Sexual Assault Affects Public Health

CONTENT WARNING: This blog discusses rape and other forms of sexual violence.


Over recent years, the #MeToo movement has grown to bring sexual violence, abuse, and toxic behavior into awareness within American culture, but there is still much misinformation and stigma to combat to ensure the health and safety of everyone affected. Rape is the most under-reported crime with only 36% of rapes, 34% of attempted rapes, and 26% of sexual assaults reported to law enforcement. Despite misconceptions, the prevalence of false reporting is low — between 2-7%. The consequences of sexual assault reach far into the lives of survivors, families, and communities and have a major effect on public health.


Victims of sexual harassment and assault are often thought of as women, but men can also be affected. Statistically, one in five women and one in 67 men are raped at some point in their lives. Nearly 50% of women and 20% of men experience sexual violence other than rape.


LGBTQIA communities are disproportionately affected by sexual violence:

  • 44% of lesbians and 61% of bisexual women compared to 35% of heterosexual women;
  • 40% of gay men and 47% of bisexual men compared to 21% of heterosexual men;
  • 47% of transgender people are sexually assaulted at some point in their lives.


Black, indigenous, and people of color (BIPOC) also experience an unequal level of sexual violence in the United States:

  • 29.1% of Black women, 12% of Black men;
  • 37.5% of Native American women, 12.4% of Native American men;
  • 23.4% of Hispanic/Latina women, 7.4% of Hispanic/Latino men;
  • 30.2% of mixed race women, 9% of mixed race men;
  • compared to 24.8% of white women, 7.5% of white men.


Sex workers (escorts, exotic dancers, adult film actors, nude models, etc.) are often ignored when it comes to sexual violence and have their jobs conflated to sex trafficking in politics and law enforcement, endangering people working consensually in the sex industry. Disregarding the sex worker community in conversations about sexual assault prevention and rape culture perpetuates the stigma and culture of violence that allows violence to be committed — especially against marginalized people.


People with a history of being victimized by sexual harassment or assault are three times more likely to have depression and twice as likely to have anxiety. Trauma can happen whether or not a person is physically harmed, and can have lasting effects on one’s emotional or physical wellbeing. A study from the Journal of the American Medical Association (JAMA) found women with a history of sexual assault have higher blood pressure and poorer sleep. Unwanted sexual attention that may appear “complimentary” on the surface can negatively affect a person’s self-esteem, body image, or sense of self-worth.


Accompanying body image and self-esteem issues, sexual harassment can lead to disordered eating or lack of appetite. Harassment can take pleasure out of experiences survivors would otherwise enjoy and cause them to withdraw from activities or places they frequent, going so far to change daily habits to avoid discomfort. One’s perception of sexual harassment as a threat can lead to chronic elevation of the stress hormone cortisol which can lead to inflammation throughout the body, lower immunity, and raise the risk for serious conditions like heart disease and cancer.


A disturbing trend in our culture is the blaming of survivors of sexual violence for their victimization. Sexual predators and other perpetrators of sexual violence are often given the benefit of the doubt with their supporters citing their own experience of the accused, asserting that the victim is not “innocent” enough, or making victims feel responsible for their own assault.


Victims are assigned blame because of what they wear, how they behave, or where they go — none of which makes one responsible for someone assaulting them. Alcohol consumption is involved in half of all sexual assaults and is often used to shift blame away from a perpetrator, though studies have shown perpetrators of sexual violence report using alcohol at the time of the assault 10-30% more than victims. Negative views about women and anti-social behavior are much stronger predictors of sexual violence than alcohol use. These factors and more contribute to rape and sexual assault being the most under-reported crime in the United States — which in turn fosters more victim blaming.


The Trump administration effectively reversed Obama-era guidelines for college campuses investigating sexual assault, narrowly defining sexual assault as “unwelcome conduct on the basis of sex that is so severe, pervasive and objectively offensive that it denies a person access to the school’s education program or activity” instead of the widely accepted  “unwelcome conduct of a sexual nature.” Trump education officials put protections in place for those who have been accused of sexual assault, require a cross-examination of the victim which can be intimidating and traumatic for survivors, and made it harder to find schools legally responsible for failing to address harassment. President Biden has initiated a review of the Trump admin rules, but changes will be slow and may not address much of the harm already being done to survivors.


The ongoing COVID-19 pandemic has an often overlooked effect on abuse victims who may have been isolated with their abusers. As the coronavirus continues to affect the world, the safest place for people is at home. But for all too many, home is not safe. Every year, more than 10 million Americans experience domestic violence, and experts fear that the pandemic and the isolation necessary to combat it have driven those numbers even higher. Perpetrators who are physically violent toward their partners are often sexually abusive as well. The pandemic also disrupted investigations into sexual assault on college campuses and elsewhere


There are ways to take an active role in increasing safety for yourself and those you care about. The most important way to raise awareness is to talk openly and clearly to young people about consent, how to respond if someone is pressuring you or someone close to you, and following safe practices while traveling or interacting online.


It is vital to public health to educate on what acts constitute sexual violence and the importance of freely-given consent when navigating any and all interpersonal relationships. A majority of Americans recognize sexual intercourse without a partner’s consent (84%) and unwanted touching, groping, or fondling (83%), but fewer are aware that voyeurism and verbal harassment also are considered assault (64% and 54%, respectively). A third of men do not recognize pressuring a partner for consent (i.e., sexual coercion) as assault.


For those who have been the victim of a sexual assault or other violent crime in the United States, there are victim compensation programs in all 50 states and Washington, D.C. These programs help victims of rape, assault, child sexual abuse, drunk driving, domestic abuse, as well as families of homicide victims. Compensation programs can cover medical bills, mental health treatment, and often includes crime-scene cleanup, travel costs to receive treatment, moving expenses, or even the cost of housekeeping or child care if the victim is unable to do so. The programs are often flexible with their eligibility, though most require reporting the crime to police within a specified time and cooperating with the investigation. You can find NeedyMeds’ listings for the crime victim compensation programs in our Diagnosis-Based Assistance Database under Violent Crimes. For more support, call the RAINN (Rape, Abuse, and Incest National Network) 24-hour hotline at 1-800-656-4673.

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