Medical Evidence and Healthcare Implications in Gender-Based Violence: A Qualitative Analysis of Spanish Supreme Court Judgments (2023–2025)

Background: Gender-based violence (GBV) represents a major public health issue with significant clinical, psychological, and legal implications. Healthcare professionals play a critical role in the detection, documentation, and medico-legal assessment of GBV cases, particularly in judicial contexts. Methods: A qualitative document analysis was conducted on Spanish Supreme Court judgments issued between 2023 and 2025 under Organic Law 10/2022. A thematic coding matrix was developed to identify interpretative patterns, criteria for evidentiary assessment, and the role of healthcare professionals. Data were analyzed using Atlas.ti, with triangulation against legal and healthcare literature. Results: The victim’s testimony was consistently established as the primary form of evidence when meeting criteria of persistence, coherence, and credibility. The gender-based aggravating factor was applied in a contextualized manner, requiring evidence of domination or discrimination. Sentence reviews reflected the principle of favorable retroactivity, although interpretative variability persisted. Healthcare professionals contributed as key evidentiary agents, particularly through clinical documentation and forensic reports, which reinforced testimonial credibility and supported the classification of habitual abuse. Conclusions: The findings highlight the increasing integration of healthcare-related evidence in judicial decision-making on GBV. Strengthening clinical documentation, interdisciplinary training, and medico-legal protocols is essential to improve both patient outcomes and judicial accuracy. A coordinated healthcare–legal approach is crucial to address GBV as a complex public health challenge.