# 06 - PJ21 Sexual maltreatment, spouse or partner,

# PJ21 Sexual maltreatment, spouse or partner, or QE51.12 history of spouse or partner ...

Clinical Descriptions and Diagnostic Requirements for ICD-11 Mental, Behavioural or Neurodevelopmental Disorders
Sexual maltreatment, spouse or partner, or history of spouse or 
partner violence, sexual
Essential (required) features
• At least one of the following acts is required for diagnosis:
• the use of physical force to compel participation in a sex act against the partner’s will, or 
when the partner is incapable of consent (whether or not the act is completed);
• the use of physical or psychological aggression to coerce the partner to participate in a 
sex act.
• The act is against the expressed wishes of the partner.
• The act causes significant distress to the partner.
Note: these categories are assigned to the victim, not the perpetrator.
If PJ21 Sexual maltreatment is diagnosed, the perpetrator should be specified as a spouse or 
partner using the extension code XE454 (PJ21&XE454). On the ICD-11 platform, the option to 
specify the perpetrator–victim relationship appears in the context of the assault field.
Additional clinical features
• Intimate partner sexual abuse is associated with an increased risk of physical injury and 
need for medical attention.
• Intimate partner sexual abuse is associated with an increased risk of poor physical health 
and of development of a chronic disease.
• Intimate partner sexual abuse is associated with increased risk of various mental disorders 
(e.g. depressive disorders, anxiety and fear-related disorders, disorders due to substance 
use), as well as suicidality.
Boundary with normality (threshold)
• Sexual violation and coercion are not part of healthy functioning relationships.
PJ21/
QE51.12
Relationship problems and maltreatment | Relationship distress and current or past maltreatment by spouse or partner