Contrary to what many think, victims of gender violence, including sexual violence, want to tell it. They need to talk about what happened to get that pain out of them and breathe again. Healthcare environments are an ideal space for this, because there children, adolescents and adults feel protected. But to do this, health personnel must ask and must do so with care and empathy.
“Healthcare spaces (Primary and Hospital Care) can be privileged settings for the detection of recent or past gender violence, as long as there is an active, inclined and deliberate attitude to investigate among health professional teams. It has been shown that women who come for consultation are able to speak and tell if they are, or have been, victims of gender violence in the recent or distant past when asked directly. It is essential that health teams collect and update information from the situation of women who come for consultation, either through periodic inquiries or the initial registration of a clinical history”.
This is indicated by the protocol of the National Health System against Sexual Violence approved by the Interterritorial Health Council, a text that has the specific objective of establishing common criteria for professional, standardized and homogeneous action, regarding detection, assessment and intervention. in cases of sexual violence (past or recent) in adult women, girls, boys and/or adolescents, including cases of daughters and sons of women who suffer or have suffered violence within their partner or ex-partner.
What to ask? The protocol offers some general guiding questions regarding gender violence and sexual violence. For example, if the healthcare provider suspects that the patient is a victim due to the symptoms or psychological problems found, he or she can question her with “I would like to know your opinion about those symptoms that you have told me about (anxiety, nervousness, sadness, apathy.). Since “When do you feel this way? What do you think these symptoms are caused by? Do you relate them to anything? Has anything happened in your life lately that makes you worried or sad?” or “Do you have a problem with, perhaps, your partner? Or with your daughters or sons? With someone in your family? At work? With someone else?” “It seems as if she is alert, scared, what are she afraid of?” o Do you have any difficulty seeing your friends or family? What prevents you from doing so?
And, according to the aforementioned protocol, the improvement in the detection of recent or past violence and its registration is related to the fact that the investigation becomes an assiduous and routine practice among professionals, through the use of standardized tools ( short and simple in their application) for the early detection of gender violence in any of its expressions, including sexual violence.
“There are many ways to approach the topic and, according to scientific literature, it will always be better to ask it than not, since women who are victims usually need to tell it. More general psycho-social questions can be used or reference can be made to the objective detection (given the high prevalence of the problem); the important thing is to always ask the questions in a safe setting, in which the woman feels as comfortable as possible, ensuring total confidentiality (avoiding the presence of the partner)” , points out the text.
The WHO has already warned of the need to ask. “The WHO tells us that, contrary to popular belief, the majority of women are willing to disclose that they are victims of violence and abuse when asked in a direct and non-evaluative way. Ask women, in Primary Care consultations, from the age of 14, if they are suffering or have suffered any type of sexual violence in their lives, with appropriate questions, according to age, situation and characteristics of the women, in an environment of safety and trust for them, is the way to detect this form of violence against women,” the protocol indicates.
The WHO believes that this practice will make it possible to spread among the population the idea that health services personnel are interested in and concerned about these issues, given that they affect individual and collective health, progressively encouraging the fact of asking questions to be accepted. naturally by the population and by professionals.
“Not doing so,” says the WHO, “is allowing violence to continue and women’s health to worsen. Taking action contributes, in addition to being able to resolve the case, to dispel the myths and beliefs that accompany gender violence. It is often not interventions are made out of fear of not knowing what to do, causing more damage, or other conditions, but it is important to point out that the mere fact of listening respectfully is a therapeutic act. Frequently the consultation is the only space that the woman has to talk about Its happen with him.
