Hesperian Health Guides

Gender-based violence harms health in many ways

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HealthWiki > Health Actions for Women > Chapter 6: Ending Gender-based Violence > Gender-based violence harms health in many ways

a man hitting a disabled woman.

At least 1 out of every 3 women has been beaten, forced to have sex, or physically abused in some other way, usually by a man she knows. The health effects of this type of physical violence include severe pain, permanent disabilities, and injuries such as broken bones, burns, black eyes, cuts, and bruises.

Many women suffer miscarriages from being beaten during pregnancy. Problems such as headaches, asthma, belly pain, and muscle pains may last for years after abuse.

a man forcing a woman to have sex.
Sexual abuse causes sexual health problems including unintended pregnancies, sexually transmitted infections, fear of having sex, pain during sex, and lack of desire. Sexual abuse in childhood can cause confused feelings about sex later in life, and fear of having a healthy sexual relationship.
Some forms of violence cause no outward signs of injury, but they still harm health in many ways. For example, laws and customs about marriage can be a form of violence if a woman is forced into a role where she has very few rights. Her low status in the marriage could affect her health if it deprives her of food and health care, or dictates when and how to have sex, or whether or not she will get pregnant. Her low status could indirectly affect her health if it deprives her of education, prevents her from working outside the home, or forces her to work for low wages. These conditions often force women to stay in violent situations that are harmful to their health.
a woman holding out her hand to a man who stands with arms crossed.
Denying a woman money to support herself and her children, or denying them food, is a form of economic violence.
a woman looking down as a man shakes his finger at her.
Emotional violence, such as a man insulting, humiliating, shaming a woman or forbidding her to leave the house, to see family, or to talk to friends, is also harmful. This abuse can make a woman feel she cannot act on her own behalf or leave an abusive or unhealthy situation. She may not seek health care and may suffer long-term emotional problems.
Insulting and blaming a woman for family problems is a form of emotional violence that causes long term harm.
many pairs of shoes with women's names written below them.
In Mexico, human rights groups display empty shoes of women who have disappeared or whose bodies have been found brutally murdered. The authorities have done little to stop the violence.

Abuse can lead to mental health problems, such as constant fear, depression, lack of motivation, low self-esteem, shame, selfblame, and problems eating and sleeping. To cope with violence or these resulting feelings, women act in harmful ways by avoiding other people, using drugs or alcohol, having many sex partners, injuring themselves, or committing suicide.

Femicide is the intentional killing of a woman. Femicide includes the murder of a woman by her partner or a former partner, usually in a relationship with a pattern of constant abuse. Another type of femicide is "honor killing" when a woman’s male relatives kill her because she is accused of disapproved sexual or social behavior, and sometimes because she has been raped. In India, thousands of women are murdered each year by their in-laws because of conflicts over dowries (payment by the woman’s family when she marries). And countless women are attacked, sexually abused, and murdered by men who are never identified, especially in places where many men are involved in drug trafficking and armed conflict.

Gender-based violence hurts everyone

Violence affects not only the person who has been abused, it harms everyone else too. Gender-based violence discourages respectful, healthy relationships in families, schools, public spaces, and even health centers. As long as people believe that men are more important than women — and that women deserve to be beaten, shamed, and deprived of rights or resources — everyone suffers in some way from the injustice.

Violence deprives children, families, and communities of healthy and fully functioning women who are able to participate and contribute. Women who are frightened or silenced cannot take an active role to improve the health and raise the status of women in the community.

Gender-based violence reinforces the harmful idea that masculinity means behaving violently. This encourages men to act in violent ways that can lead to more injuries and deaths.

Gender-based violence harms children

a boy pushing a girl.

Children who are abused or who witness constant abuse often suffer strong feelings of helplessness, anger, sadness, shame, or guilt. These feelings may lead them to be aggressive and abusive toward others, copying the violence they have seen. Nightmares and other fears, bed wetting, and emotional problems are common, and may become long-term mental health problems. Some children become quiet and withdrawn because they fear saying or doing something that might provoke abuse, or because they are afraid to tell anyone what has happened to them.

Children in abusive families often grow and learn more slowly. They may have trouble paying attention in school and have more illnesses, such as stomach aches, headaches, and asthma. And too many children are injured and killed when violence is used against them.

HAW Ch6 Page 145-2.png
Girls and boys learn gender roles from the adults around them. If men abuse women and then blame the women for the abuse, boys learn to do the same. If women blame themselves, girls learn to feel the same way. But violence against a woman is never her fault.

The activity Role play: Gender-based violence affects everyone can help a group explore and discuss the ways that gender-based violence harms everyone — the victim, those who witness it, and the person who is the abuser.

a man speaking while thinking about his father hitting his mother.
I saw my father beating my mother from childhood, so I thought it was normal. When I learned about violence, and understood how much it harms everyone, I stopped beating my wife. I didn’t know how to talk to my wife about it, and it took a long time for her to trust me.

Role plays to discuss gender-based violence

Participants in role playing act out real-life situations. This helps people discuss topics that they feel are private or personal, such as men’s and women’s roles and relationships in a family. The activities Role play: Gender-based violence affects everyone, Explore the causes of gender-based violence, and Role play the bystander in this chapter use role plays about gender-based violence to help people think about why violence happens and about different ways violence is harmful. Discussing the role plays can help a group look at attitudes, customs, and patterns in the ways men and women act with each other, think of ways to work together to stop gender-based violence, and also change ideas and customs that justify violence.

You can choose to do these activities separately or as a series. You may want to first discuss gender roles with the group (see Chapter 3: Gender and Health).

These activities can work well with a group of women and men together. Having men play the women’s roles and women pretend to be men can help people think about inequality and gender in a new way.

Preparing to role play

Prepare situations in advance. Try to invent situations that are believable but not too violent or upsetting. Role-playing will be more realistic if you gather some props and clothes that people can use to show the roles they are playing. Examples for the situations below include shopping bags, a necktie, a man’s hat, a sewing machine, candies, and jewelry.

Here are some sample situations:

Situation 1
a man hitting a woman while another woman and 2 children watch in fear.

abuser: husband
victim: wife
witnesses: children and wife’s younger sister

A wife comes home late from a community meeting. Her husband has had a rough day and is already angry because there was no dinner ready when he got home. The wife’s younger sister has been taking care of the children. They are all at the house waiting for the wife to arrive home. What do you think happens next?

Situation 2
illustration of the below: a woman entering a man's office.

abuser: sweatshop boss
victim: woman worker
witnesses: workers who collect their pay first and leave the scene

A young woman has been working for 1 week in a small garment factory. When she goes to collect her pay, the boss tells her to come back later. He makes her wait until everyone has left the factory and then tells her to come into his office alone. What do you think happens next?

Situation 3
illustration of the below: 3 boys following a girl who is wearing pants.

abuser: adolescent boy
victim: adolescent girl
witnesses: other adolescent boys

An adolescent girl prefers to dress like a man rather than wearing the traditional skirts or dresses most young women wear. Walking home alone after school, she passes a group of young men and they begin to call out insults. One of them follows her.
What do you think happens next?

HAW Ch6 Page 147-3.png
Role-playing situations that include violence may be difficult or upsetting for some participants, especially if it touches on violence they have personally suffered or forms of violence that they have yet to consider, such as gay bashing or marital rape.
ActivityRole play: Gender-based violence affects everyone

  1. Divide the participants into groups of about 5 people each. Give each group a short description of a situation, such as those in the previous section, that might lead to violence. (You may want to give some guidance about not going too far in depicting violence in the drama.) Ask them to spend 15 to 20 minutes preparing a 5-minute drama that presents the situation and what they think will happen. Encourage everyone to play a part.
  2. Ask each group to act out its situation.
  3. After all the groups have presented, ask the groups to put aside their props and costumes. Then ask the participants to form 3 new groups based on their roles as "victims," "abusers," and "witnesses." Ask the participants in each of these groups to describe how they felt in their roles.
  4. Ask each of the 3 groups to say how they think the violence affected the characters they played. What harm could it cause?
    2 groups facing each other; 1 person in each group speaks.
    As a "victim," I might stop going to meetings.
    As a "witness," I realized that when children see adults using violence, they think it is the right way to act.
  5. Ask participants how they felt watching the other groups’ role plays. How were they affected?
  6. To conclude, ask the group as a whole to talk about the different ways that genderbased violence harmed women in the role-plays. Summarize the group’s ideas about how the violence in the role-plays also harms a woman’s children, her family, others who witness it, and the community. You can then continue with a discussion about the causes of gender-based violence (use the activity Explore the causes of gender-based violence, or a discussion about how the characters’ roles could change to prevent violence, using the activity "Happy ending" role plays to think about change.

ActivityPass the cabbage

When concluding group discussions and activities — especially on difficult subjects — it is good to ask everyone to talk about what they learned, how they feel about the issue, and how they are inspired to take action to work for change. In addition, it is important to give all participants the opportunity to evaluate and provide feedback. This activity is a fun way to involve everyone in this reflection and evaluation.
To prepare: Have sheets of notebook paper, masking tape and pens. Depending on the size of the group, write 1 or several sets of the 4 evaluation questions below on separate sheets of notebook paper.

  • Name one thing we did.
  • Name one thing you learned.
  • Say something you liked, and say something you disliked.
  • What will you do with what you have learned?

  1. At the close of an activity or workshop, ask the group what questions they think are key to understanding the topics you have discussed. Write each question on a separate piece of notebook paper.
  2. illustration of the below: paper cabbage.
    Create a "cabbage" by crumpling the last evaluation question sheet (number 4) in a tight ball and then adding layers of sheets around it. Alternate adding notebook sheets that include questions the group has suggested, an evaluation question, and some trick questions like "do a dance" or "sing a song" until you have created a real-sized cabbage. Make sure the evaluation questions are placed in reverse order, so as the cabbage is peeled they will be read in 1, 2, 3, 4 order.
  3. Play music or clap your hands, and ask people to pass the cabbage. When the music stops, the person holding the cabbage peels off a leaf and answers the question. Repeat this until all the leaves have been peeled.

    Note: You can write what people say on a large piece of paper that everyone can see, or just listen carefully to what everyone says. By thinking about what everyone says, you can learn a lot about what was most effective about a workshop and how to do it better the next time.