Science-based guidance for women for their bodies
If you or someone you know is in immediate danger, call emergency services:
US: 911 | UK: 999 | Australia: 000
National Domestic Violence Hotline (US): 1-800-799-7233
1800RESPECT (Australia): 1800 737 732
National Domestic Abuse Helpline (UK): 0808 2000 247
The World Health Organization defines intimate partner violence as "any behavior within an intimate relationship that causes physical, psychological, or sexual harm to those in the relationship." This encompasses current and former spouses, dating partners, and cohabiting partners regardless of legal marital status.
Physical Violence: Hitting, kicking, slapping, choking, burning, use of weapons, or any intentional use of physical force causing injury, harm, or death
Sexual Violence: Forced sexual intercourse, unwanted sexual contact, sex trafficking, sexual coercion, or any sexual act committed without consent
Psychological Violence: Humiliation, intimidation, isolation from family and friends, stalking, threats, emotional manipulation, and control tactics
Economic Violence: Controlling access to financial resources, preventing employment, hiding assets, or sabotaging financial independence
Non-partner sexual violence includes rape, sexual assault, unwanted sexual contact, and sexual harassment perpetrated by acquaintances, strangers, or institutional figures. This category encompasses campus sexual assault, workplace harassment, and violence by authority figures including healthcare providers, teachers, or religious leaders.
Legal definitions of sexual violence vary significantly across jurisdictions, but medical professionals utilize standardized criteria for documentation and treatment. The CDC defines sexual violence as "sexual activity when consent is not obtained or not given freely," encompassing situations involving force, threats, coercion, or when the victim cannot consent due to age, disability, illness, or substance use.
The most comprehensive global data comes from the World Health Organization's multi-country study and subsequent systematic reviews, revealing that intimate partner violence affects women across all regions, cultures, and economic strata.
Intimate partner violence prevalence varies significantly across WHO regions, reflecting complex interactions between cultural norms, legal frameworks, economic conditions, and social support systems.
Sub-Saharan Africa: 33% lifetime prevalence (highest globally)
South-East Asia: 31% lifetime prevalence
Eastern Mediterranean: 26% lifetime prevalence
Americas: 25% lifetime prevalence
Western Pacific: 25% lifetime prevalence
Europe: 22% lifetime prevalence (lowest, but still affecting 1 in 5 women)
Risk of intimate partner violence follows distinct age patterns, with young women facing disproportionately high rates during peak reproductive years when relationship formation is most common.
Official statistics significantly underestimate the true prevalence of partner and sexual violence due to widespread underreporting, varying legal definitions, and methodological challenges in population surveys.
Research consistently demonstrates that fewer than 40% of women who experience intimate partner violence seek help from any formal service, and fewer than 10% seek help from police. Multiple factors contribute to this "silent epidemic" including shame, fear of retaliation, economic dependence, lack of support systems, and institutional barriers.
Intimate partner violence causes a wide spectrum of acute physical injuries, from minor bruises to life-threatening trauma requiring emergency medical intervention.
Head and Neck Injuries: Traumatic brain injury, facial fractures, strangulation injuries, dental trauma (most common target areas)
Musculoskeletal Trauma: Fractures, sprains, bruises, particularly defensive injuries on arms and hands
Internal Injuries: Abdominal trauma, organ damage, internal bleeding
Sexual and Reproductive Trauma: Genital injuries, sexually transmitted infections, unwanted pregnancy
Non-fatal strangulation occurs in 50-68% of intimate partner violence cases, representing one of the most dangerous forms of assault with potentially fatal delayed consequences.
Strangulation interrupts blood flow to the brain and restricts airway function through compression of the carotid arteries, jugular veins, and trachea. Loss of consciousness can occur within 10-15 seconds of arterial compression, while death can result from as little as 4-5 minutes of sustained pressure. Many survivors show no visible external injuries despite experiencing potentially life-threatening internal trauma.
Beyond acute injuries, intimate partner violence creates lasting physical health problems through chronic stress responses, repeated trauma, and barriers to healthcare access.
Neurological: Chronic headaches, seizures, memory problems, traumatic brain injury sequelae
Cardiovascular: Hypertension, heart disease, stroke (2-fold increased risk)
Gastrointestinal: Irritable bowel syndrome, ulcers, chronic abdominal pain
Reproductive: Pelvic inflammatory disease, infertility, pregnancy complications
Musculoskeletal: Chronic pain, arthritis, fibromyalgia
Immune System: Increased susceptibility to infections, autoimmune disorders
The psychological consequences of partner and sexual violence often prove more debilitating and longer-lasting than physical injuries, affecting every aspect of survivors' mental health and functioning.
Intimate partner violence often results in Complex PTSD, a severe form involving prolonged, repeated trauma that disrupts fundamental assumptions about safety, trust, and self-worth.
Chronic exposure to intimate partner violence fundamentally alters brain structure and function. Neuroimaging studies reveal decreased hippocampal volume (affecting memory), increased amygdala reactivity (heightening fear responses), and altered prefrontal cortex function (impairing decision-making and emotional regulation). These changes create lasting vulnerability to anxiety, depression, and difficulty forming healthy relationships.
Intimate partner violence triggers chronic activation of the hypothalamic-pituitary-adrenal (HPA) axis, fundamentally altering how the brain and body respond to perceived threats.
When faced with intimate partner violence, the brain's survival system activates three primary responses: fight (aggressive resistance), flight (escape attempts), or freeze (immobilization). The freeze response, often misunderstood as "consent" or "not resisting," represents an involuntary neurobiological survival strategy when fight or flight options are unavailable or dangerous.
Intimate partner violence often involves cycles of abuse and reconciliation that create powerful psychological bonds between survivors and perpetrators, making separation extremely difficult despite ongoing danger.
Researcher Lenore Walker identified a repetitive cycle involving three phases: tension building (walking on eggshells, increasing anxiety), acute battering incident (explosion of violence), and reconciliation/"honeymoon" phase (apologies, promises to change, expressions of love). This cycle creates intermittent reinforcement patterns that psychological research shows create the strongest behavioral bonds, explaining why leaving abusive relationships proves so challenging.
While intimate partner violence affects women across all demographics, certain factors increase vulnerability to experiencing or perpetrating violence.
Historical Factors: Childhood abuse, witnessing domestic violence, previous victimization
Demographic Factors: Young age (15-24), pregnancy, separation/divorce proceedings
Socioeconomic Factors: Financial dependence, unemployment, low education, poverty
Relationship Factors: Partner jealousy, controlling behavior, substance abuse, age disparities
Social Factors: Social isolation, lack of support systems, neighborhood disadvantage
Childhood exposure to domestic violence significantly increases risk of both perpetrating and experiencing intimate partner violence in adulthood, though this pattern is not deterministic.
Broader social norms and structural inequalities create environments that either support or discourage intimate partner violence.
Countries with greater gender inequality consistently show higher rates of intimate partner violence. Factors including women's limited economic opportunities, restrictive divorce laws, weak rule of law, and cultural norms supporting male authority over women create contexts where violence is more likely to occur and less likely to be addressed effectively.
Pregnancy represents a particularly vulnerable period, with intimate partner violence affecting 3-20% of pregnant women globally and often escalating during this time.
Violence during pregnancy often targets the abdomen and may represent attempts to control reproductive decisions or responses to pregnancy-related stress. Intimate partner violence during pregnancy increases risk of miscarriage, preterm birth, low birth weight, and maternal depression, creating intergenerational cycles of trauma and health problems.
Sexual and gender minorities experience intimate partner violence at rates equal to or higher than heterosexual women, but face additional barriers to recognition, support, and services.
Women with disabilities experience intimate partner violence at significantly higher rates than non-disabled women, facing unique forms of abuse and additional barriers to safety.
Abusers may withhold medications, break or hide mobility devices, threaten institutionalization, or exploit caregiving relationships. Women with intellectual disabilities face particularly high vulnerability due to difficulties recognizing abuse, limited social networks, and communication barriers that complicate help-seeking and service provision.
Intimate partner violence places enormous strain on healthcare systems through emergency department visits, long-term medical care, and mental health services.
Intimate partner violence creates significant economic hardship for survivors through lost productivity, unemployment, and long-term health costs.
Studies show that 56% of intimate partner violence survivors lose jobs due to safety concerns, absenteeism from injuries, or perpetrator interference. Annual lost productivity reaches $1.8 billion, while many survivors face long-term economic instability that perpetuates cycles of abuse by creating barriers to leaving dangerous relationships.
The most effective approach to addressing intimate partner violence involves preventing its occurrence through changing social norms, improving relationship skills, and addressing structural inequalities.
School-Based Programs: Comprehensive sexuality education, healthy relationship curricula, bystander intervention training
Community Mobilization: Social norm change campaigns, engaging men and boys, religious and community leader involvement
Economic Empowerment: Microfinance programs, job training, education initiatives for women
Policy Reform: Legal reforms, law enforcement training, workplace policies addressing domestic violence
Teaching community members to safely intervene when witnessing potentially harmful situations has shown significant promise in preventing sexual violence.
Direct Intervention: Safely confronting the perpetrator or assisting the victim
Distract: Creating diversions to interrupt potentially harmful situations
Delegate: Getting help from authorities, security, or other capable individuals
Delay: Checking in with potential victims after incidents to provide support
Engaging men and boys as allies in violence prevention has emerged as a crucial strategy, recognizing that most men are not violent and can be powerful advocates for change.
Healthcare settings provide crucial opportunities for identifying intimate partner violence and connecting survivors with resources and support services.
Professional organizations recommend universal screening for intimate partner violence in healthcare settings using validated tools. The HITS (Hurt, Insult, Threaten, Scream) screening tool asks: "How often does your partner physically hurt you, insult or talk down to you, threaten you with harm, or scream or curse at you?" Responses indicating any frequency beyond "never" warrant further assessment and safety planning.
Educational institutions serve critical roles in identifying teen dating violence and providing early intervention before patterns of abuse become entrenched.
Adolescent relationship abuse affects 23% of high school students, with many experiencing first violence in dating relationships. Warning signs include extreme jealousy, isolation from friends and family, monitoring technology use, threats of suicide if relationship ends, and rapid relationship escalation with intense emotional pressure.
When working with intimate partner violence survivors, safety assessment and planning represent the highest priorities, requiring careful evaluation of lethality risk factors.
Escalating Violence: Increasing frequency or severity of abuse
Strangulation History: Previous non-fatal strangulation attempts
Threats of Homicide/Suicide: Explicit threats to kill victim or self
Weapon Access: Perpetrator access to firearms or other weapons
Separation: Recent or planned separation/divorce
Stalking Behaviors: Following, monitoring, unwanted contact
Substance Abuse: Perpetrator substance abuse problems
Pregnancy: Victim pregnancy, especially if unwanted by perpetrator
Effective safety planning involves collaborative development of individualized strategies that acknowledge survivors' expertise about their own situations while providing professional guidance on evidence-based safety strategies.
Immediate Safety: Safe places to go, people to contact, emergency funds/documents
Legal Protection: Protection order information, documentation strategies
Technology Safety: Secure communication methods, privacy settings, safe computer use
Children's Safety: School notification, custody planning, teaching children safety strategies
Emotional Support: Trusted friends/family, counseling resources, support groups
Civil protection orders represent important legal tools for establishing boundaries and providing legal recourse when violations occur, though effectiveness varies significantly based on implementation and enforcement.
Law enforcement and criminal justice responses to intimate partner violence have evolved significantly, though substantial challenges remain in ensuring consistent, effective responses.
Domestic violence courts, which handle intimate partner violence cases with specialized judges, prosecutors, and support services, show improved outcomes including higher conviction rates (67% vs. 41% in traditional courts), increased sentence compliance, and reduced recidivism. These specialized responses recognize the unique dynamics of intimate partner violence that traditional criminal justice approaches often fail to address effectively.
Effective treatment for intimate partner violence survivors requires specialized approaches that address complex trauma while building safety, trust, and empowerment.
Cognitive Processing Therapy (CPT): Addresses trauma-related thoughts and beliefs
Eye Movement Desensitization and Reprocessing (EMDR): Processes traumatic memories
Trauma-Focused CBT: Combines cognitive-behavioral techniques with trauma processing
Dialectical Behavior Therapy (DBT): Builds emotional regulation and distress tolerance skills
Internal Family Systems: Addresses internal conflicts and self-blame
Group interventions provide unique benefits for intimate partner violence survivors, including reduced isolation, normalized experiences, and mutual support and encouragement.
Digital technology has created new avenues for perpetrating intimate partner violence through surveillance, harassment, and control tactics that transcend physical boundaries.
Digital Surveillance: Monitoring phone records, GPS tracking, secret installation of monitoring apps
Cyberstalking: Persistent unwanted digital contact, monitoring social media, creating fake profiles
Image-Based Sexual Abuse: Sharing intimate images without consent, threatening to share images
Economic Abuse: Controlling online banking, hiding assets digitally, sabotaging employment through technology
Social Sabotage: Impersonating victims online, spreading false information, interfering with relationships
Addressing technology-facilitated abuse requires specialized safety planning that considers digital privacy, security, and the complex ways technology intersects with traditional abuse tactics.
Device Security: Password protection, two-factor authentication, regular software updates
Communication Safety: Secure messaging apps, email safety, safe computer/phone use
Social Media Safety: Privacy settings, blocking perpetrators, managing online presence
Documentation: Safely capturing evidence of harassment or threats
Emergency Communication: Ensuring ability to call for help even if devices are monitored
International human rights law increasingly recognizes violence against women as a violation of human rights, with several key conventions establishing legal obligations for prevention and response.
CEDAW (1979): Convention on the Elimination of All Forms of Discrimination Against Women
Istanbul Convention (2011): Council of Europe Convention on preventing and combating violence against women
Beijing Declaration (1995): UN Fourth World Conference on Women platform for action
SDG 5.2: UN Sustainable Development Goal to eliminate violence against women and girls
Countries worldwide have developed comprehensive national strategies addressing intimate partner violence through coordinated approaches involving legal reform, service provision, and prevention programming.
Economic empowerment interventions address structural vulnerability factors that increase women's risk of experiencing intimate partner violence while reducing barriers to leaving abusive relationships.
The Intervention with Microfinance for AIDS and Gender Equity (IMAGE) study provided the first randomized controlled trial evidence that economic empowerment programming could reduce intimate partner violence. Participants in combined microfinance and gender training showed 55% reduction in intimate partner violence compared to control groups, demonstrating that addressing structural inequality can have direct violence prevention benefits.
Employment settings represent critical contexts for both identifying intimate partner violence and providing support to survivors while protecting their economic security.
An estimated 275 million children worldwide are exposed to intimate partner violence, experiencing profound effects on their development, behavior, and future relationships.
Developmental Delays: Language, cognitive, and social skill delays in young children
Behavioral Problems: Aggression, withdrawal, regression, school difficulties
Mental Health: Depression, anxiety, PTSD, increased suicide risk
Physical Health: Sleep disorders, headaches, stomach problems, compromised immune function
Future Relationships: Increased risk of perpetrating or experiencing abuse in adult relationships
Effective interventions for children exposed to intimate partner violence address both immediate trauma and building resilience for healthy development and future relationships.
Child-Parent Psychotherapy: Joint treatment addressing attachment and trauma for children 0-5
Trauma-Focused CBT: Individual trauma processing for school-age children and adolescents
Kids' Club: Group programming providing peer support and skill-building
Multicomponent Programming: Comprehensive approaches addressing family safety, economic stability, and therapeutic support
Effective intimate partner violence intervention requires understanding how cultural, religious, and ethnic identity intersect with experiences of violence and help-seeking behaviors.
Research demonstrates that intimate partner violence services are most effective when they acknowledge and integrate cultural values and practices while maintaining safety as the primary priority. This includes providing services in appropriate languages, understanding religious and cultural constraints on help-seeking, involving trusted community leaders when appropriate, and recognizing how racism and discrimination compound trauma for survivors from marginalized communities.
Indigenous women globally experience extremely high rates of intimate partner violence, reflecting the intersection of historical trauma, structural violence, and ongoing colonization.
Emerging technologies offer new possibilities for prevention, intervention, and support while also creating new challenges for safety and privacy.
Safety Apps: Discrete apps for emergency contacts, safety planning, evidence documentation
AI-Powered Screening: Automated risk assessment and safety planning tools
Virtual Reality Training: Immersive bystander intervention and response training
Blockchain Documentation: Secure, tamper-proof evidence collection and storage
Telehealth Services: Remote counseling and support services for isolated survivors
Ongoing research continues refining understanding of what prevents intimate partner violence and sexual violence before they occur, with promising developments in several areas.
Crisis hotlines provide immediate support, safety planning, and resource connections for intimate partner violence and sexual assault survivors worldwide.
United States:
National Domestic Violence Hotline: 1-800-799-7233
RAINN Sexual Assault Hotline: 1-800-656-4673
Crisis Text Line: Text HOME to 741741
International:
UK: National Domestic Abuse Helpline: 0808 2000 247
Australia: 1800RESPECT: 1800 737 732
Canada: Assaulted Women's Helpline: 1-866-863-0511
Comprehensive intimate partner violence response involves multiple specialized services addressing survivors' diverse needs for safety, healing, and rebuilding.
Emergency Shelter: Temporary safe housing with 24/7 support and security
Transitional Housing: Longer-term housing assistance with supportive services
Legal Advocacy: Assistance with protection orders, court accompaniment, custody issues
Counseling Services: Individual, group, and family therapy using trauma-informed approaches
Economic Empowerment: Job training, education assistance, financial planning support
Children's Services: Therapeutic support, educational advocacy, developmentally appropriate interventions
Addressing the global crisis of partner and sexual violence affecting 840 million people requires comprehensive, coordinated responses that combine immediate support for survivors with long-term prevention strategies. No single intervention can solve this complex problem, but research demonstrates that coordinated community efforts combining legal reform, service provision, prevention programming, and social norm change can significantly reduce violence rates and improve survivor outcomes.
The scale of partner and sexual violence—affecting nearly one-third of women globally—represents one of the most persistent human rights violations of our time. Yet this crisis is entirely preventable through evidence-based interventions that address its root causes in gender inequality, harmful social norms, and structural violence.
Understanding intimate partner violence and sexual assault through a scientific, evidence-based lens enables more effective responses while honoring survivors' experiences and expertise. As research continues advancing our knowledge of prevention and intervention strategies, the ultimate goal remains clear: eliminating violence against women and creating societies where all people can live free from fear, harm, and coercion.
Whether as individuals, families, communities, or nations, we all have responsibilities for preventing partner and sexual violence. This includes believing and supporting survivors, challenging harmful attitudes and behaviors, educating ourselves and others about healthy relationships, supporting evidence-based prevention programs, and advocating for policies that address structural inequality and violence. The evidence is clear: intimate partner violence and sexual assault can be prevented, but only through sustained, coordinated commitment to change.