The Mental Health Effects of Sexual Assault and Abuse

Sexual Assault / Abuse


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Sexual abuse is any form of sexual violence, including rape, child molestation, incest, and similar forms of non-consensual sexual contact. Most sexual abuse experts agree sexual abuse is never only about sex. Instead, it is often an attempt to gain power over others.

Immediate crisis assistance after sexual assault can prove invaluable and even save lives. A person can report sexual assault by calling local police. Survivors may also wish to get a physical exam at a hospital. 

Therapy can also be helpful for those who experienced sexual abuse in the past. Some therapists specialize in addressing the trauma of sexual assault. Long-term assistance may be beneficial to some survivors of sexual abuse.

Types of Sexual Assault and Abuse

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Sexual abuse is common, particularly for women and girls. Ninety percent of all rapes are committed against women. One in six women in America have experienced rape. One in five girls and one in 20 boys experience childhood sexual abuse.

Sexual abuse and sexual assault are umbrella terms used to refer to multiple crimes. These crimes include:

  • Rape: Forced sexual contact with someone who does not or cannot consent. Forcing sex upon someone who does not want it, who is intoxicated, or who is not legally old enough to give consent all count as rape. Date rape is sexual assualt that occurs between people with an established relationship. A handful of states limit their definition of rape to forcible sexual intercourse. Yet any form of forcible sexual contact can have long-lasting effects on a person. Most states now recognize forced oral sex and similar forms of assault as rape.
  • Child molestation: Child molestation is any sexual contact with a child. Many children who are molested are too young to know what is happening and may not fight back. Some abusers use the child's cooperation in these cases as "evidence" that no one was harmed. Examples of child molestation might include fondling or demanding sexual favors from a child.
  • Incest: Incest describes sexual contact between family members who are too closely related to marry. While incestuous sexual activity may occur between consenting adults, this is not common. Most reported incest occurs as child abuse. Over a third of American sexual assault survivors under the age of 18 are abused by a family member, according to latest statistics. However, incest is an underreported crime, so the actual number of incest survivors may be higher.
  • Non-consensual sexual contact: This category includes any unwanted sexual touching, such as groping or pinching. Attempted rape can also fall into this category.
  • Non-contact sexual abuse: Not all sexual abuse fits neatly into common legal or psychological definitions. For instance, parents who have sex in front of their children or who make sexually inappropriate comments to their children are engaging in sexual abuse. So-called revenge pornography sites, which publish nude photos of people without their consent, are another form of sexual abuse.

The laws governing sexual abuse are constantly changing. For this reason, most professionals who work with sexual abuse survivors rely on the person's feelings, not the law, when determining whether a sexual assault has occurred. For example, marital rape can be deeply traumatic, especially in an otherwise abusive relationship. Yet marital rape did not become a crime anywhere until the 1970s. It is still a challenging crime to prosecute.

Sexual Violence in the Military

Sexual violence occurs in the U.S. military in high numbers. According to a 2014 report:

  • Nearly 5% of all women and 1% of all men on active duty reported experiencing unwanted sexual contact. 
  • Nearly half of reports from women involved penetrative sexual assault (rape or penetration with an object). This rate was 35% for men. 

Due to the gender ratios in the military, more men experience sexual violence than women. A man in the military is 10 times more likely to be sexually assaulted than a civilian man.

Most perpetrators commit these crimes out of a desire for domination. Offenders often wish to establish control over their "inferiors.” Sexual attraction is rarely the motivating factor.

A man in uniform wrings his hands as he speaks to an unseen person.Sexual violence among service members is an under-reported crime. Studies suggest only one in four survivors of military sexual assault report their attacks. Among male survivors, an estimated 81% never report their attacks.

People who report their assaults often face retaliation. In 2014, 62% of female reporters said they faced retaliation. Many were shunned by colleagues or blamed for the assault. Survivors of both genders may face consequences in their professional lives. Some are even discharged from the military.

Reporters may also face barriers to mental health treatment. Research suggests the military has falsely diagnosed many sexual assault reporters with personality disruptions as an excuse to discharge them. The Department of Veterans Affairs classifies personality disruptions as a pre-existing condition. Thus, it rarely covers the expense of survivors’ mental health treatment.

Male Victims of Sexual Assault and Abuse

Men who experience sexual assault can face severe stigma. U.S. culture promotes a stereotype that men always want sex. Many people believe men cannot possibly be victims of rape.

When men report sexual assault, they often face doubt and ridicule. Others may blame the abuse on the man’s “weakness” or alleged homosexuality. Victim-blaming is especially likely when a man accuses a woman of sexual abuse.

Due to stigma, male survivors can be reluctant to label their experiences as rape or abuse. Some may not mention the event at all. However, a reluctance to disclose can prevent men from getting treatment. Without professional help, some men resort to substance abuse or self-harm to cope with trauma. 

Sexual Assault and Abuse in the LGBTQ+ Community

The rates of sexual assault for homosexual and bisexual individuals are comparable or higher than the rates for heterosexual people. Hate crimes account for many sexual assaults against LGBTQ+ people.

Among cisgender women, the lifetime prevalence rates for rape are:

  • 46% for bisexual women.
  • 13% for lesbian women.
  • 17% for heterosexual women.  

Rape statistics among cisgender men are limited. The lifetime prevalence rates for sexual assaults other than rape are:

  • 47% for bisexual men.
  • 40% for gay men.
  • 21% of heterosexual men.

Around 64% of transgender people will experience sexual assault in their lifetimes. This statistic includes transgender people of all sexual orientations and gender identities. Transgender youth are particularly vulnerable to sexual assault. In a 2011 survey, 12% of trans youth said peers or educational staff had sexually assaulted them in a school setting.

Silhouette holding a rainbow umbrella as the person overlooks an empty field.Sexual crimes in the LGBTQ+ community are often not reported. Survivors may fear revealing their gender identity or sexual orientation to others. They may not trust the legal system to protect them. Survivors could also fear inciting further violence.

Like other survivors, LGBTQ+ people often encounter stigma after they report sexual violence. Discrimination in the health care system may prevent survivors from getting care. Friends and family may believe stereotypes about LGBTQ+ people and blame the victim. In cases of domestic violence, members of the local LGBTQ+ community may refuse to believe the survivor or hold the offender accountable.

LGBTQ+ survivors of sexual assault can get help from a therapist. Mental health professionals cannot disclose one’s personal information to others. Therapy is a confidential place where one can find support without judgment. 

Race/Ethnicity and Sexual Assault

In the U.S., certain races and ethnicities are more likely to experience sexual assault. According to the National Intimate Partner and Sexual Violence Survey (NISVS), the lifetime prevalence rates for rape are:

  • 9.5% of Asian or Pacific Islander women
  • 15.0% of Hispanic women
  • 19.9% of white women
  • 20.7% of black women
  • 28.9% of American Indian or Alaskan Native women
  • 31.8% for multiracial women
  • The report in question did not include data on male survivors. 

Racism can place racial/ethnic minorities at higher risk of sexual assault. Many people of color are fetishized as “exotic,” hypersexual beings. As such, survivors are more likely to be labeled “willing” participants. Sexual assaults on white people are often punished more harshly than assaults on people of color.

As such, people of color are much less likely to report their sexual assaults. Some people may not trust the legal system to treat them fairly. Others may fear “betraying” their community by disclosing personal information. In some cases, cultural values create extra stigma for people who report. These factors can also prevent survivors from seeking mental health treatment.

Childhood Sexual Abuse

The sexual abuse of children can take many forms. It may involve a stranger or someone as close as a parent. A child doesn’t need to be touched to be sexually abused. Voyeuristic actions, such as watching a child undress or shower, count as sexual abuse. Adults who expose their genitalia to children are also committing abuse.

An adult who sexually abuses children may, in some cases, have a sexual attraction to children. Yet sexual attraction is not necessary to commit abuse. Often, a perpetrator abuses a child to gain power over them. 

Childhood sexual abuse is common. In the United States:

  • 44% of sexual assault victims are under the age of 18. 
  • Children are most vulnerable to childhood sexual assault between 7 and 13 years old.
  • 10% of American children are abused before the age of 18. 
  • Among children who are sexually abused, 20% experience sexual abuse before age 8.

Despite being common, children who experience abuse do not always report it right away. This may be partly due to power the offender has over the child.

  • Up to 93% of children who have been sexually abused know their attackers well. An offender will often threaten or manipulate the child to prevent them from disclosing the abuse.
  • Over a third of abusers are part of the child’s family. 
  • 73% of child targets do not disclose the abuse for a year or more. 
  • 45% of child targets do not disclose abuse until at least five years have passed. 

Although sexual abuse in children can be difficult to recognize, detection is possible. If a child shows the following warning signs, there may be cause for concern:  

  • Torn or stained underwear
  • Frequent urinary or yeast infections
  • Nightmares and anxiety around bedtime
  • Bedwetting past the appropriate age
  • Preoccupation with one’s body
  • Anger and tantrums
  • Depressed and withdrawn mood
  • Sexual behaviors or knowledge that are not age-appropriate

The above signs are not necessarily proof a child is being sexually abused. Children may show these behaviors due to another issue. However, one does not need proof to report child abuse. Finding proof is the job of Child Protective Services. To report abuse, one only needs “reasonable suspicion” that abuse is taking place. 

Reporting sexual abuse may prevent a child from having mental health concerns in adulthood. People who experienced sexual abuse as children are at greater risk of substance abuse or eating and food issues. They are also more likely to be sexually abused as adults.

If you think a child is being abused, you can call your state’s Child Protective Services to investigate. You can also call the Childhelp National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453).

What Is Sexual Harassment?

Sexual harassment often falls under the umbrella of sexual assault. While the definitions of both sexual assault and sexual harassment include non-consensual sexual contact, there are some distinct differences. 

The term “sexual harassment” is often used in a legal context. According to the U.S. Equal Employment Opportunity Commission, sexual harassment includes:

  • Unwanted sexual advances or contact 
  • Harassing a person on the basis of their sex
  • Making offensive comments or jokes about a particular sex
  • Pressure to go on a date or perform sexual favors

Sexual harassment can occur anywhere, but many of the laws that protect people who may experience sexual harassment refer to harassment in the workplace. The broader definition of sexual harassment can include cat-calling, making sexual gestures or comments toward a person, staring, referring to someone using demeaning language such as “babe” or “hunk,” and giving unwanted or personal gifts.

Mental Health Issues Resulting from Sexual Assault

After sexual assault, survivors may feel their bodies are not really their own. Survivors often report feelings such as shame, terror, and guilt. Many blame themselves for the assault. 

Due to the trauma and negative emotions linked to sexual abuse, survivors may be at risk for mental health conditions. Survivors of sexual abuse may develop:

  • Depression: The loss of bodily autonomy is often difficult to cope with. It can create feelings of hopelessness or despair. It may also reduce one’s sense of self-worth. Depressive feelings may be mild and fleeting, or they can be intense and long-lasting.
  • Anxiety: The loss of bodily autonomy can also cause severe anxiety. Survivors may fear the attack could happen again. Some may experience panic attacks. Others may develop agoraphobia and become afraid to leave their homes. In some cases, a survivor may develop a chronic fear of the type of person who harmed them. Someone who was raped by a tall, fair-haired man with blue eyes may instinctively dislike, mistrust, or fear all men who match that description.
  • Posttraumatic stress (PTSD): Someone who survived sexual assault may experience intense memories of the abuse. In some cases, flashbacks may be so disruptive they cause a survivor to lose track of surroundings. A person may also develop a related condition called complex posttraumatic stress (C-PTSD). C-PTSD yields a chronic fear of abandonment in addition to symptoms of traditional PTSD. Some people with C-PTSD also experience personality disruptions.
  • Personality disruptions: Sexual abuse can sometimes result in personality disruptions such as borderline personality. The behavior linked with personality disruptions could actually be an adaption to abuse. For instance, a characteristic of borderline personality is a fear of abandonment. That fear might not be adaptive in adulthood. Yet avoiding abandonment might have protected someone from sexual abuse as a child.
  • Attachment issues: Survivors may find it challenging to form healthy attachments with others. This is especially true among children who have been abused. Adults who were abused as children may have insecure attachment patterns. They could struggle with intimacy or be too eager to form close attachments.
  • Addiction: Research suggests abuse survivors are 26 times more likely to use drugs. Drugs and alcohol can help numb the pain of abuse. Yet substance abuse often leads to the development of different concerns.

Sexual abuse does not only leave psychological scars. It can also have long-lasting health consequences. 

A person who is assaulted may sustain bruises and cuts. They could also have more severe injuries such as knife wounds, broken bones, and damaged genitals. Others may develop chronic pain without an obvious physical cause. 

Some survivors experience sexual dysfunction and fertility issues. Others may develop sexually transmitted infections. Contrary to myth, it is possible for a sexual assault to result in pregnancy. In cases where a child becomes pregnant, giving birth may be physically dangerous.

Counseling After Sexual Assault and Abuse

Many survivors develop mental health conditions after sexual assault. Having a mental health concern does not make you “weak” or “broken.” People cope with trauma in different ways. 

People who have survived sexual assault can get help from a mental health professional. Therapy offers a safe, private place to get help without judgment. You do not have to handle your problems alone.

References:

  1. Child sexual abuse statistics. (n.d.). Retrieved from http://www.d2l.org/site/c.4dICIJOkGcISE/b.6143427/k.38C5/Child_Sexual_Abuse_Statistics.htm
  2. Child sexual abuse statistics. (n.d.). Retrieved from http://www.victimsofcrime.org/media/reporting-on-child-sexual-abuse/child-sexual-abuse-statistics
  3. Incidents of rape in military much higher than previously reported. (2014, December 5). Military Times. Retrieved from http://www.militarytimes.com/story/military/pentagon/2014/12/04/pentagon-rand-sexual-assault-reports/19883155
  4. Marital rape. (n.d.). Retrieved from https://www.rainn.org/public-policy/sexual-assault-issues/marital-rape
  5. NISVCS: An overview of 2010 findings on victimization by sexual orientation. (n.d.) National Center for Injury Prevention and Control. Retrieved from https://www.cdc.gov/violenceprevention/pdf/cdc_nisvs_victimization_final-a.pdf
  6. Paulk, L. (2014, April 30). Sexual Assault in the LGBT Community. Retrieved from http://www.nclrights.org/sexual-assault-in-the-lgbt-community
  7. Rape and sexual assault. (n.d.). Retrieved from http://www.bjs.gov/index.cfm?ty=tp&tid=317
  8. Recognizing child abuse. (n.d.). Pennsylvania Family Support Alliance. Retrieved from http://www.pa-fsa.org/Mandated-Reporters/Recognizing-Child-Abuse-Neglect/Recognizing-Child-Abuse
  9. Reporting rates. (n.d.). Retrieved from https://rainn.org/get-information/statistics/reporting-rates
  10. Sexual Assault & LGBT Survivors. (n.d.). Retrieved from http://sapac.umich.edu/article/58
  11. Sexual Assault: The Numbers | Responding to Transgender Victims of Sexual Assault. (2014, June 1). Retrieved from http://www.ovc.gov/pubs/forge/sexual_numbers.html
  12. Sexual Assault of Young Children as Reported to Law Enforcement: Victim, Incident, and Offender Characteristics. (2000). Bureau of Justice Statistics. Retrieved from http://www.bjs.gov/content/pub/pdf/saycrle.pdf
  13. Sexual harassment. (n.d.). Retrieved from https://www.eeoc.gov/laws/types/sexual_harassment.cfm 
  14. "Son, Men Don't Get Raped." (2014). GQ. Retrieved from http://www.gq.com/long-form/male-military-rape
  15. Van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma (1st ed.). New York, NY: Viking.
  16. What is sexual harassment? (n.d.). Retrieved from http://www.un.org/womenwatch/osagi/pdf/whatissh.pdf 
  17. Who are the victims? (n.d.). Retrieved from https://www.rainn.org/get-information/statistics/sexual-assault-victims
  18. Women of color and sexual assault. (n.d.) Connecticut Alliance to End Sexual Violence. Retrieved from https://endsexualviolencect.org/resources/get-the-facts/woc-stats

 

Last updated: 09-06-2018

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