TRANSGENDER SEXUAL VIOLENCE SURVIVORS A Self Help Guide to Healing and Understanding PHOTO BY KIM KLEIN PHOTOGRAPHY Michael Munson Executive Director Loree Cook-Daniels Policy and Program Director TRANSGENDER SEXUAL VIOLENCE PROJECT SEPTEMBER 2015 Table of Contents Thank You ____________________________________________________________________ 7 Introduction __________________________________________________________________ 8 Welcome _____________________________________________________________________ 8 Introduction to Self-Help Guide _________________________________________ 10 Guide Contents _____________________________________________________________ 11 Trauma and its Aftermaths __________________________________________ 13 The brain and trauma _____________________________________________________ 13 Additional readings on how trauma affects the brain _____________________________ 16 Aftereffects of sexual abuse or assault ________________________________ 16 Emotional regulation problems ________________________________________________ 18 Isolation / avoidance / denial __________________________________________________ 20 Shame, guilt, and self-blame __________________________________________________ 21 Depression / anxiety / self-harm / suicide ______________________________________ 22 Substance abuse ____________________________________________________________ 23 Physical health problems _____________________________________________________ 24 High need for control versus helplessness ______________________________________ 26 Anger _______________________________________________________________________ 26 Sleep disturbances / irritability ________________________________________________ 27 Revictimization / reenactment _________________________________________________ 27 forge-forward.org A SELF-HELP GUIDE TO HEALING AND UNDERSTANDING 2 Interpersonal problems _______________________________________________________ 28 Additional readings on the aftereffects of sexual assault and/or trauma ___________ 30 Transgender Survivors of Sexual Abuse ______________________ 32 Sexual violence statistics and myths ___________________________________ 32 Being too young and/or feeling responsible _____________________________________ 33 Not understanding that “sexual assault” encompasses what happened to them _________________________________________ 34 Being male and/or having a female perpetrator _________________________________ 34 Experiencing additional complications due to gender identity or politics ___________ 35 Wanting to deny or avoid thinking about the trauma _____________________________ 35 Transgender sexual violence survivors data __________________________ 36 Most transgender survivors have experienced repeated sexual violence ___________ 36 Most transgender people were first assaulted as a child or youth _________________ 36 Most perpetrators were known to the victim ____________________________________ 37 More than a quarter of transgender survivors have been assaulted by females _____ 37 Gender is sometimes perceived to be the motivator of abuse ____________________ 38 Survivors rarely report the abuse ______________________________________________ 38 The abuse can leave physical scars ____________________________________________ 38 Emotional scars can last a very long time ______________________________________ 39 Relationships are heavily impacted ____________________________________________ 40 Survivors often partner with other sexual assault survivors _______________________ 41 Trans survivors access many types of help _____________________________________ 42 Trans-specific aspects of sexual assault ______________________________ 43 Anti-trans abuse or sexual abuse? _____________________________________________ 43 Cause and effect _____________________________________________________________ 43 Trans bodies and body dysphoria ______________________________________________ 45 Not being believed or minimizing the assault(s) _________________________________ 45 Transgender perpetrators _____________________________________________________ 46 Service provider perpetrators _________________________________________________ 47 Meeting complex needs within a basic service system ___________________________ 48 Complicated relationship with therapists _______________________________________ 49 forge-forward.org A SELF-HELP GUIDE TO HEALING AND UNDERSTANDING 3 Intersectionality ______________________________________________________________ 50 Options for Healing _____________________________________________________ 51 Talk therapy _________________________________________________________________ 51 Medication __________________________________________________________________ 52 Additional readings on medications ________________________________________ 52 Body-based therapies ________________________________________________________ 52 Additional readings on alternative therapies _________________________________ 53 Movement-based therapies ___________________________________________________ 54 Other “alternative” therapies __________________________________________________ 54 Faith-based support__________________________________________________________ 55 Peer-to-peer help ____________________________________________________________ 56 Mainstream and LGBT Services _________________________________________ 57 LGBT anti-violence programs (AVPs) ___________________________________________ 57 State sexual violence coalitions _______________________________________________ 57 National sexual assault hotline ________________________________________________ 58 Rape crisis hotlines or community rape treatment centers _______________________ 58 Sexual assault treatment centers, sexual assault nurse examiners, and hospitals ________________________________________________ 58 Sexual assault response teams (SART) or coordinated community response (CCR) _______________________________________ 59 Victim assistance programs ___________________________________________________ 59 Victim compensation _________________________________________________________ 59 LGBT community centers _____________________________________________________ 59 Support groups ______________________________________________________________ 60 Therapy _____________________________________________________________________ 60 Restraining orders ___________________________________________________________ 60 Law enforcement ____________________________________________________________ 60 Trans support groups _________________________________________________________ 61 12-step programs ____________________________________________________________ 61 Suicide hotlines and support __________________________________________________ 61 FORGE Services____________________________________________________________ 62 For Survivors ________________________________________________________________ 62 forge-forward.org A SELF-HELP GUIDE TO HEALING AND UNDERSTANDING 4 For Providers ________________________________________________________________ 63 Self-Help Techniques and Concepts ____________________________ 65 Healing is hard work _________________________________________________________ 66 Techniques for coping with strong emotions _______________ 68 Getting out of the basement _____________________________________________ 68 Breathing ____________________________________________________________________ 69 90 seconds __________________________________________________________________ 69 Getting moving / getting physical _______________________________________ 70 Using your voice ___________________________________________________________ 70 Cross brain actions ________________________________________________________ 71 Checklists ___________________________________________________________________ 71 Use technology _____________________________________________________________ 71 Emergency Standard Operating Procedures (SOP) __________________ 72 Techniques, exercises and concepts for healing __________ 76 Container exercise _________________________________________________________ 76 Coping with anniversary dates __________________________________________ 77 Coping with triggers _______________________________________________________ 80 Triggers: Dialogues _______________________________________________________ 80 Triggers: Coping via a “series of tasks” _____________________________________ 81 Additional readings on coping with triggers _________________________________ 83 Making meaning _____________________________________________________________ 83 Additional readings on making meaning ____________________________________ 84 Mindfulness and meditation ___________________________________________________ 84 Additional readings on mindfulness as a healing tool _________________________ 86 Resourcing __________________________________________________________________ 87 Sexuality _____________________________________________________________________ 87 forge-forward.org A SELF-HELP GUIDE TO HEALING AND UNDERSTANDING 5 Additional readings on sexuality _______________________________________________ 89 Breath training _____________________________________________________________ 90 Emotions and healing _____________________________________________________ 91 The five stages of emotions ___________________________________________________ 91 Being witnessed in your emotions _____________________________________________ 93 Additional readings on emotional regulation _________________________________