The health effects associated with physical, sexual and psychological gender-based violence against men and women: a Burden of Proof study

Caroline Stein, Luisa S. Flor, Gabriela F. Gil, Mariam Khalil, Molly Herbert, Aleksandr Y. Aravkin, Alejandra Arrieta, María Jose Baeza de Robba, Flavia Bustreo, Jack Cagney, Renzo J. C. Calderon-Anyosa, Sinclair Carr, Jaidev Kaur Chandan, Joht Singh Chandan, Carolina V. N. Coll, Fabiana Martins Dias Andrade, Gisele N. Andrade, Alexandra N. Debure, Erin DeGraw, Ben Hammond, Simon I. Hay, Felicia M. Knaul, Rachel Q. H. Lim, Susan A. McLaughlin, Nicholas Metheny, Sonica Minhas, Jasleen K. Mohr, Erin C. Mullany, Christopher J. L. Murray, Erin M. O’Connell, Vedavati Patwardhan, Sofia Reinach, Dalton Scott, Cory N. Spencer, Reed J. D. Sorensen, Heidi Stöckl, Aisha Twalibu, Aiganym Valikhanova, Nádia Vasconcelos, Peng Zheng and Emmanuela Gakidou ()
Additional contact information
Caroline Stein: University of Washington
Luisa S. Flor: University of Washington
Gabriela F. Gil: University of Washington
Mariam Khalil: University of Washington
Molly Herbert: University of Washington
Aleksandr Y. Aravkin: University of Washington
Alejandra Arrieta: University of Washington
María Jose Baeza de Robba: Pontifical Catholic University of Chile
Flavia Bustreo: Fondation Botnar
Jack Cagney: University of Washington
Renzo J. C. Calderon-Anyosa: McGill University
Sinclair Carr: University of Washington
Jaidev Kaur Chandan: University of Warwick
Joht Singh Chandan: University of Birmingham
Carolina V. N. Coll: Federal University of Pelotas
Fabiana Martins Dias Andrade: Federal University of Minas Gerais
Gisele N. Andrade: Federal University of Minas Gerais
Alexandra N. Debure: University of Miami
Erin DeGraw: University of Washington
Ben Hammond: University of Birmingham
Simon I. Hay: University of Washington
Felicia M. Knaul: University of Miami
Rachel Q. H. Lim: University of Birmingham
Susan A. McLaughlin: University of Washington
Nicholas Metheny: Emory University
Sonica Minhas: University of Birmingham
Jasleen K. Mohr: University of Birmingham
Erin C. Mullany: University of Washington
Christopher J. L. Murray: University of Washington
Erin M. O’Connell: University of Washington
Vedavati Patwardhan: UC San Diego School of Medicine
Sofia Reinach: Vital Strategies
Dalton Scott: University of Miami
Cory N. Spencer: University of Washington
Reed J. D. Sorensen: University of Washington
Heidi Stöckl: Ludwig-Maximilians-University Munich
Aisha Twalibu: University of Washington
Aiganym Valikhanova: University of Washington
Nádia Vasconcelos: University of Washington
Peng Zheng: University of Washington
Emmanuela Gakidou: University of Washington

Nature Human Behaviour, 2025, vol. 9, issue 6, 1201-1216

Abstract: Abstract The health impacts of exposure to physical, sexual or psychological gender-based violence (GBV) against men and women are substantial yet not well delineated. We systematically reviewed and meta-analysed 40 studies to evaluate the associations between GBV (including but not limited to intimate partner violence) and eight health outcomes: sexually transmitted infections excluding HIV, maternal abortion and miscarriage, HIV/AIDS, major depressive disorder, anxiety disorders, drug use disorders, alcohol use disorders and self-harm. Using the Burden of Proof methods, we generated conservative metrics of association—including star ratings from one to five—reflecting both effect size and evidence strength. Sexual violence was associated with six outcomes, with moderate, three-star evidence of association for sexually transmitted infections, maternal abortion and miscarriage, and major depressive disorder—increasing the risk by at least 104%, 101% and 50%, respectively. Seven outcomes were associated with physical GBV with two- or one-star associations, reflecting weak associations and/or inconsistent evidence. Of the four health outcomes analysed in relation to psychological GBV, one, major depressive disorder, had a significant association with a one-star rating. These findings emphasize the serious health consequences of GBV for survivors and the necessity of additional data to further our understanding of this complex public health issue.

Date: 2025
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DOI: 10.1038/s41562-025-02144-2

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