gynecology and obstetrics
Domestic Violence
Introduction
Domestic violence includes physical, sexual, and psychologic abuse between people who live together including sex partners, parents or guardians and children, children and grandparents, and siblings. Domestic violence includes intimate partner violence (IPV), which refers to physical, sexual, or psychologic abuse by a current or former sex partner or spouse. (See also Overview of Child Maltreatment and Domestic violence occurs among people of all cultures, races, sexual orientations, genders, occupations, income levels, and ages. In the US, more than 10 million adults experience domestic violence every year. Women are more commonly victims of domestic violence than are men. About 95% of people who seek medical attention as a result of domestic violence are women. Women are more likely to be severely assaulted or killed by a male partner than by anyone else. In the US, about 1 in 4 women and nearly 1 in 10 men have experienced sexual violence, physical violence, and/or stalking by an intimate partner during their lifetime ( General references ). In the US, domestic violence is as prevalent (or more prevalent) among lesbian and bisexual women, gay and bisexual men, and transgender people as among the general population ( General references ). During the COVID-19 pandemic, domestic violence became more prevalent in many countries. Reasons probably include stress due to loss of income and loss of contact with other people. Also, people who were abused often could not escape to a shelter or another safe place ( General references ). Physical abuseis the most obvious form of domestic violence. It may include hitting, slapping, kicking, punching, breaking bones, pulling hair, pushing, and twisting arms. The victim may be deprived of food or sleep. Weapons, such as a gun or knife, may be used to threaten or cause injury. is also common; many women who are physically assaulted by their partner are also sexually assaulted by their partner. Sexual assault is any type of sexual activity or contact that a person does not consent to. Sexual assault involves the use of threats or force to coerce sexual contact and includes unwanted touching, grabbing, or kissing, as well as Medical Examination of the Rape Victim . Psychologic abusemay be even more common than physical abuse and may precede it or occur at the same time. Psychologic abuse involves any nonphysical behavior that undermines or belittles the victim or that enables the perpetrator to control the victim. Psychologic abuse can include Abusive language Social isolation Financial control Usually, the perpetrator uses language to demean, degrade, humiliate, intimidate, or threaten the victim in private or in public. The perpetrator may make victims think they are crazy (gaslighting) or make them feel guilty or responsible, blaming them for the abusive relationship. The perpetrator may also humiliate victims in terms of their sexual performance, physical appearance, or both. The perpetrator may try to partly or completely isolate the victim by controlling the victim’s access to friends, relatives, and other people. Control may include forbidding direct, written, telephone, or e-mail contact with others. The perpetrator may manipulate the victim into thinking that others cannot or will not help, or use jealousy to justify these actions. The perpetrator may also prevent the victim from accessing medical care. Often, the perpetrator withholds money to control the victim. The victim may depend on the perpetrator for most or all of their money. The perpetrator may maintain control by preventing the victim from getting a job, by withholding information about their finances, and by taking money. After an incident of abuse, the perpetrator may beg for forgiveness and promise to change and stop the abusive behavior. However, typically, the abuse continues and often escalates. The perpetrator's outbursts of violence tend to be episodic and unpredictable. Thus, victims may live in near-constant fear of the next outburst. Perpetrators may use technology (eg, social media web sites, phones) to post videos or stalk the victim and to monitor, isolate, punish, threaten, and/or humiliate victims ( General references , 