Women of all ages and backgrounds are at risk of many different types of violence. In fact, millions of women in this country have experienced violence. Violence greatly affects the lives and health of women: the impact can last for years, even a lifetime. But there are places to turn for help, ways to protect yourself, and hope for healing and a better future.
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Violence Against Women
235
Violence Against
Women
Women of all ages and backgrounds are at risk of many different
types of violence. In fact, millions of women in this country
have experienced violence. Violence greatly affects the lives and
health of women: the impact can last for years––even a lifetime.
But there are places to turn for help, ways to protect yourself,
and hope for healing and a better future.
Women at risk
Women and girls of all ages, races, cul-
tures, religions, education levels, and sex-
ual orientations can experience violence.
Based on reported cases, U.S. women
most at risk of violence are:
l American Indians/Alaskan Natives
l African Americans
l Hispanics
l girls younger than 18
l women and girls living in poverty
The impact of violence
Experiencing violence can greatly impact
how you feel about yourself, relation-
ships, and the world around you. It can
affect your physical and mental health.
And it can change your behavior and
daily life.
No one has the right to hurt you or make
you feel afraid. Do not let feelings of
fear, shame, or guilt stop you from seek-
ing help. You are not at fault, and you
do not need to hide what has happened.
Many people and groups are willing to
help you.
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The Healthy Woman: A Complete Guide for All Ages
Forms of Violence
Many terms are used to describe vio-
• Homicide, femicide
lence against women:
• Dating violence, dating abuse, teen
• Intimate partner violence
dating violence
• Domestic violence
• Indecent exposure
• Spouse or partner abuse
• Voyeurism
• Wife beating
• Stalking
• Rape, marital rape, date rape
• Harassment
• Family violence
• Human trafficking
• Sexual abuse, sexual violence, sexual
• Genital mutilation
assault
• Exploitation
• Molestation
• Forced prostitution
• Beating, battering
• Forced pornography
Effects of Violence on Women
Mental health
Women hurt by violence may have:
• Depression
• Low self-esteem, loss of confidence
• Posttraumatic stress disorder (PTSD)
• Guilt or shame
• Shock and disbelief
• Anxiety and panic attacks
• Emotional numbness
• Anger
• Self-hate or self-blame
• General sense of fear
• Fear of men, being alone, going out in public, intimacy, or anything that may trig-
ger memories of the violence
• Suicidal thoughts
• Sense of being worthless or without hope
Violence Against Women
237
Effects of Violence on Women
Behavior
Common actions after experiencing violence are:
• Thoughts or acts of suicide or self-injury
• Risky sexual behaviors, such as unprotected sex
• Alcohol or drug abuse
• Eating disorders
• Avoiding doctor visits or making unnecessary doctor visits
Physical health
Common physical injuries and health problems from violence include:
• Increased risk of sexually transmitted infections (STIs) and HIV, which can lead to
pelvic inflammatory disease and a higher risk of cervical cancer
• Unwanted pregnancies, or rapid, repeat pregnancies
• Miscarriages and other reproductive problems
• Vaginal bleeding or pelvic pain
• Injuries such as bruises, cuts, broken bones, or internal damage
• Back or neck pain
• Chronic pain syndrome
• Trouble sleeping and nightmares
• High blood pressure or chest pain
• Arthritis
• High stress and lowered immune system
• Central nervous system problems, such as headaches, seizures, or nerve damage
• Respiratory problems, such as asthma and shortness of breath
• Digestive problems, such as stomach ulcers and nausea
Economic
Common financial struggles due to violence are:
• Loss of income from missed work or a partner who withholds money
• Medical bills
• Legal fees
• Rent or moving costs of new housing
• Extra child care and protection costs
Social
Common social issues due to violence include:
• Stigma and discrimination
• Trouble getting medical, social, and legal services
• Strained relationships with friends and family
• Social isolation (from family, friends, and others who could help)
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The Healthy Woman: A Complete Guide for All Ages
Impact on children
Violence against women can also im-
pact children. About 50 percent of men
who assault their wives also physically
abuse their children. Also, women who
are abused are more likely to abuse their
children. And children can be injured
during violence between their parents.
Studies show children who witness or
experience violence at home may have
long-term physical, emotional, and so-
cial problems. They are also more likely
to experience or commit violence in the
future. Protect your children by getting
help for yourself.
Common forms of violence
Although women often fear being at-
tacked or hurt by a stranger, they are at
greatest risk of violence from people they
know:
l About 25 to 30 percent of women are
physically or sexually abused by a ro-
mantic partner.
l One in 6 women reports being raped
or sexually assaulted in her lifetime.
And nearly 70 percent are attacked
by someone they know. (Research has
shown that most women do not re-
port their rapes to police, so the actual
number of women raped may be much
higher.)
l Around 1 million women are stalked
each year, most often by someone
they know, such as an ex-husband, ex-
boyfriend, or peer.
This chapter focuses on three types of
common violence against women:
• intimate partner violence
• sexual violence
• stalking
Intimate partner violence (IPV)
IPV can be a one-time event or a pattern
of physical, sexual, or psychological harm
by a current or former partner or spouse.
It happens in both heterosexual and
same-sex couples. And it can happen in
nonsexual relationships. Teen dating vio-
lence has many of the same risk factors,
warning signs, and effects as IPV.
Violence Against Women
239
Forms of IPV
Physical violence or threats
Your partner may:
• Hurt or threaten you, possibly with a weapon
• Become violent after alcohol or drug use
• Destroy your things
Sexual abuse or threats
Your partner may:
• Force you to have sex or be sexual in other ways
• Threaten to rape or hurt you sexually
Psychological/emotional abuse
IPV often starts with emotional abuse, then leads to physical violence.
Your partner may:
• Control who you spend time with, where you go, and what you do
• Trace your phone calls
• Insult you and get angry about small things
• Accuse you of cheating
• Make fun of you
• Control how you spend your money or refuse to give you money
• Act jealous when you spend time with friends
• Blame you for his or her violence
• Use your children to manipulate you
• Follow you when you go out
• Try to make you afraid
IPV is never okay, even if it only happens
once in a while. It can be hard to admit
you are in an abusive relationship or find
a way out. But if your partner is hurting
you, it is time to get help.
Many abused women stay with their
partner out of fear or because they do
not see a way out. Others stay because
they love their partner and believe he
or she will change. But the longer the
abuse goes on, the more damage it can
cause. Whether you decide to leave your
partner or stay, make a safety plan in case
IPV happens again. (See page 241 for
“Planning Ahead.”)
If you leave, plan ahead for legal, medi-
cal, and emotional support, because IPV
can escalate even after leaving a partner.
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The Healthy Woman: A Complete Guide for All Ages
You may even need help from police and
women’s shelters. They can help you find
ways to protect yourself and your children.
l If you are in immediate danger, call 911.
l For 24-hour help and support, call the
National Domestic Violence Hotline
toll-free number listed in the resource
section on page 249.
Preventing IPV
Help prevent IPV in your own life by
seeking and building healthy relation-
ships. Below are some signs of healthy
and unhealthy relationships.
IPV and Pregnancy
IPV can affect the health of the mother
and unborn baby. Abuse from a part-
ner may begin, or increase, during
pregnancy and can lead to:
• low-birth-weight babies and other
health risks
• death of unborn and newborn babies
• homicide, which is the second lead-
ing cause of traumatic death for
pregnant women and mothers with
newborns
Signs of a healthy relationship
Signs of an unhealthy relationship
• Respect for each other
• Honesty
• Trust and support
• Able to compromise
• Shared decision making
• You are able to be yourself
• Time spent together and apart
• Good communication
• Peaceful solutions to conflict
• Anger control
• Self-confidence and happiness
• Feeling safe with partner, even when he or she is
upset
• Disrespect
• Blaming and lying
• Mistrust and jealousy
• Put-downs, insults, name calling
• One partner controls decision making
• “Need” to be with partner; cannot be without the
other
• Fear of partner’s temper or actions
• Partner pressures or forces other to be sexual
• Fights get out of control
• Feeling worthless or bad about yourself
• Feeling unsafe with your partner
Early warning signs of IPV
If your partner displays one or more of
the early signs below, get help early to
prevent future IPV. If you start dating
someone who displays warning signs,
think twice about getting involved.
Does your partner or person you date:
l Get jealous when you spend time with
other people?
l Act possessive?
l Have low self-esteem?
l Act aggressive?
l Create conflict, use put-downs, or
argue a lot?
l Mistreat animals?
l Abuse drugs or alcohol?
l Have poor relationships with others?
l React badly to stress?
l Have extreme emotional highs and lows?
Violence Against Women
241
l Have a quick temper and lots of anger?
l Punch walls or throw things when
angry?
l Need to be in control of the relation-
ship?
l Have a history of bad relationships?
Highest risks of IPV
You cannot always predict whether your
partner will become violent. But stud-
ies show some traits increase the risk of
someone becoming violent with their
partner. These traits include:
l abusing drugs or alcohol
l thinking violence in a relationship is
all right
l strict beliefs about traditional gender
roles
l having a lot of anger or hostility
l a history of partner abuse
l depression
l career or life stress, such as not having
a job
l having been a victim of, or exposed to,
violence as a child
Planning Ahead
If you are being abused, create a safety plan. Contact the
National Domestic Violence Hotline for help.
A few ways to prepare are to:
• Plan all possible escape routes from your home.
• Know your partner’s “red flags”; leave the house if you
sense your partner will become violent.
• Avoid fights in rooms without access to a door or where weapons are kept.
• Find a safe place to go if you are in danger—family, friends, a shelter.
• Get a court protective order.
• Memorize emergency numbers.
• Have money available—cash kept with a friend, a separate savings account, a cred-
it card.
• Teach your children not to get in the middle of a fight between you and your partner.
• Have a cell phone or calling card handy; do not use your home phone or cell phone
to call for help if your partner can trace the numbers.
• Create a signal to use with friends and family to alert them to danger.
• Have access to important items such as extra car keys, a driver’s license, social
security number, checkbook, address book or a list of important numbers, health
insurance card, passport, immigration papers, copies of birth certificates for you
and your children, school and medical records, and children’s favorite toys.
• Keep copies of important papers and items (including a change of clothes) with a
trusted friend or relative.
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The Healthy Woman: A Complete Guide for All Ages
Leaving an abusive partner takes cour-
age, support, and planning. But it is pos-
sible. For your safety and the safety of
The Cycle of Violence
IPV can follow a three-stage cycle that
repeats over and over. It is called the
“Cycle of Violence.”
1. Tension-building stage: Tension
builds over time and may include
“minor” incidents such as pushing
or threats. To delay movement to
stage two the victim may act pas-
sive, “stay out of the way,” and avoid
making the partner upset.
2. Violent stage: Tension explodes,
resulting in severe abuse.
3. Honeymoon stage: The abuser
apologizes, promises to stop the
abuse, and often is very loving for
a while. The abuser may feel sorry
about the abuse, promise to stop
and get help, and show regret and
extra kindness. The victim then feels
loved and believes the violence will
end. The cycle then repeats.
In time, the honeymoon stage may get
shorter, and the tension-building and
violent stages longer.
Tension-building
stage
Violent
stage
Honeymoon
stage
your children, talk about your options
with an IPV counselor before you leave.
If the IPV is mild or has just started, get
professional help before it gets worse. If
you choose to stay with your partner, the
abuse may get worse over time—even if
you get help. So have a safety plan ready.
You cannot change your partner by lov-
ing him or her more, by changing your-
self, or by hoping he or she will change
if you wait it out. Your partner needs to
get help, but even that may not stop the
abuse. A relationship should not leave
you feeling scared, depressed, hopeless,
worthless, or in danger. You deserve to be
safe and treated well. If the abuse contin-
ues, help is just a phone call away.
Sexual violence
Sexual violence is all completed or at-
tempted sexual contact or behavior that
happens without your clear, voluntary
consent. No one has the right to make
you be sexual, including your partner.
Sexual violence can shatter a woman’s
life in an instant. And it can take years to
emotionally heal from the experience.
Sexual violence includes:
l Improper and unwanted touching,
kissing, fondling, and groping.
l Sexual assault, such as rape or attempt-
ed rape (vaginal, oral, or anal). This
includes sex when the victim is drunk,
unconscious, or unable to give willing
consent. It also includes unwanted sex
with a partner, spouse, or date.
l Verbal, visual, or other noncontact sex-
ual actions that force a person to join
in unwanted sexual contact or atten-
tion. This includes flashing of sexual
Violence Against Women
243
Elder Abuse
Elder abuse is doing something, or failing to do something, that causes harm or risks
harm to a vulnerable older adult. Nearly 90 percent of the abusers are family mem-
bers, most often adult children or spouses. Elder abuse also happens in places such
as nursing homes and hospitals. Among the elderly, women ages 80 and older are at
highest risk for being abused or neglected.
Elder abuse includes:
• physical, sexual, or emotional abuse
• financial abuse such as taking or misusing an elderly person’s money or property,
or tricking her into spending or investing money
• ignoring or abandoning an elderly person under your care
If you think an elderly person you know is being abused, please tell someone. Call
your local adult protective services, long-term care ombudsman, or the police.
If you are being abused, you can:
• Tell someone you trust, such as a doctor or friend.
• Call the U.S. Administration on Aging’s Eldercare Locator toll-free number listed in
the resource section on page 249 to find a local agency that can help.
• Contact your state or local adult protective services (APS).
body parts, being shown pornography,
and verbal or written sexual harass-
ment.
Sexual violence can happen anywhere—
on a date, at a party, at work, at home, or
in public. The attacker may be a stranger
or someone you know, such as a partner,
family member, or peer. In fact, in 8 of
10 rape cases, the victims know their
rapist.
Survivors may feel shame or guilt. But
you are never at fault—even if you didn’t
fight back or say no because of fear or
shock. You are never to blame for some-
one else’s violence.
If you are a survivor of sexual violence,
professional help and support groups are
available. Even if the abuse or assault is
from childhood, it may still deeply af-
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The Healthy Woman: A Complete Guide for All Ages
fect you. You are not alone, and you do
not need to hide what happened. Silence
only gives the abuser more power. Help
stop sexual violence by healing yourself,
speaking out, and supporting other
survivors.
Sexual Violence: Risk Factors
Risk factors for experiencing
sexual violence
• Young age—more than half of all rapes occur before age 18
• Drug or alcohol abuse
• Having experienced past sexual violence
• Living in poverty
• Having risky sex, such as unprotected sex, sex with many partners,
and/or sex at a young age
Risk factors for becoming
sexually violent
• Alcohol and drug abuse
• Fantasies about forced sex (rape)
• Impulsive and antisocial behavior
• Preference for impersonal sex
• Hostility toward women
• Extreme male stereotyped behaviors
• Sexual and physical abuse as a child
• Witnessed family violence as a child
Getting help after a sexual assault
Take steps right away if you’ve been
assaulted:
l Get away from the attacker and find a
safe place as fast as you can. Call 911
and report the crime.
l Call a friend or family member you
trust. Or call a crisis center or a hot-
line, such as the National Sexual As-
sault Hotline toll-free number listed
in the resource section on page 249.
l Do not wash, comb, or clean any part
of your body. Do not change clothes if
possible, so the hospital staff can col-
lect evidence. Do not touch or change
anything at the crime scene.
l Go to your nearest hospital emergency
room right away. You need to be ex-
amined and treated for injuries.
• Ask if the hospital has a Sexual As-
sault Nurse Examiner (SANE) who
can perform your exam and provide
emotional support. She will collect
evidence using a rape kit to find fi-
bers, hairs, saliva, semen, or clothing
the attacker may have left behind.
• You will be screened for sexually
transmitted infections, offered coun-
seling, or given other treatment.
Violence Against Women
245
• Most hospitals will offer emergency
contraception pills to help prevent
pregnancy. If it is not offered, you
can request it.
• The hospital staff can call the po-
lice and contact a rape crisis center
counselor.
Ways to protect yourself
To reduce your risk of sexual violence:
l Trust your feelings. If you feel in dan-
ger, you probably are and need to get
away.
l Notice what and who is around you.
Know where you are going and stay in
well-lit areas. Park your car in well-lit
areas.
l After getting in your car, drive away.
Do not sit in your car to look at items
you bought or make phone calls.
l If you are in danger, blow a whistle, or
yell “FIRE” instead of “help” or “rape.”
l Never leave a social event with some-
one you just met or do not know well.
l Never walk or jog alone at night or in
secluded areas.
l Meet new dates in public places. Be
careful when meeting people from In-
ternet dating sites. Tell a friend where
you are going and who you are going
out with.
l Never drink anything that has been
out of your sight, or that you did not
see being poured from a new bottle.
Date rape drugs are odorless and
tasteless.
l Avoid parties where a lot of alco-
hol may be served, such as frater-
nity events. Control your drinking at
events.
l Keep your car and home doors locked.
Lock home windows. Install home
security.
l Go out in groups and have friends
watch out for each other.
l Offer help to other women who may
be in danger.
Stalking
Stalking is a pattern of repeated, un-
wanted attention, harassment, or contact
that directly or indirectly communicates
a threat or scares a person.
Stalkers may:
l follow or wait for you in certain places
l appear at your home or work
l sit outside your home
l make harassing phone calls
l leave written messages or objects
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The Healthy Woman: A Complete Guide for All Ages
Cyberstalking
Cyberstalking is use of the Internet, e-mail, or other forms of online communications
to stalk another person. It can include:
• harassment or threats in chat rooms
• e-mail, instant messages (IM), or text message threats and harassment
• improper messages on a message board or in a guest book
• tracing your computer and Internet use
• obscene or improper e-mail messages or photo attachments
• sending electronic viruses
• someone pretending to be you in a chat room
If you are cyberstalked:
• Log off right away and stay off-line for at least 24 hours.
• Send the person a clear, written warning to stop harassing you and to never con-
tact you again.
• If the harassment continues, do not respond to anything the person writes. It gives
them a sense of power and can increase the stalking.
l damage or steal your things
l harass you through the Internet,
e-mail, or chat rooms
l use a hidden camera to watch you
l use computer software and hardware
tools to track and harass you
l send gifts or love letters
l call all the time
Stalking is illegal, yet 1 in 12 women will
be stalked in their lifetimes. It is a crime
that can be hard to prove, harder to stop,
and difficult to get others to take seri-
ously. Yet 76 percent of women killed by
their intimate partners were first stalked
by them.
Most victims are stalked for about 1.8
years. These women often feel helpless,
anxious, and depressed. They often have
nightmares; feel out of control; have
trouble sleeping, eating, and concentrat-
ing; and live with constant fear. Stalking
can also cause financial problems if fear
or depression keeps a woman from going
to work.
Steps to take if you are being stalked:
l Trust your instincts. If you are, or
think you may be, in danger, find a safe
place to go, such as a police station, fire
station, or public area.
l Plan in advance what you will do if
you are in danger.
l If you cannot get out of danger, but
can get to a phone, call 911.
l Get a restraining order. If the or-
der does not stop the stalker, call a
violence hotline for advice (toll-free
numbers are listed in the resource sec-
tion on page 249.)
Violence Against Women
247
• Change your online identity and all of the
information in your IM or chat profile.
• Change your e-mail address and Internet
service provider (ISP).
• For e-mail stalking, contact the person’s
ISP and file a complaint.
• Keep all e-mails or log files from the stalker
for evidence.
• If you think you are in physical danger, con-
tact the police or Federal Bureau of Investigation (FBI).
Be safe online:
• Never post online profiles or messages with details that could be used to identify
or locate you (such as age, sex, address, workplace, phone number, school, teams
you play on, or places you hang out).
• Do not post photos on a site that can be accessed by the public, such as in a
MySpace profile, online dating profile, chat group, or blog.
• Do not tell anyone your online ID or passwords.
l Take threats seriously. File a complaint
with the police. If they cannot help, call
a violence hotline for advice. Until the
stalkers do something they can be ar-
rested for, police can only talk to them.
l Collect evidence for police. Record
every incident. Include the time, date,
and other important information.
l Keep videotapes, audiotapes, answer-
ing machine/voicemail messages, e-
mail messages, photos of the person
outside your home or workplace, prop-
erty damage, and any letters or e-mail.
l Cut off all contact with the stalker.
l Carry a cell phone at all times.
l Secure your home with alarms and
motion-sensitive lights.
l Keep your garage and car locked.
Check around you before getting in
the car. Get a locking gas cap. Know
safe locations you can drive to if being
followed, and stay in the car and blow
your horn to get attention when you
stop.
l Get help. Tell police, your employer,
and family, friends, and neighbors
about the stalking.
Violence against women is a serious
threat to health and well-being. Yet you
can take important steps to reduce your
risk of violence. If you have experienced
violence, there are people who can help
you heal emotionally and safely move on
with your life. The first step is to ask for
help. If you or someone you know is ex-
periencing violence, contact the resources
listed in “For more information” or talk
with someone you trust. No one deserves
to be hurt. n
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The Healthy Woman: A Complete Guide for All Ages
One Woman’s Story
When I started a new job in a different state, it was hard for me to meet new people
and make friends. I became very lonely, so I turned to the Internet for help. I dis-
covered that through online dating sites, I could easily find men willing to meet me and
buy me drinks. I enjoyed the company and attention; each time I met a new person was
exciting, and it made me feel attractive, sexy. I became addicted to that feeling. While at
first I was cautious about meeting them in person, I later became less concerned about
my own personal safety. I ignored the horror stories I heard about women disappearing
or being murdered by someone they met on the Internet. All I wanted was that next time
when I would get dressed up, go out with someone new, and feel on top of the world. I
was blessedly lucky—at first.
I met Joe online (his name has been
changed), and even though he lived 2
hours away, we arranged to meet at a
halfway point. I missed all the warning
Don’t let anything
signs from the start. He had me meet him
at a gas station where we left his car and
took mine. We went to a club, and I drank
come before your
too much to drive home safely. He said
he would pay for a hotel and promised he personal safety.
would not try anything sexual. I trusted
him. He did not keep his promise, no mat-
ter how many times I said STOP. I should
have screamed at the top of my lungs. I should have kicked him. I should have left and
never looked back. But all I kept thinking was, “This only happens to people I hear about
in the news, not me. Maybe this is my fault. Did I bring this upon myself?” I should have
kicked and screamed and MADE him stop. But I didn’t want to make a scene. I didn’t
want to drive home drunk. I didn’t want to strand him there with his car halfway across
town. I lay there and cried. He asked what was wrong and I told him, “You RAPED me.” He
denied it and made me feel like an idiot. I never reported him.
The next morning I cursed myself all the way home for being so stupid. It took a lot of
time and therapy to realize that, although it was stupid to put myself in such a dangerous
situation, what happened to me was not my fault. Even now it’s hard to believe that. The
point of this story is not to scare anyone out of online dating. Years later I signed up for
online dating again—my sense of personal safety and self-esteem intact—and I met the
man of my dreams. The important thing to remember is this: don’t let anything come be-
fore your personal safety. And don’t be afraid to scream like crazy and cause a scene. You
are worth it.
Lisa
San Diego, California
Violence Against Women
249
For More Information…
Office on Women’s Health, HHS
200 Independence Ave SW, Room 712E
Washington, DC 20201
Web site: www.womenshealth.gov/
violence
Phone number: (800) 994-9662,
(888) 220-5446 TDD
Administration on Aging, HHS
1 Massachusetts Ave
Washington, DC 20201
Web site: www.eldercare.gov
Eldercare Locator: (800) 677-1116
National Center on Elder Abuse, AOA
c/o Center for Community Research and
Services
University of Delaware
297 Graham Hall
Newark, DE 19716
Web site: www.ncea.aoa.gov
Phone number: (302) 831-3525 for
information on elder abuse,
(800) 677-1116 to find help in your state
Office for Victims of Crime Resource
Center, DOJ
PO Box 6000
Rockville, MD 20849-6000
Web site: www.ojp.usdoj.gov/ovc/ovcres
Phone number: (800) 851-3420
National Center for Victims of Crime and
the Stalking Resource Center
2000 M St NW, Suite 480
Washington, DC 20036
Web site: www.ncvc.org
Phone number: (800) 394-2255,
(800) 211-7996 TTY/TDD
National Domestic Violence Hotline
PO Box 161810
Austin, TX 78716
Web site: www.ndvh.org
Phone number: (800) 799-7233,
(800) 787-3224 TTY
National Teen Dating Abuse Hotline
Web site: www.loveisrespect.org
Phone number: (866) 331-9474,
(866) 331-8453 TTY
Rape, Abuse and Incest National
Network and the National Sexual Assault
Hotline
2000 L St NW, Suite 406
Washington, DC 20036
Web site: www.rainn.org
Phone number: (800) 656-4673