New Curtin University research, in collaboration with WAAC (formerly the WA AIDS Council), is putting the spotlight on the significant challenges and barriers faced by LGBTIQA+ individuals experiencing intimate partner violence (IPV) in accessing primary care in Western Australia, calling for greater improvements to ensure services are more inclusive and responsive.

The research encompassed a comprehensive state-wide survey and in-depth consultations with LGBTIQA+ individuals and primary care providers and included the creation of educational materials aimed at increasing awareness of IPV and equipping primary care providers with the tools needed to offer appropriate support.

Chief investigator Dr Roanna Lobo (pictured above), from Curtin’s School of Population Health, said the study revealed a critical need for the development of more understanding primary care to ensure LGBTIQA+ individuals experiencing IPV receive the support they need.

“Our research shows more than half of the LGBTIQA+ participants reported experiencing forms of abuse in their intimate relationships, with many struggling to seek help due to fears of judgement and a lack of understanding within primary care settings, while providers revealed a lack of confidence in recognising IPV in LGBTIQA+ clients and expressed a desire to give better support,” Dr Lobo said.

“Our findings highlight a disturbing gap in our primary care system that fails to provide safe, affirming and effective care for LGBTIQA+ individuals facing IPV. It’s imperative that we bridge this divide by integrating comprehensive education into primary care settings.”

Research develops new tools to assist people affected by Intimate Partner Violence

Co-investigator Dr Jack Farrugia (pictured above), from Curtin’s School of Population Health, said IPV is a significant public health concern, particularly affecting LGBTIQA+ individuals, families and communities.

“Primary care settings must be capable of responding in an appropriate way to avoid further compounding harm to individuals in crisis,” Dr Farrugia said.

“This research will help guide the development of services, interventions and further resources to facilitate early help-seeking, recognise individuals in crisis situations and enhance psychosocial wellbeing.”

The ‘Safer Options’ study recommends the development of clear guidelines for primary care services to address IPV as experienced within LGBTIQA+ relationships, the adaption of existing resources to be more inclusive and the establishment of a referral directory for LGBTIQA+ friendly primary care services.

Speaking to OUTinPerth Dr Farrugia said the team decided to apply for research funding when there were reports of more people seeking support for intimate partner violence during the Covid period.

“It was to explore how to best improve the responses from primary care providers to support LGBTIQA+ people experiencing. IPV and just recognising that there may be some service provision out there that might not be best responding in the way that is needed for the community.” Dr Farrugia said.

The researcher said it was important to recognise that IPV may look different in same-sex relationships.

“IPV can look differently within LGBTIQ+ plus relationships compared to those non-queer relationships.”

Dr Farrugia explains that the challenge is twofold, first controlling behavious might look different in a same sex relationship compared to a heterosexual relationship.

“Threatening to out to friends and family or withholding access to gender affirming treatment – all these things that maybe those who are not queer, wouldn’t experience. But because IPV is typically understood from cisgender and heteronormative experiences, what they were experiencing was hard to identify at the time.” he said.

This leads to service providers, and the those experience the controlling behaviour, sometimes not recognising that it is actually occurring.

The other challenge is that LGBTIQA+ people seeking support reported at time they did not feel welcome at some of the state’s primary service providers in this area.

“For the participants that sort of took that extra step to then seek support from the primary care services, some told us stories of just completely been rejected from the service and are not I haven’t really been reading through the door.”

Dr Farrugia said sometimes something as simple as the sound of the voice on the end of the phone could give the impression that LGBTIQA+ people were not welcome at some support services.

For those who did begin engaging with services they often encountered a lack of recognition of LGBTIQA+ relationships, sometimes all the examples used in materials were of only heterosexual scenarios.

Some participants in the study reported that they kept the details of the relationship secret and would pretend to be in heterosexual unions because they thought that is what was expected by service providers.

The researchers also spoke to those providing the services. While some were confident in their ability to welcome LGBTIQA+ clients, others felt that there were gaps in their training and service delivery.

“We did hear from primary care providers that a lot of it was down to being time poor, not having the time to go out and educate themselves on how to best respond to IPV as it’s experienced by queer people.” Dr Farrugia said.

Simply updating training and adding more signs on inclusivity however is not the solution, Dr Farrugia says to be successful organisations need to work with people in the LGBTIQA+ communities.

“We know that with a lot of LGBTIQA+ people, probably the only way that community members know about a service is if peers have had positive experiences. So that’s word of mouth. Services really needs to be aware that if they are going through all of the hard work to educate every primary care provider and make sure that their policies and their service provision are as inclusive as they possibly can, they also need to actually go out and engage with community in an authentic way so that they can get people through the front door, not just when a crisis has occurred.” Dr Farrugia said.

Destigmatising discussions about intimate partner violence is central to getting more people to take action.

“There was a clear need for LGBTIQ+ Western Australians to have greater awareness and knowledge to better recognise what they’re experiencing is IPV and to destigmatize it, as well as to have conversations with each other and feel comfortable to share it with trusted friends and family or service providers.” Dr Farrugia said.

At the same time the researchers say there is a need for a more streamlined approach for training staff at primary care organisations and there needs to be an awareness of IPV within queer communities that extends across each organisation’s touch points.

The Safer Options website that was launched as part of the project’s work provides a wide range of information for everyone.

On the website you’ll find helpful answers to the questions WHat is IPV? Do you need support? and links to primary care services. There’s also helpful brochures, posters and guides for service providers.

Graeme Watson, Declaration: OIP co-editor Leigh Andrew Hill is a employee of Curtin University, Graeme Watson is a former volunteer with WAAC.