You are missed–personally and professionally–every day.
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Two Years
The Center for Victim Research is hosting a webinar, Insights from the NCVS Data for the Victim Assistance Field: Who Might We Be Missing? The session will be held May 30th at 2pm. From the announcement:
A major goal of the Center for Victim Research is to develop a community of victim service providers and researchers to improve practice through the effective use of research and data. This webinar will focus on how data from the National Crime Victimization Survey (NCVS) can help inform the victim service community about victimization patterns and service needs among different groups in the population. The NCVS is the nation’s primary source of information on criminal victimization, representing the self-reported victimization experiences of survivors 12 and older across the United States. Though the NCVS data is publicly available, it is difficult for those without training to do their own analysis, including in pursuit of information not easily answered through annual NCVS reports (e.g., looking at victims and related needs intersectionally, considering multiple characteristics at once).
Presenters will share findings from the NCVS about who is at greatest risk for violence and the use of victim services. Special emphasis will be placed on issues of race, ethnicity, gender, age, poverty, access to services, and the impact of victimization, especially at a time when historic funding levels and increased flexibility make data-driven strategies for return on investment in victim assistance as critical as ever.
Webinar participants will have the opportunity to ask questions about the data and how they might be used to inform their research and practice.
Register here.
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10 Things: Ethiopia
Last week, Sasha and I were fortunate enough to have been invited to teach for several days on responses to gender-based violence for the US embassy in Ethiopia (Russ Strand was the 3rd member of our party, and taught on our day off). I spend a great deal of time traveling, both domestically and internationally, but this was my first time in Africa, and I went without any preconceived ideas about what we would experience. Although the trip was relatively brief (we spent only 4 days on the ground), I felt like I was able to see quite a bit of Addis Ababa. If you have any interest whatsoever, please keep reading. Otherwise, come back tomorrow for regular FHO programming.
- Addis Ababa is more than 7700′ in elevation, making the weather in May relatively cool, dry and honestly, not what I expected. It was lovely, and Sasha and I spent each evening sitting outside having drinks or dinner at our hotel, which was a welcome respite from the general chaos of the city. Addis is crowded and sprawling–traffic is impressive and that’s coming from someone who lives in the city with some of the worst traffic in the US. The streets weren’t just crowded with cars, but with people, and without a clear sense of traffic laws or signals. By the time we got back each evening, the idea of venturing back out wasn’t particularly appealing, so adventures were saved for the couple of unscheduled days we had in the city, where both time and the ability to safely negotiate the regulated yellow cabs (as opposed to the unregulated blue cabs and vans, from which we were warned away) was simpler. Addis doesn’t have the kind of violent crime that many countries are known for, but muggings and pickpocket-type crimes are prevalent, and because of what we do for a living, we are probably more vigilant than most. So safety was always on our minds, and we moved around the city accordingly. Most ex-pats we met had stories of having their wallets lifted in some fashion or another, but thankfully we did not run into any issues.
- The focus of the conference was on eradicating GBV in Ethiopia, but until we showed up on Day One, it wasn’t clear who our audience would be, or even what the true goal of the conference was, as it was the first time any embassy had hosted something like this. We went with the impression that our predominant audience would be embassy personnel (healthcare providers, security staff, etc.) with some local professionals also invited. In truth, there were very few embassy personnel and the audience was overwhelmingly local professionals. This made for incredibly rich discussion but required us to shift our plan for teaching on the fly. We had local law enforcement, prosecutors, physicians, victim advocates, UN personnel, and a variety of other individuals. Our sessions were simultaneously translated into Amharic, the local language, although the majority of participants also spoke English. We covered a pretty broad range of topics during the two days that Sasha and I taught, including female genital mutilation/cutting; identifying and addressing IPV in the healthcare setting; injury in sexual assault cases; strangulation assessment; and corroboration in sexual assault. I honestly don’t know how effective the lectures were, but the conversations they spurred felt incredibly valuable.
- As is the case in the US, if you want to know the breadth of what is happening, ask the victim advocates. No one has a better sense of the realities for victims, and we saw this dynamic repeatedly during our time in Ethiopia. At one point I was having a discussion with the group about strangulation assessment and the physicians were politely listening, but they let me know that this wasn’t something they saw frequently in Ethiopia. The UN personnel mentioned that acid attacks were perhaps something that should garner greater attention than strangulation. But the victim advocates stepped in and made it clear that they heard about strangulation over and over again from victims, which surprised many in the room. That multidisciplinary conversation was impactful, and shared perspective made for some great dialogue during our time with the group. And the advocates, as we so often see in the US, seemed to have the fullest picture.
- We met many, many remarkable professionals in our short time there, but none more so than Maria Munir, who started the
first shelter for rape and domestic violence victims in Ethiopia. The things she has accomplished are impressive, and we were so privileged to see her work in action on our last day when we were invited to visit the shelter. We met (and danced) with many of the teens and preteens, were treated to a traditional coffee and sweet made by some of the residents and staff and received a tour of the facilities. If I had done nothing else, the trip would have been worth it for that visit alone. Their shelter educates the children who live there, provides skills training for the women before they leave to live independently (we received beautiful scarves made by them), provides a huge range of healthcare, including deliveries, for the residents, and has on-site counseling services, child care services and pretty much anything else you could imagine being offered by a small village of dedicated women. You can read more about Maria and her amazing work here. - To prepare for the trip we followed all recommended CDC guidelines for travel in Ethiopia (with the exception of malaria, because we were only in the city and it was still the dry season). That meant all the immunizations, water and food precautions, and traveling pharmacy for emergencies. Knock wood, we seem to have managed without major issues, so good guidance all the way around.
- Many of you asked how public Sasha and I planned to be about our marital status. The answer is simple. Not public at all. We shared a hotel room, but we reverted back to our days living under Don’t Ask, Don’t Tell, and while it felt lousy to proceed in that fashion, compromising our safety or freedom would most definitely have felt worse. The embassy organizer was aware of our marital status, we took our advice from him, it ended up being fine. Not ideal, but our reality for the week was tolerable. And I was reminded of just how lucky I am that I get to live freely most days of my life, with a family that looks like mine, and not get hassled a whole lot for it. So yeah, it was what needed to be done. It was fine. My heart aches for the hundreds of thousands of people in this world who are not free to love like I get to.
- Sasha was a huge hit. Seriously, what did you expect?
- We identified more commonalities, and many issues felt more familiar than I think we expected. For instance, Ethiopia has several existing or planned “one-stops”, hospitals that essentially mirror the family justice center model with multiple services under one roof. One of the lectures during the conference was from a physician from Gandhi Hospital, the site of a one-stop (Facebook page), and their services mirrored many of the ones we also offer (no DNA testing, though–only two private labs in the country have the capacity to analyze, and they are prohibitively expensive). As Sasha was talking with the group about prosecuting these cases, many of the frustrations in the room about challenges in taking cases successfully to trial were similar to challenges we face in the US every day–consent, coercion, culture. Familiar.
- Shutting up and listening was the most effective thing I could do while I was there. And so I tried to do that as much as humanly possible. Our jobs were ultimately less about teaching and more about facilitating conversation and to that end, I hope we succeeded.
first shelter for rape and domestic violence victims in Ethiopia. The things she has accomplished are impressive, and we were so privileged to see her work in action on our last day when we were invited to visit the shelter. We met (and danced) with many of the teens and preteens, were treated to a traditional coffee and sweet made by some of the residents and staff and received a tour of the facilities. If I had done nothing else, the trip would have been worth it for that visit alone. Their shelter educates the children who live there, provides skills training for the women before they leave to live independently (we received beautiful scarves made by them), provides a huge range of healthcare, including deliveries, for the residents, and has on-site counseling services, child care services and pretty much anything else you could imagine being offered by a small village of dedicated women. You can read more about Maria and her amazing work 
10. My intention is to stay connected to the remarkable people that I met there–to Maria and her great good works; the physicians who are seeing enormous patient loads because there are too few providers for the population; to the various other professionals who have already reached out for protocols or slides or additional resources. The trip wasn’t an easy one, but it was extraordinary, and I have never met, collectively, a more welcoming, generous, hospitable people than those I met in Ethiopia. We came home with some great stories, an obscene amount of coffee, and burning desire to figure out how we can keep supporting the work happening there. So very lucky to have been able to go.
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Before I head out of the country for the week, I leave you with newly published data from the CDC’s National Intimate Partner and Sexual Violence Survey: 2015 Data Brief. There’s a lot of information to sort through, but a few highlights:
- In the U.S., over 1 in 3 (36.4% or 43.6 million) women experienced contact sexual violence, physical violence, and/or stalking by an intimate partner during their lifetime.
- In the U.S., about 1 in 3 (33.3% or 37.2 million) men experienced contact sexual violence, physical violence, and/or stalking by an intimate partner during their lifetime.
- Both women and men experience these forms of violence, but a greater number of women experienced several types of violence examined. For instance, during their lifetime, 1 in 5 women experienced completed or attempted rape; 1 in 6 women were stalked; and 1 in 4 experienced contact sexual violence, physical violence, and/or stalking by an intimate partner and reported some form of intimate partner violence-related impact.
Read the full data brief here.
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SAFEta and KIDSta have a webinar coming up next month, Differential Diagnosis in Pediatric Sexual Assault: Looking for the Zebra. The session will be held June 19th at 2pm ET. The session will be archived if you cannot attend live. From the registration:
Due to the well-documented acute and long-term negative health consequences associated with child sexual abuse, the medical forensic examination is an integral component of the coordinated community response to child sexual abuse. This webinar presentation will illustrate the differential diagnosis tree the clinician must consider when performing a prepubescent medical forensic exam or consulting when ano-genital injury has been identified. A review of normal pediatric anogenital anatomy, followed by case studies that include normal variants that can be mistaken for abuse, STI’s that may mimic trauma, straddle injury review, and traumatic injuries from sexual abuse.
Register here.
Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.
It’s time once again for Articles of Note, our (almost) monthly romp through the peer-reviewed literature. Somehow I missed April–sorry about that. Keep in mind this is not an exhaustive overview; simply a list of what is particularly interesting and relevant to my practice that I thought you might also find useful. There’s some really interesting stuff here–I hope you’ll spend time sorting through the abstracts and grabbing articles that speak to you. Active links lead to PubMed (no free full-text articles this month):
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Since Last We Spoke, 5-7-18
Friends, I am getting ready to embark on a really amazing professional adventure on Saturday, so it’ll be business as usual at FHO this week, and then it’ll be quiet here next week. I can’t share too many details until my return, but I will devote some real estate to the trip when I am back in the office. In the meantime, I have a new Articles of Note coming this week, and maybe another goodie or two. And of course, I was perusing the interwebs during quiet moments over the weekend; here’s what caught my eye since last we spoke:
Every Thing This Man Writes
How to complain so a partner will listen
Democrats aren’t the only women who care about #MeToo
Interesting op-ed about the loss of genetic privacy
In case you were hoping air travel could get worse
Consent is only one part of the conversation. Pleasure is another.
And finally, this week is National Nurses Week –a very happy one to all my friends and colleagues!
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More peds webinars coming up: the Tribal Forensic Healthcare Project is presenting Normal Variants in Pediatric Exams. The session will be held June 27th at 2pm ET. Diane Daiber and Kim Nash, both IAFN staff, will present the content. As with all webinars from this project, CEUs/CMEs are available. It will be archived if you cannot attend live. From the website:
This webinar presentation will illustrate the differential diagnosis tree the clinician must consider when performing a prepubescent medical forensic exam or consulting when ano-genital injury has been identified. A review of normal pediatric anogenital anatomy, followed by case studies that include normal variants that can be mistaken for abuse, STI’s that may mimic trauma, straddle injury review, and traumatic injuries from sexual abuse.
Register here.
Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.
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Since Last We Spoke, 4-30-18
Greetings to you all–as I write this I am sitting in a United Club getting ready to board a flight to Miami where I will be teaching most of the week with the Army. I’ve been looking forward to this week for some time, so while it’ll be mentally rigorous (as all new courses are), it barely feels like work. Just a reminder I am still looking for folks who fit the criteria I outline in this post–I heard from a few of you, but not nearly as many as I had hoped. Please, people, visibility is important; diversity is a necessity if we are going to have national level projects that truly speak to the full breadth of patients we serve. FHO readership has always been exceedingly shy–but I am asking you to use this platform to show off your practice. Readers are more interested than you realize (I know from the dozens of emails I did get from people telling me they loved the idea). I will also be knocking on some virtual doors, but I would love to highlight new voices in particular–folks who have yet to step onto a national stage. Hit me up–I know you’re out there. And thanks to those of you who already have–I haven’t been ignoring you. Just getting my proverbial s%^& together.
And now, here’s what’s caught my eye since last we spoke:
Proud to have called AEQ my home for a time
Not an easy read but a good one
C’mon, NFL
C’mon, Nike
I’m having trouble wrapping my head around the outrage at her jokes, but not his conduct.
I’ll be in Montgomery next week and hope to be able to take a couple hours to visit
I love what this technology has meant for people with disabilities
This causes so much rage in me. The entitlement…
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Midwest Regional Children’s Advocacy Center has a webinar coming in June, It Really Is “Normal to be Normal” in Child Sexual Abuse. The session will be held June 28th at 1pm CT. I’m posting this pretty early, so hopefully, people will be able to make it, but they archive their sessions, so no worries if you have a conflict. From the website:
Brief Overview: A child abuse pediatrician will describe the medical evaluation for a child suspected of having been sexually abused with emphasis on why physical and laboratory findings are often absent. Reasons why children typically delay disclosure will be presented with accompany published references. Strategies and techniques for court preparation when a case of suspected child sexual abuse with a normal€ exam is being presented for civil hearing or criminal trial will also be discussed. Resources and literature references will be provided for the attendees.
Expert Presenter: Karen Farst, MD, MPH, is a child abuse pediatrician at Arkansas Children’s Hospital. She is an associate professor in the College of Medicine, Department of Pediatrics, at the University of Arkansas for Medical Sciences (UAMS) and director for the university’s Center for Children at Risk. She is a past president of the National Children’s Alliance Board of Directors. She earned her B.A. and M.D. from Texas Tech University and then completed a residency in internal medicine and pediatrics at UAMS. Following a child abuse fellowship at Cincinnati Children’s Hospital, she completed a Masters of Public Health from Fay Boozman College of Public Health at UAMS.
Register here.
Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.
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Since Last We Spoke, 4-23-18
Greetings, dear readers. Always best intentions when I’m on the road, but some jobs are simply not conducive to posting. Sorry to have missed everyone these last couple weeks. I’m back in the office this week, though, and hope to get caught up. Before I do that, here are a few things that caught my eye since last we spoke:
Loved everything about this
Good guy, no gun
Women veterans, IPV and homelessness
Watching a movement catch fire in real time
Badass, indeed
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Since Last We Spoke, 4-9-18
Good morning from Ft Hood, Texas. For the next two weeks, postings will be somewhat light–I leave here and head straight to Italy for more work, and then on to Cleveland (for the kid’s spring musical), so please bear with me. I will miss everyone at this year’s Leadership and Lobby Days, but I am certain it will be a great success. Confession–the migraines have been crushing as of late, so I didn’t spend a ton of time online this weekend, but here’s what caught my eye since last we spoke:
Sadness: this was the source of much of my education as a kid, and one of the reasons I ended up doing what I do today
Another man mansplaining #MeToo
Must read: the legacy of childhood trauma
This was Twitter gold
So true (as I get very close to 50 this year)
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In the latest issue of Free Range Thinking (PDF), Andy Goodman references a recent issue brief from the Hollywood Homeless Youth Partnership, Navigating the Ethical Maze: Storytelling for Organizations Working with Vulnerable Populations (PDF). I post about it here because many of us include survivor stories in the work we do–as a way to help funders see the real world impact of our work as we attempt to garner program support, or as a component of trainings and educational opportunities so that clinicians understand the consequences of our interactions with patients. While this piece doesn’t focus completely on our issue (there is a great deal of overlap), there is much to be considered in the brief. Worth your time.
BTW, NSVRC has a storytelling series that starts next week–if you’re interested in this subject and want to explore it in greater depth, I encourage you to check out their 4 webinars (space is limited, but they will all be archived):
Session One: Thursday April 12, 2018 @ 1-2pm Eastern
Introduction to the Value of Personal Storytelling for Sexual Violence Intervention
Session Two: Thursday May 10, 2018 @ 1-2pm Eastern
Understanding a Trauma-Sensitive Approach to Storytelling
Session Three: Thursday June 14, 2018 @ 1-2pm Eastern
A Review of Ethics Guidelines for Working with Sexual Violence Stories
Session Four: Thursday July 12, 2018 @ 1-2pm Eastern
Publicly Sharing Stories to Effect Change
(Register for the webinars here)
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Since Last We Spoke, 4-2-18
Happy Easter and Passover to all of you who celebrate–we hosted a lovely seder last night filled with great food and lots of laughter and love. We were 11 in my little house; crowded, but wonderful. A note for this week–posting will be light this week, as I will be in NYC looking at colleges with the girlchild. I love these trips and intend to relish every moment with the kid, so no computer for the bulk of the week. However, before I leave, here’s what caught my eye since last we spoke:
Black students at MSD want their voices heard too
The folks at Monster Energy have a serious sexual harassment problem
Ugh–were you a Ren and Stimpy watcher?
March 31st was the Transgender Day of Visibility
Also.
Confronting the Native Harvey Weinsteins
I can’t believe it took so long to pass this law
In China, women are using emojis to talk openly about harassment
My wife and I had a good laugh over this–and agree
Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.
IAFN is offering a free webinar next month, Drug Facilitated Sexual Assault. the session will be held April 25th at 2pm ET. From the website:
This webinar will define DFSA. It will review the drugs used, their signs and symptoms and prevalence. It will present details about specimen collection and will present the latest (2017) SOFT guidelines for laboratory analysis in DFSA cases.
Presented by: Teri Stockham, Ph.D.
Dr. Teri Stockham is a respected consultant, author and lecturer in the field of forensic toxicology. Over the past three decades, she has gained extensive education, training and experience both in the laboratory and the courtroom. The three degrees Dr. Stockham earned have all been focused in the specialty of forensic toxicology. She holds a Ph.D. from the Medical College of Virginia, and a Master’s degree from The George Washington University. She graduated Magna Cum Laude from Indiana State University. Her laboratory training, including the role as Chief Toxicologist for Broward County, Florida, complements her education and expertise. Dr. Stockham is experienced on the witness stand and has testified hundreds of times.
Dr. Stockham serves as a consultant to a number of law firms, providing her expertise for various court cases involving personal injury, insurance defense, probation/parole, court martial, DUI, workers compensation, child custody and drug-facilitated sexual assault. Her forensic toxicology services have encompassed a large number of clients who represent insurance companies, individuals, government agencies and healthcare providers.
Register here.
Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.
The Tribal Forensic Healthcare project has a webinar coming up, Developing a SART in Indian Country. It’ll be held April 18th at 3pm ET. All of their webinars are archived; CEUs/CMEs are available. From the site:
American Indian and Alaska Native women are raped at rates higher than any other race. Despite the alarming rates, sexual assault is still the most underreported crime. In response to this crisis occurring in Indian Country, tribal nations have been developing culturally appropriate programs and adapting existing response models to create appropriate responses to sexual assault. One such model is the Sexual Assault Response Team (SART). SART establishes a multidisciplinary team that collaborates to create a coordinated response to sexual assault. Presenters will share their experiences, challenges, successes and the importance of developing practices and protocols that are responsive to the immediate needs of adult victims of sexual assault victims and overall benefits to the criminal justice response.
Register for the session here.
Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.
Saturday was the remarkable March for Our Lives, and I am so grateful I could be a part of it. My daughter (plus a bestie), her dad, and his wife all came into town to participate. Truly, it was an epic day. We were down there early enough to be relatively close to the main stage, and the energy of the event was indescribable. From the first notes of Andra Day’s Rise Up, which kicked off the event, to the inspiring speeches by young people from around the country, I have never been prouder to be part of a crowd of 800,000 people (actually I’ve never been part of a crowd of 800,000 people, so). So today’s post is everything I saw and read since last we spoke (warning–there’s some redundancy amongst the links):
The editorial staff of MSD took over the Guardian; here’s their manifesto for change
Trauma and anxiety in the aftermath of gun violence (actually, it’s worth checking out all of Teen Vogue, because they are making it happen right now)
The loudest silence in the history of protest
The most powerful moments of the march
The 6 most powerful speeches of the March
Possibly the most punk rock moment of the event (I will never pretend away my nerves before speaking again)
From our local community newspaper: Naomi Wadler, remember that name.
Rick Santorum got dragged by ED and trauma clinicians on Twitter after his unhelpful advice for students
My daughter and her friend, Dylan:
If you’d like to see more of my photos, you’ll find them over on my Instagram…
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It’s rare that I post a single research article, but when the subject is one that rarely appears in the literature, it’s worth highlighting. So it is with this one, Intimate Partner Violence Among Transgender Youth: Associations with Intrapersonal and Structural Factors. It’s currently available free, full-text online ahead of print, so I would encourage you to download it now while it’s as accessible as it is (for those of you without library access to this particular journal). From the abstract:
Structural results found that TGNC youth experiencing extreme victimization, a history of incarceration, and participation in sex work were much more likely to report IPV. The only intrapersonal variable that was associated with IPV was depressive symptomatology; however, this relationship was strong, with participants being nearly eight times more likely to report IPV if they experienced symptoms of depression. Gaining a better understanding of the complexity of both structural and intrapersonal factors among TGNC youth will greatly inform the development of IPV prevention and services for TGNC youth experiencing this type of violence.
View the full table of contents and abstracts from the current issue of Violence and Gender.
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(Apologies for the delayed notice on this one, but it just came across my desk)
Battered Women’s Justice Project has an upcoming webinar, Promising Strategies and Practices in Medical Forensic Compliance. The session will be held March 29th at 2pm CT. They archive their webinars, so if you can’t make it for the live session you should be able to find it online afterward. From the website:
This webinar will outline the key components of medical forensic compliance and what a compassionate and competent response to victims/survivors can look like. Challenges that many communities face with medical forensic compliance will be explored such as medical forensic exam access and quality, kit storage and testing, and statewide coordination issues. We will share what we have learned through our Statewide Medical Forensic Policy Program and some promising strategies and practices in medical forensic compliance.
PRESENTERS:
Caroline Palmer, Public and Legal Affairs Manager, Minnesota Coalition Against Sexual Assault and Jude Foster, Statewide Medical Forensic Policy Program Coordinator, Minnesota Coalition Against Sexual Assault.
Register here.
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Since Last We Spoke, 3-19-18
Let’s see how this week will go, shall we? It’s started off on the crappier side, what with the immunization-induced malaise I’m currently rocking in anticipation of some overseas travel coming up in May. But I will be on the Hill tomorrow for a tick, and my kiddo is coming in for #MarchForOurLives on Friday, plus some reasonably fun work projects over the next couple days, so I have high hopes that the week gets better from here. Sasha was gone Sunday so I worked a good portion of the weekend. Still had a bit of time to surf, though. Here’s what caught my eye since last we spoke:
People with disabilities have been left out of the conversation
Abortion is safe, so says a landmark study
The lack of media coverage around this case is troubling
Woke America and Great America can learn from each other
More on the benefits of exercise
Maybe next time don’t joke about domestic violence
My favorite place to procrastinate has a great partnership with Time’s Up (and you, too, can record stories of your own)
Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.