Missing Stories: Women with Physical Disabilities' Navigation and Responses to Domestic and Family Violence

Abstract

There is significant global evidence that highlights both the high rates of domestic and family violence (DFV) for women with disabilities and the challenges they can face when navigating and responding to DFV. The purpose of this study was to understand women with physical disabilities’ experiences of help-seeking when they did not access generalist DFV services. Presented are the participants’ lived experiences of navigating and responding to DFV. Key findings include how participants resisted ableism, challenged assumptions about passivity, and the impacts of this resistance on their navigation of DFV.

Keywords

women with physical disability domestic and family violence help-seeking

Introduction

Domestic and family violence (DFV) is recognized as a violation of women's human rights and a significant social and public health issue (United Nations, 2006). It is also understood as multidimensional and cuts across all cultural, geographic, religious, social, and economic boundaries, affecting all women regardless of class, religion, ability, age, or sexual identity (Shah et al., 2016; United Nations, 2006; World Health Organisation, 2005). It is generally acknowledged that DFV regarding women has been explored in great depth over several decades. The same depth of research has not occurred in relation to DFV against women with disabilities which has meant there has been a hidden and invisible element to it. This is mostly due to being under-acknowledged and not considered a significant issue within the feminist-based literature, nor a gender issue within the disability-based literature. However, statistics currently show that women with disabilities experience significantly higher rates of DFV than women without disabilities (Australian Bureau of Statistics, 2012; Cox, 2015; Dowse et al., 2013; Hughes et al., 2012). It is important to note that women with disabilities can experience the same types of DFV as women without disabilities. However, in addition, they also experience disability-specific types of DFV that include having disability equipment immobilized or broken, or having their medication withheld, stolen, or overdosed (Nosek et al., 2001; Powers et al., 2002). Furthermore, for women with disabilities, DFV is not only perpetrated in intimate relationships but can also occur within a range of formal and informal caring relationships or within institutional or residential settings (Attard & Price-Kelly, 2010; Dowse et al., 2013; Eastgate et al., 2011; Healey, 2014). Within both institutional and residential contexts, women with disabilities experience alarming rates of sexual violence that can include a number of abuse tactics such as inappropriate touching during caregiving, taking control of reproductive processes, and demanding sexual activities (Nosek et al., 2001).

It is noted and acknowledged that there are contestations around the use of language in the context of disability/impairment. The terminology in this article is based on the social model of disability that makes the distinction between impairment, which relates to differences, and disability, which relates to barriers faced by people with impairments that are caused by social structures (Oliver, 2009).

Although insufficient attention has been given to the experiences of women with disabilities who have experienced DFV, there is even less of an evidence base to understand how women with specific impairments navigate and respond to DFV, particularly those who do not engage with the generalist DFV sector. This article reports on a research study about the experiences of women with physical disabilities experiencing DFV, a group of women who have not been represented in any great depth within the extant literature. As physical impairments pose unique forms of disablement that differ from mental, developmental, or sensory impairments (Disability Discrimination Act, 1992), it is important that this gap is addressed in order to inform future directions in DFV policy and service provision.

Literature Review

Many countries, including Australia, have developed policy initiatives and practices regarding DFV (Patton, 2005; Wendt et al., 2017). It is acknowledged that the development of DFV initiatives and practice has not been as responsive for women with disabilities (Dowse et al., 2013; Healey, 2014; Robinson et al., 2021), and this has resulted in support options that are not as well established as those for other women (Dowse et al., 2013; Frawley et al., 2015). The lack of support options for women with disabilities experiencing DFV is often due to the incorrect assumption that women with disabilities are not in the types of relationships where they would experience DFV as they are often portrayed as being asexual, unmarried, and childless women (Slater et al., 2018; Tepper, 2000). In addition, women with disabilities have fallen through service gaps mainly due to an ambiguity as to who is responsible for responding to the issue—the DFV sector or the disability sector (Healey et al., 2008; Office of the Public Advocate, 2012). Furthermore, Australian inquiries by different States into violence and abuse against people with disability have found large cover-ups by disability organizations (Robinson, 2013; Royal Commission, 2017).

The help-seeking research has flourished and shows numerous factors related to accessing support for women, including women with disabilities (Arenella, 2014; Fanslow & Robinson, 2011; Frawley et al., 2015, 2017; Meyer, 2010, 2016; Wendt et al., 2017). Some of those factors include the woman's commitment to a partner; staying for the sake of the children; fear of removal of the children; shame and embarrassment; financial considerations; fear and stigma; and a belief that they can solve their personal problems (Arenella, 2014; Crowe & Murray, 2015; Laing, 2017; Meyer, 2010, 2016; Pacheco & McConnell, 2017; Pestka & Wendt, 2014; Resko, 2010; Wendt et al., 2015). Many women with disabilities experience these same factors as well as factors related to impairment. These include that they are often not aware of their rights (Attard & Price-Kelly, 2010) or what is available to support them—including a lack of awareness of refuges and generally a low awareness of other sources of help (McCarthy et al., 2017).

Women with disabilities are also impacted by a range of accessibility issues that reduce the likelihood that they will receive effective support from DFV services. For example, women with disabilities may be in situations or relationships where other people exercise control and power over their lives, such as in caring relationships, group homes, institutions, or residential settings (Cockram, 2003; Hague et al., 2008; Healey, 2014; Healey et al., 2008; Salthouse & Frohmader, 2004). This can mean that disclosures of DFV are mediated through family, institutions, or carers—and the danger of this situation is significantly heightened when such people are implicated or complicit in the abuse (Maher et al., 2018). There are further barriers faced by women with physical disabilities in accessing DFV support and services, such as planning/modifications relating to the need for ramps, accessible bathrooms, accessible kitchens (e.g., the height of kitchen benches, cupboards, and stovetops/ovens; accessible taps). In addition, perpetrators of violence can exploit mobility issues to prevent women with disabilities from accessing DFV services, for example, through breaking or immobilizing disability equipment, withholding medication, or using the medication as an overdosing mechanism to control and limit women's responses to violence (Nosek et al., 2001; Powers et al., 2002).

Women with a range of disabilities also perceive they lack credibility and will not be believed if they disclose DFV (Frohmader & Connor, 2015), and they often lack an awareness of what constitutes DFV (Cockram, 2003). Also noted within the literature is how women with disabilities are generally constructed as passive, helpless, dependent, and nonautonomous beings (Coffman-Rosen, 2014; Women with Disabilities Australia, 2007). Other noted factors include that they are overprotected, segregated, and taught to be compliant and, as a result, these common stereotypes can be internalized by women with disabilities when seeking help (Cockram, 2003; Meekosha, 2004). Stern et al. (2019) found that impairment/disability-related stigma and discrimination, being devalued because of impairment, and being regularly isolated and excluded from social interactions and community affairs by intimate partners, family, and community members meant less access to DFV resources. The authors also argue that stigma and discrimination, inaccessibility, and internalized stigma are limitations for women with disabilities in their ability to be actively involved in DFV services and can undermine the potential benefits of participating in DFV services and programs (Stern et al., 2019).

There are also numerous studies that highlight the many strategies women use in navigating DFV. These include placating, minimizing, resisting, or withdrawing from the perpetrator. In general, these strategies are used before they seek other types of informal or formal support (Ghafournia & Easteal, 2019; Wendt et al., 2017). Furthermore, most of the research in relation to help-seeking and women with disabilities has focused on issues related to physical inaccessibility (Frawley et al., 2015, 2017; Hague et al., 2008; Healey, 2014; Healey et al., 2008). It is generally understood that effective support systems are beneficial to women in terms of their safety and mental well-being (Liang et al., 2005). It has also been demonstrated that initial responses women receive will determine whether they will further engage with help-seeking efforts (Bui & Morash, 2007).

Moreover, DFV has not traditionally been a socially acceptable issue for disclosure. In decades past, DFV has often been something that lessened the worth of women, and DFV was considered the woman's fault (Carretta et al., 2015). Choosing to disclose DFV is something that is encouraged and thought to be of help to women experiencing DFV (Carretta et al., 2015). On the other hand, choosing not to disclose can be viewed as a self-protective measure as a woman can control the amount of information she gives and possibly preserve her relationship without further DFV occurring (Duncan & Western, 2011; Jack, 1991). Accordingly, disclosure of DFV for women with disabilities will depend on how they perceive support as well as on their situations and prior help-seeking experiences. Some women with disabilities have typically had long histories of contact with government and/or other service agencies of various kinds due to living in public/social housing and/or engaging with the disability support sector (Bigby et al., 2015), and many of those experiences have been negative (Women with Disabilities Australia, 2007). As a result, some women with disabilities have low expectations regarding the likely helpfulness of services and, therefore, believe that nondisability services also will be unlikely to be responsive to their needs or situation (Hague & Mullender, 2006; Women with Disabilities Australia, 2007). This often adds to the already low self-esteem many women with disabilities experience, and the perception that they have no other options but to stay in an abusive relationship (Cockram, 2003; Ortoleva & Lewis, 2012).

Women with physical disabilities who choose not to engage with the generalist DFV sector have received little attention. Studies that have been conducted with women with physical disabilities experiencing DFV have largely focused on women who have engaged with specialist DFV services (Chang et al., 2003; Milberger et al., 2003; Nosek et al., 2006; Olkin, 2003; Rich, 2014). There is little understanding about women with physical disabilities who are not known to generalist DFV service providers. Bringing the stories of women with disabilities who have not accessed DFV services forward is important in order to inform more inclusive and responsive DFV policy and services.

Importantly, this study aimed to shed light on experiences of help-seeking that go beyond thinking about physical barriers and inaccessibility to also include the interlinked nature of ableism and gender oppression and the role that these intersecting oppressions play in women with physical disabilities’ navigation and responses to DFV. Few studies that have looked beyond physical barriers in order to explore accessibility issues that extend beyond narrowly defined physical and programmic definitions of “access” (Frantz et al., 2006; Frawley et al., 2015, 2017). Using a broad lens to understand how accessibility is defined by women themselves, beyond the most obvious issues relating to physical barriers, is important in ensuring that services are aligned meaningfully to the needs and hopes of women with disabilities (Robinson et al., 2021). In addition, the ways in which gender and disability are being performed and responded to (Davies & Gannon, 2005) are key to understanding the complex nature of gender, disability, and DFV, and the reasons why some women with physical disabilities might not engage with DFV services. This study therefore sought to explore the intersections of gendered and disability oppressions in order to contribute to new knowledge about the complex embodied and subjective experiences of women with physical disabilities as they navigate an experience of DFV.

Method

Participants

Inclusion criteria for participation in the study were self-identification of physical impairment, being over the age of 18 years, living in NSW at the time of the interview, had an experience of DFV, and had not accessed any generalist DFV services. Recruitment of eligible participants involved placing flyers with the research information in peak disability advocacy organizations' newsletters or on their social media platforms. Flyers were also placed in neighborhood centers and GP offices. Advertising in print media included local newspapers, and university websites and newsletters were also used. The participants came from various sources: one from the newspaper advertisement, two from disability advocacy websites/newsletters, and one from the university's online student newsletter. To ensure diversity of perspectives and recruitment possibilities (Morris, 2006), women with physical disabilities were also recruited using snowballing techniques; six additional participants were recruited using information given to the author by other participants. In all, the research involved 10 women with physical disabilities who had not accessed generalist DFV services.

Participants represented a variety of physical impairments; two had congenital impairments and the other eight had acquired impairments ranging from 5 to 20 years ago. The women were of diverse ages ranging from 22 to 85 years old. They had varying relationship circumstances: married; unmarried; same-sex; children; no children. They also differed in their personal, geographic (place of origin), and religious backgrounds. They were predominately from higher socioeconomic backgrounds, and English was their first language.

Ethical Considerations

This research study was approved by the University of Sydney ethical guidelines, Protocol Number 14092. This study also took into consideration the World Health Organization's published guidelines for addressing ethical and safety issues in research into violence against women (World Health Organisation, 2001). Pre-interview, as part of the initial recruitment phase, the research aims and objectives were explained, and the participants were assured that their data would remain private and confidential. Each participant could choose or be given a pseudonym; therefore, excerpts from participants’ interviews are not attributed to their real identities. When participants agreed to be interviewed, they were asked to sign a consent form and each interviewee received a Participant Information Sheet. If a participant was unable to sign the consent form, the study procedures and assurances were verbally explained to gain verbal consent. Any part of the research process that involved capturing verbal data, be that interviews or consent that was read out over the phone, was done in accordance with the relevant legislation regarding the recording of telephone conversations (i.e., Telecommunications Act 1997 [CTH], Listening Devices Act 1984 [NSW]) and was strictly adhered to. Furthermore, due to the sensitive nature of the topic and the questions being asked, participants were given the opportunity for referral to supports following the interview. This occurred by asking participants how they had experienced the interview, giving them an opportunity to debrief, and providing a resource sheet containing support options, including agency information, websites, and telephone numbers.

Data Collection

Eight semistructured interviews were conducted face to face and two were conducted over the telephone. Each participant was interviewed once. Face-to-face interviews were conducted at a place and time convenient to the participants. All women who chose a face-to-face interview chose to come to an office at the University of Sydney to be interviewed as they felt it was a safe, accessible, and neutral space. All interviews were conducted by the author and all audio recordings were transcribed verbatim by the author, to improve the quality of the data and to allow in-depth analysis. Interviews took between 70 and 120 min and extended time was factored into the interview schedule to enable interviewees enough time to share their stories. Participants were given an AUD$25 gift card to thank them for their participation.

Analysis

The main research question underpinning this study was: How do women with physical disabilities experience, navigate, and respond to DFV? To answer this question, Thematic Analysis was employed to elicit major themes from the interview data, allowing flexibility during the process (Braun & Clarke, 2006). When analyzing the qualitative interview data, some general themes were initially developed from the literature. The analysis also involved developing preliminary categories through a process of coding, which was tested and revised repeatedly as new themes and patterns emerged (Braun & Clarke, 2006). Finally, the thematic codes were checked to determine whether they were extensive, which again led to some revision. All data categories and coding were developed using NVivo 10 software. Furthermore, as a researcher, this project has been undertaken from an insider perspective drawing on my lived experience of physical impairment that lent substantial benefits to the analytical process.

Reflexivity: The Research Process

Reflexivity and the author's relationship to the research study and the participants is an important issue to consider. In her role as researcher, the author was an “insider” as a member of an “in-group”—in this case, the disability community—who shares experiences of daily navigation of physical impairment and disabling social structures with the research participants (Jenkins, 2000). This lived experience and familiarity (Griffith, 1998) enabled the author to think of questions that perhaps a researcher without a disability may not think to ask, adding depth and richness to the research findings, and opening up opportunities to coproduce knowledge when meeting with participants, through the intentional sharing of lived experience. At the same time, the author engaged in reflexivity to recognize and make space for the differences between the author's experiences and the narratives of participants relating to experiences of DFV.

Limitations

As is the case with qualitative research based on a purposive sample, a cautionary note regarding the generalizability and transferability of findings is needed. The experiences shared by participants in this research are not necessarily representative of other women with physical impairments who live with DFV in their relationships. The small sample size (n = 10) also requires caution regarding generalizability. Further limitations include that the research focused on women with physical impairments who had not accessed DFV services, allowing for an in-depth analysis of the experiences of women with physical impairments but limiting the generalizability of the findings to women with other impairments or experiences of disability. Participants were predominantly of Anglo-Saxon and European cultural descent, meaning that there was limited cultural diversity in the study, and participants with severe physical impairments did not participate in the study.

Results

Impairment and Disability: Resisting Ableism

In the current study, participants were asked how they navigated and responded to impairment. This was to ascertain whether there were differences in how participants sought help for impairment versus seeking help for DFV. All participants described their impairments using negative language often associated with abnormality or deficits. Interestingly, this negative disability identity did not influence how they managed their impairment. All participants spoke openly and felt that managing impairment was an obvious and normal thing to do using medical interventions, and none expressed any shame or weakness in doing so:

Look, I’ve had arthroscopies on the knees … other surgery that I had was to help me lose weight. … So, I’ve had what they call the sleeve gastrectomy so similar to the banding but it's permanent because they actually remove part of the stomach then they leave you with a tiny little bit … yeah. (Lisa)

In addition, most of the participants had a high socioeconomic status; for those who had the resources, they were able to manage impairment using alternate methods outside of the medical system:

I walk and swim a lot—this clears my mind and helps with my fitness in general, it also helps me with my stress levels. (Anne)

I also meditate every day now, every day, I use to meditate a little bit, now I meditate every day … I meditate every day, be it 10, 20, or 30 minutes. I give myself permission. (Geo)

Participants also strategically used language to manage assumptions of inadequacy or abnormality that are often associated with medicalized notions of disability (Oliver, 2009). This was revealed as they qualified their experience of disability using language such as “it's normal” or “it's no biggie.” Geo, in particular, minimized her disability experience:

Well, they are very simple ones; for example, I can’t face the world until I have actually been to the toilet in the morning and I can’t do that until … because as soon as I wake up I have got to have a morphine tablet to do that because it's excruciating painful … which it's … hey, it's no biggie. … (Geo)

Because I’ve had my disability all my life, I’ve learnt that's normal to me … cos I’ve always had [it]. … I guess I’ve compensated for it … because I just live with it, so it is always been there and I just don’t really think about it. (Ruby)

Others minimized their disability identity by making light of their impairment, using either laughter or playing down the severity of their impairment and disablement. A few women were apologetic because they thought their impairment was not “bad” enough to warrant calling it an impairment:

I didn’t even see myself as having a disability because nobody treated me like someone who actually had a disability … because I always minimized my own experiences and my own health. (Bella)

Several women with varying types and degrees of impairment and disablement also struggled with the “disabled” identity and used resistance to negotiate normative ideas of womanhood. They posited themselves as not “disabled” by claiming it's not much to deal with:

Yeah, I guess because it's not visible. I am not walking along with only one leg or in a wheelchair so other people are unaware that I have a disability visually, so yes, if I bump into people I apologise and sort of try to say, “I’m sorry I can’t see out of that eye,” so I guess I try to justify if I have a problem, but yeah, I don’t think it's so much. (Anne)

Challenging Passivity: DFV Strategies

Women use many strategies to navigate DFV. In the current study, although all participants perceived themselves to be strong and agentic women, they used what some would call “passive” strategies, such as minimizing the DFV to initially navigate and respond to it:

Because I guess I didn’t think it was … like, I think when you think domestic violence you automatically think wife beating or spousal beating or whatever and people kind of get out of that situation, whereas mine was just psychological slash verbal type thing, so yeah, so, it wasn’t heading in that kind of direction at all. (Lisa)

Other strategies some women used to navigate the perpetrators’ behaviors included trying to placate him:

I used to try and placate my ex-boyfriend by agreeing with him or not upsetting him … making sure he didn’t get angry and making sure I didn’t say anything wrong and apologizing. (Cher)

I tried to keep him as placid as possible, I wouldn’t speak about it, he would go into the room where his computer was kept and he would do whatever. (Emma)

Aspects of navigating DFV involved several women speaking about “managing themselves.” Women said this included strategies such as withdrawing from and/or avoidance of the perpetrator:

I avoided him like the plague. I was pleased when he went out because I didn’t have to deal … I didn’t have to pander to his needs and I didn’t have to deal with his stuff, yeah, ... it just meant I didn’t have to deal with him. (May)

I have learnt now I can read between the lines. … I just back off completely, I put a bubble around myself. … I’ve got that bubble there now. (Geo)

In addition, some participants engaged in withdrawal strategies, either psychological or sexual in nature. These women used either their impairment and/or their sexual agency to strategically respond to DFV. Some employed sexual intimacy as a management tool either by providing intimate sexual acts or withdrawing from intimate sexual acts in their relationships:

I stopped having sex with her pretty quickly (laughs) because she would go out drinking all night and hang around groups of guys, and I mean who knows what she did with the guys really, you know. (Bella).

I should also say that the only boundary that I was able to put up between myself and [boyfriend] was that I didn’t give him sex; I am still a virgin, he consistently pressured me into having sex, he told me that I was being a cock-teaser. He told me this constantly, every time he slept over together; and often just to shut him up I would let him do things to me like, sorry for the graphic details, but like oral sex and things like that, that was to shut him up. (Cher)

Impairment was also used by a small number of women to strategically navigate DFV in their relationships. In Geo's case, it was not clear whether she was using her impairment to strategically manage DFV or whether it was that the DFV exacerbated her impairment and thus rendered her exhausted:

I will remove myself by saying I’m really tired, I have to go to bed, and this was usually under the pretense of saying I’m so tired I don’t want to have another seizure. (Anne)

I’d be too weak to get out of bed for days. So, I’d just spend 3 or 4 days in bed to avoid him. … (husband) just used to think I was sulking but it just used to just drain me so much that I couldn’t get up physically. (Geo)

Other women kept DFV silent/hidden to perhaps feel that they had some control in their lives:

I was already seeing a counselor about my disability and not disclosing to the counselor about the abuse because I knew … I had knowledge of what domestic violence was and felt stupid … but it was a strategy I could have used … but I didn’t really use; like, as I said, I wasn’t even honest to my counselor about how bad it was at home. (Bella)

I just think it's a private matter and I didn’t want everyone knowing my business and you know pitying me … I’m not sure … you know, half the things that are available today weren’t back then and we didn’t talk about it so to speak. (Mary)

Most participants constructed themselves as agentic women, and they were not afraid to make use of that agency. Participants felt they could utilize this strength and agency to strategically act upon and respond to DFV. This included a few participants either verbally standing up to the perpetrator or using physical means toward the perpetrator as a tactical tool to manage DFV:

Oh yeah, it was physical at one stage, the last time he hit me I hit him back and he's never hit me again … yeah, he just got a bit violent and he hit me and my first reaction was to hit him back and I hit back as hard as he gave me (laughs), he never did it again. (Leah)

Yeah, like if it's something that I just go … yeah, right, okay … just walk away … then do what I want to do anyway; but if it was something that I was really … felt strongly about I would stand up to him, yeah. (Ruby)

Part of participants’ survivorship and navigation of DFV included not drawing from societal norms that have embedded notions of victimization. Several women spoke about how they felt no responsibility for the DFV, nor were they to blame for the DFV in their relationships. In this sense, they saw the “problem” as that of the perpetrator, rather than as their “problem” to “fix”:

I don’t think I am the one who needs the help; he is the one who needs help … I didn’t feel that I needed help. I felt that he needed help, so I didn’t think it was me, I thought he needed help to control his temper and or what would you call resolve whatever it was that was setting him off. I suppose, yeah, I always thought that he was the one that needed help, it wouldn’t be me. (Ruby)

I think it was pretty much, it was always present, cos like I said, he was already very manipulative of me with the self-injury and, like, when he found out about my sexual assault, he would (big sigh), like we would talk about things that had happened to me and make them all about him; like, he's like, “I’m fucked up," sorry for the language, but it was, "I’m fucked up because you told me this and this happened to you and now I’m fucked up and I’m," you know … trying to blame me but its him … not me. (Cher)

Resisting Passivity and Ableism

Research on navigating DFV overwhelmingly indicates that after women exhaust their own ways of navigating DFV, they turn to other people such as family and close friends for support (Keys Young, 1998; Rose et al., 2000; Sylaska & Edwards, 2014). Most participants in this study also turned to close friends as a key means of navigating DFV. Very few participants identified siblings or parents as sources of support:

Well, help could be just basically talking to other people … so yeah, just get it out … so vent my spleen and feel better. I would ring up my girlfriends and say I need a coffee (laughs), meet me for a coffee, I have got to get out of the house. (Ruby)

The people in my life that support me, that help me … Make sure I’m okay. Make sure I am safe. Make sure my kids are okay. I had two very close girlfriends who knew exactly what was going on. (Emma)

In contrast, a few women who were not ready to leave, or who chose to stay in the relationship as a response strategy, discussed how complex this could be due to an unhelpful side to approaching close friends. Several women discussed that a significant factor that impeded the effectiveness of this type of support was the unexpected conditions or value-laden expectations attached to the support:

And then it got to a point basically they [friends] didn’t want anything to do with me if I didn’t pack my bags and get out. So, their expectations … or they lost their patience with me. I think they started losing respect. (Geo)

I felt that the friends who were helping me … basically talking to me and telling me “to get out” didn’t understand how hard it was to leave and in the end some of those relationships suffered. (Anne)

When participants discussed seeking help for impairment or navigating DFV using their own terms and strategies, they perceived themselves as strong and agentic women. However, when discussing seeking help from formal DFV services, they used excuses such as, “I am not at that stage” or “It wasn’t serious enough”:

Well, I didn’t … nah, no, I am not really at that stage, no, I’m not at that stage. My friend with the son … her husband used to physically abuse her really badly. … Yeah, she was the classic battered wife, yeah, very bad, I mean she was basically in the same situation as my mum but … so, she would be the sort of person that would need to go to a refuge or something, not me. (Ruby)

Other participants used excuses such as they perceived themselves as weak, or they lacked any kind of credibility:

I thought that I had no credibility and my account of the situation would not be believed over my husband's. (Anne)

Well, in those stages I couldn’t ask for help because to me it meant that I was weak, and I should have known better and I’d made my bed and so I had to lie in it. (Bella)

For those participants who approached and engaged with generalist health professionals, this was considered acceptable behavior because they used these occasions to navigate DFV, or to try to glean information:

I went to see a couple of people by myself-—psychologists, but not specialised in violence and abuse-—one particular woman was very good as a psychologist. (Geo)

As discussed by Anne, seeking help was a way in which she could glean information from others to navigate and respond to her situation. Anne had discussed that her husband insisted she had a mental health issue and she should go see a doctor, which she did:

Basically, she [GP] just said, you know, "I can send you to a psychiatrist," which she did, but she believed that, that would only conclude that I didn’t have a mental illness, so … but I guess that was good for myself to verify that I didn’t have an issue mentally. (Anne)

For those who engaged with GPs or generic counselors, this type of help was not always helpful or effective. Several women had approached generalist counselors when going through tough times of dealing with the impact of DFV:

I had some counselling when I was going through major, major (real emphasis here) issues with my ex-husband; I only went to two sessions because the first time I went the lady said, "Well, tell me your story," and I told her, and she just sat there and cried and then yep … and then I went back a fortnight later, then she said, "How have you been going," and I told her what was going on and she just sat there and cried and in the end … I thought, no, this is not good for me. (Emma)

Several women actively accessed information from generalist legal professionals. For those women who chose this, they discussed how it gave them the confidence to possibly redress or challenge the status quo at some later point in the relationship. Approaching generalist legal services was important to Geo and Emma because they wanted to secure information about their situations and were determined to secure their own futures and that of their children.

I got advice from a lawyer saying definitely the house, no matter what, half the house is mine because it's in both our names, so that has given me such a huge boost, because even though everyone kept telling me that I just, I know him so well, somehow he’ll have something up his sleeve that, you know, because when he left his first wife, he was really horrible to her … so having that knowledge gave me heaps of confidence, yeah. (Geo)

I knew it was abusive, but I couldn’t see any way of getting out of that and keeping my children; and you know, I’d gone and seen the solicitor and they kind of said, "Look you are going to end up worse off; you’re not gonna have your children … but I needed to get information. (Emma)

Furthermore, in Emma's case, she engaged with a female legal professional to find out what her options were if she left her husband. When going through the leaving process, the response she received was disturbing and underpinned by patriarchy and paternalism:

"Well, you know you’re very lucky that he is still allowing you to live in the house … and you won’t get the children because he’ll be able to prove that you know that you can’t look after them" … they kind of said, "Look, you are going to end up worse off; you’re not gonna have your children." Well yeah, but because he … he then said, "Well, look, I’ll give you" … at one stage, he offered 30% and so we said no and then he offered 40% and I said no, so it had to go to mediation and then I didn’t want to see him and then the lady that was doing the mediation got very exasperated with me and said, … "Don’t you realise" … cos at this time you’re saying 50% … however, I still have two children at home … and I said, no, I’m not accepting 50%. I deserve a bit more than that, and she turned around and got really exasperated with me and said that, . "Well, I really think that because you haven’t worked all these years what you are being offered is more than fair," and I said, yes, but I have this disability, and she said, "Yes, but he has depression," and I said, yes, but I’m an incomplete quad. (Emma)

There were a few other participants who had divorced the perpetrator or permanently left the relationship as a way of responding to DFV, which could be perceived as the final act of power and resistance. These participants said they had left the relationship with the hope of changing the situation and felt this was the best way to respond at the time:

I had left him … yes, that was just over [number] months ago. I just got literally to the point where I just couldn’t take anymore and I couldn’t bear listening to him, so I said I’m leaving and I think that was shocking to him and he didn’t want me to go … it was I just literally can’t listen to this anymore and it wasn’t premeditated, it wasn’t, I didn’t have any plan, I literally just, I couldn’t, I didn’t care where I went, I just wanted to get away from his voice. (Anne)

Participants discussed how they were reluctant to engage with the criminal justice system. A few women spoke about being hesitant and fearful to seek help from police as they were afraid of the consequences of doing so. Their responses also included that they felt the severity of their impairment would invoke feelings they would not be believed, or they were petrified to call the police for fear of the perpetrator's response, or they felt the police would think they had made the story up:

I thought about going to the police, but I was petrified, I thought he would … and I thought that would be the end of me. Too scared to, too scared to, yeah, I did (hesitancy) but too scared to, one of those women that thought that if I called the police would he, not kill me, but what would he do to me at some stage. Would he … what would he do, I was scared at what he might do … violently beat me to pieces. (Geo)

In regard to calling the police. My husband is verbally abusive, and I have a head injury. So if the police were to attend, it would be a matter of his word against mine. If he were physically abusive, I would definitely call the police and obtain an AVO. (Anne)

Yeah, so I was even, so I was worried that people would think that I was just making it up or something. (Cher)

Discussion

Without doubt, women with physical disabilities' navigation and responses to DFV are complex. This study sheds light on the ways in which these participants sought to navigate and respond to DFV. There are similarities to other women, including women with disabilities, in the strategies participants used to navigate the challenges of DFV and disability-specific types of DFV; these included minimizing, placating, and withdrawing (Hague et al., 2008; Healey et al., 2008; Pestka & Wendt, 2014). However, a difference found was how a few participants, at certain times in the relationship, utilized their impairment and/or their sexual intimacy as strategic tools of resistance when navigating DFV. Also, contrary to other research where women blame themselves for DFV (Carretta et al., 2015; Meyer, 2010), participants in this study revealed they did not hold themselves responsible for DFV, as they expressed that they were not the ones who needed to seek help.

By understanding themselves as being able to “cope,” they were able to construct themselves as agentic, self-reliant, and independent regarding both impairment and DFV. Therefore, they did not take up stereotypical disabling ideas that suggest they are dependent and compliant (Coffman-Rosen, 2014; Women with Disabilities Australia, 2007), women who are unable to care for themselves or unable to be self-determining. When living with a physical disability, one is strategically navigating ableist and systemic barriers everyday; this possibly sets these participants up with a range of skills to strategically navigate DFV. These findings are similar to research that has found that women with intellectual disabilities have agency and can be self-determining in their decision-making around DFV (Pestka & Wendt, 2014).

According to this study, utilizing close friends as sources of support also played an important role in navigating DFV. This appeared to be helpful as this support provided an immediacy to support which they felt was nonjudgmental, trustworthy, and a type of support that held legitimacy to how they wanted to navigate DFV in their relationships. Utilizing informal supports aided in providing a connection these participants felt they may not receive elsewhere and provided equitability to these helping relationships. However, the only issue with this support for some was there were limitations on the usefulness of this support, as they were expected to leave the relationship.

In terms of formal help, half of the participants in this study initially engaged with the health sector for DFV. This may reflect that when things are going “wrong” for women with disabilities, they go to health professionals; consequently, this is where they went when things went “wrong” with their relationships. It may also reflect participants did this to determine a particular outcome and, as such, control what was going on in their situations. In some cases, the usefulness of seeking support from health professionals was that participants were able to glean information to assist them. However, the usefulness of this support was limited for other participants as the health professionals referred them to psychiatrists that led to “symptoms” being managed within a medical paradigm, such as counseling and/or medication. It could be argued, therefore, that women with physical disabilities in this study frame and are framed by medical paradigms, so it is not surprising they use a similar paradigm to manage DFV.

Several participants engaged with generalist legal services and were met with varying responses. Some were favorable, as again these supports were used to garner information, and others less so, as the responses were underpinned by patriarchy and paternalism. This is counter to the ideals and the cultural “weight” given to disclosure of DFV and the helpfulness of disclosure (Liang et al., 2005). As previously mentioned, women with disabilities already have a lot of experience of using services and have had mixed responses (Bigby et al., 2015; Women with Disabilities Australia, 2007). In this sense, their reluctance to disclose DFV and/or access specialist DFV services makes sense. Furthermore, the subtle forms of power used through inappropriate responses underpinned with paternalism highlight how ableism and gender oppression played a role when these participants sought support for DFV. This is similar to other research showing that women with disabilities are often disempowered and treated as nonautonomous beings when they engage in decision-making with institutions and/or individuals (United Nations, 2016; Women with Disabilities Australia, 2016). Furthermore, paternalistic attitudes in relation to impairment and disability (Oliver, 2009) very often include people speaking for women with disabilities, rather than with them and asking about or listening to what it is that they need. In this context, for participants in this study not being listened to and feeling devalued when interacting with generalist formal supports is perhaps why they see informal support as worthwhile and beneficial.

Existing research in relation to help-seeking, DFV, and women with a range of disabilities has focused on the lack of physical or programmic access as to why women do not engage with the DFV support sector (Dowse et al., 2013; Frawley et al., 2015, 2017; Hague et al., 2008; Healey et al., 2008). In contrast, the nonengagement of participants in this study with the generalist DFV support sector was not due to physical or attitudinal barriers, but rather because they chose to engage with a system that was familiar to them, the health system, and close friends who were also familiar to them.

Much the way participants minimized their impairment experience, participants’ responses to DFV were also couched in language that minimized their situations; they framed their experiences as, “I can handle it.” This paralleled their resistance to ableist attitudes and demonstrates the relevance of understanding the interlinked nature of ableism and gender oppression and how these intersecting issues can create challenges in navigating DFV and accessing support. Nevertheless, the participants’ skills in navigating ableism meant that they also had developed skills that enabled them to resist DFV.

Conclusion: Where to from Here?

As noted, much of the research written about how to respond to DFV in relation to women with disabilities has generally focused on the physical barriers to DFV services and the provision of accessible services in the form of physical modifications. However, there are very limited published data on whether there are other complex issues at play in how women with physical disabilities navigate and respond to DFV when they do not engage with generalist DFV services.

This study aimed to highlight the complexity in these participants’ lived experiences of seeking help. Addressing broader issues beyond “ramps, accessible toilets and attitudes,” a better understanding of help-seeking for women with physical disabilities who have not engaged with DFV support services has been highlighted. Hearing these participants’ voices helps create opportunities for understanding the complex and intersectional nature of DFV, impairment, and gender identities that also shape women with physical disabilities' navigation and responses to DFV. Furthermore, the study highlights that their identities were not discrete and rigid categories but rather mutually constitutive and interacting (Goethals et al., 2015).

This study highlights how these participants saw themselves as agentic women when they responded to both impairment and DFV. Thinking about women with physical disabilities in this way—as motivated and agentic—builds on existing knowledge about women with physical disabilities who are primarily thought of as different, dependent, asexual beings who are not in reciprocal relationships. Therefore, this study offers insights that are essential in order that the sector can better understand and integrate women with physical disabilities' experiences. As such, there is a need to understand the link between gender oppression and ableism, which influences these participants’ navigation and responses to DFV. In addition, the study demonstrates the importance of exploring generalist services, since this is where many women attempt to access support. And in understanding this is where women with physical disabilities intersect with the support system, we can see this as part of the help-seeking equation and support this aspect of the process.

Footnotes

Acknowledgments

The authors would like to thank all the women who participated in this study.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Karen Jordan

Author Biography

Karen Jordan is a social worker. Her research focus is women with physical disability, social justice, accessibility, and inclusion. Her work aims to inform and progress inclusive policy and practice and also to support and give voice to women with physical disabilities.

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