Helping LGBTQ Patients in the Forensic Setting

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nurse consoling a patient

In the past two decades, numerous studies have shown that members of the LGBTQ community suffer sexual abuse at a disproportionate rate when compared to the general population. The statistics show 44% of lesbians, 26% of gay men, 61% of bisexual women, 37% of bisexual men and about half of transgender people will be raped, attacked or stalked by an intimate partner in their lifetime.

When forensic nurses work with the LGBTQ community, they address physical and emotional needs following sexual violence. Working in LBGT victim services, forensic nurses, including sexual assault nurse examiners (SANEs), collect evidence, document crimes and provide vital information to police and prosecutors.

The Human Rights Campaign, the largest LGBTQ advocacy group in the United States, said LGBTQ survivors of sexual assault deserve culturally competent care.

“For LGBTQ survivors of sexual assault, their identities – and the discrimination they face surrounding those identities – often make them hesitant to seek help from police, hospitals, shelters or rape crisis centers, the very resources that are supposed to help them,” the organization said in “Sexual Assault and the LGBTQ Community.” “This epidemic of sexual violence in the LGBTQ community is something we must all work together to address.”

Registered nurses (RNs) who earn a master’s in nursing degree (MSN), including an online master’s in nursing, and work as forensic nurses can assist the LGBTQ community and address concerns. By working in LBGT victim services, RNs can help disenfranchised communities get the medical and legal assistance they deserve.

Barriers to Helping LGBTQ Sexual Assault Victims

While healthcare agencies work to provide informed care to LGBTQ patients, the community still faces obstacles. In an article in, Michael Johnson, Ph.D., RN, chairman of the Gay and Lesbian Medical Association, Nursing Section, said sensitivity training is vital to LGBTQ care.

“Some members of the LGBTQ community avoid seeking healthcare services because of previous negative experiences in which they faced discrimination,” Johnson said in “How to care for the LGBTQ community’s health issues.” “Studies have shown most LGBTQ patients want to be able to share their sexual orientation or gender identity with their healthcare provider but are often reluctant to open up because they fear they may be treated badly or even refused care.”

Also, LBGTQ patients may have specific concerns related to sexual orientation or gender identity following sexual violence. The concern may be related to the assault or interactions with the healthcare, legal or criminal justice systems, Sexual Assault Support Services of Midcoast Maine said in “LGBTQ+ Advocacy.”

Some concerns include:

  • Fear that officials (including law enforcement, healthcare professionals and counselors) won’t be sensitive
  • Fear of being outed
  • Fear of not being supported or believed

Meeting LGBTQ Sexual Violence Survivor Needs

Lyzanne Malfitano, a therapist and shift supervisor at the Chicago Rape Crisis Hotline, also said LGBTQ victims – particularly transgender people – worry about harassment and abuse at the hands of providers.

“Another challenge is thinking about how disclosing violence within intimate relationships may confirm some stereotypes about LGBTQ relationships being inherently inferior or unhealthy. It’s a lot for a person to have to weigh after experiencing violence,” Malfitano said in an interview with Joyful Heart Foundation, an LGBTQ advocacy group.

The International Association of Forensic Nurses said victim-centered care for LGBTQ patients is vital and should include:

  • Intake forms and documents with space for patients to write information about sexual orientation and gender identity rather than a checkbox
  • Referring to victims using preferred pronouns or names
  • Treating the patient’s LGBTQ status as confidential medical information
  • Not showing surprise, shock, dismay or concern when a transgender patient reveals personal information

Forensic Nursing and the LGBTQ Community

Malfitano also said policies should be changed to ensure equal treatment for all victims of sexual violence, including removing gender-based language. LGBTQ victims should feel supported while receiving care, she said.

“A survivor shouldn’t be turned away from necessary care because their gender marker is male, yet they might still be at risk for pregnancy as a result of assault. I also advocate for a change from the gender violence model, which is that sexual assault is a crime against women perpetrated by men,” Malfitano said. “This paradigm is really difficult for survivors who don’t fit that model and assume that services may not exist for them.”

RNs who hope to work in support of LGBTQ sexual assault victims and other victims of sexual violence can earn an MSN in Forensic Nursing through Duquesne University’s online MSN program. Through the program, RNs learn the essentials of advanced care, from nursing terminology to specialized clinical care.

About Duquesne University’s Online MSN in Forensic Nursing

Duquesne University’s MSN in forensic nursing program has garnered national attention for its dedication to melding nursing and criminal justice. The program operates in partnership with the university’s Cyril H. Wecht Institute of Forensic Science and Law. The university is one of the few in the nation to offer an in-depth study in forensic nursing.

RNs who graduate from Duquesne University’s MSN in Forensic Nursing online program work as sexual assault nurse examiners (SANEs), forensic nurse investigators, nurse death investigators and expert witnesses. The program also provides opportunities for students to add a concentration in nursing education or transcultural nursing.

Duquesne University also offers an online Post-Master’s Certificate in forensic nursing for RNs who already have an MSN. For more information about the programs, contact Duquesne University today.



Sexual Assault and the LGBTQ Community: Human Rights Campaign

How to care for the LGBTQ community’s health issues:

Working With LGBTQ Survivors of Sexual Violence: Joyful Heart Foundation