8.1 Violence against women

Violence against women is a pervasive issue affecting millions worldwide. It takes many forms, including physical, sexual, and psychological abuse, as well as economic exploitation and harmful cultural practices. These acts stem from gender inequality, societal norms, and various socioeconomic factors.

Addressing violence against women requires multi-faceted strategies. Prevention efforts, survivor-centered approaches, and batterer intervention programs show promise. However, the long-term consequences of such violence on physical and mental health underscore the urgent need for effective interventions and support systems.

Forms of Violence Against Women

Physical, Sexual, and Psychological Abuse

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• Violence against women encompasses a wide range of abusive behaviors and acts, including physical abuse (hitting, kicking, or using weapons), sexual abuse (forced sexual activity or unwanted sexual contact), and psychological abuse (threats, humiliation, or isolation from friends and family)
• Intimate partner violence (IPV) is a pattern of abusive behavior in any relationship used by one partner to gain or maintain power and control over another intimate partner (physical violence, sexual violence, stalking, or psychological aggression)
• Sexual violence refers to sexual activity when consent is not obtained or freely given, and it is a form of sexual abuse (attempted or completed forced penetration, unwanted sexual contact, or non-contact unwanted sexual experiences)
• Psychological abuse involves trauma to the victim caused by acts, threats of acts, or coercive tactics (humiliating the victim, controlling what the victim can and cannot do, or isolating the victim from friends and family)

Economic Abuse, Harassment, and Exploitation

• Economic abuse involves controlling a victim's ability to acquire, use, and maintain economic resources, perpetuating the victim's dependence on the abuser (withholding money, sabotaging employment opportunities, or running up debt in the victim's name)
• Sexual harassment is unwelcome sexual advances, requests for sexual favors, and other verbal or physical harassment of a sexual nature in the workplace or learning environment (inappropriate touching, sexually suggestive comments, or display of sexually explicit materials)
• Human trafficking involves the use of force, fraud, or coercion to obtain labor or commercial sex acts. Women and girls are disproportionately affected by sex trafficking (forced prostitution, sexual exploitation, or domestic servitude)
• Female genital mutilation/cutting (FGM/C) involves the partial or total removal of external female genitalia for non-medical reasons, and it is a form of violence against girls and women (typically performed on young girls between infancy and age 15)

Factors Contributing to Violence Against Women

Gender Inequality and Harmful Cultural Norms

• Gender inequality and traditional gender norms that support male superiority and entitlement contribute to an environment that accepts violence against women (belief that men have the right to control women or that women are subordinate to men)
• Societal norms that support violence as an acceptable way to resolve conflicts contribute to the persistence of violence against women (notion that violence is a private family matter or that victims are responsible for their own abuse)
• Cultural and social norms related to male honor can lead to violence against women (honor killings of women who are perceived to have brought shame to their families or FGM/C as a rite of passage)

Socioeconomic Factors and Exposure to Violence

• Poverty and lack of economic opportunities for women can increase their vulnerability to violence and exploitation (human trafficking, transactional sex, or staying in abusive relationships due to financial dependence)
• Lack of legal sanctions and impunity for perpetrators of violence against women can contribute to an environment that tolerates abuse (inadequate laws, weak law enforcement, or cultural attitudes that blame victims)
• Exposure to violence in childhood, either as victims or witnesses, can increase the likelihood of future perpetration or victimization (intergenerational cycle of violence or learned behavior)
• Substance abuse, particularly alcohol abuse, is a risk factor for the perpetration of violence against women (increased aggression, impaired judgment, or using substance abuse as an excuse for violent behavior)

Effectiveness of Intervention Strategies

Prevention Strategies at Different Levels

• Primary prevention strategies aim to prevent violence before it occurs by addressing the root causes and risk factors for violence (challenging harmful gender norms, promoting gender equality, or providing education on healthy relationships)
• Secondary prevention strategies focus on early identification and intervention for individuals at risk of experiencing or perpetrating violence (screening for intimate partner violence in healthcare settings or providing support services to at-risk populations)
• Tertiary prevention strategies aim to provide support and services to survivors of violence and hold perpetrators accountable to prevent future violence (crisis intervention, legal advocacy, or batterer intervention programs)

Multi-Sectoral Approaches and Survivor-Centered Practices

• Comprehensive, multi-sectoral approaches that engage various stakeholders are more effective in preventing and responding to violence against women (collaboration between healthcare providers, law enforcement, community organizations, and educational institutions)
• Bystander intervention programs teach individuals how to safely intervene when they witness situations that could lead to violence and have shown promise in reducing violence against women, particularly in college settings (teaching skills to recognize warning signs, safely interrupt situations, and support survivors)
• Survivor-centered approaches prioritize the rights, needs, and wishes of survivors in all aspects of service delivery and ensure that survivors have access to comprehensive support services (empowering survivors to make their own decisions, respecting their choices, and providing a range of services to meet their needs)
• Batterer intervention programs aim to hold perpetrators accountable and change their abusive behavior, but the effectiveness of these programs is mixed and depends on factors such as program length and content (cognitive-behavioral therapy, developing empathy for victims, or teaching non-violent conflict resolution skills)

Long-Term Consequences of Violence

Physical Health Consequences

• Violence against women can result in a range of physical health consequences (injury, chronic pain, gastrointestinal disorders, sexually transmitted infections, or gynecological problems)
• Intimate partner violence during pregnancy is associated with adverse maternal and fetal outcomes (low birth weight, preterm delivery, or maternal mortality)
• Sexual violence can lead to unwanted pregnancies, unsafe abortions, and an increased risk of sexually transmitted infections, including HIV
• The chronic stress associated with experiencing violence can have long-term effects on the cardiovascular, immune, and endocrine systems, increasing the risk of chronic health conditions (heart disease, autoimmune disorders, or hormonal imbalances)

Mental Health and Intergenerational Effects

• Violence against women is associated with an increased risk of mental health problems (depression, anxiety, post-traumatic stress disorder (PTSD), or suicidal behavior)
• The psychological consequences of violence can persist long after the abuse has ended and can affect survivors' ability to function in various aspects of their lives (work, relationships, or parenting)
• Survivors of violence may cope with the trauma through substance abuse, which can further exacerbate physical and mental health problems (alcohol or drug dependence, overdose, or increased risk of revictimization)
• Experiencing violence can also have intergenerational effects, as children who witness or experience violence are more likely to experience or perpetrate violence as adults (learned behavior, trauma response, or difficulty forming healthy relationships)