The Hormone Therapy That Many Transgender Women Rely On Could Come With A Life Threatening Risk

That’s Tia, a 26-year-old transgender woman whose name has been changed for this story, talking about the severe abuse she experienced at the hands of her partner. Like many transgender people, Tia was apprehensive about seeking help.

“It’s hard for anyone being abused to seek help in fear of what may happen,” Tia says. “However, it’s equally as hard since you feel that the caregivers at the shelter may view you differently.” Police, too, were a risk. A recent study by the National Center for Transgender Equality and the National Gay and Lesbian Task Force found that 22% of transgender respondents had experienced police harassment, and nearly half reported feeling uncomfortable seeking police assistance.

A recent study found that 22% of transgender respondents had experienced police harassment.

Because of her fears, Tia did not initially turn to law enforcement or a domestic violence shelter to seek assistance. Instead, she turned to technology. Through a peer support network app called Project Toe, Tia shared her story anonymously and was able to find the support she needed.

“The beauty of the online support groups is that I can chat with anyone at any hour, and I don’t have to reveal what I look like or my actual name,” Tia says. “I can get advice without the consequence of being discovered.” That made Project Toe a much safer option than going to the police.


Tia joined the LGBTQ group on the app, and shared her abuse with users. Eventually, another user convinced her to go to a shelter for help, which she says saved her life: “I can honestly say that if I didn’t go to the shelter, I wouldn’t be able to share my story today. Even though it may be tough at first, you’ll realize that the abuse isn’t going to end.”

Afraid To Get Help

Tia was extremely fortunate to find a supportive community that encouraged her to get help, and a domestic violence shelter that accommodated her needs and assisted her in leading a safer life. But her story of abuse is becoming alarmingly common in the transgender community — and, like Tia, many abuse victims feel they have nowhere to go.

Transgender individuals, particularly trans women and trans people of color, are most at risk to be victims of intimate partner violence, or IPV (abuse between romantic partners, whether or not they are married or live together). According to the National Coalition of Anti-Violence Programs, or NCAVP, these groups also face the most severe forms of IPV.

Forms of IPV include physical violence (hitting, biting, grabbing, punching, etc.), stalking, psychological abuse, and sexual violence (rape, forcing the victim to penetrate someone else, verbally being pressured to have sex with someone, unwanted touching, and non-contact unwanted sexual experiences like forcing someone to watch pornography). The abuse can go in and out of severe periods. It can also vary in frequency.

Many abuse victims feel they have nowhere to go.

According to a 2013 NCAVP report, transgender survivors were nearly twice as likely to experience physical abuse in their relationships compared to LGBTQ IPV survivors overall. And they were most likely to experience this violence out in the open, in public spaces. What’s most alarming from these findings are the reports of police violence toward IPV survivors. Transgender women were 5.2 times more likely to experience police violence after reporting an IPV incident.

Reports like these are prompting scholars, activists, and counselors that specialize in IPV in the LGBTQ communities to increasingly express concern about the barriers transgender individuals face when reporting their violence to police. There is also an increased concern that trans folks are fearful of seeking help from domestic violence shelters. For years, these shelters have catered to only cisgender women. If agencies are only equipped with cisgender-focused personnel, tools and resources, they can’t effectively help a battered transgender person. When you don’t have the tools, you can’t do the job. Ultimately, it results in a huge breakdown of services — and rejection of the person seeking those services.

Alexis Champion is a training manager at the Georgia Coalition Against Domestic Violence (GCADV). She sees a major barrier for transgender people trying to get help in violent situations. Champion says it has to do with our heteronormative idea that abuse is most common between a man and a woman, and that the man is the aggressor.

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“I think that our culture still perceives IPV as being something that happens in heterosexual relationships, with the male as the abuser and the female as the victim,” Champion says. “While statistically it is true that women are more likely to be victims in straight IPV relationships, this narrow interpretation creates additional barriers for LGBTQ victims. Many LGBTQ victims do not believe that traditional services such as domestic violence shelters are open to them, or even that what they’re experiencing in their relationships is called ‘domestic violence.’”

In addition to these pressures, there’s the very real fear of judgment and harassment. The first step for many victims of IPV is to involve law enforcement or social service providers, but transgender people have a reason to feel apprehensive about asking for help.

Rafe McCullough, a doctoral student at Georgia State University, has been working in counseling and LGBT advocacy for 10 years. He hears about a lot of these fears while on the job every day.

“The trans person is sitting there thinking, no one’s gonna believe me,” says McCullough.

Transgender people are constantly dealing with microaggressions that play out in their everyday interactions. These may be interactions with their local baker, or grocer, or even health-care professional. Microaggressions can be subtle snubs, insults, or well-concealed discriminatory behaviors.

Transgender people are constantly dealing with microaggressions that play out in their everyday interactions.

In the case of a microaggression, says McCullough, “it’s impossible to prove that you’ve been discriminated against. But you want to avoid that feeling so you avoid reporting. You avoid going to the doctor. You avoid going to counseling. Whatever it is. You avoid going to the employment office because that happens to you enough that you start to expect it and you expect it because it really will happen. And sometimes trans and LGB people are just not up for it.”

No Support From Shelters

Trans people’s fears regarding treatment at shelters are not unfounded. There are reports showing that discriminatory behaviors are playing out in both homeless shelters and domestic violence shelters.

A 2011 National Transgender Discrimination Survey revealed that of those transgender people surveyed who sought shelter, 55% were harassed by shelter staff, 29% were turned away because of their gender presentation, and 22% were sexually assaulted by residents or staff. And a report published in the >Harvard Law Journal found that shelters often admit residents based on their sex at birth rather than their gender identity, sometimes even if they’ve undergone sex reassignment surgery.

Many shelter workers admit to being scared of bringing a trans person into the shelter, especially trans women, because they’re seen as “invaders.” Transgender women who try to use gender-segregated services, like domestic violence shelters, are often turned away because of the fear from the staff.

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One reason for the fear and confusion among agency staff, and subsequent rejection of transgender survivors, could be that shelters aren’t required to partner with LGBTQ-focused providers. A shelter can willingly partner, but they’re not mandated. If these shelters aren’t exposed to LGBTQ information, they will ultimately rely on mainstream heteronormative and cissexist beliefs. A heteronormative foundation for services can result in transgender survivors being denied access to shelters and programs.

Transgender people know that when seeking help, there is a real possibility that they will be misunderstood, mistreated, or even victimized.

McCullough describes what a transgender survivor may be thinking when determining whether or not to seek help from a shelter:

“What shelter are you going to go in? The men’s or the women’s shelter? And say you identify as a woman but they identify you as a man, and say that you’re a threat to the women in the shelter so they put you in the men’s shelter where you feel really uncomfortable and outside of your gender and you might experience violence from the men because you’re not a man and you don’t look like them either.”

Many shelters have to adhere to strict policies that forbid them to deny anyone services, and have explicit non-discrimination language built into their policies. But policy isn’t always put into practice, especially when shelter workers simply aren’t equipped to understand LGBTQ issues, or worry that bringing transgender survivors into a shelter setting could make cisgender residents feel unsafe.

The discriminatory treatment in the social services sector isn’t just being decried by trans people. Those who work in these settings are admitting that there is a real problem — indeed, a crisis — with the treatment of LGBTQ survivors across the board. One national study of 648 service providers from a variety of social services and law enforcement settings found widespread reports of staff who were incompetent or unequipped to handle the needs of the LGBTQ population. Over half of the providers said more training was needed.

According to Champion, shelter staff are constantly trying to navigate the challenges of group living. LGBTQ issues are not all they’re dealing with — they represent just one example. Other potential sources of conflict include parenting styles, religious beliefs, housekeeping habits, mental illness, and substance abuse.

She admits that creating a culture of respect is easier said than done. But she believes it can be achieved through regular support, training, and practice. The question is whether shelters are making that a priority. Lack of funds is a common and perpetual problem in many of these shelters and agencies. But having the funds and adequately trained personnel to offer services specifically to transgender clients is crucial. Once a shelter makes the commitment to not ignore transgender folks, and to rally for funds and properly trained staff, they’ll be able to ditch their “one size fits all” approach to services and really serve the whole population.

Re-Victimized By Police

The damaging, heteronormative mindset that persists at domestic violence shelters isn’t unique to shelters. Transgender IPV survivors are experiencing even more mistreatment and re-victimization when reporting their abuse to law enforcement.

Historically, trans folks have a negative perception of police, and for good reason. The Harvard Law Journal article describes multiple examples of negative interactions between trans individuals and police, specifically in cases of intimate partner abuse.

Transgender people interviewed in the article say police officers refuse to recognize them as their authentic (and sometimes their legal) gender. When they seek help, they instead face profiling and harassment. Often, they said, police officers would use the wrong pronouns to refer to them. In some instances officers asked, “What are you?” A guy or a girl?” Or they’ve referred to a transgender person as “it.”

In all of these instances, victims are being re-victimized by the system that’s supposed to protect them.

Historically, trans folks have a negative perception of police, and for good reason.

In a conference back in 2001, one researcher discussed LGBT IPV calls to police. They found that when the police arrived on scene, sometimes no arrests were made, or both the survivor and the abuser were arrested. And sometimes, both the aggressor and the abused were placed in the same jail cell.

Though that report was 15 years ago, it’s important to bring it up here to show just how damaging a transphobic or homophobic reaction can be for a transgender abuse survivor. A police officer who behaves that way toward a survivor is re-victimizing an abused individual and could be placing them in a life-threatening situation.

Progress is slow. The tide is turning with regards to how officers treat transgender people, and it’s because police departments across the United States are catching on to the idea that LGBTQ training is needed in order to properly serve their communities.

The Atlanta Police Department, for instance, is instituting policies intended to protect the LGBTQ community. Officers Eric King and C.J. Murphy comprise the LGBT Liaison unit within the department.

APD officers know that LGBTQ policies are important. They learned that the hard way, when the department was sued after an Atlanta gay bar raid. According to the investigation, in 2009, Atlanta Police Officers broke the law during a raid conducted at the Atlanta Eagle gay bar. The officers unlawfully seized and detained patrons who weren’t even suspected of a crime. Some officers made anti-gay slurs during the raid. And later, some officers destroyed evidence to protect themselves.

“The Eagle raid kind of defined and changed the way we do things in relation to the LGBT community,” says Officer King.

Since then, Atlanta’s LGBT Liaison unit has been busy creating new policies that protect not only the safety of their officers, but the safety of the people they’re supposed to serve.

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King and Murphy promote communication and cooperation between the LGBT community and the police force. This means conducting meetings with local business owners, residents, community activists, and officials from neighborhood precincts. More than anything, it means listening, really listening to what is going on in the community.

The liaisons also provide information and follow-up investigation on suspected LGBTQ hate crimes or discrimination. They conduct LGBTQ diversity training for all APD officers, local jurisdictions, and even international groups — and they provide that training for free. Any jurisdiction from around the country or the world that expresses a desire to be more aware of LGBTQ issues in relation to law enforcement can participate in APD’s training at no charge. They just have to put in a request and be willing to travel to Atlanta.

And in those training sessions, Officer King and Officer Murphy say, transgender issues are the most requested and revisited topic.

“That seems to be the most problematic thing for people because they still don’t understand it. As far as bathroom usage, who searches a transgender woman, who searches a transgender man, who transports,” says Officer King.

Transgender Interaction Policy within the Atlanta Police Department states that any person identifying as transgender or outside the gender spectrum will have a female officer search them, if available. (The previous rules simply stated that female officers could search both men and women, but male officers could only search men.) That may not be an ideal solution for trans men who want to be treated as men, but even having rules in place that recognize the existence of gender diversity is a step forward from the situations reported in 2001.

Small policy changes like this one are helping to rebuild the trust between law enforcement officers and the LGBTQ community. The officers also hope that these changes break down barriers for LGBTQ individuals who want to report crimes like abuse.

“We just have to get people comfortable with reporting,” says Officer Murphy — meaning transgender victims of IPV, but also cisgender victims. “It’s very difficult because a lot of times they feel helpless, and they feel like if they do call us, things will get worse.” (The APD’s LGBT Liason unit’s number is 404–546-LGBT, and they take calls from all over the country — even if you’re not in Atlanta, they can help abuse victims get help.)

Trans-Specific Abuse

Intimate partner abuse looks much the same whether you’re transgender or cisgender, but abusive partners may use particular tactics against trans people, says Champion.

“While the types of violence are certainly shared no matter what type the relationship is, there are specific tactics of abuse that could be used against transgender survivors,” she says. “Some examples of these include the abusive partner threatening to ‘out’ their partner’s assigned gender at birth. The abusive partner could also deny the victim access to medication or health care, especially if the victim is in the process of hormone treatment therapy. The most devastating abuse can be verbal and emotional — ridiculing the victim because of their gender identity, refusing to call them by their chosen name or gender pronoun, criticizing their appearance, or calling them sick or crazy.”

Abusive partners may use particular tactics against trans people.

Champion notes that emotional and verbal abuse — such as controlling, isolation, and stalking behavior — is often the most harmful form of IPV. These types of violence occur in all kinds of relationships, but they can be particularly devastating for LGBTQ victims who don’t have strong support systems within their family or within their community.

What Can Be Done

The domestic violence and social services systems aren’t the only systems that are flawed. They are failing to properly support trans people, because we don’t have enough policies in place to protect trans people at any level of care in this country.

Right now, we can start introducing legislation and backing legislation that supports LGBTQ people across the board. There should be laws that explicitly address discrimination against transgender people in the workplace. There should be health-care policies to ensure insurance companies are covering certain transgender-related health-care services. Living a healthy life is important to everyone. It’s a basic human right. But the reality is that 19% of transgender respondents in a National Transgender Discrimination Survey reported being refused medical care due to being transgender or gender non-conforming.

If we start backing basic human right policies that protect trans people, we’ll start to see social services following suit, and hopefully we’ll see them implement their own ethics policies that go even above and beyond the law.

If we start backing basic human right policies that protect trans people, we’ll start to see social services following suit.

In the meantime, people who feel isolated during or after an abusive relationship can use technology and social media to find support outside the usual channels, the way Tia did. Apps like Project Toe can help survivors share their stories and get help in an anonymous way. There are also apps that aim to keep us safe. The Circle of 6 app tracks your location and pings it to the six most trusted people in your life (of your choosing). Technology-based solutions and apps like those need to be introduced and promoted to advocacy groups. Social services workers and police may have some catching up to do, but technology at least is charging ahead.

As long as we have gender inequality in this world, and in this country, there will be violence. But we can stop survivors from being hurt more by the people who are supposed to help.

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