[In same-sex relationships, domestic violence] is not a gender issue, since both men and women can be either batterer or victim. Domestic violence is a crime, and perpetrators are criminals. Individual acts of domestic violence are not caused by a victim's provocation, not by a violent, patriarchal society, not by alcohol or by any other excuse or rationalization one could dream up. Domestic violence is caused by individual, violent people. Because domestic violence is a decision made by a batterer, a batterer's violent actions are premeditated. Abusers intend to harm their lovers. Therefore, domestic violence is an enormous mental health problem in America. A batterer cannot possibly be seen as a mentally healthy, well-fuctioning member of a domestic couple. In fact, in this book we show that batterers suffer from a diagnosable, progressive mental disorder in their domestic setting, with their partners as the targets of their un-healthy condition, manifested most clearly just before, during, and just after one of their violent attacks. Batterers do not voluntarily seek help, cannot and do not fix themselves magically, and become increasingly abusive over time. Batterers have learned to be violent, evidencing both a disorder that is correctible through treatment and behaviour that is punishable by law. Both consequences must follow for batterers.

Island and Letellier estimate that each year in the United States 500,000 Gay men are existing in violent and abusive relationships. Extrapolating this number to Canada, which has one-tenth the population of the United States, suggests that perhaps as many as 50,000 Canadian Gay men are existing in violent and abusive relationships. Island and Letellier feel that their estimate for the United States is probably on the low side.