Male Victims of Domestic Violence: Clinical and Behavioral Insights from an Italian Hospital-Based Study

Domestic violence against men remains significantly under-recognized, despite affecting 20-40% of men worldwide. Societal stigma, gender-normative expectations, and institutional biases often discourage help-seeking behaviors among male victims. This retrospective analysis characterizes domestic violence against adult men by examining victim-perpetrator dynamics, injury patterns, reporting behaviors, and behavioral barriers to help-seeking within an Italian emergency department setting. Overall, 80 adult male domestic violence victims presenting to the Emergency Department of Careggi University Hospital (Florence, Italy) between January 2017 and December 2022 were examined. Data included demographics, injury characteristics, perpetrator relationships, and formal reporting rates. Descriptive statistics and chi-square tests were used to examine associations between victim characteristics and help-seeking behaviors. The majority of victims were Italian men (age range 18-90 years, mean 44.2 ± 15.1); of these, 55% experienced IPV perpetrated by female partners. Physical injuries were predominantly minor (classified as minor according to ED prognosis ≤ 7 days) (78.8%), including abrasions and contusions affecting the head (52.5%), neck (28.8%), and upper limbs (41.3%). Formal reports were filed with judicial authorities in 58.8% of cases, yet only 15% accepted protective interventions. Visible facial injuries (OR = 3.85, 95% CI, p = 0.004) and female perpetrators (OR = 8.23, 95% CI, p < 0.001) were independent predictors of formal reporting. Documented behavioral barriers included stigma (68%), fear of disbelief (45%), and adherence to traditional masculine norms (52%). Our findings demonstrate that male domestic violence victims face substantial behavioral and systemic barriers that prevent help-seeking. Enhanced clinical-forensic training, gender-inclusive response protocols, and public awareness campaigns are essential to provide equitable support and reduce under-reporting.