Biden Administration Takes on Intimate Partner Violence, Releasing New Clinical Guidance

A new Justice Department protocol seeks to ensure clinical interventions prioritize intimate partner violence survivors’ health and well-being, while preserving forensic evidence for use in legal proceedings.

President Joe Biden is introduced by Ruth Glenn, CEO and of the National Coalition Against Domestic Violence, during an event celebrating the reauthorization of the Violence Against Women Act (VAWA) at the White House on March 16, 2022. (Kent Nishimura / Los Angeles Times via Getty Images)

Recognizing that intimate partner violence (IPV) is a significant public health issue in the United States, the U.S. Department of Justice’s Office on Violence Against Women (OVW) last month issued clinical guidance on how health professionals can provide comprehensive, trauma-sensitive care to patients experiencing IPV.

The National Protocol for Intimate Partner Violence Medical Forensic Examinations—designed by a broad coalition of healthcare, justice, survivor advocacy and law enforcement experts—seeks to ensure that clinical interventions prioritize the survivor’s health and well-being while preserving forensic evidence for use in potential legal proceedings.

IPV—defined as a pattern of emotional, sexual and/or physical abuse or aggression which occurs between romantic partners who may or may not live in the same household—is pervasive and prevalent in the United States.

Despite these grim numbers, experts believe IPV is underreported, due to threats, lack of resources, cultural norms and stigma.

Jane Manning, director of Women’s Equal Justice, a New York-based nonprofit dedicated to helping survivors of sexual violence navigate the criminal justice system, said OVW deserves enormous credit for the new protocol.

“What we know from experience is that standardized medical protocols can move things forward by leaps and bounds in caring for victims of gender-based violence,” said Manning. “The value of standardized medical protocols is that doctors, nurses and administrators who may not have their own extensive background in the area of gender-based violence can follow the protocols to deliver vastly better care. This means better diagnosis and treatment for the physical and mental injuries inflicted by an abuser, better support for survivors’ efforts to seek safety and better collection of evidence that can help survivors pursue protection and justice.”

Nearly 20 people per minute are physically abused by an intimate partner in the United States—totaling more than 10 million people annually.

All types of gender-based violence (GBV) are interrelated and reflect historical power imbalances, the report makes clear.

While IPV can impact anyone, racial and ethnic minority groups are disproportionately affected, with women between the ages of 18 and 24 most likely to experience violence. Survivors experience challenging mental, emotional, physical and social impacts, making survivors three times as likely to meet the criteria for post-traumatic stress disorder.

Tackling IPV is essential on a societal level as well. The lifetime economic costs attributable to medical services for IPV-related injuries, lost productivity from paid work, criminal justice expenditures and other costs are a whopping $3.6 trillion and the cost over an individual victim’s lifetime is estimated to be $103,767 for women and $23,414 for men.

Clinicians are the first line of defense in the fight against IPV, the new protocol recognizes. It provides guidance for holistic, culturally-sensitive and patient-specific evaluation and treatment—including proper techniques for screening, confidentiality considerations and strategies to ensure survivor safety.

The protocol also addresses the connection between clinicians and criminal justice accountability—including evidence collection, giving medical testimony and mandatory reporting.

To the extent that IPV reflects societal and cultural norms, the protocol could also disrupt pathways toward partner violence and help IPV survivors—who are often reticent to speak about their experiences—overcome fear, stigma and embarrassment.

Research consistently demonstrates that different forms of violence are strongly interconnected, with victims of one type more likely to experience others during their lifetime. The new protocol for IPV joins the National Protocol for Sexual Assault Medical Forensic Examinations: Adults/Adolescents and the National Protocol for Sexual Abuse Medical Forensic Examinations: Pediatric as voluntary guides to improve responses to sexual and other violence by institutionalizing best practices around survivor care and evidence collection.

Biden Administration Tackles Gender-Based Violence

These efforts join the Biden administration’s other initiatives to combat gender-based violence, including the release last month of the first-ever National Plan to End Gender-Based Violence: Strategies for Action, which recognizes the devastating impacts of gender-based violence and provides a roadmap to guide federal government actions to prevent and address the problem. The report calls IPV “a manifestation of historically unequal power relations between men and women.”

The Biden administration also supports the passage of the Equal Rights Amendment joint resolution to give Congress the power to reauthorize the federal civil rights remedy to be free from gender-based violence.

While the protocol will help identify survivors, improve clinical outcomes and potentially reduce IPV, only approximately one-third of those injured by IPV seek medical care. With a notable increase in IPV during the COVID-19 pandemic, there is a long way to go in encouraging reporting and care-seeking behaviors as part of a multi-faceted effort to support IPV survivors and hold offenders accountable.

If you, or someone you know, needs help, call the 24/7 National Domestic Violence Hotline: 1-800-799-7233.

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Michelle Onello is an international human rights lawyer and senior legal advisor at the Global Justice Center, a nonprofit organization that uses international law to advocate for gender equality and reproductive rights.