMSM (those aged under 18) remains at a nascent stage. A number of recent studies have illustrated that younger GBMSM experience similarly high levels of IPV as experienced by those aged over 18. For example, Halpern et al. (2004) found that among a sample of 117 youth who reported exclusively same-sex romantic relationships, 25% had experienced any psychological or physical IPV, while about 10% had experienced physical victimization from partners. High levels of IPV among sexual minority youth have been further identified in studies showing an estimated 59% experienced psychological IPV (Zweig et al., 2013), 17%−89% experienced physical IPV (Dank et al., 2014; McLaughlin et al., 2012; Zweig et al., 2013), and 23%−61% experienced sexual IPV victimization (Dank et al., 2014; Zweig et al., 2013). These disparities appear to continue into young adulthood. Compared to heterosexual college students, sexual minority students are at 2–3 times higher risk for psychological abuse and physical violence, and five times the risk for sexual victimization by a romantic partner (Porter & Williams, 2011; Rhodes et al., 2009). Sexual minority young adults are also more likely than their heterosexual counterparts to have been in a recent intimate relationship that was emotionally, physically, or sexually abusive (Blosnich & Bossarte, 2009). A number of U.S. probability studies suggest wide disparities in IPV among high school students in both recent (Kann, 2016; McLaughlin et al., 2012) and lifetime victimization (Freedner et al., 2002; Reuter et al., 2015).

There are a number of reasons to suspect that the antecedents and context for IPV may be different for younger GBMSM. Adolescence is a critical developmental period during which GBMSM begin to explore their sexual identities and are exposed to their first experiences of forming and navigating intimate sexual and emotional relationships. During this process, young GBMSM (YGBMSM) must learn how to communicate with partners and develop for themselves an understanding of what they conceptualize as a successful relationship. While this is true for all adolescents, YGBMSM are often undergoing this process in climates of minority stress, placing additional stressors on their relationships. In this article, we add to the nascent body of literature on IPV among partnered YGBMSM through an analysis of qualitative data from in-depth interviews (IDI) with partnered YGBMSM, exploring issues of relationship development, relationship contexts, and understandings of IPV. The application of qualitative methods to the understanding of IPV among YGBMSM offers the opportunity to move beyond measuring the prevalence of IPV to understand how YGBMSM are perceiving of and reacting to experiences of IPV. This study sought to explore the forms of and antecedents to IPV experienced by YGBMSM in their current and past romantic relationships.

Methods

Procedures

Data for the current analysis are taken from an ongoing feasibility study (We Prevent) of a relationship-focused HIV prevention intervention for partnered YGBMSM (Gamarel et al., 2019). The first phase of We Prevent (conducted from July–November 2018) consisted of IDI with 30 young YGBMSM ages 15 to 19 who self-reported that they were in a romantic relationship with another male. Recruitment of participants for the IDI consisted of placing advertisements on social media websites (e.g., Facebook, Instagram, Snapchat). Recruitment advertisements featured photos of young same-sex male couples representing a range of races/ethnicities. People who clicked on the advertisement were then directed to a study screener webpage that provided basic information about the study and participants were asked to complete a brief survey to determine their eligibility. To be eligible, participants needed to be (1) between the ages of 15 and 19 years; (2) identify that they are in an emotional and/or sexual relationship with another man; (3) assigned male on their birth certificate and currently identify as male or transgender man with an intention to have sex with men, (4) report that they have engaged in any sex (oral, anal, vaginal) in their lifetime, (5) meet the age of sexual consent in their state of residence; (6) have access to a personal device with internet access within their home, (7) self-report being HIV negative or unknown serostatus, and (8) speak and read English. Although relationship status was an eligibility criterion, the study did not enroll both members of a dyad. A waiver of parental consent to screen and enroll those under the age of 18 years was approved by the University of Michigan IRB: requiring parental consent poses a risk for revealing same-sex behaviors or identities to parents.

Thirty in-depth interviews were conducted between July and November 2018 online via VSee, which is a HIPAA-compliant videoconference platform. A sample size of 30 was chosen as the primary aim of this phase was to inform the development of a behavioral intervention for YGBMSM in romantic relationships. We intentionally recruited up to 30 participants until we reached thematic saturation (Dworkin, 2012). IDI were conducted by a white cisgender woman who was trained in public health (MPH degree) and had received training in qualitative interviewing methods. Interviews involved participants responding to pre-prepared questions and also creating timelines that represented their relationship histories (Gamarel, Darbes, et al., 2020; Gamarel, Stephenson, et al., 2020; Goldenberg, Finneran, et al., 2016). Using Adobe Illustrator, participants were asked to draw a line that represented the time between their first relationship and the relationship they were in at the time of the interview. Participants were first asked to annotate the timelines with characteristics of the relationships: for each relationship, they provided a name/ nickname, duration of relationship and were asked to annotate the type of relationship (i.e. boyfriend, partner, friend with benefits). Participants answered a series of questions on each relationship that they included on the timeline through an action-oriented process that involved participants annotating the timelines. Participants annotated the timeline with notes that included relationship tags (e.g., partner, boyfriend, friend with benefits), relationship rules (e.g., monogamous, open), and emotions (e.g., trusting, loved, disrespected). The timeline provided an anchor for discussions regarding relationship communication and expectations for appropriate/ desired behaviors within relationships. Participants were not asked directly about experiences of violence in their relationships, as the original intent of the IDI was to understand relationship dynamics and communication among YGBMSM in their romantic relationships and not focused on IPV. Participants were asked to describe positive and negative experiences they had in their relationships (“tell us what you liked about your relationship,” “what were the good and bad things that happened in your relations”) and then for each of these questions probes were asked to elicit specific examples around experiences of conflict, violence, sex, and discussions around sex. Interviews ranged from 35 minutes to one hour in length and participants received a $40 gift card for their participation.

Analysis

All interviews were audio-recorded and then transcribed by the UNC/Emory Center for Innovative Technology (iTech) as part of the Adolescent Medicine Trials Networks for HIV/AIDS Interventions (Hightow-Weidman et al., 2018). The interviewer then reviewed each of the transcriptions for accuracy and removed any identifying information. A template analysis was applied to coding all interview transcripts (Brooks et al., 2015). Codes were discussed and developed by the interviewer, first, and last author using the following interview guide domains: negative experiences in relationships, definitions of IPV, experience of IPV, perpetration of IPV, and perceived antecedents for IPV. Each overarching theme then had sub-themes that emerged from our analyses, discussions, and synthesis of the transcripts by the research team. At weekly team meetings, the interviewer, first author (who identifies as a white cisgender gay man), and the last author (who identifies as a white cisgender queer women) reviewed each IDI to identify codes and areas of questioning for future IDIs. Through this process, codebooks developed that included a detailed description of each code, inclusion and exclusion criteria, and examples of the code in use. First, deductive codes based on the interview guide and prior research with adult GBMSM (Stephenson & Finneran, 2013) were added to the transcripts to highlight key themes and guide comparisons, which was followed by inductive codes based on emerging themes. The interviewer, first and last author independently coded each transcript, with discrepancies in coding discussed and resolved at team meetings. The first and last author then applied the finalized codes to all transcripts using NVivo software (version 12). The two authors had several discussions to resolve divergences and reach consensus in the final coding and interpretations.

Results

Sample Characteristics

Participants (n = 30) ranged in age from 15 to 19 years of age (M = 17.8, SD = 1.1) and resided in 30 different U.S. states. The majority of participants identified as gay (83.3%, n = 25), with 13% (n = 4) identifying as bisexual and one identifying as pansexual. All participants identified as cisgender men and approximately half identified as a person of color [3% Black (n = 1), 6% Asian (n = 2), 3% Multiracial (n = 1), 37% Latino/x (n = 11), and 6% other (n = 2)]. Approximately one-third of the participants were completing their high school degree or GED (36.7%, n = 11) and over half of the participants had been in their current relationship for 6 months or less (53.3%, n = 16). Over half of the participants (53.3%, n = 16) reported examples of behaviors in their current or past relationships that could be classified as IPV.

We identified a range of forms of IPV experienced among partnered YGBMSM, which included physical IPV, emotional IPV, sexual IPV, and controlling behaviors. We first present each of these forms of IPV followed by the contexts in which IPV was reported as being experienced.

Physical IPV

Only one participant reported experiencing an instance of physical IPV in their relationship, and this was expressed as bidirectional physical violence. This young man described a disagreement with a past boyfriend that led to bidirectional physical IPV.

He came over [to] my empty house … and he hit me and I hit him back. I hope I wish him the best in his journey, we are not together anymore (White, gay, aged 17)

Emotional IPV

Emotionally violent behaviors were the most commonly reported form of IPV in participants’ relationships. Emotional IPV including using negative comments to undermine self-confidence and often were directed at a participant’s appearance or abilities. In the quote below, a young man discussed how his last boyfriend enacted emotional IPV that made him feel “stupid” in moments when his boyfriend was angry with him.

But my last boyfriend made me feel really stupid, and I guess I didn’t like that because I wasn’t doing anything to be considered like that—I’m a little quirky. And like in general, he was really nice, but every now and then he would be mad and he’d be like, “Hey, that’s really stupid, I hate when you do that,” I’m like, “Oh, what do I do,” and so that was kind of really awkward (White, gay, aged 19)

Other young men noted how their partners would make negative comments on their abilities, in an attempt to damage their self-confidence. These emotional attacks on self-confidence and self-esteem often occurred on multiple occasions over the course of their relationship. These constant negative comments were described as hurtful and confusing to participants.

He would always remind me where I was going wrong, and that kind of, is very hurtful. With [name], I felt—I felt appreciated, but at the same time, I felt stupid which is, him, whatever problem with things I liked, and that was kind of hurtful (Latinx, gay, aged 17)

So it was—so I’m an artist, and he would—we had a mutual friend who was also an artist. He would remind me, “Oh, right, you’re not as good as her, why are you even trying?” like, “There is no point,” and I was working on my college portfolio at the time, and he’d be like, “Oh, that’s not as good as this portfolio.” And like we play games, and even like, “Oh my god, you’re still terrible at this point, you even try,” and he was always like extremes. And then if I got it very upset he’d be like, “Oh, I never said any of that,” and it would be very weird (White, gay, aged 16)

Participants also noted examples of emotional IPV that were specific to their context as high school or college students. Examples included threats to “ruin their school reputation,” “stop me from achieving my school goals” or, in the quote below, spreading rumors about the participant with the intention of forcing a participant to continue a relationship that they had expressed the desire to leave.

He basically started spreading rumors about me around the school that I stole money from him, that I bullied other people to quit school, I—all these rumors and stuff like that because I wasn’t interested in talking to him at the time. But yeah, that’s what happened (Other, gay, aged 18).

Sexual IPV

Although participants did not express that they had experienced sexual violence, several examples were provided in which participants felt they had not fully, or were not able to fully, consent to sexual activity. Participants couched these experiences in terms of feeling uncomfortable discussing issues of consent with their partners, and often didn’t feel that their partner listened to what they felt was explicit communication surrounding behaviors that they did not want to engage in. While participants did not report instances of forced sex, they reported several examples of feeling coerced into sexual activity.

With other rules, like his—there was a lot of like touching and I’m not sure if how else to phrase that, like non-consensual, and he never asked me, and that was kind of another thing. I was like, “Please ask if you’re going to be like touch me or something” (White, gay, aged 17)

So it was at my house and he was like kind of like touching around my thighs, and so I was like, “Can you stop, please, I told you to ask,” because he would do it in the school and I’m like, “Just ask me if you’re going to do something.” And I was direct about that, but then he kept doing it, he was like, “What? It’s fine, we’re like together.” I’m like, “Don’t, please ask me,” and it was just very awkward (Asian, gay, aged 18)

Participants expressed consent in terms of the ability to make their own choices around sex, for example, “Obviously like if you don’t want to have sex and they get upset or get angry, that’s like they need to understand that you don’t want to. So I think it’s important that if you don’t need to do anything like you make your own choices like you’re your own person” (White, gay, aged 17). While participants all noted the need for consent for sexual activity, the majority of participants felt unable to have discussions around consent with their partners or felt that partners did not listen when they did not provide consent, and the result was that they felt emotionally coerced into sex. Despite being able to define what consent is, participants reported feeling confused and concerned around what actually constituted consent within their relationships, and often reported examples in which they described feeling emotionally coerced into unwanted sexual activity. In the three quotes below, participants talk about the need to differentiate between consent and “enthusiastic consent” and situations in which perceptions of implied consent had led to participants feeling uncomfortable with, and coerced into, sexual activity.

I heard about consent really be like a big issue in terms of people not realizing, you know, what counts as consent and enthusiastic consent. So that would be really helpful chapter or you know section. I don’t know a lot of people like their school system doesn’t teach on sexual health like for same-sex couples almost at all (White, gay, aged 19)

And that was—I would say implied at first—it was implied, it was implied. And then like, um, it kind of became stronger, the rules because he—he was very touchy with me and it was uncomfortable in that it’s a little bit weird (Black/ African American, gay. Aged 18)

With [name] because they were very reluctant to say the word [sex] and that was a challenge because I was like I want consent, I don’t want to do something you don’t want to do, and they were kind of just like nodding and when it was like just if you want to say yes, say yes, say not if you don’t want to, and it was kind of like, I didn’t want to see him like I was pressuring him into anything, but it also like I didn’t want to have non-consensual sex (Other, gay, aged 18)

Controlling Behaviors

Approximately half of the participants reported examples of controlling behaviors by past or current partners. The most often reported controlling behavior was preventing the participant from seeing his friends and using jealousy as a tactic for isolating the participant.

Um, with my last two [partners], uh it was always very aggressive and like, “you can’t be with that person. They uh, don’t think you’re just a friend and they’re trying to take you away from me.” That kind of thing (White, bisexual, aged 16)

Controlling behaviors were the most commonly reported act of violence perpetrated by participants. Seven participants reported that feelings of jealousy had caused them to feel “possessive” of their partners and that they had intentionally tried to limit their partner’s social interactions. These acts were most commonly reported to stem from fears of their partner ending their relationship.

I want to tell them everything that happened like I want to be with him 24–7. I’d be kind of possessive like crazy possessive in my mind where it’s like your mind, you can’t talk to anyone else I’ll get like super jealous like even if they talk to—even if like [name] or [name] talk to a check I’ll be like, “No, stop talking to them, I’m here, that is all you need to worry about,” like hello (White, bisexual, aged 17)

Contexts for IPV

Participants described several situations that they felt had heightened their risk for IPV. Five participants reported that their desire to be in a relationship had led them to put up with the negative behaviors of their partners. Each of the participants that reported that being in a relationship was a way for them to fit in with their peers, and that they wanted to be in a relationship “by any means necessary.” Participants described that their desire to be in a relationship stemmed from wanting to fit in with their peers in high school or fulfill their sexual desires.

When I was in middle school, I was mostly just trying to find someone to occupy my time. And it’s just—it’s very superficial there’s not really much beyond that—beyond having someone that you can you know maybe intimate with to satisfy like, you know, the hormones that you have as a teenager and everything and like even now for young adults and everything (Latinx, gay, aged 18)

Definitely. That was like a year when I was like really wanted a boyfriend by any means necessary. I didn’t get one, but it’s—had to wait a couple of years for that, but yeah. I wanted to be like everyone else (White, bisexual, aged 17)

Participants who reported that they had experienced this “desperation” to be in a relationship also reported that they then felt ill-equipped to deal with the relationship, leading to disagreements and fights with partners, leaving them at risk of IPV. In particular, participants reported feeling as if they were not emotionally prepared for a relationship and lacked the communication skills to talk openly to their partner, to accurately express their needs and desires. As a result, participants reported they would “put up with” their partners’ negative behaviors.

I think I didn’t really have a lot of control of like emotion wise but like I just give in to everything that he said. Like I just feel like I’d always be wrong and he’d always be right whatever he said. And I never really like would stick up for myself when I was right. So like I just wanted the idea of a relationship so badly because it was my first one that like I would be like, “Oh whatever he says is like what’s right (Latinx, gay, aged 18)

One participant reflected on his first relationship and noted that he felt unable to talk to his partner or to express his opinions. He went on to explain that his inhibition was due to fears of his partners’ reactions and inexperience of being in a relationship.

Because you’re a novice. You’re just like—you’re just like a chair that they sit on, you definitely don’t know if what’s happening right now with you is it right or is it—or it’s not right. So you’re a little bit afraid of speaking to him because you don’t actually know what’s going to be followed by this (White, bisexual, aged 17)

Several participants described how they felt limited in their abilities to talk with their partners given the short-term nature of adolescent relationships. Many participants reported that relationships for this age group were usually short-term (often only a few weeks long), and therefore, felt that it was “not important to talk” or that “it would be over soon anyway.”

Issues arise that are probably very easy to work out if you just sit down and like try to calm down and get past the issue, but it’s just easier just to leave because like they’re short-term so maybe like care about them but like you know you’re not in it for the long haul so what’s the point of putting in the effort (Latinx, gay, aged 18)

I don’t know, I think being 18 like generally just drama happens, like something big like some kind of argument or like a drama or somebody cheats on somebody and then like you’re just like, “This is over,” and then it’s just done (Other, gay, aged 18)

Young men also described how societal stigma, specifically heteronormativity, was a precipitant to IPV. Specifically, four participants reported that they had to hide their relationships or keep their sexuality a secret from friends and family. Participants reported that keeping up this secrecy added a layer of stress to their relationships, often leading to disagreements or fights.

I don’t think it would be enjoyable if we constantly stressed out about someone walking and finding us. The need to keep it hidden—means we are always fighting. It’s just a lot (White, gay, aged 17)

The perceived need to hide or keep relationships a secret stemmed from actual or perceived experiences of heteronormative stigma. Participants reported that they often felt inhibited in displaying physical contact or intimacy with their male partner in public settings (especially in school), and that this would lead to disagreements with their partners. Participants expressed this as a specific form of minority stress experienced while being in a relationship, and noted that this stress surfaced as fights between partners, and would often lead to hurt feelings of one partner as the other reacted to the pressures of societal stigma.

I also like to be kind of amorous, like with men who are kissing or a little PDA [public display of affection], but the homophobia in one of my relationships, I held hands with my boyfriend and I would get like really weird stares, and like there was a security guard who kind of like was eyeing me as I was walking around without my boyfriend, and it was just really awkward. So I was like, “Don’t hold my hand when we’re in school like only outside,” and it was kind of weird. He would get upset and not talk to me when I did that—but I had no choice (White, bisexual, aged 16)

So it’s already people—especially older people—say, “Oh, you know you’re not supposed to be together, so why are you together,” this, that and the other. So you know it’s just like they’re listening to the outside world instead of listening to whom they are with. It means you end up fighting with him instead—trying to keep it quiet ‘cos others tell you that you shouldn’t be doing it. You just end up being mad at each other all the time (White, gay, aged 19

Discussion

Our study explored the experiences of IPV among a sample of partnered YGBMSM in the U.S. Study results demonstrated that YGMSM experience a range of forms of IPV with more than half of the sample reporting experiencing some form of IPV in their current or past relationships. Only one participant reported experiencing physical IPV, and this took the form of bidirectional physical violence. However, emotional IPV, sexual IPV, and controlling behaviors were commonly experienced in participants’ current and prior relationships. Emotional IPV often took the form of negative comments that undermined self-confidence and self-esteem. Although participants did not mention experiencing sexual IPV, several young men discussed concerns about explicit sexual consent, and feelings of emotional coercion into sexual activity. Controlling behavior manifested in restricting access to friends and other acts of jealousy. Importantly, experiences of IPV were attributed to wanting or feeling pressured to participate in relationships as a means of fitting in with peers, short-lived relationships, and sexuality-based stigma and discrimination. These findings extend prior literature with adult GBMSM but also underscore the critical necessity of accounting for the specific contexts and lived experience of YGBMSM.

Emotional IPV and controlling behaviors were the most commonly reported forms of IPV, mirroring the results of studies with adult GBMSM (Finneran & Stephenson, 2013) and one recent study of IPV among sexual minority youth (Whitton et al., 2019). With the exception of one incidence of physical violence (which was bidirectional), participants did not articulate the behaviors they experienced (and sometimes perpetrated) as violence, instead expressing them as acts that made them feel “uncomfortable” or “confused.” Several previous studies have noted that sexual minority populations often do not perceive emotional IPV or controlling behaviors as IPV given norms that shape perception of IPV as an act between a male perpetrator and female victim (Goldenberg, Stephenson, et al., 2016; Sorenson & Thomas, 2009). It is plausible that not recognizing these experiences as IPV could serve as a barrier to both leaving a violent relationship and engaging in help-seeking behaviors. As such, there is a clear need for educational interventions that aim to increase awareness of IPV and its forms and antecedents among YGBMSM. The provision of inclusive information about IPV that attends to the needs of sexual minority youth in middle and high school sexual education curriculum is particularly important given the timing of first relationships and potential for school environments to create stigmatizing contexts that give rise to IPV.

Although participants in this study did not mention experiences of sexual IPV, several discussed struggles with talking about consent and establishing consent with sexual partners. Report of feeling “uncomfortable” with their own or their partners’ lack of verbal consent during sex and of feelings of being coerced into unwanted sex demonstrate a critical need for interventions that directly build skills for establishing and maintaining sexual consent. Beyond IPV, there is also a need for wider discussions of relationships, sexual behavior, and sexual consent within school-based comprehensive sex education. Pingel et al. (2013) explored the desired needs of sexuality-based education among a sample of YGBMSM aged 18–24, and found that many of the participants’ sexuality and same-sex sexual behaviors were excluded in sex education lessons, with no content that focused on the unique experiences and stressors faced by YGBMSM in relationships. While there have been calls to include content on sexual consent and relationship skills in sex education (Coy et al., 2016), this discourse has focused on youth generally, and missing from programmatic action are interventions that aim to provide specific sex education needs of YGBMSM in or seeking to be in relationships.

While some of the potential antecedents to IPV noted by participants may be common to adolescents regardless of sexual orientation (i.e., desire to be a in a relationship, short-lived relationships), YGBMSM reported experiences of sexual minority-specific stressors that added unique strains to their relationships, and that may intersect with stressors from other minority identities (i.e., race). This often involved the need to keep relationships secret to prevent disclosure of their own or their partners’ sexual orientation. Studies with adult GBMSM have noted that minority stressors, including internalized and enacted stigma, are associated with increases in the experience and perpetration of IPV (Stephenson & Finneran, 2017). Participants noted similar pathways to prior studies with adult GBMSM (Stephenson & Finneran, 2017). That is, the added stress of having to hide their relationship can manifest as anger and negative communication within relationships, which can serve as a potential antecedents for IPV.

Participants in this study described feeling ill-equipped for relationships and lacking communication skills to talk with their partners. As such, young men may lack the acumen to understand how stigma serves to undermine their relationships as well as the coping skills required to address it. In the sphere of HIV prevention, several recent dyadic interventions have addressed communication among same-sex male couples as a pathway to reducing HIV risk, including YGBMSM in romantic relationships (Bazzi et al., 2016; Stephenson et al., 2017). To date these interventions have focused on teaching couples (mainly adult couples) to work together on HIV prevention issues: the content of these interventions could be adapted further to address sources of stress in relationships for young male couples, as a strategy for IPV prevention.

Limitations

While the results illustrate a range of experiences of IPV among diverse, geographically dispersed YGBMSM, study findings should be interpreted within the context of several limitations. Thirty IDI were conducted, and while this is a reasonable sample size for a qualitative study (Dworkin, 2012), the study was designed to collect data on YGBMSM experiences of relationships in general and not specifically to address issues of IPV. We did not directly inquire about experiences of IPV, although probes were included to assess violence, conflict, and coercion for questions that asked the participant what they liked or didn’t like in their relationship. Thus, the examples of IPV presented emerged as examples of negative characteristics of the relationships participants discussed. It is plausible that experiences and forms of IPV may be underreported, which necessitates future research to better understand and explicitly address experiences of IPV among YGBMSM. Participants were recruited online using convenience sampling methods, which has important implications for generalizability. We most likely were not able to reach those YGBMSM experiencing significant structural vulnerabilities (e.g., homelessness, incarceration) and who often face additional challenges seeking prevention services (Lippy et al., 2019). The interviewer was a white cisgender woman, and it may be possible that some participants felt reluctant or embarrassed reporting same-sex behaviors; however, the interviewer was well-trained in interviewing techniques and had experience working with the LGBT community. The iTech Youth Advisory Board provided feedback on the study materials (e.g., advertisements, interview questions) and our research has extensive experience working with diverse YGBMSM; however, it is plausible that our interpretations may not generalize to all YGBMSM (Lincoln & Guba, 1985). Recall bias may have shaped the reporting of relationship details. Most importantly, only one member of the dyad was interviewed, which is standard practice when collecting data on IPV to protect the safety of the participant; however, this prevented a dyadic understanding of how relationship contexts shape the risk for IPV among YGBMSM.

Conclusions

Results from this study collectively point to the need for interventions and programming to ensure that YGBMSM experience positive, healthy, and safe relationships. Study results highlight the importance of the provision of information and skills around how to establish consent, how to talk with partners and communicate relationship expectations and most critically, how to recognize all forms of IPV, both experienced and perpetrated. While many previous researchers have called for sex education to address the needs of sexual minority youth (Meadows, 2018), there is evidence that teachers or health care providers are often uncomfortable or lack the knowledge to provide this invaluable education to sexual minority pupils (Formby et al., 2010), and several states in the U.S. prohibit the inclusion of comprehensive sexual education in their curricula. Furthermore, parents may also feel reluctant to discuss sexuality with their children (Feinstein et al., 2018) or hold erroneous heteronormative assumptions about IPV (Neighbors et al., 2010). Without addressing societal stigma that leads to sexual minority stress, YGBMSM will remain at high risk for IPV. The current study offers insights into future research and programs to address IPV among YGBMSM, especially for those experiencing their first relationships, and may inform efforts aiming to reduce IPV among YGBMSM.

Footnotes

Declaration of Conflicting Interests

Funding

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

ORCID iDs

Rob Stephenson

Matthew T Rosso

Kristi E. Gamarel

Author Biographies

Rob Stephenson, PhD, MSc, MA, is professor and Chair of the Department of Systems, Population, and Leadership in the University of Michigan School of Nursing and the Director of the Center for Sexuality and Health Disparities.

Lynae A. Darbes, PhD, is an associate professor in the Department of Health Behavior and Biological Sciences at the University of Michigan School of Nursing and in the Center for Sexuality and Health Disparities, University of Michigan.

Matthew T. Rosso, MPH, is a program manager for the BATLab, at the University of North Carolina, Chapel Hill.

Catherine Washington, BA, is a project manager at the Center for Sexuality and Health Disparities in the University of Michigan School of Nursing

Lisa Hightow-Weidman, MD, is a professor in the Division of Infectious Disease, in the School of Medicine at the University of North Carolina, Chapel Hill.

Patrick Sullivan, PhD, is a professor in the Department of Epidemiology at the Rollins School of Public Health, Emory University.

Kristi E. Gamarel, PhD, EdM, is the John G. Searle assistant professor of Health Behavior and Health Education, in the Department of Health Behavior and Health Education, School of Public Health, University of Michigan.

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