International Journal of Coercion, Abuse, and Manipulation Volume 9 2026 4
formally, and 31% of those were wrongfully arrested
instead of their abusers (NCAVP, 2016).
The phrase “intimate partner violence” has
traditionally carried cisnormative implications,
leading to the exclusion of TGD individuals in IPV
research. Consequently, survivors of T-IPV often
struggle to recognize their experiences as abuse or
hesitate to identify the violence they face because it
does not align with the typical cisgender, heterosexual
narrative of IPV (Dolan &Conroy, 2021 Kurdyla
et al., 2021). Furthermore, mental health outcomes
associated with T-IPV differ from those traditionally
studied in cisgender relationships (Henry et al., 2021
Peitzmeier et al., 2021 Scheer &Poteat, 2021). One
study revealed that 72% of TGD adults surveyed had
encountered at least one form of IPV in their lifetime,
with significant correlations found between abuse and
increased levels of anxiety and depression, especially
for victims of sexual IPV (Henry et al., 2021). The same
study, utilizing the Satisfaction with Life Scale (SWLS),
reported that TGD survivors were less likely to report
life satisfaction and faced higher risks of enduring
emotional distress and mental health issues.
The negative mental health outcomes frequently
observed among T-IPV survivors are further intensified
by inadequacies in treatment, such as unequal services
in victim support. For instance, trans women are 2.44
times more likely to receive disparate treatment after
experiencing violence (NSVRC, 2019). Considering
additional factors like unequal access to resources,
inadequate medical care, identity documentation
issues, internalized and externalized transmisia,
dysphoria, institutional betrayal, revictimization,
and other exacerbating aspects unique to T-IPV that
survivors face, the disparity in the study and treatment
of mental health outcomes between experiences with
cis-IPV and T-IPV becomes increasingly evident
(Beyer et al., 2022 Kurdyla, 2023 Seelman, 2015).
TGD victims report IPV less frequently than cisgender
victims, mainly due to potential consequences like
lack of protection, being outed, or institutional
betrayal (NCAVP, 2016). Additionally, survivors face
violence from institutions such as law enforcement
in 2022, 58% of TGD victims reported mistreatment
by police (NSVRC, 2019). Other factors like disability,
homelessness, and past transmisia further affect
reporting behaviors (Kurdyla, 2023). Formal reporting
poses serious risks for TGD individuals, often resulting
in denial of help or resources, underscoring the need
for inclusive screening and intervention practices
(Valentine et al., 2017).
Current Trauma-Informed Care for T-IPV
As it stands, many of the current trauma care models for
T-IPV survivors are informed by cis-heteronormative
language and assumptions, which limit effectiveness
by failing to address the unique relational, systemic,
and identity-based traumas TGD individuals face.
Many models focus on acute, event-based harm (e.g.,
physical or sexual violence) but can often neglect to
examine the complex, chronic relational trauma that
T-IPV survivors frequently experience. Recognizing
the longevity and complexity of interpersonal trauma
is crucial in working with this population, due to TGD
individuals facing compounding systemic invalidation
and relational betrayal not only from partners but also
from institutions meant to protect them (Goode, 2023
Dolan &Conroy, 2021).
Survivors often face coercive control reinforced by
systemic barriers—such as housing insecurity, police
mistrust, and lack of legal protections—yet many trauma
models often focus on individual healing without
addressing these structural entrapments or relational
complexity (Momen &DeKeseredy, 2020 Marrow et
al., 2024). Furthermore, these systemic factors play a
part in upholding and perpetuating identity-based
violence, which many trauma frameworks do not
explore or acknowledge. Deeper insight and analysis
of systemic factors is crucial in trauma work with TGD
individuals, as survivors are routinely misgendered,
denied services, mistreated during forensic or medical
exams, or excluded from shelters (Seelman, 2015
Kattari et al., 2020).
Despite their strengths, even the most progressive
models commonly do not offer critiques of cis-
heteronormative influences, do not explore the
necessity of building relational safety and resilience, do
not include survivor-led interventions or narratives,
and do not integrate community-based or peer-led
care, which many T-IPV survivors find more affirming
than institutional services (James et al., 2016 Scheer
&Poteat, 2021 Singh &Moss, 2016). Together,

5
Ruby Cramer and Sarah Stillwell |SINCERE: A Relational Safety Model for Counselors
these gaps reveal a pressing need for trauma care
models that are not just inclusive in language, but
transformative in practice—grounded in relational
safety, intersectionality, and survivor-led wisdom.
Clinical Competency for Working with T-IPV
Mental health professionals are the second most
common resource sought by TGD survivors of
violence, following assistance from close friends (James
et al., 2016 Scheer &Poteat, 2021). Around 39.5% of
these survivors prefer seeking help from mental health
services instead of law enforcement, medical experts,
or hotlines (Kurdyla et al., 2021 Kattari et al., 2020).
Due to the significant level of trust placed in counselors
by this group compared to other healthcare providers,
counselors are in a unique position to detect signs of
abuse and intervene when clients are experiencing
or at risk of violence. Consequently, counselors hold
a crucial role in addressing violence against the TGD
community. Counseling professionals must understand
the complexities and characteristics of the population to
be competent in creating trans-inclusive IPV screening
instruments and trauma-informed intervention and
prevention strategies (Peitzmeier et al., 2021).
Recent studies highlight the importance of client-
centered, trauma-informed care for TGD violence
survivors (Kattari et al., 2020). Mental health providers
are often the second responders in crises involving
TGD clients (James et al., 2016 Scheer &Poteat,
2021). Those who perceive high levels of trauma-
informed care report greater empowerment, support,
emotional regulation, social connection, and physical
wellness (Scheer &Poteat, 2021). Conversely, low
perceived trauma-informed care correlates with social
withdrawal, isolation, shame, and reduced well-being
(Scheer &Poteat, 2021). This underscores the need for
counselors to develop multicultural competence and
trauma-informed approaches.
To work effectively with TGD survivors of IPV,
clinicians must develop a robust set of competencies
that extend beyond general trauma-informed care.
This includes proficiency in identity-affirming
practice, intersectional case conceptualization, and
systemic advocacy. The Sexual, Affectional, Intersex,
and Gender Expansive Identities (SAIGE) Counseling
Competencies for Working with Transgender Clients
provide a foundational framework, emphasizing
the importance of understanding gender identity
development, recognizing the impact of transmisia
and institutional betrayal, and integrating culturally
responsive interventions. Clinicians should also be
familiar with the World Professional Association for
Transgender Health (WPATH) Standards of Care,
which outline best practices for supporting TGD
individuals across medical and mental health domains
(Coleman et al., 2022). Competency in this context
means more than knowledge it requires attunement
to the lived realities of TGD survivors, the ability to
navigate complex identity-based trauma, and the
commitment to co-create therapeutic spaces that
foster safety, agency, and resilience. Without these
competencies, clinicians risk replicating the very
systems of harm that survivors are seeking refuge from.
Addressing Bias, Malpractice, and Stigma
Stigma—whether institutional, interpersonal, or
internalized—has profound and compounding
consequences for TGD survivors of IPV. For mental
health clinicians, addressing stigma is not only a clinical
imperative but an ethical responsibility. Survivors often
navigate systems that invalidate their identities, deny
them access to affirming care, or actively retraumatize
them through misclassification, misgendering, or
wrongful arrest (James et al., 2016 Kurdyla, 2023
NCAVP, 2016). These experiences of institutional
betrayal can reinforce the abuser’s control and deepen
the survivor’s sense of isolation and hopelessness
(Peitzmeier et al., 2021 Scheer &Poteat, 2021).
Interpersonal stigma within clinical relationships—
such as pathologizing gender identity, minimizing
abuse, or failing to broach identity—can result in
malpractice and further psychological harm. Survivors
may internalize these messages, leading to shame, self-
doubt, and reluctance to seek future support (Beyer
et al., 2022 Kussin-Shoptaw et al., 2017). Clinicians
must be vigilant in recognizing how their own biases,
assumptions, and cultural positioning may impact the
therapeutic alliance. This includes critically examining
how cisnormative frameworks, diagnostic tools,
and treatment models may inadvertently exclude or
misrepresent TGD experiences.
To mitigate these harms, clinicians should integrate