Characterizing intimate partner violence-caused brain injury in 2S/LGBTQIA+ communities

Brain injury (BI) is a consequence of intimate partner violence (IPV). Current research regarding IPV-caused BI (IPV-BI) largely excludes 2S/LGBTQIA+ communities. Heteronormativity and cisnormativity are entrenched not only into the research process, but also into care designed to support survivors. My doctoral dissertation used an explanatory sequential mixed methods design (QUANT → QUANT/QUAL embedded → QUAL) across three studies to examine IPV-BI in 2S/LGBTQIA+ communities located in the western Canadian province of British Columbia. First, an observational cross-sectional online survey characterized the prevalence of IPV-BI among 2S/LGBTQIA+ survivors (QUANT; Chapter 4). The results demonstrated that 68% of the sample had experienced IPV that resulted in symptoms consistent with a BI. Follow-up semi-structured interviews were then conducted with service providers, three of who had lived experience, who work with 2S/LGBTQIA+ survivors of IPV-BI. The following chapter (QUANT/QUAL; Chapter 5) combined both survey and interview data from 2S/LGBTQIA+ IPV-BI survivors regarding experiences of navigating formal care as a result of IPV-BI. Quantitative analyses indicated that most 2S/LGBTQIA+ survivors of IPV-BI accessed formal services, particularly healthcare and psychosocial supports, with trans women accessing significantly more sources of support and types of service providers compared to other participants, while queer participants accessed significantly fewer sources of support and types of providers, highlighting variation in service engagement across gender identity and sexual orientation. Qualitative analysis demonstrated that 2S/LGBTQIA+ service providers with lived experience engaged with formal systems of care yet did so within service landscapes that remain largely structured around cisgender, heterosexual assumptions. The last analysis chapter (QUAL; Chapter 6), situates findings within broader sociological, health, and IPV literature to examine how interpersonal dynamics, institutional practices, and systemic structures shape 2S/LGBTQIA+ IPV-BI survivors experiences. Drawing on interviews with service providers, analyzed using interpretive description, this chapter demonstrates that providers’ efforts to support 2S/LGBTQIA+ survivors are shaped by a persistent tension between facilitation and constraint. My dissertation illuminates IPV-BI as a critical public health issue in 2S/LGBTQIA+ communities, challenging heteronormative and cisnormative frameworks that shape research and care. It calls for more inclusive service systems and advances understanding of IPV-BI prevalence, context, and barriers to support.