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Call to Action Against Femicide: Illuminating a Shadow Pandemic as a Global Public Health Emergency

      “Women's rights are an essential part of the overall human rights agenda, trained on the equal dignity and ability to live in freedom all people should enjoy.”Ruth Bader Ginsburg.
      #WomenSupportingWomen, the iteration of “challenge accepted,” where women shared black and white photos of themselves on social media to show support for other women, started in Brazil with a post on July 17, 2020. Subsequently, women in Turkey began sharing photos to raise awareness about femicide after a university student was killed by her ex-boyfriend. Countless women globally posted photos in support of “Say no to violence against women” (#kadınaşiddetehayır) to raise awareness about gender-based violence (GBV) in Turkey and asked for enforcement of the Istanbul Convention. The use of black and white photos was intended to underscore how pictures of murdered women end up in black and white newsprint. Subsequently, Representative Ocasio-Cortez speaking out on the floor of the U.S. House of Representatives about sexist remarks against her led to a spike in social media posts and similar photos about female empowerment. Although the intentions of these black and white photos have varied, this challenge has emerged as a global plea for justice for women killed and awareness of GBV.
      Female homicide (femicide) is one of the leading causes of death for adolescent and young adult (AYA) women in the U.S. [
      • Coyne-Beasley T.
      • Moracco K.E.
      • Casteel M.J.
      Adolescent female homicide: A silent epidemic.
      ,
      • Coyne-Beasley T.
      • Moracco K.E.
      • Casteel M.J.
      Adolescent femicide: A population-based study.
      ]. The United Nations (UN) describes how pubertal changes increase attention to sexuality and gender roles, heightening adolescent girls' vulnerability to sexual violence, child marriage, and other forms of violence. In addition, increased risk taking such as substance use and unsafe sex, which occur in adolescence, as well as patriarchal tendencies for men to exert power over women's bodies may further increase girls' vulnerabilities to violence [
      UNICEF
      A statistical snapshot of violence against adolescent girls.
      ]. The literature is replete with evidence of how boys in general are disciplined less harshly for aggression toward their peers and girls. Furthermore, adolescent boys are socially rewarded for adopting stereotypical behaviors showing power over women and girls, setting the stage for acceptance of GBV [
      • Amin A.
      • Kågesten A.
      • Adebayo E.
      • Chandra-Mouli V.
      Addressing gender socialization and masculinity norms among adolescent boys: Policy and programmatic implications.
      ]. Adolescents may also be at risk, as this is the first time they are experiencing romantic relationships, which may increase exposure to potential perpetrators of GBV and as they may disclose or seek help less [
      • Adhia A.
      • Kernic M.A.
      • Hemenway D.
      • et al.
      Intimate partner homicide of adolescents.
      ]. Groups such as transgender women and Native American women, both in the news recently for disproportionate murders or disappearances, are likely even more vulnerable because of their multiply marginalized status. Despite the fact that violence is the second leading cause of death for adolescent girls worldwide [
      UNICEF
      A statistical snapshot of violence against adolescent girls.
      ] and almost half of female homicide victims of all ages are killed by family members or intimate partners, there is a dearth of publications discussing contexts for AYA femicide. In the U.S., the largest population-based analysis of intimate partner homicides found that 90% of the victims were girls, calling for increased attention to dynamics of AYA [
      • Adhia A.
      • Kernic M.A.
      • Hemenway D.
      • et al.
      Intimate partner homicide of adolescents.
      ].
      This commentary aims to bring attention to femicide as a global public health emergency that is increasingly apparent amidst the COVID-19 pandemic, to address actions needed globally, and to outline evidence-based approaches to guide organizational policies that promote gender equity and safety for all AYAs.

      Definition of Femicide and Its Relationship to Violence Against Women and Girls

      Femicide is a contextually specific concept to describe an extreme form of GBV. Although, to date, there is no global convention, femicide is generally defined as the killing of women and girls (inclusive of gender-diverse and transgender individuals) as a consequence of gender norms [
      UNODC
      Global Study on Homicide 2019 (Vienna, 2019).
      ] or their gender or sex [
      United Nations, General Assembly, September 23rd, 2016. Violence against women, its causes and consequences.
      ]. Femicide is beyond a violation of fundamental rights, as their lives are taken away. Gender-based intentional killing of girls and women may be perpetrated by an intimate partner, a family member, or an individual outside of the family []. Types of femicide include intimate femicide (intimate partner homicide), honor-related femicide (honor killings against a female due to actual or assumed transgressions), dowry-related femicide (e.g., females killed by in-laws for conflict related to their marital dowries), and nonintimate femicide (e.g., random killings or systematic mass killings of women) [
      World health organization
      Understanding and addressing violence against women. Femicide.
      ]. Increasingly, advocates acknowledge that misogyny may fuel femicide, often perpetrated by men, and that this should be recognized as a hate crime [
      Myrna Dawson Policy Options Politics
      Until we label misogynistic acts including killings for what they are, their underlying motivations will be obscured and our ability to respond disabled.
      ,
      • Mullany L.
      • Trickett L.
      Misogyny hate crime evaluation report.
      ]. There is a global public health crisis of girls and women being intentionally killed at the hands of their partners, families, and others in their communities because they are girls and women.

      Historical Context for Femicide

      A critical understanding of the current context of GBV requires knowledge of the historical-colonial trajectory of the creation and maintenance of patriarchy, a contested term describing the systemic oppression of women in a system of social structures and practices in which men dominate [
      • Christ C.P.
      A new definition of patriarchy: Control of women’s sexuality, private property, and war.
      ]. Moreover, patriarchy and subordination of women's rights are not inevitable or the result of any natural order in the world. Patriarchy is produced and maintained by societies, including by women themselves, as a form of survival and accommodation through internalized oppression. Violence against women has deep historical origins in the subjugation of women as part of other forms of oppression, including colonialism, imperialism, religious hegemony, and ethnic cleansing. More gender-equitable societies always existed, notably with pre-Columbian indigenous societies of the Americas [
      • Gangoli G.
      Understanding patriarchy, past and present: Critical reflections on Gerda Lerner (1987), the Creation of Patriarchy, Oxford University Press.
      ]. An appreciation of women's world history is vital to understanding the results of this historical trauma, which are enacted across cultures globally, fueling femicide.

      Femicide is an Issue Globally

      The number of femicides perpetrated by an intimate partner or family member appears to be on the rise globally, from 48,000 in 2012 to 50,000 in 2017 [
      UNODC
      Global Study on Homicide 2019 (Vienna, 2019).
      ]. This means that 137 women per day are killed by a member of their own family according to the UN [
      UNODC
      Global Study on Homicide 2019 (Vienna, 2019).
      ]. Although women only account for 18% of homicide victims globally, 64% of those deaths are by an intimate partner or family-related violence [
      UNODC
      Global Study on Homicide 2019 (Vienna, 2019).
      ]. In addition, in some regions such as Africa and Asia, high rates of femicide cooccur alongside high rates of child marriage, multiplying and complicating the vulnerabilities of AYA.
      Table 1 highlights the magnitude and widespread nature of femicide. Although the UN has made efforts to aggregate femicide data, reporting is highly variable and likely underestimated, with many countries only reporting homicides by intimate partners and not other family or community members. This incomplete reporting makes direct comparisons, tracking trends in violence, and targeting public health measures difficult.
      Table 1Global femicide statistics: Murders of women committed by partners or family members, 2017
      Source: UNODC, Global Study on Homicide 2019 (Vienna, 2019) https://www.unodc.org/documents/data-and-analysis/gsh/Booklet_5.pdf [
      UNICEF
      A statistical snapshot of violence against adolescent girls.
      ].
      Women murdered by:Murders of women per 100,000 by:
      Intimate partners (%)Intimate partners or family members (%)Intimate partnersIntimate partners or family members
      Globally>30,000 (34%)>50,000 (58%)--1.3
      Americas6,000 (20%)8,000 (16%)1.2--
      Europe2,000 (7%)3,000 (6%).6--
      Asia11,000 (37%)20,000 (40%).5--
      Africa11,000 (37%)19,000 (38%)1.7--
      Oceania200 (<1%)300 (<1%).4--

      COVID-19 Impact on Femicide

      Compounding these findings, the UN alerts a “shadow pandemic” amidst COVID-19: a silent intensification of violence against women and girls occurring globally. Economic strains, confined quarantine conditions and increased time and tensions at home, closed schools, and limited access to an overwhelmed health system can increase vulnerability and risks for different types of abuse: domestic violence, violence against sex workers, increase abuse of domestic workers who are mainly women, sexual harassment (online and offline), and economic injustice associated with gender wage gap [
      • Ragavan M.I.
      • Culyba A.J.
      • Muhammad F.L.
      • Miller E.
      Supporting adolescents and young adults exposed to or experiencing violence during the COVID-19 pandemic.
      ,
      • Ragavan M.I.
      • Garcia R.
      • Berger R.P.
      • Miller E.
      Supporting intimate partner violence survivors and their children during the CoViD-19 pandemic.
      ,
      • Allen S.
      • Julian Z.
      • Coyne-Beasley T.
      • et al.
      COVID-19's impact on women: A stakeholder-engagement approach to increase public awareness through Virtual Town Halls.
      ]. Amplifying this crisis, many women's organizations, crisis centers, helplines, and shelters have had funding cuts and are struggling to meet current increasing needs. The UN report on COVID-19 and violence against women and girls agree on global need for action in tackling GBV, supporting unpaid care, and strengthening women's economic security [
      UN women, "Issue Brief: COVID-19 and ending violence against women and girls" (2020).
      ]. The UN Development Program launched a COVID-19 Global Gender Response Tracker [
      UNDP
      COVID-19 global gender response tracker.
      ] that analyzes government measures in those three areas; only 25 countries (25% of the world) have introduced comprehensive measures to cover these three areas.

      Actions Needed to Reduce Femicide

      The previously mentioned data demonstrate that rates of femicide are rising globally with COVID-19 and the global recession exacerbating GBV. Although we concur with the UN recommendations to reverse this trend, we advocate for additional immediate actions across a variety of domains, as outlined in Box 1, to reduce femicide of AYA women. Specifically, health professionals working with AYA have opportunities to promote prevention. Interventions include ensuring all youth receive confidential access to information about GBV and relevant resources, connecting youth to vital supports including youth advocates, and nurturing youth leaders to challenge patriarchy and related oppression [
      • Ragavan M.I.
      • Culyba A.J.
      • Muhammad F.L.
      • Miller E.
      Supporting adolescents and young adults exposed to or experiencing violence during the COVID-19 pandemic.
      ].
      Critical domains for action to reduce femicide
      • Femicide data collection, transparency, and access: Data on homicides must be collected and disaggregated by age and gender globally. These data need to be regularly collected and uniformly reported with common definitions, publicly available, and timely.
      • Clarification of a femicide legal framework: National and international legal systems must establish a clear framework for addressing cases of femicide including a common definition and an explicit focus on marginalized groups such as adolescents and young adults who are already at risk for other gender-based infringements of their rights (e.g., child marriage, human trafficking, gender-diverse/transgender individuals).
      • Enforcement of legal protections for adolescent girls and young adult women: National and international legal systems must commit to enforcing the laws that exist to protect women from gender-based violence.
      • Consideration of the developmental and traumatic impacts of femicide and gender-based violence on health: The health impacts of femicide and its antecedent acts of violence against adolescents and young adults must be considered from a developmental and trauma standpoint as contributing to the burden of Adverse Childhood Events and resultant life-long health disparities.
      • Identification of AYA-specific femicide risk and protective factors: Public health research is needed to identify adolescent and young adult risk and protective factors for femicide.
      • Education as early intervention to promote equity: Education of all children, beginning in early childhood, needs to incorporate gender equity, intersectionality, equal rights, the importance of economic and social empowerment of girls, and gender studies curricula with feminist and masculinity theories.
      • Advancing women in leadership and positions of power: The advancement of women in leadership positions in public health, criminal justice, law enforcement, medicine, education, and politics will promote equity in access to systems of power.
      • Public health campaigns to promote equity: Engagement in public health campaigns to promote the need for equity and protection of the rights of adolescent girls and young women and femmes through accessible channels, including social media.
      • Reaffirm commitment to preventing GBV, including femicide, through government and civil society action: Urge governments to sign, ratify, and implement the Council of Europe Convention on Preventing and Combating Violence Against Women and Domestic Violence (Istanbul Convention) and commit to recognizing femicide as a form of GBV and actively achieve Sustainable Development Goal 5 Target 2 to eliminate all forms of GBV. Civil society should continue to hold governments accountable through platforms such as the Generation Equality Forum, which marks the 25th anniversary of the adoption of the Beijing Declaration and Platform for Action.

      Conclusion

      A robust response to femicide integrated with antioppression efforts globally is critical to ensuring that all AYA grow into empowered members of society. Adolescence and young adulthood are the developmental periods when most femicide is occurring. Thus, as advocates of AYA, we have an obligation to accept the challenge created by women worldwide, not just sharing photos but by leveraging all possible education and advocacy opportunities to create safety and freedom that all AYA worldwide rightfully deserve. This year, the 25th anniversary of the Beijing Platform for Action, an international blueprint for women's rights and empowerment, is the moment for action.

      Acknowledgments

      Y.E. is an employee of the Gates Foundation at the time of writing; however, the views expressed do not necessarily represent the views of the Gates Foundation.

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