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A bridge to safety – for whom?: intimate partner violence and formal support for women with disabilities in Sweden
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0002-4278-7089
2025 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
En väg till trygghet — för vem? : våld i nära relationer och  samhällets stöd till kvinnor med funktionsnedsättning i Sverige (English)
Abstract [en]

Aim: This thesis explores the lived experiences of women with disabilities subjected to intimate partner violence (IPV) and assesses support providers’ readiness and self-perceived competence to support them. It applies an intersectional and epistemic injustice lens to understand how gender, disability, and structural aspects shape both experiences of IPV and institutional responses.

Methods: This study employed both qualitative and quantitative methods and comprises two sub-studies. The first sub-study involved in-depth interviews with 11 women with disabilities who had experienced IPV and sought support from various formal support institutions, including the police, social services, shelters, healthcare, and the Centre against Violence. Their narratives were analyzed using reflexive thematic analysis. The second sub-study assessed the perspectives of support providers through a nationwide survey (N=1,151) and 18 qualitative interviews, focusing on their self-perceived competence and readiness to support women with disabilities subjected to IPV.

Findings: The women with disabilities interviewed reported experiencing multiple forms of IPV — physical, psychological, sexual, economic, digital — and disability-specific abuse, often extending beyond intimate partners to others in their intimate personal spaces. They described psychological abuse as being particularly harmful yet often overlooked in institutional responses. The women’s experiences were marked by testimonial injustice, where their credibility was undermined and hermeneutical injustice, where support systems lacked the conceptual and structural frameworks needed to understand and respond to their needs. Support providers indicated that IPV and disability-specific training enhanced their self-perceived competence. However, where disability-specific guidelines existed, they were inconsistently followed. Readiness to support women with disabilities was shaped not only by individual training but also by systemic and organizational factors, including employer support, the presence of clear routines and guidelines, collaboration within and between institutions, and adaptations to ensure accessibility.

Conclusions: This thesis underscores the need for structural reforms to ensure disability inclusion in IPV support services. Tailored guidelines, meaningful accessibility, institutional collaboration, and recognition of disabled women as credible knowers are essential.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2025. , p. 96
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2377
Keywords [en]
Intimate partner violence, women with disabilities, formal support, intersectionality, epistemic injustice, Sweden
National Category
Public Health, Global Health and Social Medicine Social Work
Research subject
Public health; Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-243572ISBN: 978-91-8070-768-8 (print)ISBN: 978-91-8070-769-5 (electronic)OAI: oai:DiVA.org:umu-243572DiVA, id: diva2:1991993
Public defence
2025-09-19, 5B P6, Stora Hörsalen, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Funder
Wallenberg FoundationsForte, Swedish Research Council for Health, Working Life and WelfareAvailable from: 2025-08-29 Created: 2025-08-26 Last updated: 2025-09-30Bibliographically approved
List of papers
1. Women with disabilities’ experiences of intimate partner violence: a qualitative study from Sweden
Open this publication in new window or tab >>Women with disabilities’ experiences of intimate partner violence: a qualitative study from Sweden
2023 (English)In: BMC Women's Health, E-ISSN 1472-6874, Vol. 23, no 1, article id 381Article in journal (Refereed) Published
Abstract [en]

Background: Intimate Partner Violence (IPV) is a prevalent form of gender-based violence affecting one in three women globally. It is also a preventable cause of ill-health, disability, and death. Current research suggests that women with disabilities are at a significantly higher risk of experiencing violence throughout their lifetime. They are almost twice as likely to experience violence compared to men with disabilities or men and women without disabilities. Additionally, they experience higher rates of all types of violence. This increased vulnerability may be due to factors related to disability such as dependence on others for support, mistrust, and social and physical isolation. Although there is existing research on IPV against women in general, there is limited knowledge on IPV against women with disabilities. To address this gap in knowledge, this study aimed to explore women with disabilities’ perceptions and experiences of being victims/survivors of IPV in Sweden.

Methods: This was a qualitative study conducted through in-depth interviews with eleven women with disabilities. The participants were aged eighteen years upwards. The collected data was analyzed using reflexive thematic analysis with a constructivist epistemological standpoint.

Results: We developed four themes. Theme one: “multiple abuse by multiple abusers, over time,” describes the participants’ experiences of various types of violence from different perpetrators for prolonged periods. Theme two: “psychological abuse—harmful, but neglected and difficult to prove,” explains how women with disabilities’ perceive psychological abuse as harmful, but not given the same level of seriousness as physical violence. It also expresses the difficulties they encountered in providing tangible evidence to prove instances of psychological abuse. Theme three: “abuse does not end with separation,” highlights how abuse can continue beyond separation/divorce. Theme four: “surviving abusive relationships” describes the different and evolving ways the participants used to navigate their abusive relationships.

Conclusions: Women with disabilities face all forms of abuse. They find it challenging to prove psychological abuse, and the system is inadequate in addressing its harm. The abuse also continues after separation or divorce. The support system should consider the needs of women with disabilities who experience violence, both during and after the abusive relationship. Service providers should be better equipped to detect and handle all types of IPV, especially psychological abuse.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
In-depth interviews, Intimate partner violence, Reflexive thematic analysis, Women with disabilities
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:umu:diva-212466 (URN)10.1186/s12905-023-02524-8 (DOI)001029964600001 ()37474929 (PubMedID)2-s2.0-85165318152 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, STYB-2019/0005
Available from: 2023-08-04 Created: 2023-08-04 Last updated: 2025-08-26Bibliographically approved
2. The feeling that I'm unimportant: epistemic injustice lens on formal support for women with disabilities survivors of intimate partner violence
Open this publication in new window or tab >>The feeling that I'm unimportant: epistemic injustice lens on formal support for women with disabilities survivors of intimate partner violence
2026 (English)In: Journal of Gender-Based Violence, ISSN 2398-6808, E-ISSN 2398-6816, Vol. 10, no 1, p. 171-188Article in journal (Refereed) Published
Abstract [en]

Intimate partner violence is a pervasive injustice that affects one in three women globally. Women experiencing intimate partner violence require immediate, compassionate and nonjudgemental support, not only to prevent negative outcomes and aid in recovery but also to encourage functionality and resilience. However, maintaining equitable relationships during the support-seeking process poses challenges. Formal support can either validate or contribute to re-victimisation, thereby influencing the rectification or reinforcement of injustices. This article explores the experiences of women with disabilities seeking formal support relating to intimate partner violence, utilising an epistemic injustice lens. The focus is on formal support in Sweden, delivered by professionals in healthcare, social services, the police, women's shelters, and the Centre against Violence (centrum mot v & aring;ld). Employing reflexive thematic analysis guided by epistemic injustice as a theoretical framework, the results reveal instances of epistemic injustice. Participants expressed feelings of marginalisation, unheard voices, mistrust and misunderstanding within a formal support system they described as unintelligible and fragmented. Continuous scrutiny of the support-seeking process, coupled with improvements in the capacity of support providers and a re-evaluation of guidelines and procedures, becomes essential to promote inclusivity for women with disabilities, thereby contributing to the achieving of epistemic justice.

Place, publisher, year, edition, pages
Bristol University Press, 2026
Keywords
intimate partner violence, epistemic injustice, women with disabilities, formal support
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-242760 (URN)10.1332/23986808Y2025D000000074 (DOI)001434544500001 ()2-s2.0-105029270449 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-01841Marcus and Amalia Wallenberg Foundation, MAW 2019 0003
Available from: 2025-08-07 Created: 2025-08-07 Last updated: 2026-03-02Bibliographically approved
3. Service providers' self-perceived competence in supporting women with disabilities subjected to intimate partner violence: insights from a Swedish survey
Open this publication in new window or tab >>Service providers' self-perceived competence in supporting women with disabilities subjected to intimate partner violence: insights from a Swedish survey
2025 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 18, no 1, article id 2476822Article in journal (Refereed) Published
Abstract [en]

Background: Intimate partner violence (IPV) is a global issue, with women, especially those with disabilities, facing a higher lifetime risk than those without disabilities. Given the elevated risk factors and challenges related to having a disability, it is crucial to provide effective IPV support. The competence and expertise of service providers regarding IPV significantly influence their ability to provide adequate IPV support. Understanding service providers' self-perceived competence is essential for improving the quality of IPV support for women with disabilities.

Objective: This study assesses the self-perceived competence of service providers in supporting women with disabilities subjected to IPV in Sweden.

Methods: A cross-sectional survey was distributed to professionals in healthcare, social services, and the police, and 1,151 people participated. Descriptive statistics and linear regression analyses were performed to assess the factors influencing service providers' self-perceived competence.

Results: The findings indicate that healthcare, police, and social services professionals often encounter women with disabilities, but they rarely ask them directly about IPV. Many don't routinely inquire about IPV exposure. While institutional routines for addressing IPV exist, service providers don't consistently implement or use them. Key factors influencing self-perceived competence include receiving IPV and disability-specific training and sufficient employer support for addressing IPV among women with disabilities.

Conclusions: The findings underscore the need for a more consistent application of routines and enhanced training to strengthen the capacity of service providers to support women with disabilities subjected to IPV.

Place, publisher, year, edition, pages
Taylor & Francis, 2025
Keywords
Intimate partner violence, women with disabilities, formal support, selfperceived competence, service providers
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:umu:diva-237304 (URN)10.1080/16549716.2025.2476822 (DOI)001460725900001 ()40190214 (PubMedID)2-s2.0-105002241249 (Scopus ID)
Projects
DISTIME
Funder
Marcus and Amalia Wallenberg Foundation, MAW 2019.0003
Available from: 2025-04-07 Created: 2025-04-07 Last updated: 2026-08-24Bibliographically approved
4. Assessing formal service providers’ readiness to address ipv among women with disabilities in Sweden: a mixed-methods analysis
Open this publication in new window or tab >>Assessing formal service providers’ readiness to address ipv among women with disabilities in Sweden: a mixed-methods analysis
(English)Manuscript (preprint) (Other academic)
Keywords
Intimate partner violence, mixed methods, service providers, women with disabilities, formal support
National Category
Public Health, Global Health and Social Medicine Social Work
Research subject
Epidemiology; Public health
Identifiers
urn:nbn:se:umu:diva-243574 (URN)
Available from: 2025-08-26 Created: 2025-08-26 Last updated: 2025-08-26Bibliographically approved

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