18th December 2025
Introduction
This week, the UK government announced a major shift in how the NHS responds to domestic and sexual abuse. Under the new “Steps to Safety” initiative, survivors will be fast‑tracked via GPs to specialist NHS support services. The plan, part of the wider Violence Against Women and Girls (VAWG) strategy, is backed by £50 million and promises nationwide trauma‑informed care by 2029. On paper, it’s progress. In practice, it risks reinforcing the very biases it claims to dismantle.
A Step Forward for Survivors
The new system aims to end the postcode lottery in survivor care. Currently, support varies wildly across England. Some areas have specialist units and coordinated care; others rely on overworked GPs and underfunded charities. The government’s vision is for uniform access: trained staff, direct referrals, and support pathways that treat trauma as a healthcare priority, not just a policing one. For many women, this reform matters. Decades of campaigning have pushed domestic abuse out of the shadows. Survivors have called for care that recognises the neurobiology of trauma, not just the bruises. The NHS has finally admitted that violence is not just a crime scene issue — it’s a public health emergency.
The Human Cost of Delay
But acknowledgement alone isn’t enough. The system has long failed the most vulnerable. Past reports exposed how NHS staff lacked training to spot signs of coercive control, gaslighting, or post‑separation stalking. Waiting lists for trauma therapy remain months long. Most survivors still rely heavily on external charities like Refuge and Victim Support to bridge the care gap. “Trauma‑informed” can’t just be a buzzword on a whiteboard; it must translate into clinician confidence in understanding how hypervigilance works, how shame silences, how flashbacks hijack the body. This reform talks the right language, but unless it’s funded, staffed, and monitored with the same seriousness as cancer or stroke care, it risks being another PR win with no spine.
Understanding the Layers of Abuse
Domestic abuse is rarely only physical. The scars that run deepest are often invisible. Psychological abuse can look like gaslighting, manipulation, intimidation, isolation and degradation. The abuser’s aim is control, and the method is confusion — survivors often begin to doubt their own memory, perception and worth. Emotional abuse includes constant criticism, guilt‑tripping, silent treatment and blame‑shifting; over time this chips away at identity and confidence. Physical abuse — punches, kicks, strangulation — is the most visible form but often comes after psychological groundwork has been laid. Sexual abuse can be coercive or controlling even within long‑term relationships. Financial abuse — withholding money, controlling bank access, sabotaging employment — creates dependency. Abuse rarely ends at separation; stalking, harassment and threats using children or the legal system continue trauma long after the relationship ends. Every type leaves psychological footprints: anxiety, depression, dissociation, sleep disruption, self‑blame and suicidal ideation. Recovery isn’t linear, and it can’t occur in systems that fail to see the whole picture.
The Gender Gap Nobody Talks About
And then there’s the uncomfortable truth: men are being abused too, and we’re still not talking about it with anything like the nuance or resources devoted to it. Official estimates show that in England and Wales in recent years approximately 1.7 million women and nearly 700 000 men reported domestic abuse in a 12‑month period. Both genders are hurt, though reporting patterns differ and the majority of registered accusations involve male defendants and female victims. Despite this, support infrastructure does not reflect these patterns fairly — for example, one UK charity network reports over 500 refuges and support services for women across England and Wales, whereas there are only a few dozen dedicated services for male victims nationwide, and many regions have none at all. The result is that men who experience abuse — whether physical, psychological, emotional, financial or coercive — often face disbelief, ridicule, or assumptions that they must have provoked it. If they try to escape with children, the barriers are often punitive and services are scarce. This isn’t care; it’s institutionalised blindness. If trauma‑informed services are built on the assumption that the perpetrator is male and the victim is female, that bias gets embedded into recovery itself.
Abuse Dynamics: Men and Women
Typical patterns of abuse can differ by gender without implying that one is “worse” than the other. In many male‑on‑female cases the abuse is overtly physical or coercive, with control exerted through intimidation, threats, isolation and violence that leaves visible injury as well as psychological terror. In women‑on‑men abuse, patterns often involve emotional manipulation, insults, refusal of intimacy, public humiliation or sabotaging social relationships. These patterns are different but both are deeply damaging. Coercive control — a pervasive pattern of domination through isolation, intimidation, degradation and restriction of autonomy — is recognised as particularly harmful because it erodes trust, autonomy and identity over time. Psychological harm often lasts far longer than physical injury because it rewires perception of self, safety and attachment. Trust erodes; the body stays in a state of threat long after the immediate danger has passed. Recovery requires more than safety; it needs re‑establishing agency, narrative coherence, and neural regulation. This is true whether the abuse was physical, emotional or psychological.
The Christmas Effect: Why the Holidays Can Be Worse
The Christmas and holiday period can act as a pressure cooker on already fragile domestic situations. Evidence from UK sources suggests that domestic abuse incidents and police responses tend to rise in December compared with year‑long averages, with December figures showing a higher proportion of recorded abuse‑related crimes. The combination of financial stress, heightened expectations of “togetherness,” increased alcohol consumption and more time spent in close quarters can exacerbate tensions. Many charities report spikes in helpline contacts after the festive period, and research into seasonal abuse patterns historically shows increased likelihood of domestic abuse during holiday periods compared with other times of year. Surges are not limited to the UK; international studies find that holiday seasons often coincide with peak times for intimate partner violence injuries, indicating that the conjunction of stressors during festive breaks can elevate risk. It’s not that abuse only occurs at Christmas — it happens year‑round — but the traditional holiday stressors can interact with existing dynamics to make dangerous situations even worse.
A Controversial but Necessary Rebalance
The VAWG strategy focuses heavily on women and girls — and, given the scale and nature of gendered violence, that focus is warranted. But if trauma is truly the lens through which we view domestic abuse, then male victims must also be seen, heard and believed. Some critics argue that broadening the focus dilutes the message. This isn’t dilution; it’s calibration. We don’t treat one patient at the expense of another. We expand the trauma lens to include every nervous system under siege. Trauma doesn’t respect gender, and neither should the system.
What Trauma‑Informed Really Means
Trauma‑informed care isn’t just about services; it’s a worldview that assumes every person may be carrying something invisible. It respects nervous systems stuck in fight, flight, freeze or fawn. It understands that survivors don’t always present as calm, grateful or cooperative because trauma often scrambles executive function. In practice this means asking “What happened to you?” instead of “What’s wrong with you?”, recognising that trauma symptoms often are survival adaptations, and creating services that feel safe, predictable and respectful. It means listening without interrogation, validating without bias and responding without retraumatising.
Looking Ahead
There is potential here. The funding is real. The language is finally shifting. If implemented with integrity, this could be a turning point in how Britain treats the aftershocks of violence. But it will take more than press releases. The NHS must train staff to recognise diverse trauma responses, partner with credible charities already doing frontline work and monitor outcomes with ruthless honesty. We need a system where survivors aren’t just processed — they are understood. Where men aren’t just tolerated — they are supported. And where trauma care isn’t political, it’s clinical. The bruises fade. But the body remembers. The mind adapts. And the system — finally — needs to catch up.
References:
Domestic violence statistics and gender breakdown – Office for National Statistics. (2023).
https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/articles/domesticabuseprevalenceandtrendsenglandandwales/yearendingmarch2023
Mankind Initiative – Support and statistics for male domestic abuse victims.
https://www.mankind.org.uk
Refuge – National network of refuges for women and children.
https://refuge.org.uk
SafeLives – Insights on coercive control and abuse dynamics.
https://safelives.org.uk
UK Government “Steps to Safety” announcement – GOV.UK (Dec 2025).
https://www.gov.uk/government/news/abuse-victims-to-get-specialist-nhs-support
Why domestic violence increases at Christmas – DVACT.
https://www.dvact.org/post/why-does-domestic-violence-increase-over-christmas
Confronting the surge in abuse over holidays – DRN Law.
https://www.drnlaw.co.uk/confronting-the-surge-in-domestic-abuse-over-christmas
World Health Organization – Gendered patterns in domestic abuse.
https://www.who.int/news-room/fact-sheets/detail/violence-against-women
Where to Find Me Online
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