Beyond surviving: Examining inequities in access to gender-based violence support services for racialized women
About the project
Vulnerability to gender-based violence (GBV) is three times higher for racialized women as compared to non-racialized and non-Indigenous women. Structural and systemic barriers, including pervasive gender inequalities and racism within health and social care institutions, not only create and exacerbate the conditions for vulnerability, but have also sustained disparities in outcomes for racialized victims/survivors. Consequently, racialized women disproportionately experience GBV-related health and psychosocial sequela, such as mental health concerns and a decrease in quality of life, social capital, and employment opportunities. Access to culturally sensitive and trauma-informed support services is critical for mitigating the health, psychosocial and economic consequences of GBV for racialized victims/survivors. Accordingly, this scoping review examined access to support services among racialized women exposed to GBV globally.
Methods: Following the Arksey and O’Malley framework, a search was conducted in seven databases (Medline, Embase, Web of Science, Scopus, EconLit, CINAHL, and PsycInfo) to identify studies published from 2015 that focused on help-seeking behaviours and access to support services among racialized women who experienced GBV. Support services were defined as the provision of assistance to address immediate or longer-term health and non-health needs, including psychosocial and economic support, and healthcare services.
Key findings
The literature (n=127) primarily examined partner violence among Black, Latin/e/x, and South Asian populations, with fewer studies examining the experiences of East Asian, Southeast Asian, Arab, and Indigenous populations. Included studies focused on cisgender women and only seven studies reported on the experiences of transgender women. 57% of the studies were published between 2020 and 2023, and the global distribution highlights that the literature is dominated by studies from high-income countries.
Both motivators and barriers to help-seeking and access to support services were identified. The main motivators for help-seeking included having:
- informal support predominately from family and friends,
- positive experiences with services and providers, and
- a desire to protect one’s children from harm.
Four categories of barriers to accessing support services were identified:
- Intrapersonal factors: Lack of knowledge of available support services and fear of punitive actions, such as child removal and loss of financial support, were identified in several qualitative studies conducted in high-income countries. Studies with immigrant Latin/e/x and Black women highlighted how cultural acceptance of abuse, anticipated stigma and internalized shame, all embedded in cultural and religious beliefs around family, imposed barriers to help-seeking.
- Lack of culturally and linguistically appropriate services: Language and confidentiality concerns created barriers to accessing support services. Studies highlighted concerns about uncertainty and apprehension about whether they could access care in their native language. Studies with transwomen described the importance of gender-affirming care, such as gender-inclusive language, to reduce negative attitudes, biases and stereotypes that resulted in feelings of alienation.
- Systemic failures: Several studies identified institutional barriers at the point of disclosure or initial engagement with services. These included long waitlists, high out-of-pocket costs and eligibility criteria that limited access. Additionally, distrust in formal service providers due to negative past experiences of discrimination and marginalization, particularly based on race and sexual orientation, was identified in several studies. Together, these multi-system barriers impeded service uptake among racialized victims/survivors.
- Policy barriers: For immigrant women, tenuous immigration status and immigration policies presented barriers to seeking help due to bureaucratic processes. Some studies also demonstrated the challenges of employment-based insurance coverage which limited access to necessary health services for the unemployed and those with precarious immigration status.
These findings should be interpreted considering the differing political landscapes and health systems across countries represented in this review.
Policy implications
The recommendations from this review can inform program and policy development to better respond to, and address, the urgent needs of racialized women through the formation of inclusive, person-centered intervention initiatives. For example:
- Adopt an intersectional lens and trauma-informed policies to establish safe and compassionate spaces that meet the unique needs of survivors without revictimizing women and acknowledge the pervasiveness of GBV. This approach will also support culturally sensitive care; increased self-confidence that allows individuals to address feelings of fear, shame and isolation; and connections to social networks to support employment and financial independence.
- Enable the empowerment of women through training and employment opportunities to gain financial autonomy. Interventions to foster social relationships and community bonds among racialized women experiencing GBV is an area for policy and program development.
- Prioritize funding for GBV support programs, including prevention initiatives to improve the effectiveness, including cultural responsiveness and safety, of community responses and supports available to victims/survivors. Ultimately, investments in the prevention of violence that recognize diverse lived experiences and risks for GBV must be prioritized.
Further information
Contact the researchers
Beverley Essue, PhD, Associate Professor, Institute of Health Policy Management and Evaluation, University of Toronto: beverley.essue@utoronto.ca
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