The Consequences Of Sexual Assault

Sexual assault may adversely affect the physical and mental health of its victims. However, although many survivors of sexual assault experience high levels of distress in response to sexual assault, other survivors appear fairly resilient in the face of experiencing such an assault. This diversity in outcomes may be attributable to personal characteristics of the survivor, his or her level of social support, or the characteristics of the assault itself.28 In addition to the consequences for the victims, sexual violence can also adversely affect the victim's family and friends, as well as the community as a whole. The next section of this chapter reviews our current understanding of the effects of sexual assault on its victims and their larger communities. Please note, however, that not all individuals will necessarily experience any or all of these consequences. For those that do, their experiences of these effects may range from mild to severe.

Physical and sexual health consequences. Many sexual assault victims experience physical injuries during the assault itself, with female rape victims (31.5%) being about twice as likely as male rape victims (16.1%) to report being physically injured.3 Of those injured, the vast majority (74%) reported experiencing relatively minor injuries, such as scratches, bruises, or welts. About 14% of those injured suffered a broken bone or dislocated joint, while less than 10% reported cuts and knife wounds, internal injuries, muscle injuries, and/or chipped or broken teeth. Only 36.2% of female rape victims reported that they received medical treatment.3

Many victims also experience sexual and reproductive health consequences from sexual assault. According to one study, 50% to 90% of victims experience some form of genital injury from the assault, such as bruising, inflammation, tenderness, abrasions, and lacerations.29 Additionally, women with a sexual assault history are more likely than women without a sexual assault history to report experiencing severe pain during menstruation, excessive menstrual bleeding, and sexual dysfunction.30 Between 3% and 20% of victims acquire a sexually transmitted infection through sexual assault involving penetration.3,31 Among women of reproductive age, approximately 5% of those raped became pregnant from the assault, with more than 32,000 pregnancies resulting from rape each year.32

"I'm scared I may have caught something from him. I'm too afraid to get tested."

—Forty-year-old Asian American woman

Psychological and behavior-related health consequences. Sexual assault may lead to numerous psychological and behavioral health problems. While every assault survivor responds differently, common psychological consequences of sexual victimization include fear, depression, anxiety, post-traumatic stress, decreased self-esteem, sleep problems, suicidal and self-harm behaviors, trust issues, and fear of intimacy.5,33,34 Some of these consequences may be short-term reactions to the assault, while others may result in longer-term effects. That is, for some individuals, these symptoms subside approximately three months after their assault, while for others they may continue until help is received.5 Although many of these consequences may not rise to the level of a diagnosable psychological disorder, they may still result in clinically significant symptoms for the sexual assault survivor. According to the NVAWS, 33% of female rape victims and 24.2% of male rape victims reported that they received mental health counseling regarding their rape.3

"I get afraid of my emotions. I try to tell myself: 'I've put that behind me; I don't think about that now.' But I do think about it—all the time."

—Twenty-five-year-old Caucasian man

Sexual assault may also increase high-risk behaviors that can negatively impact a victim's physical health. For example, survivors of sexual assault are more likely to use and abuse alcohol, cigarettes, illicit drugs, and prescription drugs as a way of coping with the trauma they have experienced.35 Individuals who have experienced sexual assault may also be more likely to engage in unhealthy diet-related behaviors, including extreme fasting, vomiting, overeating, diet pill abuse, and overutilization of health services.36

"Every day when I get home from work, I start to feel depressed. I want to feel good. I want to feel different. So I drink."

—Forty-seven-year-old Caucasian woman

Additionally, research indicates that some survivors of sexual assault are more likely to engage in high-risk sexual behavior. Such behavior can include having multiple sex partners, choosing unhealthy sex partners (such as someone with HIV), not negotiating for or using condoms, or trading sex for money or drugs.35 Although these behaviors may provide temporary relief to victims struggling to cope with their sexual victimization, they also may ultimately increase their likelihood of experiencing other health problems.

Financial consequences. High rates of sexual assault not only take a toll on victims, but have economic implications as well. One study estimated that in 2003, the costs of rape were approximately $460 million in the United States alone.37 These costs include medical and mental health care and the costs of lost productivity. The NVAWS found that 19.4% of female and 9.7% of male rape victims lost time from work due to the rape, possibly to cope with the aftermath of the assault, receive medical or mental health treatment, or attend to legal matters.3 Thus, the sequelae of sexual assault not only affect the survivor and his or her loved ones, but also the greater community.

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