Sunday, July 21, 2019

From Frying Pan To Fire: African Key Populations (KP) In A Dilemma When Provider Bias Stands In The way To Reporting IPV abuse; A Case Of Three African Cities


Alright, let us stop for a moment and analyze Key Populations (KP) vis-a-vis Intimate Partner Violence (IPV). 

Are you aware that disempowering KP from relating within their domiciliary communities across their lifespan is counter productive?

If one were to provide opportunities for KP to lead quality lives, they should not only use Heteronormative but Homonormative lenses as well. 

Disempowering by disowning, evicting, criminalizing, imprisoning, arbitrary arrests or causing harm to LGBTIPQQ children raises the likelihood of these not reaching their actualization milestones. These children undergo “what is known as children of latency who may arrive at what is termed socially decisive steps in life later in life or not at all unlike children who are allowed to grow and develop without fear of persecution. When children are denied this guidance their ideas are distorted. They may fail to form an idealized memories of adult patients who recall “the ideal of latency,” namely, the successful warding-off of instinctual impulses during this time. It is commonly agreed that the confluence of developmental and social forces propel the school-age child outward and away from the family towards peer relationships and new adult figures,” argues Wallerstein (1976).

Disempowering KP from relating within their domiciliary communities thus affects the way they relate, who they relate with, what they look for in relations, distorts self preservation goals, interrupts autonomy, agency, and eventually how they relate intimately. Studies highlighting IPV, link it to a number of traumatic causes including interruption of: sense of self, liberty, pursuance of happiness and quality life. Victims cannot engage in a full experience of life. Perpetrators on the other hand get away with it because of the muting zeitgeist around KP-related IPV. For Key Populations (KP), this has life threatening consequences.

Goodman (2005) argues that “intimate partner violence and real-life contexts of victims’ lives should be not only linked to state policy, criminal justice reforms mandatory responses focused on counseling, restraining, and punishing batterers, protection order system relying heavily on batterer treatment programs but should provide the victim support to prevent future violence. 

Contextualizing a sufferer centered focus responds flexibly to victims’ needs and providing them with advocacy and broad social support is a more successful strategy for safety of persons. o Expanding victim-centered resources and reincorporating a particularized perspective provides agency and autonomy in bringing about an end to IPV.”


Qualifications, ideas of success, achievements, money, assets, community roles, power roles, power sources education and occupational prestige, hegemonic patriarchy, masculine identity are some of the sources of agency, autonomy, self preservation, status and power of individual people. This power plays important roles in supporting or subverting relations. 

Jewkesa (2002) argues that “The way partners communicate and what they communicate about plays an important part in how they experience agreements, disagreements and how they resolve differences. verbal disagreements and of high levels of conflict in relationships are strongly associated with physical violence. Shared and personal time, resources and spaces need to be  explored by partners in order for them not to conflict. Transgression of conservative gender roles or challenges to male privilege, as well as matters of finance are another trigger of IPV.  Unlike many health problems, there are few social and demographic characteristics that define risk groups for intimate partner violence. Poverty is the exception and increases risk through effects on conflict, women's power, and male identity. Violence is used as a strategy in conflict. Relationships full of conflict, and especially those in which conflicts occur about finances, jealousy, enforcement of hierarchy and partner's gender role transgressions are more violent than peaceful relationships. Heavy alcohol consumption also increases risk of violence. Women who are more empowered educationally, economically, and socially are most protected, but below this high level the relation between empowerment and risk of violence is nonlinear. Violence is frequently used to resolve a crisis of male identity, at times caused by poverty or an inability to control women. Risk of violence is greatest in societies where the use of violence in many situations is a socially-accepted norm. Primary preventive interventions should focus on improving the status of women and reducing norms of violence, poverty, and alcohol consumption.”


So, what is the big deal here?

Even while we go about saying KP need to be targeted, we need to identify the needs in order to provide timely and effective interventions. One such need is the realization that perpetrators of abuses among KP are also holding high positions themselves and therefore are protected by the LGBTIPQQ Community. This study aimed at identifying the subjective character and typology (intrinsicness and extrinsicness) of IPV and link it to interventions targeting KP such as: access to police, courts of law, schools, recreation facilities, social spaces, jobs, credit facilities and health care. This study has policy and programmatic implications for development, educational, health, job recruiting, competitive sports, psychology, parenting and many other areas. 

Structured interviews, literature review and FGD were employed via Skype and face to face meetings. This helped to capture case by case narratives.

The study involved 34 Providers and 157 LGBTIPQQ people aged 23-55 years (47 TG, 25 L, 35 G, 50 B) in three cities, Nairobi, Kampala and Mbarara between 2015-2019. 

The 157 LGBTIPQQ respondents had been or were in a relationship for 6 months and above. This constituted eligibility. 

No, wait a minute. Is there a link between how one reacts to what one is provided with?

Six aspects were further investigated to show link between quality of life and Provider status and these were: sense of esteem; attributes of happiness or the happy gaze; propensity to seek lifespan or relationship counseling to understand/enjoy meaningful life; role of environment on gay relationships; and cultural sensitivity of Providers to gauge how Provider bias or affinity influences life improving seeking services.

And so? 

Providers introduced to cultural sensitivity trainings provided opportunities for KP to access them and this maintained a rapport. Providers were asked which extrinsic factor was more important: job security; welcoming communities; or accommodating parents. 17 Providers chose accommodating parents as the most important; 6 pointed out welcoming communities were the most important; and 11 highlighted job security. These Providers were involved in providing life-span guidance and counselling. So, it is clear that they were pointing toward a dependent and an independent stage of life. They affirmed that the environment has a profound influence on emotional growth which in turn affects the way a person engages in problem-posing and solving skills.

Power roles, status and gender expression are three pivotal in triggering or deterring IPV among LGBTIPQQ persons. When the victims cannot report the perpetrators because they fear losing a bread-winner or face, then it becomes complicated. But one way to address this anomaly is to empower the abused or vulnerable person with employable or money generating skills. E Pelled (2000), argues that “holding such abusive partners accountable motivates them to commit to their own and the partner’s well-being. Which under certain conditions, contributes to the healthier emotional fulfillment of both.” He continues to argue that “children who grow up in abusive situations, grow up terrorized, witnessing violence, become rigid and sometimes self destructing practices. Because they are exposed to negative or limited opportunities for role models, they end up with traumatic secrets. Examples of these traumas are constant fear, feeling loneliness, experience instability, discontinuity, are always moving and cannot get a foothold into economic independence.” Perceptions of non violence companionship improve wellbeing, sense of being and direction. This means that access to life saving information, education and communication ( IEC) is crucial.

Lamerial (2015) chronicles how “differences between feminine and masculine lesbian, gay, bisexual, transgender, queer (LGBTQ), self-reported victimization, perpetration, and acceptance of IPV. Results identified that masculine LGBTQ-identifying students reported higher levels of victimization, perpetration, and acceptance of violence, providing implications when assessing for risk and protective factors of same-sex IPV. 83% of LGBTQ adults reported suffering emotional abuse and coercion within their same-sex relationship; 32% of LGBTQ adults reported some form of physical abuse, and 52% experienced being threatened by their same-sex partner. Although high prevalence rates of same-sex IPV exists, little is known regarding the risk and protective factors of IPV.” 

He re-emphasizes the role of community in ensuring quality life. 


“Individual and relational development remains important, and healthy relationship patterns serve as a protective factor to violence in adult relationships due to the lack of role models displaying healthy relationship behaviors for LGBTQ-identifying individuals,” he asserts. When it comes to IPV, Transgender and Lesbians report more incidences than say Gay persons. This is what Lamerial (2015) in another study of who among Transgender, Lesbian and Gay are more likely to report IPV. “IPV victimization, perpetration, and related attitudinal differences exists between male and female LGBTQ. Study results found that females reported higher levels of psychological victimization than gay males. Additionally, the male participants reported greater attitudinal acceptance of IPV and a propensity for sadism. Counseling implications regarding IPV victimization, perpetration, and attitudinal acceptance for IPV among LGBTQ populations need to be one-shoe fits-all.” The need for interventions that are KP-led or ally-led and focused on improving health of KP increased a culture of dignity at individual, household and community levels. This is what Strickler (2015) argues when he asserts that “Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) persons experience partner and other violence at high levels requiring culturally competent interventions.Focusing on LGBTQ experiences of violence, with intentions to collaborative or build networks with other organizations builds opportunities for experiencing fuller life by KP. It also provides opportunities for referral because different organizations would be involved in addressing sexual and partner violence, promoting LGBTQ community health and safety, and concerned with social inclusion and legal protection of LGBTQ individuals, families, and communities. These programs increase provider and community competency and capacity toward improving LGBTQ safety, health, and well-being.”


Can you tell us more? This gets interesting!

90 LGBTIPQQ respondents with median age 25 (IQR 23-45) claimed being well off was connected to access to services, admission to social spaces that improve life, freedom to associate, speech, movement, emotional growth, integrity, dignity affirmation, confidence and self care practices. Restricting the movement of others means that they cannot associate, exercise their autonomy, agency or engage in life preserving activities. 

Three FGDs of 15 members each in three cities were used to understand how emotional growth or maturity was connected to IPV. FGD A of 15 with median age 24 (IQR 22-45) cited regular or steady salary, going out, and relationship counseling were key in deterring aggressive practices, coping and dignity affirmation. 

FGD B of 15 members with median age 23 (IQR 23-45) reported that dependency and power status or the roles one played were a major role in deterring or fueling IPV events.

FGD C of 15 with median age 28 (IQR 23-49) with pensionable jobs, had health insurance and were openly gay reported that Providers who treated them with dignity encouraged them to engage in self care, errand-running, school retention up to when they gained qualifications and keep their jobs. They further pointed out that this set actualizing background compelled them to adhere to higher civic standards.

32 respondents with median age 30 (IQR 23-55) said they were happy and claimed it was due to five things: Spiritual growth, they attributed their happiness on being able to let their spirituality grow and thrive; chemistry/connecting with one another. This gave them confidence and trust; financial contentment, meant that even they earned little they could afford their lifestyle, spent or saved well; recreation, meant they engaged in a variety of community activities; compassionate and mutuality, meant they were invested in the relationship, were genuinely there for each other emotionally, financially and physically; and lastly, fidelity, was the ‘Holy Grail’ of relationships and it empowered them to agree on life preserving or safer practices and boundary setting.

35 respondents with median age 24 (IQR 23-29) had experienced IPV more than one time, reported they were deluded by grandeur, a partner had a sweet tongue and somehow they stayed. They were disappointed but preferred to be locked in abusive relationships than open up to Providers who may end up ridiculing them. 7 cited alcohol, drug and cigarette abuse. All regretted committing to the relationship but hoped things would change. Commitment remorse and avoidant coping is a common KP phenomena.

A Word To The Wise!

Relationships thrive on a continued effort to sustain investment in care, quality living, agreements of good conduct and creativity. Not delusions of grandeur, lies, appearances and pretending. This continued effort toward a goal is known as fidelity which by itself is the ‘Holy grail’ of relationships. Don’t take anything for granted but rather work harder toward thriving and happy lives.

It is like filling up one's car with fuel only to forget about coolant, water and oil. Or, forget to fill up air pressure in the wheels, and expect to run the car smoothly. Relationships start emotionally but they must be watered by the other requirements of the body. Relying on emotions may be a barrier to nurturing the structural side of relationships. This leads to a frustration domino. Poorly managed frustration breeds anger and depression. Poorly managed anger and depression breed general anxiety disorder (GAD). GAD in turn breeds aggression, which breeds self-abuse, depression and violent acts.

Conclusion:

The environment has a profound influence on emotional growth which in turn affects the way a person engages in problem-posing and solving skills. Providers empowered with cultural sensitivity trainings are more likely to motivate KP to take demand, take up and be retained in service delivery continuum. KP empowered to engage in fully experiencing their communities, thrive well and achieve quality life goals. They are able to explore meaning out of life. This opens many ways to understand people before  and if they identify a partner they have pointers to committing to long term relationships. Reading about or seeking relationship counseling is an important best practice. Age and status are crucial in understanding IPV. Identifying and measuring IPV makes it easier to provide interventions against its perpetration. Definitions or claims of being well off, should factor in attributes other than monetary or material. Emotional, biological and social services are as equally important a consideration. Finance and fidelity counseling services are an important intervention self esteem of KP is to be sustained. Further studies into life-span mentorship and guidance cultures led by KP will throw more light on positive coping skills. KP Providers who are culturally sensitive to KP-related provide quality services. When KP are willing to demand and access social support when in need and have the desire to improve on their lot, it sets in place a role model culture. It is an opportunity for self care, healing and thriving. 


For more, read Kampala Sexuality Journal. Find us at tweeter  @JournalKsj

Reference:

E Peled, Parenting by men who abuse women: issues and dilemmas, The British Journal of Social Work, Volume 30, Issue 1, February 2000, Pages 25–36, https://doi.org/10.1093/bjsw/30.1.25


Goodman, Lisa, and Deborah Epstein. “Refocusing on Women: A New Direction for Policy and Research on Intimate Partner Violence.” Journal of Interpersonal Violence, vol. 20, no. 4, Apr. 2005, pp. 479–487, doi:10.1177/0886260504267838.

Lamerial Jacobson, Andrew P. Daire & Eileen M. Abel (2015) Intimate Partner Violence: Implications for Counseling Self-Identified LGBTQ College Students Engaged in Same-Sex Relationships, Journal of LGBT Issues in Counseling, 9:2, 118-135, DOI: 10.1080/15538605.2015.1029203


Lamerial E. Jacobson, Andrew P. Daire, Eileen M. Abel & Glenn Lambie (2015) Gender Expression Differences in Same-Sex Intimate Partner Violence Victimization, Perpetration, and Attitudes among LGBTQ College Students, Journal of LGBT Issues in Counseling, 9:3, 199-216,DOI: 10.1080/15538605.2015.1068144


Rachel Jewkesa. “Intimate partner violence: causes and prevention.” The Lancet Vol. 359, Issue 9315, 20, April 2002, pp. 1423-1429, https://doi.org/10.1016/S0140-6736(02)08357-5



Wallerstein, J. S., & Kelly, J. B. (1976). The effects of parental divorce: Experiences of the child in later latency. American Journal of Orthopsychiatry, 46(2), 256-269.

Strickler, Edward, Jr, MA, MA,M.P.H., C.H.E.S., and Quillin Drew. "Starting and Sustaining LGBTQ Antiviolence Programs in a Southern State." Partner Abuse, vol. 6, no. 1, 2015, pp. 78-106. ProQuest, https://stmarys-ca.idm.oclc.org/login?url=https://search.proquest.com/docview/1648967251?accountid=25334, doi:http://dx.doi.org/10.1891/1946-6560.6.1.78.



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