Sexual violence

Sexual violence is a major social and public health issue around the world, including in Sweden. Sexual violence can be defined as violation and abuse with sexual overtones, and includes everything from molestation and harassment to rape and incest. The perpetrators are almost exclusively men, making up 99.5% of the perpetrators according to the Swedish National Council for Crime Prevention. Even though women and girls are more likely to be the victims of sexual violence, it can happen to women, men, girls and boys.

A common misconception is that sexual violence is carried out by an unknown assailant. In most cases, it is actually done by someone the victim knows. Most sexual assaults occur indoors, in the home. The number of unreported cases of sexual violence in a close relationship is estimated to be large. Sexual violence is often the most difficult form of violence to talk about, and many feel guilt and shame that they experienced this at the hands of a partner. It is not uncommon for physical violence to be followed by sexual violence. Being sexually available can also be a way of avoiding being subjected to other forms of violence and punishment.

Research including interview studies with offenders has shown that the abuse is fundamentally about power and domination, not sex. Violence, including sexual violence, is also used to restore and maintain the imbalance of power and inequality between men and women. The sexual violence also affects women and teen girls who are not direct victims. The fear of experiencing sexual violence is something that limits their perceived ability to act freely and their access to public space.

The most extensive EU-level study to date on women’s experiences of physical, psychological and sexual violence, sexual harassment, and victimisation was published in 2014. The study was based on personal interviews with 42,000 women in all 28 EU countries, with an average of 1500 interviews per country. 12 percent of the women in the survey indicated that they had experienced some form of sexual abuse or acts by an adult before the age of 15, representing 21 million women in the EU. 5 percent of the women had been raped at some point after their 15th birthday. The study also highlights cyber violence against women: 11 percent of the women experienced inappropriate advances on social media or received emails or text messages (SMS) with sexually explicit content. 20 percent of the young women (age 18–29) have experienced this type of internet harassment. The study shows that 81 percent of women in Sweden have been subjected to sexual harassment after the age of 15.

The study “Våld och hälsa – En befolkningsundersökning om kvinnors och mäns våldsutsatthet samt kopplingen till hälsa” [Violence and health – A population study of women’s and men’s exposure to violence and the link to health] shows that one out of five women in Sweden have been the victim of serious sexual violence at some point in their life. The study defined serious violence as follows:

“That as a child a person was forced to have sexual intercourse (including attempts) at some time and/or was the victim of other sexual assault repeatedly and/or was sometimes/often struck with a fist, injured with a weapon or the like, and/or was often the victim of other physical violence, and/or was often threatened with physical violence and/or was often called names, bullied, etc., and/or had repeatedly seen or heard violence between their parents. That as an adult a person has been forced to have intercourse or the like (including attempts) and/or was struck with a fist/object/kicked or was the victim of violence with a weapon, and/or was systematically and repeatedly subjected to psychological violence.”

Two percent of the women and half a percent of the men had been subjected to some form of sexual abuse before the age of 18 by their father, stepfather or mother’s cohabitee/significant other. The “Våld och hälsa…” study shows that less than ten percent of the victims have received professional help and less than five percent filed a police report.

The study “Slagen Dam” [Battered Woman] also shows that 30 percent of the women were subjected to violence by a man outside of a relationship, with half of the violence being sexual. 13 percent of the women in the study had experienced serious sexual violence by a man outside of a relationship.

A 2009 survey of high school students showed that 58 percent of the girls and 15 percent of the boys had experienced some type of sexual abuse (such as pawing, sexual and unwelcome touching, or verbal abuse online). The same study showed that 13.5 percent of the girls and 5.5 percent of the boys had experienced serious abuse, often repeatedly.

Being the victim of violence, including sexual violence, often has profound effects on the individual’s mental and physical health. Research shows that sexual abuse doesn’t just cause immediate effects on the health of the victim, but that the negative effects can continue for a long time and even lead to diseases later in life. It is not just the abuse itself that can cause serious ill health. Different circumstances related to the assault, the course of events that follows it, and how the people in the victim’s immediate surroundings react can have a major impact on the victim’s ability to recover. Research shows that poor treatment, disbelief, blame and lack of support may cause greater harm to the individual than the original sexual assault.

The harm stemming from a sexual assault is rarely just physical. However physical injury does occur and could be made more severe if the perpetrator uses violence or weapons in the assault. The victim sometimes reduces the severity of the physical injury by acting in a way that causes the perpetrator to use less physical violence. Acute stress reactions to trauma are controlled by the brain, which is responsible for basic survival functions. If a danger is considered inevitable and overwhelming, the victim may react by becoming paralysed. Giving up and even “helping” may be the response that best minimises the injury of the assault. During an acute stress reaction, it is not uncommon for the victim to suffer dissociative amnesia, which is the inability to remember parts of an event.

There is no “right” way to react during or after a sexual assault, and there is no “right” way to feel when you are or have been the victim of an assault. How a person reacts and feels and how they handle their experiences depends on many different factors, and no way is more “correct” than any other. The assault is still an assault, and the one who experienced it is a crime victim.

Many victims of sexual or other violence suffer from many negative health effects over a long period of time. If the victim does not get the right support and help, the health effects can be numerous, serious and long-lasting. PTSD (post-traumatic stress disorder) and complex PTSD are common conditions affecting individuals who experienced different forms of violence. PTSD is a prolonged and severe anxiety disorder that impairs quality of life significantly. PTSD manifests itself in several ways, but always consists of three psychological symptoms – reliving the event, avoiding anything that reminds the person of the event, and feeling keyed up (called hyperarousal). PTSD may go away on its own, but may also require trauma therapy. The consequences of chronic PTSD are a number of other symptoms and diseases, like infections, autoimmune diseases, inflammatory diseases and cancer. Several common chronic pain conditions, such as fibromyalgia and chronic abdominal and pelvic pain, are linked to sexual assault.