Is intimate partner sexual violence a singular violence?

Objective: This study aims to examine the specificities of intimate partner sexual violence among heterosexual partners, as well as to contrast them to the sexual violence perpetrated by strangers or acquaintances.

Method: A narrative review was conducted to identify relevant findings in the scientific and medical literature to inform about intimate partner sexual violence. Findings were also analysed with the lens of the clinical experience of the authors working with men convicted of intimate partner sexual violence.

Results: Intimate partner sexual violence was legally recognized by article 222-22 of the French Penal Code in 2006. In France rape committed by intimate partners accounts for 34% of rapes of adult women. Intimate partner sexual violence is likely to be underestimated due to variables of individual, relationship, community, and societal levels. Despite a common perception that intimate partner sexual violence is located at the lower end of the severity continuum compared with other forms of sexual violence, studies have shown that intimate sexual violence is as or even more harmful to a woman. Compared to victims of other types of sexual violence, women sexually abused by an intimate partner experience more severe mental health outcomes such as depression, anxiety, anger, self-blame, increased feelings of shame, post-traumatic stress disorder, substance abuse to cope or suicide attempt. Intimate partner sexual violence is also associated with humiliation and betrayal of trust, greater physical violence, greater risk of sexually transmitted infections, re-victimization, higher risk of serious injury or homicide. Beyond the legal definition of sexual rape, intimate partner sexual violence encompasses a wide range of subtle and complex behaviors such as coercive tactics, blackmail, implicit threat or reproductive control. The COVID-19 pandemic lockdown seems to have played a "revealing" or "aggravating" role rather than a "triggering" of intimate violence. The treatment of intimate partner sexual violence is complex and should consider diverse therapeutic strategies to deconstruct the offenders' societal misrepresentations and to make them aware of their partner's inter-subjectivity.

Conclusions: Identifying and understanding intimate partner sexual violence need to be improved both to refine the treatment of the offender-victim dyad and to break down the toxic relational dynamics maintaining abusive behaviors.