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Adolescent Health
Practice Update from the National Association of Social Workers

Volume 1, Number 2
July 2001

What Social Workers Should Know about Gender-Based Violence and the Health of Adolescent Girls


Gender-based violence refers to the perpetration or threat of emotional, verbal, physical violence, or sexual assault targeted toward adolescent girls within the context of a dating relationship.

Facts About Gender-Based Violence in Adolescents

Nearly one in five high school young women report having been physically or sexually abused (Harris, 1997).

Female teenagers are more likely to suffer dating violence, to be injured, and to suffer emotionally than are their male peers. At least one study has shown that a teenage girl is nearly three times more likely to suffer a beating than her male counterparts, who are more likely to be the perpetrators of violence in relationships (Advocates for Youth, 2000).

Although partner violence transcends all racial, ethnic, and socioeconomic groups, African American teenage girls are more likely to report being slapped or hit by a boyfriend (CDC, 2000a)

The phenomenon of youth violence in America has become a headlining issue. The onslaught of recent school shootings seized the media and effectively catapulted this most important and pressing topic into the mainstream rank order of national and public health priorities. These incidents have brought long overdue and well-deserved attention and analysis to the complexity of concerns and issues affecting teenagers that often manifest themselves in violent and aggressive acts toward others. What has been largely absent in this public discourse, however, is the gender-based dimension of youth violence and its tremendous impact on the health and well-being of girls and on the larger society as well.

Domestic violence is the number one public health threat to women, responsible for more injuries than any other cause. About half of all American women experience violence from men at some point in their lives (Allison, 1996). Intimate partner violence or dating violence is important to consider and address within the context of adolescence in that the prevalence merits serious cause for concern. A quarter of eighth and ninth-grade students have experienced dating violence, and 8 percent have been victims of sexual dating violence (CDC, 2000a). Although teenage dating violence and violence in general affects adolescent males and females, the application of gender analysis to the data unequivocally exposes a pattern of targeted victimization of teen girls. Consider the facts:

Facts About Gender-Based Violence in Adolescents
  • Teenagers who have suffered from abuse are more likely to exhibit depressive symptoms and low self-esteem. They are also more likely to suffer episodic or chronic depression, posttraumatic stress syndrome, and other mental health disorders. These patterns are also more likely to continue into adulthood, often in a series of abusive relationships (The Commonwealth Fund, 1999).
  • The impact of intimate partner violence on the overall health and well-being of young girls is significant. Dating violence has severe consequences - in addition to physical injuries that may be sustained, young women are three times more likely to report severe emotional trauma when a violent episode occurs in a dating situation. Other long-term consequences can include continued or chronic health problems, increased use of medical services and hospitalizations, and poor self-rated health status (The Commonwealth Fund, 1999).
  • Rape is a crime primarily committed against girls and young women. Adolescents are considered to be at highest risk for sexual assault, with more than half of reported assaults occurring in dating situations (Johnson et al., 1999). Overall, 12.5 percent of young women in grades 9 through12 reported being forced to have sexual intercourse (CDC, 2000b). Age 14 is a young woman's year of greatest risk of sexual assault (Snyder & Sickmund, 2000).
  • Other health-damaging behavior is also more common in female adolescents experiencing violence. They are more likely to smoke and use other substances, and are at increased risk for pregnancy, sexually transmitted disease, suicide attempts, and unhealthy weight loss (Johnson et al., 1999).
  • In addition to the impact of dating violence, sexual harassment, particularly in school settings, is also an issue that disproportionately affects adolescent girls, though often overlooked as a significant factor in environments hostile to young girls (Kopels & Dupper, 1999).
Contextual Correlates of Gender-Based Violence: Understanding the Influences
The Influence of Childhood Experiences and Family Dynamics

The social work perspective as it relates to systems theory and the ecological perspective helps to clarify the contextual correlates of gender-based violence in adolescents. The etiology of abuse in relationships is often linked with childhood experiences. Witnessing acts of violence in the home increases the likelihood that boys will batter and that girls will be victims. Observing family violence is related to a fourfold increase in male adolescents' likelihood to assault their dates (Johnson et al, 1999). Nearly 62 percent of women who report childhood abuse experienced domestic violence as an adult (Harris & Associates, 1999). Girls are more likely than boys to experience abuse as children (Jensen & Howard, 1999). Adolescent females experience violence in their homes, in schools, and in their communities. The exposure of youth to chronic community violence tends to be related to increased levels of aggression and acting out (Osofsky, 1999).

The Influence of Social Institutions

Gender-based violence is in part, rooted in gender and power inequities that marginalize girls and women within relationships and society overall. While it is important to understand and identify the individual correlates of violence, it is also important to understand the role of social institutions in impacting gender-based violence. The previous legal right of men to beat their wives - the notorious "rule of thumb"- provides some insight into the institutionalization of gender inequities and gender-based violence. The economic disparities that continue to exist between men and women continue to reflect inequities and contribute to conditions that increase the vulnerabilities of young girls and women to victimization by violence. As social workers, committed to social justice and gender equity, it is important to advocate for policies and practices that promote gender equity and equal treatment of women and girls in their relationships, their families, and in society.

The Influence of Gender Socialization

Gender socialization and accepted social norms about adolescent development contribute to the varied experiences of males and females during these years. These experiences however, are often stratified in ways that are harmful to adolescent girls and ripen conditions for victimization through violence. The issue of sexual harassment provides an example. The sexual harassment of girls by boys during adolescence has been socially viewed as a part of normal adolescent development. The notion that "boys will be boys" has framed our thinking and responses to this issue, the immediate and long-term consequences of which have not been considered until recent years. Though large groups of both girls and boys, 83 percent and 79 percent respectively, report experiencing harassment, girls are more likely to report being negatively affected by it. Girls are far more likely than boys to feel "self conscious" (44 percent to 19 percent), "embarrassed" (53 percent to 32 percent), and "less confident" (32 percent to 16 percent) because of an incident of harassment. Girls are more likely than boys to change behaviors in school and at home because of the experience, including not talking as much in class (30 percent to 18 percent) and avoiding the person who harassed them (56 percent to 24 percent)(AAUW, 2001).

Socially permissive attitudes about gender-based violence have been internalized by our youth. Sixty-two percent of students surveyed believed that a male is not at fault if he rapes a girl who dresses provocatively on a date, and males were less likely to believe that the male is totally at fault (Advocates for Youth, 2000). Beliefs about gender-based violence that exist in our young people and within the larger society can create barriers for young women dealing with violent relationships. Many teens remain silent about their experiences and harbor feelings of guilt, shame, and responsibility for the acts perpetrated on them, and are hesitant to tell anyone and to seek services. In a survey of young women in grades 9-12 who reported experiencing dating violence or date-forced rape, 29 percent had told no one (Harris & Associates, 1999). It is important that social workers involved with youth, help to shatter misconceptions about gender-based violence, and help to create environments and opportunities where young girls and boys can feel comfortable talking about their experiences and obtaining needed services.

Creating Positive Youth Environments for Adolescent Girls: Implications for Social Work Practice

As social workers, we have tremendous opportunities to directly and indirectly impact the health and well-being of adolescent girls with respect to gender-based violence. Our interdisciplinary roles in medical and healthcare settings are particularly critical in enhancing the identification and provision of services to teenagers experiencing violence. Research suggests that while victims of violence are more likely to seek medical attention than mental health services, the response of the medical community in both identification and treatment is inadequate (Nayak, 2000). The involvement of social workers in increasing awareness across disciplines within the medical community will greatly enhance the provision of services to adolescents. This is but one of many ways in which the involvement of social work can result in better health outcomes for adolescent girls.

Opportunities for Intervention: Practice, Programs & Policy

Here are some practical ways in which social workers can become involved with the issues of gender-based violence and help promote good health and well-being for adolescent girls.

Practice Implications:

  • Implement identification of and follow-up strategies for gender-based violence within your practice. Work with families and communities in raising awareness of gender-based violence in adolescents. This is critical, as many teens do not report violence because of fear that their parents will not approve of their relationship. Help families experiencing violence to understand the long-term consequences of violence in the home.
  • Encourage the development and or awareness of community services to assist both victims and batterers. Many domestic violence services, particularly shelter services, are not available to individuals under 18.
  • Establish referral networks that may include hotline numbers, medical services, support groups, law enforcement, counseling, and the like. Have this information to young people with whom you work.
  • Have information on gender-based violence and healthy relationships, such as brochures and fact sheets, available in your practice setting.

Program Implications:

  • Organize or conduct workshops for schools, community-based centers, churches, and the like to raise awareness of gender-based violence.
  • Organize or conduct peer training on relationship violence. Youth often share information about violent experiences with their friends before anyone else.
  • Encourage school systems and community centers to adopt policies and programs that address gender-based violence and appropriately intervene in gender-based violence.
  • Become a part of or organize a campaign such as "Love Doesn't Have to Hurt."
  • Involve relevant contacts and coalitions including youth centers, health departments, law enforcement, the medical community, and teens and their families in efforts to increase awareness and responses to gender-based violence.

Policy Implications:

  • Infuse the gender-based perspective in local and national policy dialogues on youth violence.
  • Work with your local NASW chapter or social work organization in adopting positions on gender-based violence in adolescents. Become familiar with your local reporting laws and policies on youth and gender-based violence, statutory rape, etc.
  • Advocate for research, programs, and policy initiatives that promote the prevention of gender-based violence.
  • Advocate for policies that promote collaborative and comprehensive approaches to gender-based violence, and give equal measure to intervention and treatment, as well as legal recourse.

Advocates for Youth Factsheet: Dating Violence Among Adolescents, 2000

Allison, K., & Slupik, R. American Medical Association: Complete Guide to Women's Health. New York: Random House, 1996.

American Association of University Women (AAUW) Education Foundation (2001). Hostile Hallways: Bullying, Teasing, and Sexual Harassment in Schools. Washington, DC.

Centers for Disease Control and Prevention (CDC) (2000a). National Center for Injury Prevention and Control. Factsheet on Dating Violence. (available online: www.cdc.gov/ncipc/factsheets/datviol.htm#References)

Centers for Disease Control and Prevention (CDC) (2000b). Youth risk behavior surveillance, 1999. In CDC Surveillance Summaries. MMWR (No. SS-5)

Harris, L. & Associates (1997). The Commonwealth Fund Survey of the Health of Adolescent Girls. New York, NY: The Commonwealth Fund.

Jensen, J., & Howard, M. (1999). Youth violence: current research and recent practice innovations. Washington, DC: National Association of Social Workers

Johnson, N., Roberts, M., Worell, J. (1999). Beyond appearance: a new look at adolescent girls. Washington, DC: American Psychological Association.Kopels, S. & Dupper, D. (1999). School-based peer sexual harassment. Child Welfare, LXXVIII (4): 435-460.Nayak, M. (2000). Factors influencing hesitancy in medical student's to assess history of victimization in patients. Journal of Interpersonal Violence, 15 (2): 123-133.Osofsky, J. (1999). The impact of violence on children. The Future of Children, 9 (3): 33-49.Snyder, H., Sickmund, M. Juvenile offenders and victims: 1999 national report. Washington, DC: Office of Juvenile Justice and Delinquency Prevention.

The Commonwealth Fund (1999). Improving the Health of Adolescent Girls: A Policy Report of The Commonwealth Fund Commission on Women's Health.

Shelia Clark, MSW
Senior Staff Associate
Adolescent Health

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