rape and sexual assult

Understanding rape and sexual assault

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Rape and sexual assault are sexual acts which take place without someone’s consent. Sexual violence can have a devastating effect on health and wellbeing. The Sexual Offences (Scotland) Act 2009 defines rape as ‘penetration of the vagina, anus or mouth of another person by the penis without consent’. The offence covers surgically constructed genitalia, for example as a result of gender reassignment surgery.

The Act also covers a range of sexual assault and abuse, such as:
•  penetration of the vagina or anus by parts of the body (e.g. a finger)  or objects (e.g. a bottle or a vibrator)
• being forcibly touched in a sexual manner
• ejaculating semen onto a person
• forcing or coercing someone to have sex with someone else
• being forced to look at pornography
• sexual harassment.


Rape or sexual assault can be a one-off event or can happen repeatedly. Some women are violated over years, for example by an abusive partner. Others may be raped or sexually assaulted by different people at different times in their lives. Humiliation and degradation are often part of ongoing sexual violence, for example being forced to watch or act out pornography, or having private intimate images shared without consent. Asylum seekers and refugees may have been sexually violated as victims of war or torture.


Many people believe that rape and sexual assault are commonly carried out by strangers and involve force. Yet in most cases assaults are carried out by someone known to the victim. This includes spouses, sexual partners, casual acquaintances, family members, colleagues and others. Most rapes are committed indoors, usually in the home.

Who is at risk?

Rape and sexual assault can happen to anyone regardless of sex, sexual orientation or gender identity. The key risk factor for experiencing sexual violence, however, is being female. 


Women 

While there is a higher prevalence of sexual violence among young women it  can happen at any age. Since gender-based violence is so common, many women experience more than one form of abuse during their lifetime. Sexual victimisation in childhood or adolescence increases the risk of both physical and sexual abuse in adulthood.


Within the context of commercial sexual exploitation, women report repeat victimisation and a UK survey found that 11% had been raped and 22% had experienced an attempted rape. (Church S, Henderson M, Barnard M, Hart G. Violence by clients towards female prostitutes in different work settings: questionnaire survey. British Medical Journal 2000 11/02;322(7285):524-525.) Sexual violence is more prevalent in women who have been trafficked, especially those trafficked for sexual exploitation. (www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(16)30261-9/fulltext) Disabled women and girls are at greater risk of physical, sexual and psychological violence (https://fra.europa.eu/en/publication/2014/violence-against-women-eu-wide-survey-main-results-report) with learning disabled women more likely to experience sexual abuse than other disabled people.
Among black and minority ethnic communities sexual violence is underreported and stigmatised. The maintenance of virginity may be an issue and the opportunity to marry after a rape may be affected. This is complicated by language barriers, cultural issues, social isolation and family pressures.(Cybulska B, Forster G, Welch J, Rogstad K, Lazaro N. UK National Guidelines on the Management of Adult and Adolescent Complainants of Sexual Assault 2011. British Association for Sexual Health and HIV: Macclesfield; 2012)
Statistics vary depending on what is being measured, definitions and terminology used, and methodology. For example, in the National Survey of Sexual Attitudes and Lifestyles in Britain respondents were asked if, since the age of 13, ‘anyone tried to make you have sex against your will’ and ‘has anyone actually made you have sex against your will’.( https://www2.gov.scot/Topics/Health/Services/Sexual-Health/Natsal3 ) This definition of what they called  ‘non-volitional sex’ identified a greater prevalence of abuse than captured in crime surveys.

Men 
Although fewer men than women are sexually assaulted, the health and  emotional effects are just as severe. It may be very difficult for men to talk  about what has happened because of a commonly held view that men should be ‘strong’ and able to protect themselves or, in the case of men who are heterosexual, because they think the assault has ‘made them gay’.  
‘One of the biggest challenges faced by male survivors is society’s projection  that men should be able to withstand and  endure terrible circumstances.’ (Michael May, SurvivorsUK
A review of the literature on adult men who have experienced sexual assault reports that the sex of the perpetrator has a significant impact on the psychological consequences. Where the assailant was male this was associated with more harm and was perceived as more distressing. Attitudes such as perceptions that men should be able to ‘resist’ male sexual assault, or negative views of gay men, resulted in victim blaming and higher levels of stigma. 
In contrast, the researchers reported some evidence that because of gender expectations on men to seek sexual opportunities, heterosexual men may view coercive contact by a woman as a ‘sexual experience’ rather than ‘a violation of will’. They found that although for some men there may be resentment or hostility about such coercion, fewer men were likely to be severely traumatized by such an encounter (www.sciencedirect.com/science/article/pii/S0272735810001443

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Acknowledging the trauma of the assault can be difficult for some men who react physically during it by having an erection or ejaculating. They may feel confused afterwards that it meant they enjoyed the experience, or that people won’t believe they were really assaulted. They may need reassured that this is a physiological reaction which in no way indicates the experience was pleasurable or that they wanted it.
Since sexual assault of men is less common, they may not come forward because they think they will not be believed or will face ridicule. But sexual violence undoubtedly affects men’s physical and mental health, their sexual health risk behaviors and sexual functioning, and it is vital that they get help
LGBT+
The invisibility of lesbian, gay, bisexual, transgender and intersex people in many public messages on abuse and violence means they may not recognize their experiences  as abusive or may feel silenced and marginalized.
While LGBT+ people experience the same adverse consequences of sexual violence, they may face additional barriers in both disclosing abuse and accessing services. For example, if the survivor identifies as lesbian, gay, or bisexual, and is in the process of coming out, they may question how others perceive their sexual orientation. If they have not ‘come out’ they may fear that the abuser will ‘out’ them to friends, family or employers. Similarly, they may feel under pressure to disclose their sexual orientation if reporting the assault, and have concerns that defense solicitors or juries may view this negatively in any subsequent proceedings.
The persistence of stereotypes, e.g. that gay men are promiscuous or that LGBT+ sexual practices are ‘abnormal’, as well as homophobic or trans-phobic attitudes, can influence any decision about disclosure or reporting. Lesbians are particularly invisible in relation to sexual violence. Stereotypes can minimize or invalidate their experience, e.g. that women are incapable of rape, that it is much less serious than male assault, or that it is not criminal. Intersex people may have had medical procedures carried out in childhood which they found traumatic, and may be fearful of submitting to further examinations. (http://www.galop.org.uk/hate-crime-report-2013/ )
How rape and sexual assault affect health 
Rape and sexual assault can have a serious effect on short and long-term physical, mental and sexual health.
This may vary according to the nature of the assault, when it took place, previous history of abuse (sexual or otherwise) and the other circumstances  of an individual’s life.
Experiencing sexual violence as an adult can trigger intense reactions for those who experienced sexual abuse as a child and is linked to significantly elevated levels of post-traumatic stress disorder (PTSD) and depression.
Research on the health impact of sexual violence within intimate relationships identifies higher levels of depression and anxiety, PTSD and gynaecological disorders than those associated with physical violence alone. Cumulative experiences of repeat victimisation can lead to what is described as complex  post-traumatic stress disorder
Physical/sexual
• Shock, injury and trauma
• Possible pregnancy
•  Sexually transmitted infections (STIs)
• Urinary tract infections
• Lower abdominal pain   and lower back pain
• Headaches
• Difficulty in defecating   and bowel disorders
• Sexual dysfunction
• Gynaecological problems

Mental/emotional
• Self-harming
• Depression, anxiety
• Addiction issues
• Sleep and eating   disturbances
• Panic attacks
• Flashbacks
• Suicidal feelings
• Post-traumatic   stress disorder

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