Intimate Partner Violence: A Mixed Methods Case Series that Focuses on a Subgroup of Minority Patients With Cancer

Abstract

Background

Sexual and gender diverse (SGD) individuals comprise nearly 10% of the United States’ population but remain underrepresented in cancer research, particularly in intimate partner violence (IPV) studies. Although IPV rates are comparable or higher in SGD individuals than in non-SGD individuals, the literature on IPV in SGD patients with cancer remains sparse.

Methods

This qualitative study was conducted within a Mayo Clinic IRB-approved parent database on SGD patients with cancer. Eligible patients were adults who self-identified as non-heterosexual or non-cisgender, had an invasive cancer diagnosis, and reported IPV via a four-question screening tool. A detailed medical review was performed to extract qualitative data related to IPV and other violence. Two investigators employed thematic analyses to understand these qualitative data.

Results

Among 258 SGD patients whose medical records were screened, 13 (5%) reported IPV. Six key themes emerged: (1) IPV co-occurred with other violence (childhood, workplace, sexual violence); (2) IPV was associated with mental health conditions (depression, PTSD, suicidality); (3) Unhealthy coping mechanisms (substance use, risky behaviors) were common; (4) Social isolation and lack of support exacerbated challenges; (5) Internalized stigma influenced self-perception, relationships, healthcare experiences; (6) Chronic stress from cumulative trauma negatively impacted cancer care.

Conclusion

IPV was reported by a small proportion of SGD cancer patients, and cause and effect associations been IPV and the above themes have not been demonstrated. These findings suggest a need for trauma-informed, culturally competent interventions to address IPV and its broader psychosocial effects in these underserved populations.