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Abstract

Trans women and trans feminine people are exposed to alarming rates of sexual violence in the United States of America. Responsibility for this violence rests solely with perpetrators. However, violence prevention efforts that target perpetrators are generally ineffective, whereas those that empower participants to actively resist assault, termed empowerment self-defense (ESD), show more promise. ESD programs are largely inaccessible to trans women and do not address the unique needs of diverse gender communities. To address this gap, we tailored a 5-week, 20-hour ESD program for trans women and trans feminine people and piloted the tailored program to assess its acceptability, feasibility, and initial impact. Participants (N = 39) completed weekly acceptability surveys and were administered a baseline questionnaire battery and follow-up immediately after program completion and six months post-training assessing sexual victimization, self-defense attitudes and actions, and gender minority stress and resilience factors. Feasibility and acceptability analyses demonstrated high program attendance and satisfaction. In pre-post surveys, significant changes were observed over time reflecting preliminary evidence for improved sexual assertiveness, reductions in minority and posttraumatic stress, and reduced odds of sexual violence. Findings are discussed in terms of ESD as an essential component of a comprehensive violence prevention for trans women and trans feminine people.

Keywords

clinical trial empowerment self-defense posttraumatic stress disorder (PTSD)transgender health transgender violence prevention

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References

Anzani

Lindley

Tognasso

Galupo

M. P.

Prunas

(2021). “Being talked to like I was a sex toy, like being transgender was simply for the enjoyment of someone else”: Fetishization and sexualization of transgender and nonbinary individuals. Archives of Sexual Behavior, 50(3), 897–911. https://doi.org/10.1007/s10508-021-01935-8

ATLAS.ti Scientific Software Development GmbH . (2022). ATLAS.ti (version 22.0.6) [Qualitative data analysis software]. http://atlasti.com

Barr

S. M.

Snyder

K. E.

Adelson

J. L.

Budge

S. L.

(2022). Posttraumatic stress in the trans community: The roles of anti-transgender bias, non-affirmation, and internalized transphobia. Psychology of Sexual Orientation and Gender, 9(4), 410–421. https://doi.org/10.1037/sgd0000500

Berke

D. S.

Hotchkiss

Smith

Gilbert

(2024). Mapping multilevel contributions to the sexual victimization of trans women and trans feminine people. A qualitative intersectional analysis. Journal of Sexual Abuse, 34(5-6), 579–599. https://doi.org/10.1080/10538712.2024.2414996

Berke

D. S.

Miller

Palatnik

(2025). Empowerment self-defense for sexual and gender minority populations. In Orchowski

Hollander

(Eds.), Empowerment self-defense: Theory, research and practice. Elsevier.

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Brooks

V. R.

(1981). Minority stress and lesbian women. Lexington Books.

Cermele

McCaughey

(2022). Self-Defense as an effective and neglected form of sexual assault prevention: A commentary and overdue correction to the literature. Sex Roles, 86(9), 493–503. https://doi.org/10.1007/s11199-022-01284-3

Ching

T. H. W.

Lee

S. Y.

Chen

R. P.

Williams

M. T.

(2018). A model of intersectional stress and trauma in Asian American sexual and gender minorities. Psychology of Violence, 8(6), 657–668. https://doi.org/10.1037/vio0000204

10.

Connolly

Aldridge

Davies

Maier

L. J.

Ferris

Gilchrist

Winstock

(2021). Comparing transgender and cisgender experiences of being taken advantage of sexually while under the influence of alcohol and/or other drugs. The Journal of Sex Research, 58(9), 1112–1117. https://doi.org/10.1080/00224499.2021.1912692

11.

Coulter

R. W. S.

Mair

Miller

Blosnich

J. R.

Matthews

D. D.

McCauley

H. L.

(2017). Prevalence of past-year sexual assault victimization among undergraduate students: Exploring differences by and intersections of gender identity, sexual identity, and race/ethnicity. Prevention Science, 18(6), 726–736. https://doi.org/10.1007/s11121-017-0762-8

12.

DeGue

Valle

L. A.

Holt

M. K.

Massetti

G. M.

Matjasko

J. L.

Tharp

A. T.

(2014). A systematic review of primary prevention strategies for sexual violence perpetration. Aggression and Violent Behavior, 19(4), 346–362. https://doi.org/10.1016/j.avb.2014.05.004

13.

Edwards

K. M.

Siller

Wheeler

L. A.

Charge

L. L.

Charge

D. P. L.

Bordeaux

, Herrington, R., Hopfauf, S. L., & Simon, B. (2022). Effectiveness of a sexual assault self-defense program for American Indian girls. Journal of Interpersonal Violence, 37(15-16), NP13245–NP13267. https://doi.org/10.1177/0886260521997942

14.

Gidycz

Orchowski

Probst

Edwards

Murphy

Tansill

(2015). Concurrent administration of sexual assault prevention and risk reduction programming. Violence Against Women, 21(6), 780–800. https://doi.org/10.1177/1077801215576579

15.

Gidycz

C. A.

Dardis

C. M.

(2014). Feminist self-defense and resistance training for college students: A critical review and recommendations for the future. Trauma, Violence, & Abuse, 15(4), 322–333. https://doi.org/10.1177/1524838014521026

16.

Goldstein

R. B.

Smith

S. M.

Chou

S. P.

Saha

T. D.

Jung

Zhang

Pickering

R. P.

Ruan

Huang

Grant

B. F.

(2016). The epidemiology of DSM-5 posttraumatic stress disorder in the United States: Results from the national epidemiologic survey on alcohol and related conditions-III. Social Psychiatry and Psychiatric Epidemiology, 51(8), 1137–1148. https://doi.org/10.1007/s00127-016-1208-5

17.

Hendricks

M. L.

Testa

R. J.

(2012). A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the minority stress model. Professional Psychology Research and Practice, 43(5), 460–467. https://doi.org/10.1037/a0029597

18.

Hollander

J. A.

(2014). Does self-defense training prevent sexual violence against women? Violence Against Women, 20(3), 252–269. https://doi.org/10.1177/1077801214526046

19.

Hollander

J. A.

(2016). The importance of self-defense training for sexual violence prevention. Feminism and Psychology, 26(2), 207–226. https://doi.org/10.1177/0959353516637393

20.

Hollander

J. A.

(2018). Empowerment self-defense. In Orchowski

L. M.

Gidycz

C. A.

(Eds.), Sexual assault risk reduction and resistance: Theory, research, and practice (pp. 221–244). Academic Press.

21.

Hotchkiss

M. E.

Weinberg

Berke

D. S.

(2024). Implementation of empowerment self-defense programming in a university counseling center: An effective sexual violence prevention delivery model. Journal of American College Health, 72, 2432–2440. https://doi.org/10.1080/07448481.2022.2115299

22.

IMPACT™ International . (2024). Retrieved from http://www.impactpersonalsafety.com/

23.

Jackson

Hernandez

Scheer

Sicro

Trujillo

Arayasirikul

McFarland

Wilson

E. C.

(2022). Prevalence and correlates of violence experienced by trans women. Journal of Women’s Health, 31(5), 648–655. https://doi.org/10.1089/jwh.2021.0559

24.

Jindasurat

Waters

(2014). Lesbian, gay, bisexual, transgender, queer and HIV-affected intimate partner violence in 2014. National Coalition of Anti-Violence Programs.

25.

Kattari

S. K.

Walls

N. E.

Whitfield

D. L.

Langenderfer-Magruder

(2017). Racial and ethnic differences in experiences of discrimination in accessing social services among transgender/gender-nonconforming people. Journal of Ethnic & Cultural Diversity in Social Work, 26(3), 217–235. https://doi.org/10.1080/15313204.2016.1242102

26.

Katz

May

Sorensen

DelTosta

(2010). Sexual revictimization during women’s first year of college: Self-blame and sexual refusal assertiveness as possible mechanisms. Journal of Interpersonal Violence, 25(11), 2113–2126. https://doi.org/10.1177/0886260509354515

27.

Kelley

E. L.

Orchowski

L. M.

Gidycz

C. A.

(2016). Sexual victimization among college women: Role of sexual assertiveness and resistance variables. Psychology of Violence, 6(2), 243–252. https://doi.org/10.1037/a0039407

28.

Kidd

J. D.

Tettamanti

N. A.

Kaczmarkiewicz

Corbeil

T. E.

Dworkin

J. D.

Jackman

K. B.

Hughes

T. L.

Bockting

W. O.

Meyer

I. H.

(2023). Prevalence of substance use and mental health problems among transgender and cisgender U.S. adults: Results from a national probability sample. Psychiatry Research, 326(8), 115339. https://doi.org/10.1016/j.psychres.2023.115339

29.

Koss

M. P.

Oros

C. J.

(1982). The sexual experience survey: An empirical instrument investigating sexual aggression and victimization. Journal of Consulting and Clinical Psychology, 50(3), 455–457. https://doi.org/10.1037/0022-006X.50.3.455

30.

Livingston

J. A.

Testa

VanZile-Tamsen

(2007). The reciprocal relationship between sexual victimization and sexual assertiveness. Violence Against Women, 13(4), 298–313. https://doi.org/10.1037/0022-3514.68.4.704

31.

Lloyd

Frasca

K. J.

Thompson

Stewart

English

(2024). Understanding the impact of gender identity nonaffirmation: The mediating role of psychological needs thwarting. Psychology of Sexual Orientation and Gender Diversity. Advance online publication. https://doi.org/10.1037/sgd0000740

32.

Loya

R. M.

(2015). Rape as an economic crime: The impact of sexual violence on survivors’ employment and economic well-being. Journal of Interpersonal Violence, 30(16), 2793–2813. https://doi.org/10.1177/0886260514554291

33.

Mardorossian

C. M.

(2003). Review of rethinking rape and rape on the public agenda and new versions of victims. Signs, 29(1), 265–269. https://doi.org/10.1086/375670

34.

Marx

B. P.

Calhoun

K. S.

Wilson

A. E.

Myerson

L. A.

(2001). Sexual revictimization prevention: An outcome evaluation. Journal of Clinical and Consulting Psychology, 69(1), 25–32. https://doi.org/10.1037/0022-006X.69.1.25

35.

McLemore

K. A.

(2018). A minority stress perspective on transgender individuals’ experiences with misgendering. Stigma and Health, 3(1), 53–64. https://doi.org/10.1037/sah0000070

36.

Meyer

I. H.

(2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697. https://doi.org/10.1037/0033-2909.129.5.674

37.

Miller

Berke

D. S.

(2025). Elucidating Relational mechanisms of community-engaged dissemination and implementation with a transgender women community. Global Implementation Research and Applications, 1–15. https://doi.org/10.1007/s43477-025-00171-9

38.

Moore

C. D.

Waterman

C. K.

(1999). Predicting self-protection against sexual assault in dating relationships among heterosexual men and women, gay men, lesbians, and bisexuals. Journal of College Student Development, 40, 132–140. https://psycnet.apa.org/record/1999-10727-002

39.

National Women’s Martial Arts Federation . (2024). Empowerment self defense? Retrieved from https://nwmaf.org/resources/empowerment

40.

Norris

Zawacki

Davis

K. C.

George

W. H.

(2018). The role of psychological barriers in women’s resistance to sexual assault by acquaintances. In Orchowski

Gidycz

(Eds.), Sexual assault risk reduction and resistance (1st ed., pp. 87–110). Academic Press.

41.

O’Neil

E. N.

Kaiser

K. A.

(2015). Resistance strategies and sexual assault outcomes: Do measurement decisions influence empirical outcomes? Criminology, Criminal Justice, Law and Society, 16(16), 56–73. https://scholasticahq.com/criminology-criminal-justice-law-society/

42.

Orchowski

L. M.

Gidycz

C. A.

Raffle

(2008). Evaluation of a sexual assault risk reduction and self-defense program: A prospective analysis of a revised protocol. Psychology of Women Quarterly, 32(2), 204–218. https://doi.org/10.1111/j.1471-6402.2008.00425.x

43.

Ozer

E. M.

Bandura

(1990). Mechanisms governing empowerment effects: A self-efficacy analysis. Journal of Personality and Social Psychology, 58(3), 472–486. https://doi.org/10.1037/0022-3514.58.3.472

44.

Parr

N. J.

Howe

B. G.

(2019). Heterogeneity of transgender identity nonaffirmation microaggressions and their association with depression symptoms and suicidality among transgender persons. Psychology of Sexual Orientation and Gender Diversity, 6(4), 461–474. https://doi.org/10.1037/sgd0000347

45.

Porat

Gantman

Green

S. A.

Pezzuto

Levy Paluck

(2024). Preventing sexual violence: A behavioral problem without a behaviorally informed solution. Psychological Science in the Public Interest, 25(1), 4–29. https://doi.org/10.1177/15291006231221978

46.

Reisner

S. L.

White

J. M.

Bradford

J. B.

Mimiaga

M. J.

(2014). Transgender health disparities: Comparing full cohort and nested matched-pair study designs in a community health center. LGBT Health, 1(3), 177–184. https://doi.org/10.1089/lgbt.2014.0009

47.

Reisner

S. L.

White Hughto

J. M.

Gamarel

K. E.

Keuroghlian

A. S.

Mizock

Pachankis

J. E.

(2016). Discriminatory experiences associated with posttraumatic stress disorder symptoms among transgender adults. Journal of Counseling Psychology, 63(5), 509–519. https://doi.org/10.1037/cou0000143

48.

Rosenblum

G. D.

Taska

L. S.

(2014). Self-defense training as clinical intervention for survivors of trauma. Violence Against Women, 20(3), 293–308. https://doi.org/10.1177/1077801214526048

49.

Sarnquist

Omondi

Sinclair

Gitau

Paiva

Mulinge

, Cornfield, D. N., & Maldonado

(2014). Rape prevention through empowerment of adolescent girls. Pediatrics, 133(5), e1226–e1232. https://doi.org/10.1542/peds.2013-3414

50.

Senn

C. Y.

(2011). An imperfect feminist journey: Reflections on the process to develop an effective sexual assault resistance programme for university women. Feminism and Psychology, 21(1), 121–137. https://doi.org/10.1177/0959353510386094

51.

Senn

C. Y.

Eliasziw

Barata

P. C.

Thurston

W. E.

Newby-Clark

I. R.

Radtke

H. L.

Hobden

K. L.

(2015). Efficacy of a sexual assault resistance program for university women. New England Journal of Medicine, 372(24), 2326–2335. https://doi.org/10.1056/NEJMsa1411131

52.

Senn

C. Y.

Hollander

Gidycz

C. A.

(2018). What works? Critical components of effective sexual violence interventions for women on college and university campuses. In Orchowski

Gidycz

(Eds.), Sexual assault risk reduction and resistance (1st ed., pp. 245–289). Academic Press.

53.

Sinclair

Otieno

Mulinge

Kapphahn

Golden

N. H.

(2013). A self-defense program reduces the incidence of sexual assault in Kenyan adolescent girls. Journal of Adolescent Health, 53(3), 374–380. https://doi.org/10.1016/j.jadohealth.2013.04.008

54.

Smith

A. M.

Hotchkiss

Gilbert

Williams

D. N.

Madhav

Bloomfield

, … Berke

D. S.

(2023). Process adaptations to community-engaged research for preventing victimization against trans women: Failure as a blueprint toward nonexploitative implementation science. American Psychologist, 78(2), 186–198. https://doi.org/10.1037/amp0001063

55.

Stutterheim

S. E.

van Dijk

Wang

Jonas

K. J.

(2021). The worldwide burden of HIV in transgender individuals: An updated systematic review and meta-analysis. PLoS One, 16(12), e0260063. https://doi.org/10.1371/journal.pone.0260063

56.

Tark

Kleck

(2014). Resisting rape: The effects of victim self-protection on rape completion and injury. Violence Against Women, 20(3), 270–292. https://doi.org/10.1177/1077801214526050

57.

Testa

R. J.

Habarth

Peta

Balsam

Bockting

(2015). Development of the gender minority stress and resilience measure. Psychology of Sexual Orientation and Gender Diversity, 2(1), 65–77. https://doi.org/10.1037/sgd0000081

58.

Tourangeau

(Ed.) (2014). Hard-to-survey populations. Cambridge University Press.

59.

Valentine

Peitzmeier

King

O’Cleirigh

Marquez

S. M.

Pressley

Potter

(2017). Disparities in exposure to intimate partner violence among transgender/gender nonconforming and sexual minority primary care patients. LGBT Health, 4(4), 260–267. https://doi.org/10.1089/lgbt.2016.0113

60.

Valentine

S. E.

Gell-Levey

I. M.

Godfrey

L. B.

Livingston

N. A.

(2024). The associations between gender minority stressors and PTSD symptom severity among trauma-exposed transgender and gender diverse adults. Journal of Trauma & Dissociation, 25(4), 422–435. https://doi.org/10.1080/15299732.2024.2323977

61.

Walker

D. P.

(2006). Impaired sexual assertiveness and consensual sexual activity as risk factors for sexual coercion in heterosexual college women [Master's thesis, Miami University] http://etd.ohiolink.edu/acprod/odb_etd/ws/send_file/send?accession=miami1155324575&disposition=inline

62.

Weathers

F. W.

Litz

B. T.

Keane

T. M.

Palmieri

P. A.

Marx

B. P.

Schnurr

P. P.

(2013). The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at www.ptsd.va.gov

63.

Wong

J. S.

Balemba

(2016). The effect of victim resistance on rape completion: A meta-analysis. Trauma, Violence, & Abuse, 19(3), 352–365. https://doi.org/10.1177/1524838016663934

64.

Wortmann

J. H.

Jordan

A. H.

Weathers

F. W.

Resick

P. A.

Dondanville

K. A.

Hall-Clark

Foa

E. B.

Young-McCaughan

Yarvis

J. S.

Hembree

E. A.

Mintz

Peterson

A. L.

Litz

B. T.

(2016). Psychometric analysis of the PTSD checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment, 28(11), 1392–1403. https://doi.org/10.1037/pas0000260

65.

Woulfe

J. M.

Goodman

L. A.

(2020). Weaponized oppression: Identity abuse and mental health in the lesbian, gay, bisexual, transgender, and queer community. Psychology of Violence, 10(1), 100–109. https://doi.org/10.1037/vio0000251

66.

Zerubavel

Messman-Moore

T. L.

(2013). Sexual victimization, fear of sexual powerlessness, and cognitive emotion dysregulation as barriers to sexual assertiveness in college women. Violence Against Women, 19(12), 1518–1537. https://doi.org/10.1177/1077801213517566

Feasibility,Acceptability and Initial Impact of a Sexual Assault Resistance Program for Trans Women and Trans Feminine People: Findings From a Mixed Methods Pilot Trial

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