The health system is, along with the courts and the police, one of the ways to detect gender violence, but it is also the one that can have the greatest weight when it comes to detecting it early and the one with the most coverage. attention to women: everyone, at some point, goes to the doctor. For this reason, for years, different institutions have focused their attention there, and even this detection does not reach what is desirable nor does it work in the same way throughout the territory, but it has been improving throughout, especially, the last decade. While the majority of complaints do not come from hospitals and health centers, these notifications grow every year, according to the latest annual report on sexist violence from the Ministry of Health, which was presented this Friday at the Interterritorial Council of the National Health Service. and to which EL PAÍS has had access. With figures from 2022, in this increase the study especially points to one, that of the detection of sexual violence.
The nature of the data collected makes exact comparisons very difficult: the report is based on medical records (one per woman) and injury reports (in which there may be duplications). Some communities report with one of the two, and others report with both. The increases in cases of sexual violence by medical history are 86% in primary care and 58% in hospital care compared to the previous year, while for injuries they are 96% in health centers and 3% in hospitals.
However, sexual violence is the least identified in the health system, as it continues to be in the rest of the institutional settings; While in sexist violence it is estimated that the hidden pocket is 80%, in sexual violence it rises to 90%. Thus, in the medical records, the most detected was physical (24.6% of cases), followed by psychological (24.6%) and sexual (10.8%). In more than 41% of cases the type is not stated (they add up to more than 100% because in many cases both types of violence occur). In injury reports, physical abuse accounts for 51.6% of the cases, followed by psychological abuse (38%) and sexual abuse (4.1%). And it does not appear in 7.3% of the reports.
If the data is decanted, the total number of cases of gender violence detected is 22,323 (eliminating the injury reports from the communities reported by both sources). That same year, the General Council of the Judiciary registered 182,065 complaints and 176,483 female victims—the same woman can file a complaint several times. Although an exact relationship cannot be made due to the different nature of the figures, it gives an approximate idea of the weight of the health system when it comes to identifying these crimes.
It is a figure that is “still very low,” in the opinion of Carmen Fernández Alonso, a family doctor who is an expert in gender violence who has participated for years in the advisory groups of the Ministry of Health, although she is now retired. “However, there is a high proportion that is not reported, perhaps because the woman does not want it to be recorded in her medical history. And, in the case of injury reports, because only the most serious cases usually appear,” he explains.
He is struck by the “low portion” of notifications of psychological violence, when “in all cases of physical and sexual violence, there is also psychological violence.” He attributes this to the fact that it is probably still not given the importance it has, “despite the fact that it can sometimes be worse than physical injury” and to the “disappointing” judicial response that these types of complaints receive.
In 2021, the Supreme Court carried out an analysis of how habitual abuse occurred and how it affected the victims as a result of a sentence for this crime. In that x-ray he alluded to the fact that the “manifestation can be physical, but also psychological, and can even cause, in some cases, more psychological damage to the victims than the physical one,” because, he argued, through psychological violence the Women may not be able to perceive that they are being victims, “which further aggravates the fact of non-reporting in many cases and the persistence over time of psychological abuse that can seriously affect the psyche.”
“Striking increase” in the youngest
The highest rates of gender violence occur among women between 20 and 40 years old, but the report highlights a “striking increase” in women in the 14 to 19 age group, whose primary medical records have almost doubled detections. Compared to the previous year: the rate in 2022 was 100.5 cases per 100,000 women compared to 58.6 in 2021, an increase among the youngest that is repeated in the statistics of different organizations in recent years.
After the age of 50, the percentage decreases significantly. In Fernández Alonso’s opinion, at these ages there is great under-reporting: “There is more resistance and difficulty for them to reveal their problem. They have it more normalized through education, because it is more difficult to make that decision at certain ages, when you endure mistreatment for a lifetime.”
With respect to nationalities, Andean women—born in Colombia, Peru, Ecuador and Bolivia—are by far the most affected group, as has been the case in previous years. In clinical history, the case rate is 578 per 100,000 women, compared to 49.8 for Spanish women, followed by Moroccan women, with 160. And there is also a notable difference between those with high incomes (63. 7) and the low ones (154.9).
Regarding this issue, Alicia Martín, a Primary Care doctor who leads the Equality and Conciliation Group of the AMYTS union, explains that for foreign women “vulnerability increases greatly.” And it does so, above all, in those with lower socioeconomic levels. These social and economic factors “have a lot of influence,” according to Martín: “Thinking about the consequences of recognizing abuse is more difficult for those with higher social and economic levels.”
In any case, the specialist argues, the health system is “if not the best, one of the best places to stop sexist violence.” He says that they are the ones who “accompany families throughout the years in which consultations of different kinds occur in which it can be detected that there is gender violence behind them.” And it alludes to training – “luckily every day we are more trained to be able to detect it” – but also to time, especially time.
“Imagine if you had four minutes to dedicate to each patient. If you have trouble counting anything else in four minutes, imagine having to count this. It is immensely important so that they can feel comfortable, so that we can see what is happening, create a climate of trust, pull the thread. Time is an immense resource that today, especially in Madrid, we still do not have and that means that you have exquisitely trained professionals with conditions that do not allow them to do their work. Women, and the entire population, deserve that we can dedicate to them not four, but all the minutes they need,” she concludes.
Telephone 016 assists victims of sexist violence, their families and those around them 24 hours a day, every day of the year, in 53 different languages. The number is not registered on the telephone bill, but the call must be deleted from the device. You can also contact via email [email protected] and by WhatsApp at the number 600 000 016. Minors can contact the ANAR Foundation telephone number 900 20 20 10. If it is an emergency situation, you can call 112 or the National Police telephone numbers (091) and the Civil Guard (062). And if you cannot call, you can use the ALERTCOPS application, from which an alert signal is sent to the Police with geolocation.