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• Globally, between 1990 and 2019, there have been overall declines in the burden of interpersonal violence deaths and disability, however one in three countries has experienced an increase in the burden of interpersonal violence experienced by adolescents.
• In 2019, one in every four deaths due to interpersonal violence was a young person aged 10-24 years. Adolescence is a pivotal period where the burden of interpersonal violence accelerates, with a rapid increase observed from middle adolescence (15-19 years) onwards.
• Young men are over-represented in deaths and injury, with six times higher deaths, and four times higher disability adjusted life years (DALYs), than young women for all forms of interpersonal violence apart from sexual violence, in which young women experience twice the burden of DALYs compared with young men.
• There was a global decline in the burden of sexual violence for both sexes between 1990 and 2019, however the burden of sexual violence has increased in two out of three countries.
• The burden tends to be higher in countries with greater gender inequality, and this relationship is most pronounced for older adolescents (20-24 years). In terms of burden of interpersonal violence, young men benefit greatly from growing up in more gender equal countries.
• Males of all ages are recognised as the main perpetrators of interpersonal violence. Therefore, given the rapid acceleration in the burden of interpersonal violence experienced by young men, adolescence is an opportune time to intervene, as experiencing violence as a young person is associated with future experiences of violence, as perpetrator and/or victim survivor.¹
• The study findings reinforce the interrelatedness between male perpetration of violence and broader social issues, such as the unequal distribution of power and resources, firearm availability and regulation, and restrictive social constructs of masculinity.

• Given the marked increase in the burden of interpersonal violence experienced by adolescents from middle-adolescence, implementation of early intervention strategies at the pre-adolescent level, before the uptick occurs, is an urgent area of policy development and implementation.
• The association observed between gender inequality and higher burden of interpersonal violence highlights the importance for the continued pursuit of gender equality globally. Gender equality plays a role in improving the lives of all humans, including women, men, and those who identify as gender diverse, and can be addressed in early adolescence by tackling restrictive gender norms though gender transformative policies and programs.
• Whilst there is already an essential policy focus on men’s violence against women and children, there is currently little focus given to men’s violence against men, and the traumatic impact that childhood exposures to violence have on later behaviour and health.² As such, policy and program efforts should also include a targeted focus on perpetration of multiple forms of interpersonal violence, co-designed with men, boys and fathers, which address hegemonic masculinity, harmful societal norms condoning violence, and supports the development of gender-equitable masculinities.³
• Programs relevant in adolescence may include the development of bystander interventions for both boys and men, as well as programs that engage fathers and support them to develop gender-equitable masculinities and skills for parenting.³ It is also essential that policy efforts target the underlying social drivers of violence, such as poverty, wealth inequality, systemic oppression, and firearm regulation.

• Compared to other regions of the world, adolescents in high-income countries like Australia, generally grow up in circumstances of greater gender equality and lower burden of interpersonal violence. However, by contrast to other causes of interpersonal violence, the burden of sexual violence is less variable between countries, with high-income countries demonstrating a similar burden to regions and countries regardless of their differences in gender equality measures.
• Whilst Australia has seen a very significant reduction (43.9%) in adolescent female disability adjusted life years caused by interpersonal violence between 1990 to 2019, there has only been a slight decline (1.5%) in sexual violence in the same period.
• The proportion of adolescent females impacted by the perpetration of sexual violence is twice that of adolescent males, and this figure is likely a gross underrepresentation, as the majority of sexual violence is unreported.³

• Sexual violence in Australia is a persistent and entrenched problem, that therefore requires an expanded suite of measures to enact change. Measures should be implemented across four points of an action continuum, as outlined in the Australian National Plan to End Violence against Women and Children 2022-2032.³ Relevant examples of policies for adolescents in this plan include:³

• Context specific barriers that discourage girls and women from reporting, seeking justice and accessing care following sexual violence, need to be continually identified and removed. Barriers relevant in Australia include law enforcement and legal processes that create a hostile environment for victim survivors – these processes can also contribute to a general sense of community mistrust of women’s reports of sexual violence.³ Special attention should be given to groups who experience greater barriers when reporting sexual assault, these groups include but are not limited to, people from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander communities, sex workers, LGBTQIA+ and people with a disability.³

Quality datasets and research allow for context-specific, evidence-based policies and programmes to be delivered in areas of need:

• In Australia, to effectively design strategies that address the perpetration of multiple forms of interpersonal violence, data infrastructure is needed to understand the characteristics of perpetrators of all forms of interpersonal violence, including that experienced by adolescents.
• Internationally, sub-national data and research is needed to explore the insights gained from this research at a more granular level, and how trends vary within countries, between communities, to effectively intervene at a local level.
• It is important that sex and gender are accurately represented in research, to understand their differential impacts – this requires primary data systems be updated to support the collection of this. This study was restricted to the biological sex classification of male and female, and thus is limited in terms of fully exploring the role of gender identity and expression in interpersonal violence.

1. Sexual violence in Australia is a persistent problem – the burden of sexual violence is twice as high for young women compared with young men, and unlike other forms of interpersonal violence affecting young people, has barely declined in Australia in the last 30 years.
2. Whilst there is an essential policy focus on men’s violence against women and children, there is currently little focus given to men as the main perpetrators of all forms of interpersonal violence, including against other men.
3. Given the impact that exposures to violence in childhood and adolescence have on later behaviour and health, expanding the policy focus from victimisation to also encompass perpetration, must be a priority in order prevent intergenerational cycles of violence.
4. The association observed between higher burden of interpersonal violence and country level gender inequality highlight the importance for the continued pursuit of gender equality globally.

1. Jewkes R, Flood M, Lang J. From work with men and boys to changes of social norms and reduction of inequities in gender relations: a conceptual shift in prevention of violence against women and girls. The Lancet 2015 Apr 18;385(9977):1580-1589.

2. Commonwealth of Australia Department of Health. National Men’s Health Strategy 2020-2030 [Internet]. Canberra ACT: Commonwealth of Australia; 2019 [cited 2023 Aug 17]. Available from:

3. Commonwealth of Australia Department of Social Services. National Plan to End Violence against Women and Children 2022-2032 [Internet]. Greenway ACT: Commonwealth of Australia; 2022 [cited 2023 Aug 17]. Available from: