Violence and vulnerability among women attending a hospital forensic medical unit in France: a cross-sectional study using hierarchical cluster analysis

Violence against women remains a global public health priority. Forensic Medical Units (FMUs) offer a critical setting to examine vulnerability profiles among victims, yet few studies have characterised the interplay between violence types, perpetrator relationships, and associated risks. This study aimed to identify multidimensional vulnerability profiles of women attending a hospital forensic medicine unit (FMU) after experiencing violence. We conducted a cross-sectional study using data from 561 visits by women aged ≥ 18 at the FMU of Toulouse University Hospital (France) between January 1 and March 31, 2023. Data included sociodemographic characteristics, types and circumstances of violence, and psychosocial and medical vulnerabilities collected via structured forms and medico-legal certificates. Hierarchical agglomerative clustering was used to identify homogeneous subgroups, followed by Fisher’s exact tests and odds ratio (OR) calculations to characterize clusters. Five distinct clusters were identified. Cluster 1 (40.6%) was characterised by intimate partner violence, with high levels of physical and psychological violence. Cluster 2 (30.5%) included former partners violence, dominated by psychological consequences. Cluster 3 (11.8%) comprised violence involving acquaintances, with frequent sexual and workplace-related violence. Cluster 4 (10.9%) included unknown perpetrators violence, with high levels of sexual violence and social vulnerability. Cluster 5 (6.2%) involved intrafamilial sexual violence, often associated with a history of childhood trauma. Psychological consequences of violence were consistently high across all clusters. This study highlights the heterogeneity of violence experiences and associated vulnerabilities among women attending an FMU. Identifying multidimensional profiles using cluster analysis may help inform tailored clinical and psychosocial care, as well as targeted prevention strategies. Further research should explore longitudinal trajectories to inform prevention strategies.