WHITAKER ET AL. RESPOND

Abstract

Two central points made by Reed are: (1) female perpetration of intimate partner violence (IPV) is not a public health concern and (2) there is no framework for understanding female-to-male IPV. Our perspective is that IPV is an important public health problem regardless of perpetrator and victim gender and that IPV can be addressed within a public health framework. It is indisputable that women are more affected by male IPV perpetration than are men by female IPV perpetration. However, the effect on men is far from insignificant. According to the 2005 National Crime Victimization Survey, which measures criminal victimization and, thus, likely underestimates IPV prevalence, 78 180 men and 389100 women were victims of intimate partner violence in 2005,1 and, between 1993 and 2004, 36% of male IPV crime victims reported being injured (48% of female IPV victims were injured), including 4.7% who reported being seriously injured (4.5% of female victims were seriously injured).2 Studies of other community samples find that 38% of injured IPV victims are men and 62% women.3 The adverse health impact of IPV on women is well documented, but far fewer studies have examined the health outcomes for men. Studies of the physical and psychological impacts of IPV on both women and men using nationally representative samples find that both are affected by IPV similarly.4,5 Clearly, both women and men are victims of IPV and can experience related adverse health outcomes. Existing theoretical frameworks that seek to explain both male and female IPV perpetration do so by taking a broader perspective and examining how individual, dyadic, family, and social factors affect all perpetration of IPV.6–8 These can be used within the public health approach to understand and, more importantly, to prevent IPV. The “gender-based violence” perspective has focused predominantly on IPV directed at women, and has placed less emphasis on primary prevention, or intervening before perpetration begins. Primary prevention requires understanding how risk for perpetration develops, including both low-level and severe forms of IPV. Studies should, as Reed suggests, examine types of IPV, as well as context and motives, whenever possible. They should also include both genders in examining if and how gender-related constructs relate to IPV9 to understand differences and similarities, rather than focusing on only 1 gender, as is often the case.10 The public health field is the perfect arena for such work, and is the logical discipline to support and implement violence prevention efforts for all those affected by IPV.