Authors: Rhea Manohar, MPH; Meghan Etsey, Joanna Georgakas, MD; Paulette T. Cazares, MD, MPH on behalf of AMWA’s  Gender Equity Task Force

One in four women and one in seven men experience intimate partner violence (IPV) (Barkley Burnett, 2025). In the acute context, the immediate safety of those involved takes priority. It would be remiss however to think that care ends there: the long term sequelae of such significant trauma also needs to be addressed. Understanding the lasting ripple effects is essential to building systems that genuinely support healing and recovery. People who have experienced IPV, even those who seek help,  are often left vulnerable by its shortcomings. Many face continued threats, stalking, or harassment, and encounter intimidation when pursuing protective orders, child custody, or justice in the courts (Bradshaw et al., 2024). Often, separation from a perpetrator does not end the impact of IPV, rather it marks the beginning of a new set of challenges that include physical and mental ailments, social impact, and financial dependence. People may also have difficulty navigating healthcare systems, obtaining support, and navigating legal systems. 

Survivors of domestic violence often grapple with profound psychosocial impacts that compound their trauma. Psychiatric symptoms and illness- PTSD, depression, anxiety, and substance use disorders are all significantly more prevalent among survivors (Jenkins et al., 2025). Trauma can shape the way individuals navigate relationships, parenting, employment, and self-worth, casting long shadows that persist well beyond physical injuries (Barkley Burnett, 2025; Jenkins et al., 2025). Isolation from family and friends, stigma, and victim-blaming, particularly in rural or close-knit communities, can make it incredibly difficult to form or sustain healthy relationships in the aftermath of abuse (Taccini & Mannarini, 2023). Survivors face not only the external barriers of navigating institutions but also the internal burdens of mistrust, fear, and acquired  hypervigilance. The daily labor of survivorship: managing triggers, rebuilding trust, and carrying invisible trauma, is rarely recognized by those outside those with lived-experience.

Through the mind-body connection, survivors also experience disproportionately higher rates of chronic pain, including headaches, back pain, and pelvic pain, as well as gynecologic and obstetric complications. IPV is linked to increased risks of cardiovascular and gastrointestinal diseases, among others (Goldberg et al., 2021). Many survivors describe a visceral sense that their bodies have absorbed the trauma, with symptoms manifesting years later in ways that undermine both health and quality of life. 

Healthcare, which should be a space of healing, can itself become fraught for survivors. Routine exams and clinical procedures may trigger traumatic memories, particularly when providers were not trained in a trauma-informed framework. Trauma-informed care (TIC) provides a framework to address these challenges by creating a safe, supportive, and empowering environment. TIC emphasizes understanding the prevalence and effects of IPV, recognizing trauma-related behaviors, and modifying clinical practices to avoid re-traumatization. In practice, this may include offering patients choice and control over examinations, clearly explaining procedures, ensuring privacy, and validating experiences without judgment. Studies show that integrating trauma-informed approaches in healthcare settings not only improves patient trust and engagement but also enhances the overall safety and well-being of IPV survivors (Chu et al., 2024).

Without respectful, and patient-centered care, survivors risk re-traumatization, which in turn discourages them from seeking further medical attention. This cycle contributes to worsening health disparities and entrenches long-term physical and emotional harm. A trauma-informed approach means more than offering services, it means ensuring that those services are safe, validating, understood by the patient, and genuinely accessible. Even a single negative encounter with a provider or law enforcement officer can reinforce a survivor’s reluctance to seek help, perpetuating generational cycles of silence and untreated trauma.

Economic insecurity is another major consequence of IPV, often continuing long after the immediate danger has passed. Survivors may lose employment due to absenteeism, discrimination, the need to relocate, or unable to distance themselves due to financial dependence on their abuser (Barkley Burnett, 2025). Financial abuse, through control of money, sabotage of employment, or destruction of credit, is one of the most powerful tools of control and can take years to overcome (Scott, 2023). Without access to stable housing, employment, and healthcare, survivors may remain trapped in poverty and instability, unable to fully rebuild their lives. These challenges are even greater for marginalized survivors, who may face additional barriers due to racism, immigration status, disability, or sexual orientation. Structural obstacles like lack of transportation, unaffordable services, and lack of childcare only deepen the crisis (Kulkarni & Notario, 2024).

As healthcare providers, our role must extend beyond treating acute injuries, we must recognize IPV as a chronic, deeply embedded public health issue. Survivors may present with nonspecific symptoms, headaches, gastrointestinal distress, sleep disturbances, or anxiety, that mask the underlying abuse. Trauma-informed care must be integrated at every level of the healthcare system, with an emphasis on safety, dignity, and autonomy. This includes screening for abuse in a sensitive and respectful manner, partnering with community organizations, and understanding that survivors’ needs often go far beyond clinical treatment. The information survivors share is a roadmap for compassionate, effective care. By understanding the context of abuse, providers can tailor interventions, anticipate safety risks, and connect patients with legal, social, and community resources. Listening without judgment transforms a single visit into a moment of recognition, validation, and empowerment. Beyond individual care, providers have the power to advocate for systemic change: partnering with community organizations, improving resource accessibility, and ensuring that survivors’ voices shape policies that affect their safety and well-being. Every interaction matters; how we respond can be the difference between continued harm and a path toward safety, autonomy, and healing.

Moreover, physicians and healthcare professionals have a powerful role to play beyond the clinic walls. We can advocate for policies that support survivors, policies that expand access to housing, protect against employment discrimination, and fund trauma-informed services. Survivorship is not just about escaping violence; it is about managing the lasting, intersecting effects on health, safety, economic stability, and social belonging. Addressing these effects requires coordinated, culturally sensitive, and systemic responses that go beyond the individual. The weight of survivorship is immense, but with compassionate and integrated support, survivors can reclaim autonomy and their lives. In treating patients experiencing IPV, it is critical to acknowledge that many medical professionals may be survivors themselves. Recognizing the duality of their role as both careprovider and survivor can help bridge the gap between both sides of the stethoscope so that both feel seen and heard. As medical professionals, we are uniquely positioned to walk alongside them in that journey, not just in crisis, but in the long path towards recovery and healing. 

Resources for Those Experiencing Intimate Partner Violence

If you or someone you know is experiencing abuse, support is available:

  • National Domestic Violence Hotline — 24/7 confidential help
    📞 1-800-799-SAFE (7233) | 💬 Text START to 88788 | 🌐 thehotline.org
  • RAINN (National Sexual Assault Hotline) — 24/7 confidential support
    📞 1-800-656-4673 | 🌐 hotline.rainn.org
  • The Network/La Red — Support for LGBTQ+ survivors
    📞 1-800-832-1901 | 🌐 tnlr.org
  • National Human Trafficking Hotline — Crisis and safety resources
    📞 1-888-373-7888 | 💬 Text HELP to 233733 | 🌐 humantraffickinghotline.org
  • Futures Without Violence — Health and advocacy resources for professionals
    🌐 futureswithoutviolence.org

References: 

  1. Barkley Burnett, L. (2025, October 16). Intimate partner violence. Medscape. https://emedicine.medscape.com/article/805546-overview#a6 
  2. Bradshaw, J., Gutowski, E. R., & Nyenyezi, K. (2024). Intimate Partner Violence Survivors’ Perspectives on Coping With Family Court Processes. Violence against women, 30(1), 101–125. https://doi.org/10.1177/10778012231205586
  3. Chu, Y.-C., Wang, H-H., Chou, F-H., Hsu, Y-F., & Liu, K-L. (2024). Outcomes of trauma-informed care on the psychological health of women experiencing intimate partner violence: A systematic review and meta-analysis. Journal of Psychiatric and Mental Health Nursing, 31(2), 203–214. https://doi.org/10.1111/jpm.12976
  4. Goldberg, X., Espelt, C., Porta-Casteràs, D., Palao, D., Nadal, R., & Armario, A. (2021, September). Non-communicable diseases among women survivors of intimate partner violence: Critical review from a chronic stress framework. ScienceDirect. https://www.sciencedirect.com/science/article/abs/pii/S0149763421003043 
  5. Jenkins, N. D., Ritchie, C. W., Ritchie, K., Terrera, G. M., Stewart, W., & PREVENT Dementia Investigators (2025). Intimate partner violence, traumatic brain injury and long-term mental health outcomes in midlife: the Drake IPV study. BMJ mental health, 28(1), e301439. https://doi.org/10.1136/bmjment-2024-301439
  6. Kulkarni, S. J., & Notario, H. (2024). Trapped in housing insecurity: Socioecological barriers to housing access experienced by intimate partner violence survivors from marginalized communities. Journal of community psychology, 52(3), 439–458. https://doi.org/10.1002/jcop.23052
  7. Scott A. (2023). Financial Abuse in a Banking Context: Why and How Financial Institutions can Respond. Journal of business ethics : JBE, 1–16. Advance online publication. https://doi.org/10.1007/s10551-023-05460-7
  8. Taccini, F., & Mannarini, S. (2023). An Attempt to Conceptualize the Phenomenon of Stigma toward Intimate Partner Violence Survivors: A Systematic Review. Behavioral sciences (Basel, Switzerland), 13(3), 194. https://doi.org/10.3390/bs13030194

About the Authors:

Rhea Manohar, MPH, MS3

Rhea Manohar is a third year medical student from St. George’s University. She has a Masters in Public Health with a concentration in Maternal and Child Health from George Washington University Milken Institute of Public Health and a Bachelors of Science in Microbiology, Immunology, and Public Health from the University of Miami. She served as Co-VP of OB/GYN Education for St. George’s University’s Women in Medicine chapter in St. George, Grenada where she developed and implemented hands-on workshops to further reproductive health issues and bolstered medical students abilities to navigate physician-patient communication. Prior to medical school, she was a Research Associate for Fors Marsh Group, where she led qualitative and quantitative public health research and campaign development for federal agencies (e.g., CDC, NIH, DHHS, CPSC). She is also a member of the Gender Equity Task Force and Reproductive Health Coalition within the American Medical Women’s Association. When she is not pursuing medicine, you can find her reading, exploring artistic passions, and spending time connecting with friends and family.

Meghan Etsey, MS4

Meghan Etsey is a fourth year medical student from St. George’s University. She has a Bachelors of Arts in Biology and a Bachelors of Arts in Nutrition and Dietetics from Bluffton University in Bluffton, Ohio. She served as the President of the St. George’s University’s Women in Medicine chapter in St. George, Grenada where she expanded relationships with the community and worked towards educating women and helping the youth. She is also a member of the Gender Equity Task Force and Sex and Gender Health Collaborative Committees within the American Medical Women’s Association. When she is not pursuing medicine, you can find her with her friends and family on different road trips and adventures exploring the world.

Joanna Georgakas, MD

Joanna Georgakas, MD, is a psychiatrist and a Clinical Fellow in Geriatric Psychiatry at Mass General Brigham in Boston, MA. Dr. Georgakas received her BA from Middlebury College, where she majored in Neuroscience and Gender, Feminist and Sexuality Studies. She earned her medical degree from the Alpert Medical School of Brown University and subsequently completed her psychiatry residency training at Brown, serving as Chief Resident. Dr. Georgakas’s academic work has focused on the “leaky pipeline” phenomenon for women in STEM fields and feminist science studies. She has been an active member of the American Medical Women’s Association (AMWA) since 2018, where her contributions include co-founding the Brown University AMWA chapter and serving on the AMWA Gender Equity Task Force. She also created the podcast series “ Doctor and ____: Multidimensional Women in Medicine” (now run by incredible students and called  “Our Voices, Our Future”) to elevate the narratives of women advancing gender equity in medicine. In recognition of her contributions, Dr. Georgakas was a recipient of the AMWA Eliza Chin Unsung Hero Award. 

Dr. Paulette T. Cazares, MD, MPH 

Dr. Paulette T. Cazares, MD, MPH is a board-certified psychiatrist and President-Elect (2025–2026) of the American Medical Women’s Association. A U.S. Navy veteran, she has led large-scale mental health programs addressing PTSD, substance use, and women’s behavioral health within the Department of Defense. Dr. Cazares serves as Clinical Associate Professor of Psychiatry at the Uniformed Services University and directs geriatric psychiatry research at Sharp Mesa Vista’s Neurocognitive Research Center. Her work focuses on advancing mental health equity, leadership, and culturally responsive care.