Despite equivocal findings on whether men or women are more violent, the negative impact of violence is greatest for women. This discrepancy in gender symmetry in perpetration and its impact suggests women’s violence is not equal to men’s. In addressing this issue of gender symmetry, a comparison is suggested on the effects of bidirectional (mutual) intimate partner violence (IPV) on women’s injury and other physical and mental health outcomes to the effects of uni-directional IPV. This study was conducted in 2 phases (patterns of IPV and health outcomes) with 835 African-American, Euro-American, and Mexican-American low-income women in Project HOW: Health Outcomes of Women. The goal was to assess how IPV symmetry affects women’s health. The results across health outcomes were generally consistent, with moderate to large effect sizes. Male primary perpetrator (MPP) violence appeared to be the worst and have the most adverse effects on women’s health. However, women in female primary perpetrator (FPP) violent relationships reported similarly negative health effects. The results add to a growing body of research showing that the mutuality of violence should not be interpreted to support the notion that women’s and men’s violence is equal. Regardless of mutuality and gender symmetry, IPV adversely affects women’s health. References