Sexual abuse is universal and dangerous

Created 4 Jan 2014 • Last modified 15 Jul 2017

Sexual activity to which one partner does not consent is seen in all human cultures and many non-human species. Its frequency can differ dramatically between cultures, but it is very common in the United States, especially between acquaintances and romantic partners and in its milder forms. Rape is associated with even more psychological damage to the victim than non-sexual traumas, and even sexual abuse short of rape is damaging. The evidence of damage from child sexual abuse, however, is less clear than the evidence of damage from abuse of adults. Precisely what makes sexual abuse aversive during the event and traumatizing afterwards is unclear.

Introduction

In this chapter, I will examine sexual abuse from the victim's perspective: who gets abused, and what does abuse do to victims mentally? The next chapter examines possible causes of abuse, and thus concerns the abuser more than the victim. Throughout both chapters, I will examine various popular beliefs and stereotypes about sexual abuse.

Preliminaries

Talking about rape is complicated by ambiguity about the meaning of the word "rape". Often, it includes only particular sexual acts. In this book, I'll use a liberal definition: "rape" will mean any case of non-consensual (i.e., unwanted) sex (and by "sex", I mean, as usual, partnered genital or anal contact). I will use "sexual abuse" or just "abuse" (non-sexual abuse will not be covered) to mean any non-consensual act that involves sexuality. So, all rape counts as sexual abuse, but shouting eroticized comments at strangers is an example of sexual abuse that isn't rape (because it isn't sex). My concern in this book is more with sexual abuse as a whole than rape in particular, but I'll be discussing rape a lot because it has a much deeper associated research literature than less concrete forms of sexual abuse.

"Sexual violence" is an increasingly common term for what I call "sexual abuse". I think that's misleading, because violence and nonconsent are distinct and each is worth understanding in its relationship to sexuality. Sexual acts can be violent but consensual, as in sadomasochism, or non-violent but non-consensual, like a manager demanding sexual favors from his employee. See the previous two chapters for research on the connection between sex and violence.1 On the other hand, I'll avoid the term "sexual harassment" because it is often meant to include only behavior that occurs in the context of work or school.

It is important to distinguish consenting from desiring and liking. Consent is what we usually mean by the term "want" (e.g., "I want to go home" means "I'd go home if I could choose to do so"), but one can also "want" something in the sense of feeling desire for it without consenting. Hence, sexual desire does not equal consent; for all sorts of reasons, one could choose not to have sex despite experiencing desire for it, or, conversely, one could choose to have sex without desire (e.g., because there's nothing good on TV). As Muehlenhard and Peterson (2005) point out, ambivalence (at a more individual scale than I discussed in the earlier chapter on erotophobia) is underappreciated in sex research. And people of both sexes can be sexually aroused and reach orgasm during obviously involuntary sex (Levin & van Berlo, 2004; Pari, 2013). Similarly, enjoyment of a sexual act isn't the same thing as desiring it (Loewenstein, 2009) or consenting to it.

The topic of sexual abuse, even more than the rest of sexuality, is thoroughly intertwined with ethical and political issues. These concerns are an obstacle to understanding the empirical phenomena of sexual abuse. They threaten to create prejudice in the conduct and interpretation of research. In particular, there seems to be a latent requirement to emphasize how bad sexual abuse is—"bad" in the senses of both "morally reprehensible" and "damaging to victims". But if we want to prevent and treat sexual abuse as well as possible, we should try to understand it scientifically as well as we can, and that requires resisting these biases. Openly allowing ethical concerns to bias our thinking about empirical matters would be shortsighted and self-defeating.

Universality

Sometimes, rape is described as unnatural. Brownmiller (1975), for example, wrote: "…rape is a deliberate distortion of the primal act of sexual intercourse—male joining with female in mutual consent…" (p. 369). Actually, rape is probably universal in human civilization, and appears in a wide variety of animal species. In a word, rape is natural—just like many of the other possibly distasteful, but more ethical, sexual activities discussed in earlier chapters.

Palmer (1989) examined claims that rape, in the narrow sense of men forcing or coercing women into coitus, never occurs in each of 17 societies. He found contradictory evidence for many of these societies and at best sparse supporting evidence for the remainder. Rozée (1993) found rape in every one of 35 cultures she surveyed, including in her definition of rape, unlike past investigators, culturally sanctioned acts like marital or ceremonial rape. At the same time, it's worth noting Palmer's observation that punishment or censure for at least some forms of rape also appears universal. That is, there is no clear example of a culture that condones all forms of rape.

Also, despite the absence of truly rape-free cultures, there can be dramatic differences between cultures in how common or socially acceptable rape is. On one end of the spectrum are some striking examples cited by Sanday (1981). There have existed societies in which men boast of making their new wives unable to walk after their wedding night (the Gusii of Kenya), girls are gang-raped as part of a marital initiation ceremony (the Arunta and Ilpirra of Australia; Baldwin & Gillen, 1899), or men in general are permitted to rape women at will (the Marshallese). On the other end of the spectrum are societies whose ethnographers, or whose ethnographers' informants, state that rape simply does not occur, as in the case of the Lesu of Papua New Guinea and the Tewa of New Mexico (Palmer, 1989). Even if we accept Palmer's assertion that we should expect stronger evidence than an ethnographer's or informant's denial for the total absence of rape in a culture, we are obliged to believe that rape (in the narrow sense) among peoples such as the Lesu and Tewa is particularly rare. The cross-cultural variability of rape with different genders or different sexual acts, and of milder forms of sexual abuse, is an open question.

Lalumière, Harris, Quinsey, and Rice (2005) provide a detailed review of rape among animals. In some species, such as the fly Sepsis cynipsea, goldenrod soldier beetles, and northern elephant seals,2 females visibly resist every or nearly every attempt at coitus. In others, such as migratory grasshoppers, mallards, and Bornean orangutans, females welcome some coitus attempts and resist others. Animal rape can be quite violent: male elephant seals, for example, being about five times as large as females, hit and bite their victims and may injure females or pups in the course of a rape. There are even cases of animals raping humans: Galdikas (1995) observed several instances involving juvenile male Bornean orangutans. Galdikas describes some orangutans masturbating themselves against humans (p. 130, 137), one attempting to insert its penis in a man's ear (p. 130), and one forcing coitus on a woman (p. 293–294; this is the only incident for which Galdikas uses the word "rape"). However, Lalumière et al. (2005) found no cases of female animals forcing males into coitus, making this the only category of sexual behavior I know of that is unique to humans.

Some writers reject any comparison of rape among animals to rape among humans. For example, Brownmiller (2000) and Cowan (2009), which are both reviews of evolutionary-psychological books on rape, mock the included discussions of scorpionflies and snow geese, respectively, apparently on the argument that scorpionflies and snow geese do not have the social phenomena that these authors prefer to study as causes of rape. Lalumière et al. (2005) is one of the works being reviewed, but even it shies away from calling forced sex among animals "rape", preferring "forced copulation" and "resisted mating". In general, whereas many authors say it is unfair to anthropomorphize animal rape by calling it "rape", I think that this is putting the burden of proof on the wrong side of the issue. Only if we have good reason to think that animal rape is uninformative to the study of human rape should we dismiss it, and only if calling animal rape "rape" is somehow misleading should we characterize it as "not really" rape. Otherwise, we're unnecessarily prejudicing how we think about these issues.

One difficulty with the idea of animal rape is that, legally speaking, animals can't consent to anything. I see this as an example of why consent should be thought of as a nebulous entity arising from the combination of many constraints rather than an all-or-nothing phenomenon. Even if animals do not have the full decision-making and communicative capacities of humans, we can still examine how well an animal's expressed sexual choices are respected by conspecifics.

Frequency and demographics

As people are increasingly realizing in this age of Bill Cosby, Brock Turner, and Donald Trump, sexual abuse is very common, at least in the contemporary United States.3 A recent national survey produced the following figures (Black et al., 2011):

  • About 1 in 3 women and 1 in 8 men have had "non-contact unwanted sexual experiences".
  • About 1 in 4 women and 1 in 9 men have "experienced unwanted sexual contact" short of penetration.
  • About 1 in 4 women and 1 in 71 men have been forcibly penetrated, subject to attempted forcible penetration, or penetrated while intoxicated.
  • About 1 in 21 men have been forced to penetrate someone else.

Rates can be even higher in special social contexts. For example, Sadler, Booth, Cook, and Doebbeling (2003) found that 399 of 505 female veterans of the American military (79%) had been sexually abused during their time in the military.

Basile (2002), using data from a 1997 nationally representative poll of women, found that 34% "had sex with a husband or intimate partner when they really did not want to". Respondents were also asked whether they'd had such unwanted sex in a variety of circumstances, ranging from ambiguously coercive ("when you thought he expected sex from you in return for certain actions, such as spending money on you for a gift or taking you out for a nice dinner") to forceful ("after he used physical force on you in order to have sex"). In general, less coercive forms were more common.

Brousseau, Bergeron, Hébert, and McDuff (2011) examined sexual abuse in Canadian opposite-sex couples. Both partners of every included couple were asked both about what their partner had done to them and what they had done to their partner. Of 222 couples, 45% reported the woman being victimized, 30% reported the man being victimized, and 20% reported mutual victimization (also included in the former two percentages). Hickson et al. (1994) interviewed 930 British men who were ("in general") gay-identified. About 1 in 4 (28%) had been raped. The rapists were male in 96% of cases.

Notice that while, consistent with stereotype, most victims are women and most abusers are men, there are still substantial numbers of female abusers and male victims. One can find statements suggesting that nearly all rapists are men (e.g., Black et al., 2011, say "For female rape victims, 98.1% reported only male perpetrators"); an important reason is that the word "rape" is often restricted to penetration by the abuser, which excludes, for example, the abuser forcing the victim to penetrate. Krahé, Waizenhõfer, and Mõller (2003) is a rare study of women as sexual abusers of men. Krahé et al. had 248 German women complete questionnaires. 4% admitted to attempts to forcibly rape a man. 3% had verbally pressured a man into sex and 8% had attempted to exploit some incapacitated state (such as drunkenness). Abusive oral sex or coitus was less common than "sexual touch (kissing/petting)". This said, a meta-analysis (i.e., a study that tries to quantitatively integrate the findings of a large number of past studies) by Cortoni, Hanson, and Coache (2010) found that less than 3% of female sex offenders commit another sexual offense after their first conviction; this recidivism rate is substantially lower than that of non-sexual offenses among women or sexual offenses among men.

In the popular imagination, "rape" is often taken to imply the sudden violent assault of a woman by a strange man. As we have seen, less intense and forceful forms of abuse are more common, and the genders are often different. Moreover, only a minority of rapes are committed by strangers; acquaintances and romantic partners (including spouses) are more often the culprits. Martin, Taft, and Resick (2007), from a review of other studies, state "marital rape is the most common form of rape" (p. 336). In Black et al. (2011), a partner was the abuser for 51% of female victims and 45% of male victims of rape involving penetration. An acquaintance was the abuser for respectively 41% and 53%. A stranger, by contrast, was the abuser for respectively 14% and 8%. Strangers were more likely to be abusers for less severe forms of abuse (for example, 51% of non-contact abuse to women was committed by strangers), but there were still substantial numbers of partner and acquaintance abusers.

Traditionally, writers on rape have focused on the most headline-worthy sorts of rape: young, vulnerable women savaged by such frightening men as lunatics, slavers, and soldiers. Bryden and Grier (2011) observe that Brownmiller (1975), the most influential book on rape yet written, devotes many of its pages to racially and politically charged rape during wars and revolutions and few to acquaintance rape and date rape, while the clinical psychologists who were the primary authorities on rape before Brownmiller's book focused on incarcerated sex offenders. Headline-worthy rape is indeed worth our attention, but we must not lose sight of ordinary, everyday sexual abuse (rape or otherwise), the sorts of abuse that are responsible for the startlingly high abuse rates I've cited. Sexual abuse is very common, it happens to ordinary people, and ordinary people perpetuate it—and yet, it still devastates its victims. I expect we will need to understand sexual abuse in this its most basic form to understand how it fits into human sexuality as a whole.

Sexual abuse of young children seems to be much rarer than abuse of adolescents and adults. Finkelhor, Hammer, and Sedlak (2008) discuss a nationally representative sample of children and their caretakers. They found that 1 in 900 children under 12 years old and 1 in 1,600 children under 9 years old have been sexually abused.4 I would tell you something about the gender ratio, but it's hard to find research reports on abuse of prepubescents as opposed to all children under 18. (The gender ratio for all children seems to be similar to that for adults.)

Consequences

In agreement with the common view of rape as an especially horrific crime, research suggests not only that rape is mentally damaging to victims, but that it is on average more mentally damaging than other kinds of trauma. Kilpatrick et al. (1989) and Boudreaux, Kilpatrick, Resnick, Best, and Saunders (1998) found that among women, rape, compared to other crimes, was more strongly associated with symptoms of (respectively) post-traumatic stress disorder (PTSD) and other mental illnesses such as major depression and agoraphobia. Similarly, Moor and Farchi (2011) found in a sample of 304 people (including both men and women) that forcible rape, compared to non-sexual traumas such as "sudden loss of a loved one" and "involvement in a serious car accident", was more strongly associated with PTSD and with endorsement of self-blame statements such as "I got what I deserved" and "I should have been more cautious". Vrana and Lauterbach (1994) also found in a sample of 440 college students that sexual abuse was more associated with PTSD, anxiety, and depression than traumas such as combat and natural disasters.

As one would expect, less severe forms of victimization seem to be associated with less mental damage. For example, Boudreaux et al. (1998) found stronger associations between completed rape and mental illness than attempted rape and mental illness. Importantly, however, milder forms of sexual abuse, including non-contact abuse, are still related to mental illness. Petersen and Hyde (2013) asked 5th-grade children (aged about 10) about "nine potentially offensive behaviors" that same-age peers had done to them, ranging from "spread sexual rumors about you" to "touched, grabbed, or pinched you in a sexual way". Among girls, the sum of these behaviors that had occurred to subjects and that they rated as "somewhat upsetting" or "very upsetting" was positively associated with eating disorders four years later. Fitzgerald, Drasgow, Hulin, Gelfand, and Magley (1997) surveyed 473 female employees of a utility company about abuse they had experienced in the workplace such as "crude sexual remarks", "staring, leering at you", and "repeated requests for drinks, dinner, despite rejection" (items quoted from Fitzgerald, Gelfand, & Drasgow, 1995). Such abuse was associated with PTSD symptoms and a measure of general mental distress (such as anxiety and depression). In summary, it is not justified to trivialize milder forms of sexual abuse. In fact, if milder forms of sexual abuse are more common, the full human cost of milder forms may well equal or exceed the cost of forcible rape.

Consequences of child abuse

If the public views rape of adults as evil, it views rape of children as unconscionable. Surprisingly, then, empirical evidence of the damage of child abuse is less clear than the damage of adult abuse. A meta-analysis by Rind, Tromovitch, and Bauserman (1998) concluded that child abuse "does not produce pervasive and intensely negative effects regardless of gender" (p. 42); in particular, boys seem less likely to be harmed. (So popularly and politically controversial was this conclusion that the US Congress officially condemned the American Psychological Association for publishing the article; Garrison & Kobor, 2002. But this article does not actually argue that adult–child sex is acceptable; Hunter, 2008, is an example of one that does.) A nationally representative survey by Briere and Elliott (2003), on the other hand, found that child abuse is indeed associated with long-term symptomatology.

A possible obstacle to research on child abuse is that operational definitions of child abuse tend to be wider than those of adult abuse. In particular, whereas research on adult abuse usually only considers victims who say they did not want the sexual experience, research on child abuse tends to ignore this variable. Child–adult sex is often regarded as necessarily abusive, whatever the child's feelings on the matter, on the argument that a child's agreement to sex does not suffice for consent—because of the adult's social power over the child, because of the child's relative lack of knowledge about sex, or because of children's lower overall cognitive ability. (People may also be unaware that some kinds of sexual behavior with same-age children are common in prepubescents, as discussed in the chapter on preferences, leading them to believe that prepubescents can never feel genuine sexual interest.) Research on child abuse might be improved by inclusion of the child's views on the matter. In particular, I expect that child-abuse victims who do not agree to the sex at the time of the original event are no less likely to be harmed than abused adults.

Hines and Finkelhor (2007) review the sparse literature on sex between adolescents and adults that the adolescent describes as voluntary. There seem to be substantial numbers of adolescents who perceive these experiences as positive and substantial numbers who perceive them as negative, although frequencies are hard to estimate. Evidence on the distinct question of whether adolescents are actually harmed by these relationships is also mixed.

Associates of symptomatology

Intuitively, we think of psychological trauma as the lingering damage of the original, acutely aversive stressor, similarly to how a bodily injury can be painful initially and disabling in the long term. A difficulty of applying this idea to sexual abuse, however, is that isn't obvious why sexual abuse is aversive to begin with (in cases of abuse that do not involve other stressors, such as violence or the threat of violence). Violence is aversive because it's physically painful, and theft is aversive because it takes away possessions we want or need, but why is sexual abuse aversive? The question is all the more worth our attention if sexual abuse is more aversive than other traumas, which is suggested by how, as just discussed, it tends to have more negative mental effects. Unfortunately, this question has not received much empirical attention, perhaps because empirical researchers tend not to be interested in phenomenology (i.e., people's subjective experience). We can approach the matter, however, by reviewing research on how characteristics of abuse events or victims' responses to them influence the mental consequences for victims.

Victims of rape, as of other traumas, sometimes report feeling numb or detached ("as though you were in a dream or watching a movie or play"; Griffin, Resick, & Mechanic, 1997, p. 1087) during the trauma. This experience is called "dissociation". Such an emotional detachment from a traumatic event might be expected to reduce suffering during the event and hence subsequent mental damage. However, dissociation during rape is associated with worse, not better, consequences for the victim. Griffin et al. (1997), for example, found that women who reported more dissociation during a rape were higher in PTSD symptoms and depression. On the other hand, confusingly, subjective distress during a rape is also positively related to symptomatology. Feinstein, Humphreys, Bovin, Marx, and Resick (2011) found that peritraumatic (i.e., during-the-event) fear was associated with PTSD symptomatology, and Girelli, Resick, Marhoefer-Dvorak, and Hutter (1986) found that the more subjects rated they had peritraumatically been "afraid for my life and safety" and "extremely upset, crying", the greater their fear and anxiety afterwards.

Here are some other characteristics of victims' reactions to rape that are associated with symptomatology. In Moor and Farchi (2011), discussed earlier, self-blame was associated with PTSD among victims of several traumas but particularly among rape victims. Gutner, Rizvi, Monson, and Resick (2006) examined coping strategies used by women who had been raped or violently assaulted. Subjects who engaged in more wishful thinking or social withdrawal from friends and family had more PTSD symptomatology.

In lieu of more research on this subject, I would like to add some speculation.

First, recall that, although the terror of rape and the pleasure of consensual sex may seem antagonistic, victims may experience arousal and orgasm during rape (Levin & van Berlo, 2004). This suggests it should be possible to feel sexual pleasure during rape, even contemporaneously with much less pleasant emotions. (If this sounds impossible, imagine drowning in a vat of honey. While you are experiencing the agony of drowning, you can also taste the honey's sweetness, cold comfort that it is.) I hypothesize that, far from providing some sort of meager compensation for the suffering of rape (as suggested by Clayton Williams's infamous remark "If it's inevitable, just relax and enjoy it."; Associated Press, 1990), sexual pleasure will make things worse, peritraumatically or in the long term. Awareness that one has obtained sexual gratification out of the event may make one feel more blameworthy for the event and more confused about one's other, negative reactions. I know of a single case study (Coelho, Rodrigues, Andersen, Tufik, & Hachul, 2013) reporting an abuse victim's feelings of guilt for pleasure she had experienced during the abuse.

Second, recall from the chapter on ambivalence the experimental evidence that people are inherently afraid of sexuality because of its connection with death, and social constructs such as idealized romantic love serve to buffer people against this fear. When a person is sexually abused, they have an experience that is sexually charged but to which whitewashing social ideals, such as idealized romantic love, are more difficult to apply than usual. (To apply them, in fact, might contaminate them with the trauma of rape and thereby reduce their efficacy for everyday terror management in the future.) The victim is in a sense disillusioned as the creaturely nature of sexuality is bared to them. This sudden, involuntary confrontation of what people unconsciously dread about sexuality is probably not conducive to mental health.

Finally, it might be enlightening to conduct cross-cultural research on the consequences of sexual abuse for victims. In cultures in which rape is very common or institutionalized, will victims be not as badly affected (perhaps because their worldview is not much changed by being raped) or even worse affected (perhaps because they feel even more helpless)? More generally, how much are cultural forces responsible for victims' reactions to rape?

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Notes

1

Possibly the appeal of the term "violence" is just that it sounds harmful, since people talking about sexual abuse are usually trying to get the public to agree that sexual abuse is a problem. The OED's entry for the word "violence" quotes a 1984 Daily Telegraph article as saying "much violence was done to the word violence, which it appears can be used to describe almost anything you do not care for".

2

A previous version of this chapter included bottlenose dolphins in this list, on the basis of a discussion in Lalumière et al. (2005), p. 38. However, one of the same dolphin researchers whose work Lalumière et al. cite, Richard C. Connor, made an argument to the contrary 15 years later in an interview for, of all publications, PolitiFact (Carroll, 2016). The PolitiFact article concludes that dolphin rape is "just a myth". I haven't looked closely at this literature, so feel free to draw your own conclusions.

3

Yes, I, too, have been sexually abused, albeit mildly. When I was thirteen (in 2002 or 2003), one of my classmates would proposition me crudely and giggle when I cringed or gave her a look of horror. Once, she stroked my arm seductively. After I complained to one of the school's staff, she apologized to me and never bothered me again. If only most sexual abuse was so easily stopped. Incidentally, I was bullied a great deal at the same school in non-sexual ways and my many complaints about those incidents achieved nothing, but I suppose bullying is its own vast social problem that's distinct from sexual abuse.

4

I calculated these figures from Table 2 of Finkelhor et al. (2008) as (123 + 98 + 305) / ((.33 + .17 + .17) * 701727) and (123 + 98) / ((.33 + .17) * 701727).