Talking to your doctor about an abusive relationship – Harvard Health Blog
When Jayden called our clinic to talk about the worsening migraines, a change in medication was one of the potential results. But moments after our telehealth visit, it was clear that a cure for her problems couldn’t be found in a pill. “He’s out of control again,” she whispered, her lips pressed to the phone speaker, “What can I do?”
Sadly, abusive relationships like Jayden’s are incredibly common. Intimate partner violence (IPV) affects one in four women and one in ten men in the United States. People sometimes think that abusive relationships only happen between men and women. But this type of violence can occur between people of any gender and sexual orientation.
Experiencing violence can be extremely isolating and make you feel hopeless. But it is possible to live a life without violence. Support and resources are available to guide you to safety – and your doctor or healthcare professional may be able to help you as described below.
What is intimate partner violence?
Intimate partner violence (IPV) is not just physical violence like kicking or choking, although it can include physical harm. IPV is any emotional, psychological, sexual, or physical way your partner can hurt you and / or control you. This can include sexual harassment, threats to hurt yourself, stalking, or controlling behaviors such as restricting access to bank accounts, children, friends, or family.
If this sounds like your relationship, consider talking to your doctor or health care professional, or contact the National Domestic Violence Hotline at 800-799-SAFE.
What does a healthy relationship look like?
Media images show us uniformly happy relationships, but perfect relationships are a myth. This culture can prevent us from recognizing the unhealthy characteristics of our own relationships. Respect, trust, open communication and shared decisions are part of a healthy relationship. You should be able to freely participate in leisure activities or see friends without fear of your partner’s reaction. You should be able to share your opinions or make decisions without fear of reprisal or abuse. Sexual and physical intimacy should include consent – meaning that no one uses force or guilt to coerce you into doing things that hurt or make you uncomfortable.
How can a healthcare professional help me?
Healthcare professionals such as doctors or nurses can take a history and assess how the abuse may affect your health, well-being, and safety. Trauma from IPV can cause visible symptoms, such as bruising or scarring, as well as more subtle symptoms, such as abdominal pain, headache, trouble sleeping, or symptoms of head trauma. Healthcare professionals can also provide referrals to see specialists, if needed.
With your consent, healthcare professionals can take a detailed history, examine you, and document the results of the test in your confidential medical file. Let them know if you are concerned that your partner is looking at your medical records, so that steps can be taken to keep it confidential. This documentation can help strengthen a court case if you decide to take legal action in the future.
Additionally, you may be at risk for pregnancy or certain sexually transmitted infections (STIs). A healthcare professional can perform tests for STIs or pregnancy and offer birth control options. Some forms of contraception are less easy for your partner to detect, such as an IUD, an implant or a contraceptive injection.
Healthcare professionals can help you make a safety plan if you do not feel safe. They can also help connect you with social services, legal services, and specially trained lawyers. If you wish, healthcare professionals can also put you in contact with law enforcement to file a report.
What is a sexual assault exam?
If you have been sexually assaulted within 120 hours (five days), you may be offered a medical examination for sexual assault. This review is voluntary. It is performed by a qualified healthcare professional and may include a full body exam, including your vagina, penis, or anus. It may also include taking blood, urine or body surface samples and / or photographs that could be used in an investigation or legal action. You may be prescribed medicines that may prevent infections or pregnancy. You can click here to learn more about the Sexual Assault Exam.
What can I expect if I talk to a healthcare professional about IPV?
Healthcare professionals should listen to you with support and without judgment. Although not all healthcare professionals are trained in trauma-informed care, you have the right to be treated with respect and empathy to help you feel safe and empowered. You shouldn’t have to do something you don’t want to do. And that shouldn’t change the care you receive. You have the right to refuse any care with which you are not comfortable. After sharing information with your healthcare professional, you decide how you want to proceed, whether it’s seeking legal assistance, developing a safety plan for leaving the relationship, or choosing to stay. in the relationship and being connected to ongoing support. And you can choose not to share any abuse information at all.
Will the conversation be private and confidential?
These discussions should take place with you and your healthcare professional in a private space. If your abusive partner accompanies you to your appointment, your healthcare professional may ask them to leave the exam room for a period of time so that you have the privacy to speak openly. You can also ask to speak with the healthcare professional on your own.
In most cases, discussing your experiences with your healthcare professional is confidential under HIPAA. All states have laws that protect children, seniors, and people with disabilities from abuse of any kind. Your healthcare professional is obligated in certain circumstances to report abuse, such as violence against a minor or vulnerable adult. However, only a few states require healthcare professionals to report spousal violence.
Where can I find more resources on IPV?
Want to learn more about IPV and how to get help?
If you or someone you know is at risk, call the National Domestic Violence Hotline at 800-799-SAFE (7233) or 800-787-3224. This hotline is for anyone, regardless of race, sex, ethnicity, gender identity, sexual orientation, religion or ability.
If you are unable to speak safely, you can visit thehotline.org or text LOVEIS on 22522. They are available 24/7 by phone or live chat, and can work with you to find help in your area.
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