Family, domestic and sexual violence (FDSV) is a major health and welfare issue in Australia, occurring across all socioeconomic and demographic groups but predominantly affecting women and children.1 It affects people from all backgrounds — and while physical abuse may be the most visible, many victims suffer silently from emotional, financial, and sexual violence that can be just as damaging.
At Qualitas Medical Practice, we recognise the crucial role of healthcare providers in identifying, supporting, and guiding those experiencing abuse. Understanding FDSV’s complexities and risk factors is key to providing safe and compassionate care.
What Is Family, Domestic and Sexual Violence?
Family, domestic, and sexual violence describes a range of harmful behaviours that occur within close personal or family relationships. It includes patterns of abuse or control that can cause physical injury, emotional trauma, psychological harm, financial hardship, or sexual exploitation. 2
Domestic Violence (Intimate Partner Violence)
Domestic violence — also known as intimate partner violence — refers specifically to abusive behaviour that occurs in a romantic or intimate relationship. This includes abuse within current or former partnerships, casual dating relationships, or long-term cohabitation. 2
Although commonly associated with incidents in the home, domestic violence can also take place in public, online, or between people who do not live together. It remains the most common form of violence experienced by women in Australia.
Family Violence
Family violence is a broader concept that includes not only intimate partners, but also abuse occurring between other family members. It can involve 3:
- Children and young people experiencing harm from parents or guardians
- Parents or carers being harmed by children or adolescents
- Sibling violence
- Abuse from extended family members, such as in-laws or members of a close-knit community
- Elder abuse — particularly where power imbalances or expectations of care exist
- Forced marriage or servitude within a family context
Family violence is the preferred term used by many Aboriginal and Torres Strait Islander communities, recognising the complex and extended nature of kinship and family relationships across generations and households.
Sexual Violence
Sexual violence occurs when any sexual act is carried out without the other person’s clear, voluntary, and ongoing consent. This includes: 4
- Sexual assault or rape
- Sexual threats or coercion
- Unwanted touching
- Child sexual abuse
- Image-based abuse (e.g., sharing explicit images without consent)
- Sexual harassment
Types of Abusive Behaviour
Both family and domestic violence can include a range of abusive tactics used to intimidate, control, and harm, such as: 5
- Physical abuse: Hitting, pushing, choking, burning, or other forms of physical harm
- Sexual abuse: Unwanted sexual contact, coercion, or violence without freely given consent
- Emotional or psychological abuse: Manipulation, humiliation, constant criticism, or threats
- Coercive control: A long-term pattern of controlling behaviours designed to dominate and isolate the victim — including surveillance, threats, or social isolation
- Financial abuse: Withholding access to money, restricting employment, or controlling financial decisions
- Technological abuse: Using digital platforms to harass, monitor, or threaten
These behaviours may occur as isolated incidents or, more commonly, as part of a persistent and escalating pattern that erodes the victim’s autonomy and well-being over time.
Patterns and the Cycle of Abuse
Abuse often doesn’t start with obvious violence. Instead, it can follow a recurring cycle designed to control, isolate, and confuse the victim over time. Understanding this cycle can help identify unhealthy and abusive relationships early.
The cycle of abuse typically includes four stages:
1. Honeymoon/Calm
The relationship appears peaceful. The abuser may offer affection, compliments, gifts, or reassurance. This phase can feel loving and genuine, making it harder to recognise the warning signs or leave the relationship.
2. Tension Building
Tension gradually increases. The abuser may show signs of jealousy, mood swings, insults, or controlling behaviours. Victims often feel anxious, walking on eggshells to avoid triggering conflict.
3. Explosion
The abuse escalates into verbal, emotional, physical, or sexual violence. This may include threats, intimidation, property damage, or direct harm.
4. Making Up
After the incident, the abuser may apologise, shift blame, offer grand gestures, or promise to change. Gaslighting may occur — making the victim question their own memory or feelings.
This repeated cycle makes it harder for victims to leave, as the emotional highs and lows can create dependence and confusion. Recognising the pattern is a critical first step towards seeking help.
(source: Central and Eastern Sydney PHN)
What Are the Warning Signs?
Family, domestic, and sexual violence isn’t always easy to recognise — especially when there’s no visible injury. Abuse often begins subtly and escalates over time. Here are some common warning signs that may indicate someone is experiencing or at risk of abuse:
Emotional and Psychological Abuse
- Constant criticism, name-calling or belittling
- Gaslighting — making the victim question their memory, perception, or sanity
- Isolating the person from family, friends, or community
- Monitoring activities or communication
Coercive Control
- Controlling where someone goes, who they see, or what they do
- Making all financial decisions or withholding money
- Threats to harm the victim, children, pets, or themselves
- Intimidation through gestures, looks, or destruction of property
Physical and Sexual Abuse
- Hitting, pushing, slapping, choking, or using weapons
- Forcing or pressuring sexual activity without consent
- Using physical force during arguments
- Injuries with vague or inconsistent explanations
Technology-Facilitated Abuse
- Tracking someone through their phone or online accounts
- Sending abusive messages or images
- Sharing or threatening to share private photos or videos without consent
Red Flags in the Relationship
- The person feels afraid of their partner or walks on eggshells
- Rapid changes in mood or behaviour, especially around the partner
- Loss of confidence or increasing withdrawal from social life
- Their partner insists on always being present or speaking for them
How common is Family, Domestic and Sexual Violence?
Worldwide
The World Health Organisation (WHO)6 notes that globally about 1 in 3 (30%) of women worldwide have been subjected to either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime. Most of this violence is intimate partner violence. Worldwide, almost one third (27%) of women aged 15-49 years who have been in a relationship report that they have been subjected to some form of physical and/or sexual violence by their intimate partner. Remember, though, that men can also be victims and survivors of domestic violence.
Australia
27% of women and 12% of men in Australia experienced violence by an intimate partner or family member. 7 30% of non-binary people, 31% of trans men, and 20% of trans women in Australia have experienced physical violence from a family member. 8
Risk Factors Associated with FDSV
According to the Australian Institute of Health and Welfare (AIHW), FDSV is not caused by any single factor — but is influenced by a complex interplay of individual, relationship, community, and societal-level risk factors.
Commonly associated factors include:1
- Attitudes and beliefs that support violence: This includes gender inequality, male dominance in relationships, and the condoning of aggressive behaviour.
- Alcohol and drug misuse: Substance use is a common contributing factor in violent incidents and can increase the severity and frequency of abuse.
- Financial stress or unemployment: Economic insecurity is linked with higher rates of abuse, often exacerbating power imbalances.
- Mental health conditions: Both victims and perpetrators may experience mental health issues that contribute to or result from violence.
- Childhood exposure to violence: Experiencing or witnessing abuse during childhood significantly increases the risk of being a victim or perpetrator in adulthood.
- Relationship conflict or breakdown: Separation is a particularly dangerous time, with increased risk of stalking and fatal violence.
Understanding these factors helps our health professionals at Qualitas Medical Practice identify patients who may be at higher risk and offer the right interventions at the right time.
Who Is Most Affected?
Certain population groups face a disproportionate risk of experiencing FDSV:1
- Women, especially those aged 18–44
- Aboriginal and Torres Strait Islander people with higher hospitalisation and mortality rates from domestic violence
- People with disability, particularly women with cognitive disabilities
- Culturally and linguistically diverse (CALD) communities, who may face language barriers, immigration concerns, or limited access to services
- Older people, especially in caregiving relationships, where elder abuse can occur
LGBTIQA+ Communities and FDSV
While FDSV affects people across all communities, LGBTIQA+ people face unique vulnerabilities that often go unrecognised and underreported.
Key insights from the Australian Institute of Health and Welfare (AIHW):9
High prevalence: Studies show that LGBTIQA+ people are more likely than their heterosexual, cisgender peers to experience various forms of intimate partner violence, including physical, emotional, and sexual abuse.
Barriers to seeking help:
- Fear of discrimination from service providers
- Lack of LGBTIQA+ inclusive services
- Concerns around outing, stigma, and not being believed
Types of abuse unique to LGBTIQA+ people may include:
- Threats to disclose sexual orientation or gender identity
- Misgendering, deadnaming, or invalidating a person’s gender identity
- Isolation from affirming community support
At Qualitas Medical Practice, we are committed to providing safe, inclusive, and confidential care for patients of all sexual orientations and gender identities. No one should face abuse in silence due to fear of discrimination.
The Role of Healthcare Providers
As one of the few regular points of contact for many people, general practitioners (GPs) and healthcare providers are uniquely positioned to identify early signs of FDSV.
At Qualitas Health, we ensure our team is trained to:
- Offer a private, non-judgmental space for disclosure
- Recognise both physical and non-physical signs of abuse
- Refer patients to appropriate support services, including emergency housing and legal support
- Support mental health recovery with care plans, therapy referrals, and ongoing follow-up
- Maintain confidentiality while prioritising patient safety
What You Can Do If You or Someone You Know Is Experiencing Abuse
You are not alone. If you or someone you know is experiencing family, domestic, or sexual violence, there are services available that offer support, safety, and guidance.
National Support Services:
1800RESPECT – 1800 737 732
24/7 counselling and support for anyone affected by sexual, domestic, or family violence
Lifeline – 13 11 14
Crisis support and suicide prevention hotline
Legal Aid NSW: Free legal advice for domestic violence matters (1800 719 801).
QLife – 1800 184 527 LGBTIQA+ peer support and referrals
Safe Steps (VIC) – 1800 015 188
DVConnect (QLD) – 1800 811 811
Men’s Referral Service – 1300 766 491
Kids Helpline – 1800 55 1800
Taking the First Step Towards Safety
Leaving an abusive relationship can be incredibly difficult but help is available if you’re unsure where to start:
Reach Out: Confide in a trusted friend, GP, or counsellor.
Document Abuse: Keep a private record of incidents (e.g., photos, messages).
Plan Safely: Pack essentials (ID, medications, cash) and store them somewhere secure.
Remember: You deserve safety and respect. Abuse is never your fault, and support is always within reach.
You Deserve to Feel Safe
At Qualitas Medical Practice, we believe everyone deserves to live free from fear, violence, and control. Abuse is never the victim’s fault — and seeking help is a brave and important step.
If you are unsure whether what you’re experiencing is abuse, or you’re concerned about a loved one, talk to your GP. Our practices provide a safe, confidential environment where your health and wellbeing come first.
References:
[1]. Australian Institute of Health and Welfare. FDSV summary, 28 Feb 2025.
[2]. Australian Government Department of Health and Aged Care, 2025. About family, domestic and sexual violence. https://www.health.gov.au/topics/family-domestic-and-sexual-violence/about
[3]. Australian Government Department of Social Services, The National Plan to End Violence against Women and Children 2022–2032. https://www.dss.gov.au/national-plan-end-gender-based-violence/resource/national-plan-end-violence-against-women-and-children-2022-2032
[4]. Australian Institute of Health and Welfare (AIHW) , Family, Domestic & Sexual Violence
[5]. Stark, E. (2007). Coercive Control: How Men Entrap Women in Personal Life. Oxford University Press.
[6]. World Health Organization (WHO), Violence against women 2024, Key facts. https://www.who.int/news-room/fact-sheets/detail/violence-against-women
[7] Australian Bureau of Statistics, Personal Safety Survey 2021-22 (published March 2023)
[8]. Adam O. Hill, Adam Bourne, Ruth McNair, Marina Carman and Anthony Lyons, A national survey of the health and wellbeing of LGBTIQ people in Australia, 2020.
[9]. Australian Institute of Health and Welfare, Family, domestic and sexual violence LGBTIQA+ people, updated on 28th Feb 2025. https://www.aihw.gov.au/family-domestic-and-sexual-violence/population-groups/lgbtiqa-people
