Sexual abuse is universal and dangerous

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.

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.

Of course, in order to distinguish sexual abuse from non-abusive sexual behavior, we need to define consent. And here's the real trouble with that: we speak as if consent were an unambiguous discrete entity, and the law tends to treat it as such. In reality, many different constraints can affect people's sexual decisions, from physical force to employment risk to intoxication to ignorance or inexperience to intellectual disability to social norms to the other person's feelings—not to mention that animals, too, make sexual decisions, and clearly not in exactly the same way humans do. It is debatable which combinations and degrees of constraint qualify as consent and which as coercion. We can create bright-line rules to make the rule of law possible, but there are many scenarios in which people can reasonably disagree as to whether a sexual act is abusive. Is it sexual abuse to beg and plead with one's partner for sex? What about implicit exchanges of sex for other favors (like a fancy dinner or household chores)? What about threatening to leave the relationship? Untangling such difficult ethical issues is not what I intend to do here; the point is just to demonstrate that hard-and-fast rules distinguishing abuse from non-abuse (particularly, rape from non-rape) will necessarily be misleading, and therefore should be avoided in empirical (as opposed to legal) discourse.

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.

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.

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)". Considering abuse of children, Fromuth and Conn (1997) found that 22 of 546 (4%) undergraduate women admitted to sexually abusing a child 5 or years younger than themselves, generally while they themselves were also children. Most of the victims were male. 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.)

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.

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