Sexual assault is any kind of unwanted sexual activity, from touching to rape. Sexual assault can also be verbal, visual or non-contact. It is anything that forces a person to experience unwanted sexual activities or attention.
According to the Centers for Disease Control and Prevention (CDC), one in four U.S. women are victims of contact sexual violence, physical violence and/or stalking by an intimate partner, with a negative impact such as injury, fear, concern for safety or needing services. According to a 2017 report, nearly 23 million U.S. women have been victims of rape or near rape in their lifetime. Even more tragically, 8.5 million women first experienced rape before the age of 18.
Victims of sexual assault often face a lifetime of health consequences, including physical, emotional and behavioral conditions. Immediate and short-term health effects include sexually transmitted infections, unwanted pregnancy, abortion and reproductive trauma. Longer-term health effects include chronic pain syndromes (e.g. headaches, irritable bowel syndrome), insomnia, post-traumatic stress disorder, depression, anxiety, eating disorders, self injury, suicide and substance use disorders. A 2009 study found that women who were victims of sexual assault and intimate partner violence had healthcare costs that were 42 percent higher than non-abused women.
According to a 2017 report from the Institute for Women’s Policy Research, sexual assault during adolescence is associated with poorer academic performance and a higher likelihood of dropping out of educational programs. Similarly, victims of sexual assault report less productivity at work and are more likely to quit their job or be terminated.
The epidemic of sexual assault on college campuses and the recent #MeToo movement have raised the nation’s consciousness regarding sexual assault of all kinds. However, the vast majority of sexual assaults go unreported to the police. It’s estimated that two out of three sexual assaults go unreported. The reasons for not reporting are many, including: fear of retaliation, a belief that police will not or can not do anything to help, a belief that it is a personal matter, even protection of the perpetrator.
The problem of sexual assault in our society is a classic iceberg — what we see on the surface belies what hides below. To succeed in eliminating sexual assault, we must raise up against all forms of sexual assault. “Locker room talk” amongst men, or in the presence of women is not OK!
Bystander programs teach adolescents and college age individuals to step in and take action if they feel a friend (or even a stranger) is at risk for sexual violence, and should be required curriculum in every U.S. high school. Likewise, programs such as Coaching Boys to Men train high school coaches to teach their young male athletes healthy relationship skills.
As physicians, we recognize and commit to our duty to educate our patients in an effort to prevent sexual violence, and to care for them comprehensively and compassionately when they have been victimized. It will take all of us working together to stop the thread of sexual assault in all of its forms.
Elizabeth A. Joy, associate professor at the University of Utah School of Medicine, is senior outcomes researcher for Intermountain Health Care.
Elizabeth Joy, M.D., is a family medicine physician in Salt Lake City.
Audrey Jiricko, MD
Audrey Jiricko, M.D., is an obstetrician/gynecologist in Ogden.