Violencia de género y sexual en América Latina factores estructurales impactos psicológicos y desafíos de la respuesta institucional J. Law Epistemic Stud. (January - June 2025) 3(1): 20-30 https://doi.org/10.5281/zenodo.15243080 ISSN: XXXX-XXXX REVIEW ARTICLE Gender-based and sexual violence in Latin America structural factors psychological impacts and challenges of institutional response  Leonel Céspedes lcespedest@udg.co.cu Universidade Internacional do Cuanza, Angola. Received: 20 March 2024 / Accepted: 05 June 2024 / Published online: 10 January 2025 © The Author(s) 2025 Lisandra León · Leonel Céspedes Abstract This article conducted a thematic review on gen- der-based and sexual violence in the Ecuadorian and Latin American context, aiming to analyze its principal manifes- tations, impacts, and institutional responses. A qualitative approach was applied, based on the documentary analysis of scientific literature published between 2019 and 2024, re- ports from international organizations, and current national legislation. The results showed that gender-based violence takes multiple forms, including physical, sexual, psycholog- ical, patrimonial, and moral violence, affecting women of all ages in a transversal manner. A high prevalence of domestic and sexual violence was identified, with profound physical and psychological impacts such as post-traumatic stress dis- order, depression, and anxiety. Structural risk factors were also recognized, such as patriarchal culture, economic in- equality, lack of access to adequate services, and institution- al revictimization. Despite legal advancements, significant challenges persist in effectively implementing public poli- cies, comprehensive victim care, and transforming discrim- inatory cultural patterns. It was concluded that eradicating gender-based violence requires coordinated, sustained, and intersectional action that integrates legal, social, educational, and public health measures aimed at guaranteeing women’s human rights. Keywords gender-based violence, sexual violence, psycho- logical impact, risk factors, institutional response. Resumen El presente artículo realizó una revisión temática sobre la violencia de género y sexual en el contexto ecuato- riano y latinoamericano, con el objetivo de analizar sus prin- cipales manifestaciones, impactos y respuestas instituciona- les. Se aplicó un enfoque cualitativo, basado en el análisis documental de literatura científica publicada entre 2019 y 2024, informes de organismos internacionales y legislación nacional vigente. Los resultados evidenciaron que la violen- cia de género adopta múltiples formas, incluyendo violencia física, sexual, psicológica, patrimonial y moral, afectando de manera transversal a mujeres de todas las edades. Se identifi- có una alta prevalencia de violencia doméstica y sexual, con impactos físicos y psicológicos profundos, como trastorno de estrés postraumático, depresión y ansiedad. Asimismo, se reconocieron factores de riesgo estructurales, tales como la cultura patriarcal, la desigualdad económica, la falta de acceso a servicios adecuados y la revictimización institucio- nal. A pesar de los avances normativos, persisten desafíos significativos en la implementación efectiva de políticas pú- blicas, la atención integral a las víctimas y la transformación de patrones culturales discriminatorios. Se concluyó que la erradicación de la violencia de género requiere una acción coordinada, sostenida e interseccional que articule medidas legales, sociales, educativas y de salud pública, orientadas a garantizar los derechos humanos de las mujeres. Palabras clave violencia de género, violencia sexual, im- pacto psicológico, factores de riesgo. How to cite León, L., & Céspedes, L. (2025). Influence of radio promotion on cultural participation in the municipality of Sancti Spíritus. Journal of Law and Epistemic Studies, 3(1), 20-30. https://doi.org/10.5281/zenodo.15243080 Universidade Internacional do Cuanza, Angola.

J. Law Epistemic Stud. (January - June 2025) 3(1): 20-30 21 Introduction Gender-based violence represents one of the most serious and persistent violations of human rights worldwide. This phenomenon manifests itself in multiple forms, including physical, psychological, sexual, patrimonial, and moral vio- lence, disproportionately affecting women of different ages, social classes, and cultural backgrounds (United Nations Women’s Organization, 2024; WHO, 2021). In the Latin American context, and particularly in Ecuador, gender-based violence constitutes a problem of structural scope that con- tinues to show alarming rates, despite the legislative efforts and public policies implemented in recent decades (Mo- rales-Fonseca et al., 2023). The United Nations Women (UN Women) defines gen- der-based violence as any form of gender-based violence that causes, or may cause, physical, sexual, or psychologi- cal harm to women, encompassing acts of violence, threats, coercion, and arbitrary deprivation of liberty in the public or private sphere (UN Women, 2024). The magnitude of the problem is reflected in alarming global statistics: it is esti- mated that around one in three women has been a victim of physical or sexual violence at some point in their lives (PAHO, 2023; WHO, 2021). Furthermore, phenomena such as female genital mutilation, child marriage, and fe- micide continue to affect millions of women, perpetuating deep-rooted cycles of violence and discrimination. In Latin America, domestic and family violence persists as one of the most common forms of gender-based violence. Ecuador, for example, is among the countries with the high- est rates of domestic violence, ranking sixth in incidence ac- cording to international studies (WHO, 2021). Recent data from UN Women (2024) indicate that, during the COVID-19 pandemic, approximately one in four Ecuadorian women over the age of 16 reported having been victims of violence in the previous twelve months, demonstrating a worsening of the situation due to forced confinement and prolonged co- habitation with the aggressors. Sexual violence, as an extreme manifestation of gen- der-based violence, also presents worrying figures in Ecua- dor and other countries in the region. This form of violence involves non-consensual sexual acts and has devastating consequences for the physical, mental, and reproductive health of the victims (Villegas, 2021; Ramos-Aguilera et al., 2023). Studies indicate that in armed conflict settings and sit- uations of social vulnerability, sexual violence reaches even more alarming levels, becoming a strategy of control and subjugation (Sanjuán, 2024). At the domestic level, many of the aggressors are people known to the victim, which adds complexity to reporting and addressing the problem (Poa- lacín-Iza & Bermúdez-Santana, 2023). The persistence of violence against women is closely linked to cultural, historical, and structural factors that sus- tain unequal power relations. Morales-Fonseca et al. (2023) argue that the patriarchal and sexist culture in Latin America has naturalized forms of violence, generating a social silenc- ing that hinders the visibility and eradication of the problem. Gutiérrez-Ramos (2021) agrees that gender-based violence has historically been minimized and rendered invisible, both socially and legally, perpetuating the revictimization of af- fected women. The psychological impact of gender-based violence cannot be underestimated. Continued exposure to situations of vi- olence generates post-traumatic stress disorder, depression, anxiety, low self-esteem, and suicidal ideation, among other profound emotional damages (Morales-Fonseca et al., 2023). According to recent studies, many victims of sexual violence develop severe symptoms that affect their personal, social, and professional lives in the long term (Borràs et al., 2023). The lack of timely care and adequate institutional support contributes to the chronic suffering and the intergenerational reproduction of violence. This article aims to conduct a comprehensive thematic review of gender-based violence, addressing its manifesta- tions, structural causes, physical and psychological conse- quences, and regulatory and social responses in the Ecua- dorian and Latin American context. Through the analysis of recent scientific literature (2019-2024) and reports from international organizations, the article offers a critical over- view of the progress and challenges in preventing and re- sponding to gender-based and sexual violence. The focus of this review will be on domestic and sexual violence, two of the most prevalent and severe forms of vi- olence against women. The power dynamics underpinning these phenomena will be explored, the differential impact across geographic and socioeconomic contexts, and the pub- lic policies implemented to address them will be explored. The response of the health system to the physical and emo- tional consequences of sexual violence will also be analyzed, highlighting the main gaps and challenges identified in the specialized literature (Trujillo & Clarke, 2022 ). Methodologically, this review was based on indexed aca- demic sources, reports from multilateral organizations such as UN Women, WHO, and PAHO, and current legislation on protecting women’s rights. Documents were selected based on thematic relevance, the timeliness of the data (2019- 2024), and the scientific quality of the publications. This strategy provided a solid foundation for critically analyzing the issues addressed, ensuring an up-to-date and well-found- ed perspective. Ultimately, this work aims to contribute to the academic and social debate on gender-based violence, highlighting the urgent need to strengthen prevention, care, and reparation

J. Law Epistemic Stud. (January - June 2025) 3(1): 20-30 22 policies for victims and promote profound cultural changes that will eradicate the structural roots of this form of vio- lence. A review of the existing literature provides an under- standing not only of the magnitude of the problem but also of the complexity of the factors that perpetuate it and the multiple challenges facing the justice, health, and social pro- tection systems in the region. Methodology This study adopts a narrative thematic review approach oriented toward the critical and systematic analysis of recent scientific literature, reports from international organizations, national legislation, and relevant academic studies on gen- der-based and sexual violence. Since the primary objective is to integrate and synthesize existing knowledge on the ma- nifestations, impacts, and institutional responses to violence against women, a qualitative methodology based on content analysis was chosen. The documentary review was based on a careful selection of secondary sources, prioritizing indexed academic publica- tions, studies by multilateral organizations such as the Uni- ted Nations Women’s Organization, the World Health Orga- nization (WHO) and the Pan American Health Organization (PAHO), as well as relevant national legislation, such as the Law to Prevent and Eradicate Violence against Women (Na- tional Assembly of the Republic of Ecuador, 2018). Recent research by authors specializing in gender-based and sexual violence was also incorporated, ensuring an upda- ted and multidimensional approach to the phenomenon. The selected sources correspond mainly to the period between 2019 and 2024, thus ensuring the relevance and timeliness of the analyzed data (Álvarez-Gutiérrez & Castillo-Koschnick, 2019; Morales-Fonseca et al., 2023; Borràs et al., 2023). The following inclusion criteria were established for the selection of documents reviewed: Academic publications, institutional reports, or legislative documents relevant to the topic of gender-based violence, domestic violence, and se- xual violence. Documents presenting updated statistical data, regulatory analyses, physical and psychological impacts of violence, or intervention and prevention strategies. Unverifiable sources, opinion papers not academically su- pported, articles published prior to 2019, and studies focused exclusively on populations or phenomena not directly linked to the object of study (for example, violence based solely on sexual orientation, unless addressed within the framework of gender-based violence) were excluded. The search for sources was conducted through recogni- zed academic and scientific databases (Google Scholar, Re- dalyc, Scielo) and direct consultation of official websites of international organizations. Combinations of keywords such as “gender violence”, “sexual violence”, “domestic violen- ce”, “psychological impact of violence”, “femicide in Latin America”, and “legal protection against gender violence” were used. Each document was evaluated based on its thematic rele- vance, methodological rigor, timeliness, and specific contri- bution to this study’s analytical framework. Once the relevant documentation was collected, a thematic content analysis was carried out, extracting the main catego- ries of information: • Conceptualization and forms of gender violence. • Magnitude and statistics of domestic and sexual vio- lence. • Physical and psychological impact on victims. • Associated sociocultural factors. • Regulatory and institutional responses. • Intervention and prevention experiences. The information extracted was systematically organized, prioritizing the findings’ critical integration and contextua- lization within the Ecuadorian and Latin American context. This analysis allowed us to identify trends, gaps in attention, and opportunities for improvement in the social and institu- tional response to gender-based violence. The study recognizes the limitation of its reliance on se- condary sources, which implies acknowledging the potential biases of the documents reviewed. Furthermore, although an effort was made to include relevant literature from recent years, the rapid evolution of the issue of gender-based vio- lence could cause some data to become outdated quickly. However, the diversity, relevance, and rigor of the sources used guarantee the validity of the analysis, offering a repre- sentative and critical overview of the contemporary situation of gender and sexual violence in Ecuador and the region. Gender violence is not limited to physical or sexual as- sault. However, it encompasses a set of systematic control and domination practices exercised over women in different areas of their daily lives (Trujillo & Clarke, 2022). The dy- namics of psychological, patrimonial, and moral violence also constitute severe forms of rights violations, affecting the autonomy, dignity, and integral development of the victims (Pérez et al., 2017). This reality highlights the need to un- derstand the phenomenon from an intersectional perspective that considers the multiple forms of oppression that may oc- cur in women, especially those in situations of greater social and economic vulnerability. A historical analysis of gender-based violence allows us to identify how patriarchal social constructs have normalized female subordination for centuries, naturalizing behaviors and practices that are now recognized as human rights vio- lations (Tourné et al., 2024). These cultural constructs have

J. Law Epistemic Stud. (January - June 2025) 3(1): 20-30 23 perpetuated gender stereotypes that assign women roles of passivity, submission, and dependence, favoring the repro- duction of violence in unequal power relations. As Cuellar (2024) points out, despite advances in international and na- tional regulations, the transformation of these cultural struc- tures has been slow and faces deep resistance in various sec- tors of society. In Ecuador, enacting specific laws such as the Law to Pre- vent and Eradicate Violence against Women (National As- sembly of the Republic of Ecuador, 2018) has represented an important step toward protecting women’s rights. Howe- ver, the effective implementation of these regulations faces multiple challenges, including a lack of resources, insuffi- cient training for judicial and health personnel, and the per- sistence of sociocultural patterns that minimize the severity of gender-based violence (Vergara, 2024). This gap between the legal framework and practical reality reinforces the need to strengthen prevention, care, and punishment systems and promote structural changes in gender relations. Data on sexual violence in Ecuador reveal a particularly alarming reality. According to research by Álvarez-Gutiérrez and Castillo-Koschnick (2019), girls and adolescents cons- titute one of the most vulnerable groups, facing high rates of sexual violence in the family and community. Likewise, Werner (2020) warns that the underreporting of cases is dri- ven by fear, shame, and distrust of institutions, which hinder access to justice and perpetuate impunity. This situation re- flects the urgent need to strengthen mechanisms for repor- ting, protection, and comprehensive reparation for victims, ensuring a gender- and human rights-sensitive approach. The impact of sexual violence on the physical and men- tal health of victims is devastating. As García et al. (2024) argue, the consequences range from sexually transmitted in- fections, unwanted pregnancies, and severe physical harm to psychological disorders such as post-traumatic stress, de- pression, and anxiety. The specialized literature highlights the importance of comprehensive and timely care that in- cludes HIV post-exposure prophylaxis, access to emergency contraception, and specialized psychological support (WHO, 2021). However, recent studies show that the health system still has significant deficiencies in providing care to victims, particularly in access to preventive treatment and respect for the rights of women in situations of violence (Poalacín-Iza & Bermúdez-Santana, 2023; Vergara, 2024). At the international level, organizations such as the World Health Organization (2021) and the Pan American Health Organization (2023) have emphasized the need to adopt a multisectoral approach to address gender-based violence, coordinating efforts in health, justice, education, and social protection. In this regard, primary prevention strategies, fo- cused on promoting equal relationships and transforming discriminatory cultural norms, are essential to address the structural roots of the problem. However, as Morales-Fonse- ca et al. (2023) warn, these strategies require legislative and programmatic changes and a sustained commitment from all of society to eradicate violence as a form of social control. A review of recent literature also identifies successful ex- periences in the prevention and treatment of gender-based violence, which can serve as a benchmark for the region. Healthy relationship education programs, evidence-based community interventions, and integrated victim care proto- cols have proven effective in diverse contexts. Considering the country’s cultural and socioeconomic characteristics, adapting these best practices to the Ecuadorian context cons- titutes a priority challenge for public gender policies. In short, gender-based and sexual violence constitute a complex and multifaceted problem that requires a compre- hensive approach based on the promotion of human rights, gender equality, and social justice. This thematic review see- ks to contribute to academic reflection and the development of more effective strategies to prevent and eradicate violence against women, recognizing the importance of coordinated and sustained action involving all sectors of society. Results and discussion Gender violence: Concept, forms, and magnitude Gender-based violence constitutes a serious human rights violation that affects women of all ages, social classes, edu- cational levels, and cultural backgrounds. Its common ele- ment is exercising power and control over the victims’ bod- ies and lives (UN Women, 2024; WHO, 2021). This form of violence is embedded in historical relationships of inequality between men and women and manifests itself through multi- ple behaviors that seek to perpetuate this subordination. According to UN Women (2024), gender-based violence encompasses any act that causes or may cause physical, sex- ual, or psychological harm to a person based on their gender. It also includes threats, coercion, and arbitrary deprivation of liberty, in any setting, whether public or private. The current conceptualization does not limit the phenomenon to overt physical violence. Instead, it recognizes the multiple dimen- sions that affect women’s lives and rights, such as emotional, economic, and symbolic violence. Among the primary forms of gender-based violence are physical violence, sexual violence, psychological violence, property violence, and moral violence (Pérez et al., 2017; Trujillo & Clarke, 2022). Each of these forms has specif- ic characteristics, but they all share the intention to cause harm and maintain structural inequality. Physical violence includes acts such as hitting, pushing, burning, and any ag- gression that causes bodily harm. Sexual violence refers to

J. Law Epistemic Stud. (January - June 2025) 3(1): 20-30 24 any non-consensual sexual act, sexual harassment, exploita- tion, and other forms of sexual abuse (Villegas, 2021; Poa- lacín-Iza & Bermúdez-Santana, 2023). Psychological violence, for its part, impacts the emotional well-being of victims through threats, humiliation, isolation, and manipulation, profoundly affecting their self-esteem and perception of autonomy (Trujillo & Clarke, 2022). Patrimo- nial and economic violence involves the control of economic resources, the destruction or appropriation of property, and limited access to essential resources. Finally, moral violence manifests through behaviors such as defamation, slander, and public discrediting of victims, affecting their honor and reputation. The magnitude of the problem is alarming. According to WHO data (2021), approximately one in three women worldwide has been a victim of physical or sexual violence. This figure has remained virtually unchanged for decades, demonstrating the structural persistence of the problem. At the regional level, violence against women presents even more worrying figures. In Latin America, approximately 30% of women have suffered violence at the hands of their intimate partners, and Ecuador is no exception (PAHO, 2023). In Ecuador, the situation is particularly dire. According to UN Women (2024), during the COVID-19 pandemic, one in four women over the age of 16 reported having suffered some physical, psychological, or sexual violence in the past year. This situation was exacerbated by the conditions of confinement, which forced victims to live with their abusers and hindered access to support networks and protection ser- vices (PAHO, 2023). Gender-based violence manifests itself at all stages of a woman’s life. Childhood and adolescence are particular- ly vulnerable periods, as Álvarez-Gutiérrez and Castil- lo-Koschnick (2019) point out, who show that millions of girls are victims of harmful practices such as female genital mutilation and child marriage. In adulthood, violence is pri- marily expressed through domestic, sexual, and economic violence. At the same time, in old age, women often face in- visible forms of violence, such as abandonment, abuse, and property-related violence (Werner, 2020). Femicide represents the most extreme form of gen- der-based violence. The WHO (2021) indicates that approxi- mately 38% of homicides of women globally are perpetrated by their intimate partners. In Latin America, femicides have increased in recent years, becoming a critical human rights issue. In Ecuador, the number of femicides has increased alarmingly, reflecting the inability of state structures to ef- fectively prevent and punish this extreme form of violence (UN Women, 2024). A particularly worrying aspect is the high level of under- reporting of gender-based violence cases. As Vergara (2024) and Trujillo & Clarke (2022) point out, between 30% and 40% of domestic and sexual violence cases are not reported to the authorities, due to fear, shame, the normalization of vi- olence, or distrust in the justice system. This underreporting hides the true magnitude of the problem and limits the effec- tiveness of public policies aimed at eradicating gender-based violence. Gender-based violence also has profound impacts on women’s physical, mental, and social health. Victims suffer from visible physical injuries to chronic illnesses, sexually transmitted infections, unwanted pregnancies, and mental health problems such as post-traumatic stress disorder, de- pression, and anxiety (Morales-Fonseca et al., 2023; Macías, 2023). These impacts not only affect individual women but also have broader social consequences, affecting their fami- lies, communities, and entire societies. Several authors agree that effectively addressing gen- der-based violence requires addressing the structural causes that perpetuate it. Morales-Fonseca et al. (2023) argue that factors such as machismo, patriarchy, economic inequality, and gender discrimination are key elements that must be transformed to eradicate the problem. Gender-based vio- lence cannot be understood as a series of isolated incidents, but rather as a systemic phenomenon that requires compre- hensive, coordinated, and sustainable responses. Ultimately, gender-based violence is a complex, multidi- mensional, and far-reaching problem whose eradication re- quires coordinated efforts on multiple fronts: gender equal- ity education, changing discriminatory cultural patterns, strengthening protection and justice systems, and ensuring access to comprehensive, gender-sensitive health services. A thorough understanding of the forms, dimensions, and magnitude of gender-based violence is the first step toward building more just, inclusive, and human rights-respecting societies. Domestic and family violence in Ecuador Domestic and family violence represents one of the most prevalent and damaging forms of gender-based violence in Ecuador, profoundly affecting women’s physical, psycho- logical, and emotional integrity. This form of violence oc- curs predominantly in the private sphere, in contexts where protection and security should be paramount, which exac- erbates its impact and makes it difficult to report and effec- tively address it (Morales-Fonseca et al., 2023; UN Women, 2024). Domestic violence in Ecuador is embedded in a sociohis- torical context characterized by profound gender inequali- ties, where patriarchal culture and machismo continue to exert a strong influence. This historical reality has allowed

J. Law Epistemic Stud. (January - June 2025) 3(1): 20-30 25 violent practices against women to be naturalized or socially minimized, making their recognition and eradication diffi- cult. Despite regulatory advances, such as the enactment of the Law to Prevent and Eradicate Violence against Women (National Assembly of the Republic of Ecuador, 2018), do- mestic violence rates remain alarming and reflect the per- sistence of structural patterns of inequality. The dynamics of domestic violence often develop in cy- cles, as described (Trujillo & Clarke, 2022): first, there is a phase of accumulated tension, followed by episodes of acute violence, and then giving way to a stage of regret or reconciliation on the part of the aggressor. This cyclicality contributes to many victims remaining trapped in abusive relationships for long periods, with serious consequences for their physical and mental health. Domestic violence takes multiple forms, including physi- cal, psychological, sexual, property, and moral violence. As Sanjuán (2024) points out, all these forms have devastating effects on victims, affecting their dignity, autonomy, and overall well-being. Physical violence manifests itself in di- rect physical attacks; psychological violence through threats, humiliation, and emotional control; sexual violence through non-consensual sexual acts; property violence through the control and destruction of property; and moral violence through damage to women’s reputation and honor (Quisbet & Fernández, 2023). Recent statistical data demonstrate the seriousness of the situation. According to UN Women (2024), during the lock- down due to the COVID-19 pandemic, approximately 24.4% of Ecuadorian women over the age of 16 reported having been victims of some type of violence. Furthermore, femi- cide rates in the country remain at worrying levels, with the majority of victims being young women between the ages of 18 and 44, and the primary aggressors identified as partners or ex-partners in 81.5% of cases. The problem is exacerbated in rural settings and in areas with limited access to specialized services, where victims face greater barriers to reporting and receiving adequate care. In areas such as the Cariri region of Brazil, although not the focus of this study, a similar pattern of high incidence of domestic violence has been documented in larger municipal- ities, allowing for useful analogies to be established for the analysis of the Ecuadorian context (Trujillo & Clarke, 2022). A critical aspect highlighted by Morales-Fonseca et al. (2023) is the inadequacy of institutional responses to domes- tic violence. Although laws and protocols exist, their imple- mentation is limited by factors such as the lack of training for justice officials, the scarcity of resources, and persistent social tolerance toward forms of violence considered “mi- nor” or “normal.” This situation perpetuates impunity and discourages victims from seeking formal support. The silencing of victims, whether due to fear, economic dependence, or social pressure, constitutes another signifi- cant barrier to eradicating domestic violence. During the pandemic, as Trujillo & Clarke (2022) and PAHO (2023) observe, confinement increased the invisibility of the prob- lem, further hindering access to protection mechanisms and increasing the risk of femicide. The severity of domestic violence in Ecuador is also re- flected in the level of underreporting. Vergara (2024) points out that a significant percentage of affected women do not report the incidents, meaning that official figures barely rep- resent the true phenomenon. This statistical invisibility lim- its governments’ ability to design effective public policies and hinders the development of evidence-based prevention strategies. From a criminological perspective, Gutiérrez-Ramos (2021) emphasizes that domestic violence has not been ad- equately addressed from the point of view of the victims, who suffer not only physical or psychological harm, but also institutional re-victimization when their complaints are not taken seriously or when they face re-victimizing procedures in the justice and health systems. Domestic violence cannot be understood solely as an indi- vidual or family problem; it must be seen as a manifestation of the unequal power relations between men and women in society. Pérez-Martínez & Rodríguez-Fernández (2024) in- sist that the response must be comprehensive, addressing both victim care and the transformation of the cultural pat- terns that legitimize violence. Preventing domestic violence requires long-term strat- egies that include awareness campaigns, gender equality education from an early age, strengthening victim services, and effective sanctions for abusers. It is also essential to im- prove women’s access to economic resources and support networks, factors that have been identified as crucial for es- caping situations of violence (Morales-Fonseca et al., 2023). In conclusion, domestic and family violence in Ecuador constitutes a structural problem that demands coordinated, sustained, and multidimensional responses. Despite legisla- tive advances, the high rates of violence highlight the need to deepen prevention strategies, strengthen protection and cul- tural transformation mechanisms, and guarantee comprehen- sive care that respects the human rights of all women victims of violence. Sexual violence: a devastating reality Sexual violence constitutes one of the most serious and devastating forms of gender-based violence, profoundly af- fecting the dignity and physical, emotional, and reproductive health of its victims. This form of violence includes any sex- ual act committed without the victim’s consent and encom-

J. Law Epistemic Stud. (January - June 2025) 3(1): 20-30 26 passes acts such as rape, sexual abuse, sexual exploitation, human trafficking, coercion, and sexual harassment (Ville- gas, 202; Sanjuán, 2024). According to Villegas (2020), sexual violence is character- ized by its ability to violate women’s sexual and reproduc- tive rights, generating traumatic consequences that transcend the moment of the attack and affect the victim’s entire life. In Ecuador, as in other Latin American countries, sexual vio- lence occurs in multiple settings: the family, the community, schools, public transportation, and the workplace. Data from the World Health Organization (WHO, 2021) show that 38% of women in Latin America have suffered some type of sexual violence, mainly at the hands of their partners or ex-partners. In the Ecuadorian case, reports from UN Women (2024) and local studies (Werner, 2020) show that girls, adolescents, and young women constitute the most vulnerable groups, with the aggressors often being people known to or close to the victims’ family circle. Child sexual abuse, in particular, is an alarming problem. According to Werner (2020), a high proportion of victims of sexual violence in Ecuador are girls under the age of 14, with a particularly high prevalence in family contexts where the aggressor is a father, stepfather, uncle, or other close relative. The “conspiracy of silence” surrounding these cases makes reporting difficult and allows the abuse to continue for years, causing severe physical, emotional, and psychological harm to the victims (Werner, 2020; Trujillo & Clarke, 2022). The impact of sexual violence is devastating both physi- cally and emotionally. According to Ramos-Aguilera et al. (2023), a significant percentage of sexual violence cases result in consequences such as unwanted pregnancies, sex- ually transmitted infections, serious physical injuries, and psychological disorders, including post-traumatic stress, se- vere depression, suicidal ideation, and loss of self-esteem. In particular, adolescent girls between the ages of 10 and 14 have higher rates of forced pregnancies as a result of sexual assault, reflecting extreme vulnerability ( Ramos-Aguilera et al., 2023). Underreporting is one of the main obstacles to adequate- ly addressing sexual violence. As Poalacín-Iza & Bermú- dez-Santana (2023) point out, factors such as fear of retalia- tion, shame, institutional revictimization, and distrust of the judicial system inhibit reporting. It is estimated that less than 16% of rapes are reported to the authorities, and this percent- age is even lower in cases of incest (WHO, 2021). At the institutional level, the response to sexual violence has significant deficiencies (Macías, 2023). They highlight that only 52% of victims receive antiretroviral prophylaxis after sexual assault, and barely 50% have access to emergen- cy contraception. This situation reflects the urgent need to strengthen the training of health personnel and ensure the ef- fective implementation of gender-sensitive and victim-cen- tered care protocols. Sexual violence not only occurs in the private sphere but also in contexts of armed conflict, where it is used as a weap- on of war to sow terror, humiliate communities, and exert control over vulnerable populations (García et al., 2025). Although Ecuador is not currently facing a large-scale in- ternal armed conflict, widespread violence and the rise of organized crime also create risks of sexual exploitation and human trafficking, particularly among displaced women and girls or those in socioeconomically vulnerable situations. The psychological impact of sexual violence is profound and long-lasting. Victims can develop post-traumatic stress disorder (PTSD), characterized by symptoms such as intru- sive flashbacks, nightmares, hypervigilance, avoidance of trauma-related stimuli, and severe disturbances in mood and cognition (Morales-Fonseca et al., 2023; APA, 2014). Fur- thermore, victims face high levels of shame, guilt, and social stigma, factors that complicate their recovery process and their access to support networks. Sexual violence also puts victims at significantly higher risk of contracting sexually transmitted infections (STIs) such as gonorrhea, syphilis, chlamydia, HIV, and HPV. Be- tween 0.8% and 50% of women who are victims of sexual violence may contract an STI if they do not receive time- ly medical care (Macías, 2023) . Although post-exposure prophylaxis can prevent many of these infections, access to these treatments is limited, especially in rural areas or among marginalized populations (Vergara, 2024). Proper care for victims of sexual violence requires a com- prehensive approach that includes immediate medical care, specialized psychological support, legal counseling, and so- cial protection. It is also essential to guarantee respect for women’s sexual and reproductive rights, including free and informed access to emergency contraception and voluntary termination of pregnancy in cases permitted by law (UN Women, 2024; Morales-Fonseca et al., 2023). In this regard, Pérez-Martínez and Rodríguez-Fernández (2024) emphasize the need to strengthen intersectoral coor- dination between health, justice, education, and social pro- tection to provide an effective, timely, and human rights-re- specting response to victims of sexual violence. Good practices documented in other contexts show that integrated care protocols, specialized staff training, and the creation of specialized units are effective measures for improving care and reducing the traumatic effects on victims. In conclusion, sexual violence constitutes a human rights emergency that demands urgent and coordinated action at the institutional and social levels. Eradicating this form of violence requires not only punishing the perpetrators, but also transforming the cultural structures that perpetuate im-

J. Law Epistemic Stud. (January - June 2025) 3(1): 20-30 27 punity and silence, strengthening protection systems, and guaranteeing women and girls access to quality health ser- vices, justice, and psychosocial support. Psychological impact of gender and sexual violence The psychological impact of gender-based and sexual vio- lence on women is one of the most devastating and persistent consequences of these forms of violence, severely affecting their emotional well-being, mental health, and personal de- velopment. The emotional after-effects transcend the initial act of violence and impact all aspects of the victim’s life, often lasting for years or even decades if they do not receive adequate specialized care (Morales-Fonseca et al., 2023). Psychological violence, a cross-cutting component of the different forms of gender-based violence, profoundly affects self-esteem, the perception of self-worth, the sense of auton- omy, and the ability to establish trusting relationships (Pérez et al., 2017). As Morales-Fonseca et al. (2023) point out, vic- tims of psychological violence experience severe changes in their behavior and personality, including insecurity, social isolation, constant fear, feelings of guilt and shame, and dif- ficulties expressing emotions. Sexual violence, for its part, is frequently associated with the development of severe mental disorders. Ramos-Aguilera et al. (2023) and Borràs et al. (2023) found that women who have suffered sexual violence have high rates of post-trau- matic stress disorder (PTSD), major depression, generalized anxiety, and panic disorders. The presence of various symp- toms characterizes these clinical conditions. These include intrusive memories of the trauma and recurrent nightmares. Avoidance of stimuli that refer to the aggressive event is also common. Another frequent feature is constant hypervigi- lance. Added to this are irritability, feelings of hopelessness, and emotional dissociation. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) establishes specific criteria for diagnosing PTSD, highlighting that exposure to traumatic events such as sexual violence can trigger persistent symptoms that significantly affect victims’ daily lives (APA, 2014). Common symptoms include avoidance of memories or situations associated with the trauma, negative changes in cognition and mood, height- ened startle reactions, and severe difficulties forming healthy interpersonal relationships. Borràs et al. (2023) argue that the severity of the psycho- logical impact depends on various factors, including the vic- tim’s age, the severity and duration of the abuse, the rela- tionship with the abuser, the existence of support networks, and individual resilience. Victims who do not receive timely and adequate support are at greater risk of developing chron- ic symptoms, self-destructive behaviors such as substance abuse, suicide attempts, and a progressive deterioration in their quality of life. Shame and social blame are factors that aggravate the psy- chological impact of violence. As Morales-Fonseca et al. (2023) point out, many victims internalize guilt for the abuse they suffered, especially in cultural contexts where stereo- types persist that blame women for the attacks they suffer. This situation encourages silence, inhibits seeking help, and deepens emotional wounds, perpetuating a cycle of violence and revictimization. A particularly alarming aspect is the impact of sexual vio- lence on girls and adolescents. Werner (2020) points out that exposure to traumatic experiences of sexual violence during childhood or adolescence is associated with an increased risk of suffering from severe psychiatric disorders in adulthood, such as borderline personality disorder, chronic depression, and suicidal tendencies. Likewise, child sexual abuse causes significant disruptions in the development of victims’ identi- ty, sexuality, and social skills. Gender-based and sexual violence not only cause individ- ual harm but also have broad social consequences. Affected women face difficulties integrating into the educational and labor market, reducing their opportunities for economic and personal development (Trujillo & Clarke, 2022). Further- more, violence perpetuates intergenerational cycles of vic- timization, as children who witness domestic violence are at greater risk of reproducing violent behavior or becoming victims in their adult lives. Recovery from the psychological impact of gender-based violence requires a comprehensive therapeutic approach that includes specialized psychological support, access to gen- der-sensitive mental health services, and the strengthening of community and family support networks (Pérez-Martínez & Rodríguez-Fernández, 2024). Likewise, training health professionals to detect signs of abuse and provide empathet- ic and nonjudgmental care, respecting the time and needs of victims, is essential. Scientific evidence shows that interventions based on cognitive-behavioral therapy, prolonged exposure therapy, and crisis intervention approaches have proven effective in reducing symptoms of PTSD and depression in women victims of sexual violence (Borràs et al., 2023). However, access to these services remains limited, especially in rural settings and among low-income populations. In conclusion, the psychological impact of gender-based and sexual violence is profound, multidimensional, and long-lasting. To mitigate its devastating effects, a compre- hensive response is required, combining medical care, spe- cialized psychological support, effective legal protection, and profound cultural transformations that eradicate the stig- matization of victims and promote the construction of more just and egalitarian societies.

J. Law Epistemic Stud. (January - June 2025) 3(1): 20-30 28 Risk factors and perpetuation of violence Gender-based violence, far from being an isolated phe- nomenon, responds to structural dynamics that are perpet- uated through various social, cultural, economic, and psy- chological factors. These factors interact and reinforce the conditions that allow violence against women to continue, affecting their personal, family, work, and community lives (Morales-Fonseca et al., 2023). From a structural perspective, patriarchal culture is one of the main factors perpetuating violence. Morales-Fonseca et al. (2023) highlight that social norms that naturalize female subordination and legitimize violence as a form of control remain in place in large sectors of Latin American society. Gender stereotypes, which assign women roles of passivity, obedience, and economic dependence, reinforce social toler- ance toward various forms of violence, making their eradi- cation difficult. Early socialization in discriminatory gender patterns also plays a crucial role. According to Trujillo & Clarke (2022), norms that reinforce inequality between men and women are instilled from an early age, perpetuating asymmetrical power relations that later translate into violent dynamics in adult- hood. This intergenerational transmission of sexist attitudes constitutes a significant obstacle to the construction of egal- itarian relationships. In the economic sphere, women’s financial dependence on their abusers represents a significant risk factor. Mo- rales-Fonseca et al. (2023) point out that a lack of economic autonomy limits women’s ability to leave situations of vio- lence, increasing their vulnerability and prolonged exposure to abuse. Job insecurity, the wage gap, and unequal access to economic opportunities contribute to this structural depen- dence. Inequality in access to education is also a relevant factor. As UN Women (2024) indicates, women with lower educa- tional levels are less likely to recognize violence, access in- formation about their rights, or seek help. Education, in this sense, constitutes both a protective factor and an essential tool for preventing gender-based violence. At the institutional level, the lack of adequate responses from the justice and health systems perpetuates violence. Vergara (2024) points out that impunity, re-victimization in judicial proceedings, and the lack of specialized health care generate distrust among victims, discouraging reporting and encouraging continued abuse. Institutional re-victimization not only exacerbates the emotional harm suffered by women but also reinforces the silence and invisibility of the phenom- enon. Sexual violence, specifically, is exacerbated by factors such as family secrecy, the normalization of abusive power relations, and the social stigmatization of victims (Werner, 2020; Poalacín-Iza & Bermúdez-Santana, 2023). In contexts of domestic sexual violence, the fear of the rupture of emo- tional ties or economic or emotional retaliation inhibits the possibility of reporting and perpetuates cycles of intergener- ational abuse. The lack of effective support networks is another perpet- uating factor at the community level. Borràs et al. (2023) highlight that women who lack family, social, or institution- al support have greater difficulty escaping violent situations, increasing the risk of serious or fatal harm. Social isolation, often imposed by abusers as a form of control, exacerbates this situation. Multiple discrimination also increases the vulnerability of certain groups of women. As Álvarez-Gutiérrez and Cas- tillo-Koschnick (2019) demonstrate, indigenous women, women of African descent, women with disabilities, women who are migrants, or women living in poverty face greater barriers to accessing protection services, increasing their ex- posure to various forms of violence. Humanitarian crises and contexts of insecurity, as García et al. (2025) point out, amplify the risks of gender-based vio- lence, especially in situations of forced displacement, armed conflict, or natural disasters. These scenarios exacerbate conditions of vulnerability, reduce access to protection ser- vices, and increase the impunity of perpetrators. In short, the risk factors for and perpetuation of gen- der-based violence are multiple and complex, encompassing individual, family, community, institutional, and structural dimensions. A comprehensive understanding of these factors is essential for designing effective prevention and response strategies to mitigate the effects of violence and transform the conditions that generate and sustain it. Institutional responses and challenges The institutional response to gender-based violence in Ecuador has made significant progress in recent decades, primarily due to pressure from women’s movements, the strengthening of international human rights frameworks, and the visibility of structural violence affecting women. Howev- er, significant challenges remain that limit the effectiveness of public policies, protection systems, and comprehensive victim care mechanisms (Morales-Fonseca et al., 2023; UN Women, 2024). One of Ecuador’s main regulatory advances was enacting the Comprehensive Organic Law to Prevent and Eradicate Violence against Women (National Assembly of the Repub- lic of Ecuador, 2018). This law establishes a legal framework that recognizes the multiple forms of gender-based violence, promotes preventive actions, protects the rights of victims, and provides for comprehensive reparations. It also incorpo-

J. Law Epistemic Stud. (January - June 2025) 3(1): 20-30 29 rates an intersectoral approach, assigning specific responsi- bilities to the health, education, justice, and social protection sectors. Despite this advanced regulatory framework, its practical implementation faces multiple obstacles. Vergara (2024) warns that the lack of financial resources, the limited training of health and justice personnel, and the absence of monitor- ing and evaluation mechanisms limit the real effectiveness of the designed policies. Many specialized services, such as comprehensive care centers, lack the personnel, supplies, and infrastructure necessary to provide adequate and sensi- tive support to victims. Institutional revictimization constitutes one of the most serious challenges in the care of women victims of violence. According to Gutiérrez-Ramos (2021), in numerous cases, victims who turn to the judicial system or health services face insensitive interrogations, unjustified delays, minimiza- tion of their suffering, or the demand for excessive evidence to prove the facts. These practices not only violate their rights once again but also discourage other women from seeking protection or justice. In the health sector, although protocols exist for the care of victims of sexual violence, their implementation is still uneven. Borràs et al. (2023) show that less than half of wom- en who suffer sexual violence receive timely medical care, including HIV post-exposure prophylaxis or access to emer- gency contraception. Furthermore, health personnel are not always trained in trauma-sensitive care, which can lead to retraumatization and additional barriers to the victims’ re- covery. Although gender-based violence prevention programs have been implemented at some school levels, their reach re- mains limited. Morales-Fonseca et al. (2023) emphasize the need to mainstream gender equality education at all levels of the education system, from early childhood education to university, to transform the cultural patterns that legitimize violence. The judicial system, for its part, faces structural challenges in processing cases of gender-based violence. As UN Wom- en (2024) points out, impunity remains high, and judicial processes are often long, costly, and emotionally draining for victims. The lack of specialized courts, constant staff turn- over, and ongoing training from a gender perspective limit the judicial system’s ability to offer swift, effective, and hu- man rights-respecting responses. At the community level, support networks and women’s organizations are crucial in providing care and protection to victims. Psychosocial support programs, shelters, and com- prehensive care centers have proven effective in providing safe environments and promoting the recovery of affected women (Pérez-Martínez & Rodríguez-Fernández, 2024). However, these initiatives often operate with limited re- sources and rely heavily on international cooperation and volunteering. At the regional level, organizations such as the World Health Organization (2021) and the Pan American Health Organization (2023) have drawn attention to the need to strengthen multisectoral approaches and adopt primary pre- vention strategies that address the structural causes of vio- lence. Promoting nonviolent masculinities, providing edu- cation for equality, and transforming discriminatory social norms are essential components of an effective and sustain- able response. The adoption of international best practices, such as in- tegrated victim care models, specialized training in gen- der-sensitive justice, and the creation of specialized inves- tigation units for femicides and sexual crimes, represents an important opportunity to strengthen the institutional response in Ecuador (Pérez-Martínez & Rodríguez-Fernández, 2024). Finally, one of the main challenges is to ensure an intersec- tional approach in public policies, recognizing that women are not a homogeneous group and that experiences of vio- lence are aggravated by factors such as ethnicity, disabili- ty, immigration status, or socioeconomic situation (Álva- rez-Gutiérrez & Castillo-Koschnick, 2019). Prevention and response strategies must consider these multiple forms of discrimination to be genuinely inclusive and effective. Ecuador has made significant progress in the legal recog- nition of gender-based violence and the development of pub- lic policies. However, structural, cultural, and institutional challenges must be comprehensively addressed. Eradicating violence against women requires not only laws and protocols but also a profound cultural shift, sustained political commit- ment, and significant investment in quality prevention, care, and redress services. Conclusions Gender-based violence remains one of the most serious hu- man rights violations, marked by its complexity, persistence, and global scale. It extends beyond physical and sexual ag- gression to include psychological, economic, and symbolic harm, deeply affecting women’s lives. Despite legal and po- licy advances in Ecuador and Latin America, violence levels remain high due to entrenched patriarchal norms and power imbalances. The issue is especially severe in domestic and sexual violence, where girls, adolescents, and young women are most at risk, often facing long-term emotional and social consequences. Psychological impacts such as anxiety, de- pression, and post-traumatic stress highlight the urgent need for gender-sensitive mental health services. Factors like eco- nomic inequality, lack of education on gender equality, ins- titutional re-victimization, and intersectional discrimination

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Journal of Law and Epistemic Studies and/or the editors disclaim any responsibility for any injury to people or pro- perty resulting from any ideas, methods, instructions, or pro- ducts mentioned in the content.