Rape and Sexual Assault

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Rape (sexual assault) facts

  • Sexual assault is any illegal sexual contact that involves forcing a person without their consent or inflicting such contact with someone who is unable to give consent due to age or physical or mental capabilities.
  • Sexual assault may also involve sexual contact that is inflicted by someone who is trusted by or has authority over the victim.
  • Sexual harassment is defined as unwanted sexual behavior that interferes with the victim's work or school life.
  • Sexual battery refers to contact with an intimate body part of another person that is unwantedby the victim and is done in order for the perpetrator to achieve sexual arousal, gratification, or abuse.
  • Any sexual assault that involves inflicting physical injury or maiming of the victim is described as being aggravated sexual assault.
  • Rape is unlawful sexual activity involving sexual intercourse that happens by force or under the threat of some form of harm.
  • Rape occurs in a variety of contexts, as in childhood marriage, as a form of torture and is sometimes perpetrated by members of the military on their own colleagues.
  • States tend to legally define first-, second-, and third-degree rape and sexual assault based on the age of the victim and the perpetrator, and/or the amount of force, brutality, and threat inflicted on the victim.
  • Unfortunately, rape is grossly underreported to law enforcement.
  • A majority of victims of sexual victimization indicate that the perpetrator is known to them, like an acquaintance as in date rape, or by a family member or friend.
  • Signs and symptoms of someone who has been sexually assaulted or raped tend to include a variety of emotional, behavioral, social, and work-related problems.
  • Some ways to prevent sexual assault and rape are to lessen the life risk factors for being the victim or perpetrator of these crimes.
  • If left untreated, the physical and psychological effects of sexual assault and rape can be devastating, sometimes even deadly.
  • The primary consideration for caring for victims of rape or other sexual assault is to focus on the needs of the victim during this crisis, providing timely, appropriate medical, mental-health, and legal assessment and care by specially trained and experienced professionals in a timely manner.

What is sexual assault?

Sexual assault is defined as any illegal sexual contact that involves forcing a person without their consent or inflicting such contact on someone who is unable to give consent due to their age or to physical or mental incapacities. Sexual assault may also involve sexual contact that is inflicted by someone who is trusted by or has authority over the victim. Incest is one example of childhood sexual abuse that is perpetrated by a trusted person who often has authority over the victim, as when a parent or sibling engages in such a violation on another family member.

Sexual harassment is defined as unwanted sexual behavior that interferes with the victim's work or school life. It does not include behaviors that are wanted or welcome, like desired flirting, kissing, or touching. Unfortunately, sexual assault and sexual harassment take place in a variety of settings. The most common site where young women report sexual harassment is at school, including on college campuses. The workplace is another site of sexual harassment. While the U.S. Equal Employment Opportunities Commission received 6,862 complaints of sexual harassment in the workplace in 2014, many more individuals feel they have been the victim of such unwanted behavior but have not reported it. More than 17.5% of workplace sexual harassment charges in 2014 were filed by men.

Sexual battery refers to contact with an intimate body part of another person that is unwanted by the victim and is done in order for the perpetrator to achieve sexual arousal, gratification, or abuse. It may occur whether or not the victim is wearing clothes or not. Any sexual assault that involves inflicting physical injury or maiming of the victim is described as being aggravated sexual assault.

In 2011, there were 8,763 allegations of sexual victimization of inmates in prison, jails, and other adult correctional facilities. Most sexual assaults that take place during incarceration are homosexual rapes, in that the perpetrator and the victim are of the same gender. Detention and other incarceration is often the setting for rape or other sexual assault for boys and men.

What is rape?

The definition of rape is unlawful sexual activity involving sexual intercourse that happens by force or under the threat of harm. It is important to note that the threat of harm may take many different forms, like the threat of physical harm, loss of employment, reputation, or social status. Other facts about this form of sexual violation include that about 15% of women and 3% of men over 17 years of age report being raped at some time during their lifetime. About 10% of rapes are committed by more than one attacker. Rape occurs in a variety of contexts. It takes place in some societies in the form of childhood marriage, is used to torture and demoralize others in times of war, and is sometimes perpetrated by members of the military on their own colleagues.

States tend to legally define first-, second-, and third-degree rape and sexual assault based on the age of the victim and the perpetrator, and/or the amount of force, brutality, and threat inflicted on the victim. Unfortunately, rape is grossly underreported to law enforcement. The approximately 92,000 reported cases of rape each year reflect only a portion of the actual number of rapes that occur. Individuals of all races, religions, sexual orientation, and socioeconomic levels can be the victim of rape. While women of Native American/Alaskan and of mixed race apparently report being sexually assaulted at higher rates than women of other races, it is unknown if that is because it is reported at higher rates or actually indicates a higher rate of sexual victimization for individuals in those ethnic groups.

A majority of victims of sexual victimization indicate that the perpetrator is known to them, like an acquaintance as in date rape, or by a family member or friend. More than 7% of women and about 0.3% of men are the victim of marital rape or rape by a former spouse, current or former partner they live with, or by a date at some time in their life. Men who perpetrate spousal rape tend to be motivated by having a position of power in their marriage, to minimize or deny their abusive actions, and to use their children to manipulate their wife and impose male privilege.

Women on college campuses are at more risk than other women, in that about one in five college women are the victim of rape during their college career. Most sexual assaults occur in private areas like a home, hotel, or vehicle rather than in a public place. When rape is committed against a person who is under a certain age, it is called statutory rape.

What are the symptoms and signs of someone who has been sexually assaulted or raped?

Signs and symptoms of someone who has been sexually assaulted or raped tend to include depression, guilt, anger, and anxiety. Behaviorally, the victim of sexual violence might become aggressive, abuse substances, or break rules, like not attending work or school. The victim might also have sleeping or eating problems, withdraw from relationships, and have sexual problems.

What can I do to prevent sexual assault and rape?

Some ways to prevent sexual assault and rape are to lessen the life risk factors for being the victim or perpetrator of these crimes. While risk factors like being less than 15 years old and being in a married or cohabitating relationship are not amenable to change, refraining from the use of drugs or alcohol and decreasing the number of sexual partners may help decrease the vulnerability to sexual victimization. That perpetrators of rape or other sexual assault are often drunk or intoxicated with another substance at the time of the assault indicates that such offenses are frequently drug facilitated. While increased female empowerment sometimes places women at increased risk for spousal sexual violence, helping women improve their socioeconomic status out of poverty or to achieve careers outside of sex work (for example, in prostitution, adult entertainment, or what many interpret to be other forms of sexual exploitation) may decrease their risk for rape or other forms of sexual assault.

Factors that tend to decrease the likelihood that men will engage in committing a rape include individual factors like refraining from the use of drugs or alcohol, exercising good impulse control, and having good perceptions of women; family factors like having a supportive family and absence of domestic violence; and community factors like low crime rates in general and having strong laws and policies about sexual violence.

What do I do if someone I know or I have been sexually assaulted or raped?

The primary consideration for caring for victims of rape whom has been raped or otherwise sexually assaulted is to focus on the needs of the victim during this crisis. Any intervention tends to be more effective when sensitively administered in a timely way so that the survivor of a rape or other sexual assault will not have to be subjected to more questioning or other interactions than are necessary. The primary issues addressed include medical treatment of any injuries, collection of evidence, preventing unwanted pregnancy and sexually transmitted diseases, and providing psychosocial support. In addition to preventing the pain or other symptoms of injuries or a sexual transmitted disease, appropriate medical interventions include preventing the additional stress of unwanted pregnancy that can lead to potentially considering abortion. Psychosocially, it is important to reassure the victim of this trauma that their victimization is in no way their fault. This is true no matter how old they are, what they do for a living, or whether or not they have ever had a rape dream or fantasy. All that matters is that unwanted sexual contact was inflicted upon them. It is noteworthy that both male and female rape victims tend to prefer being evaluated by a woman.

The sooner a victim of rape or other sexual assault gets medical and mental-health assessment and treatment, the better their recovery from the trauma. Therefore, if you or someone you know has been sexually violated in any way, you should seek care from your nearest emergency room or rape crisis center as soon as possible. In either setting, victims of sexual assault or rape are medically and mentally assessed by a doctor or nurse examiner. The medical evaluation usually includes a full physical examination, including a pelvic exam. It also typically involves lab tests, including testing for sexually transmitted diseases. While a physical examination, particularly a pelvic examination, can be disturbing to you if you have been sexually assaulted or raped, trained professionals are usually able to help survivors feel more comfortable through reassurance and skilled assessment. Specifically, the Sexual Assault Nurse Examiners (SANE) has specially trained professionals in how to help victims of rape or sexual assault go through this process at their own pace and to participate in the attempted prosecution of the perpetrator if and when the victim feels he or she is able. In fact, survivors of such violence have been found to report their victimization to the authorities more often when provided with SANE-trained professionals.

As the number of times as well as the number of perpetrators of rape, sexual assault, and sexual abuse has a significant impact on the victim, examiners will usually inquire about whether the victim was raped, abused, or assaulted by their mother, father, sister, brother, or other family member. The Violence Against Women Act (VAWA) is a federal statute that allows survivors of sexual victimization to receive a medical exam either free of charge or to be fully reimbursed for the assessment and does not require that the assault be reported to the police, charges be filed against the perpetrator, or other cooperation with the criminal justice system unless the victim so chooses. Therefore, cost or fears about reporting the crime should not deter a victim of rape or other sexual assault from getting care. In addition to attempting to provide a comprehensive response to rape and other sexual assault, the VAWA supports such a response to domestic violence, dating violence, and stalking by enhancing victim services and the criminal justice system's ability to hold sexual offenders accountable. In addition, knowing that rape shield laws prevent the identity of survivors of this trauma from being revealed may be some comfort to victims of rape or sexual assault.

What are the physical and psychological effects of sexual assault and rape?

If left untreated, the physical and psychological effects of sexual assault and rape can be devastating, sometimes even deadly. Causes of death as the result of sexual violence include suicide, murder, and infection with the human immunodeficiency virus (HIV). Murder of sexual assault and rape victims may be perpetrated by the rapist or as part of an honor killing by family members of the victim. A victim of a rape or other sexual assault might become pregnant as a result of the rape. He or she could develop nightmares, flashbacks, changes in their sleep and appetite, or develop full-blown emotional problems, including posttraumatic stress disorder, depression, or substance abuse. Individuals who have experienced sexual assault are at risk for other day-to-day problems, including arguing with family members and having problems at work.

Where can I get more information about sexual assault and rape?

1in6 is for men who have experienced unwanted or abusive childhood sexual experiences and those who care about them.
http://www.1in6.org/

The Awareness Center: The International Jewish Coalition Against Sexual Abuse/Assault (JCASA) is dedicated to addressing childhood sexual abuse in Jewish communities worldwide.

Child Help USA exists to meet the physical, emotional, educational, and spiritual needs of abused and neglected children.
http://www.childhelp.org/

John Howard Society -- Supporting Adult Men -- Male Adult Survivors of Abuse, Substance Abuse, Harm Reduction, Domestic Violence and Anger Management.

Just Detention International seeks to end sexual violence committed against men, women, and children in all forms of detention.
http://www.justdetention.org

MaleSurvivor
PMB 103
5505 Connecticut Ave NW
Washington DC 20015-4181

Military Rape Crisis Center
http://www.stopmilitaryrape.org/

National Sexual Assault Hotline 24 hours a day.
1-800-656-HOPE (1-800-656-4673)

Parents for Megan's Law and the Crime Victims Center (PFML/CVC) provides national helpline community support and assistance on issues related to Megan's Law, sex offender management, and sexual assault prevention. 1-888-275-7365
http://www.parentsformeganslaw.org

Rape Abuse and Incest National Network (RAINN)

RAINN (Rape, Abuse & Incest National Network) is the nation's largest antisexual assault organization and operates the National Sexual Assault Hotline (800.656.HOPE and rainn.org) in partnership with over 1,100 local rape crisis centers across the country.
http://www.rainn.org/
1.800.656.HOPE

Safe Society Zone works to address sexual assault prevention in schools.

Speaking Out Against Rape, Inc. (SOAR) runs national awareness, education, and prevention programs to empower survivors of sexual violence and enhance the public's understanding and acceptance of rape victims.
http://www.soar99.org/about.html

SNAP - The Survivors Network of those Abused by Priests US, national support group for women and men abused by religious authority figures.
http://www.snapnetwork.org/

Stop Abuse for Everyone (SAFE) is a human rights organization that provides services, publications, and training to serve those who typically fall between the cracks of domestic violence services: straight men, GLBT victims, teens, and the elderly. We promote services for all victims and accountability for all perpetrators.
http://www.safe4all.org/

Victims Resource Center provides a wide range of services to men, women, and children who are victims of crime. These services include a 24-hour hotline, support groups, counseling, and advocacy for victims. VRC also provides numerous educational programs for students of all ages, professionals, and community groups. The Victims Resource Center is private, confidential, and it's services are free.
http://www.vrcnepa.org/index.php

Medically reviewed by Avrom Simon, MD; Board Certified Preventative Medicine with Subspecialty in Occupational Medicine

REFERENCES:

American Association of University Women (AAUW) Foundation Sexual Harassment Task Force. "Harassment-Free Hallways: How to Stop Sexual Harassment in School. A Guide for Students, Parents, and Schools." Washington, D.C.: Library of Congress, 2004.

Garner, B.A., ed. Black's Law Dictionary, 9th edition. United States: The West Group, 2009.

Dukes, R.L., K.N. Borega, S.L. Clayton, C.K. Dukes, et al. "Tainted Love: Content Analysis of Documents Written by Accused Spousal Abusers to Their Victims." Psychological Reports 90.2 Apr. 2002: 679-684.

Insideprison.com. "Prison Rape: The Challenge of Prevention and Enforcement." May 2006.

109th Congress of the United States of America. Violence Against Women and Department of Justice Reauthorization Act of 2005; 1/4/05, HR-3402.

Richmond, J.M., A.N. Elliott, T.W. Pierce, et al. "Polyvictimizaiton, Childhood Victimization, and Psychological Distress in College Women." Childhood Maltreatment 14.2 May 2009: 127-147.

Sadler, A.G., B.M. Booth, B.L. Cook, and B.N. Doebbeling. "Factors Associated With Women's Risk of Rape in the Military Environment." American Journal of Industrial Medicine 43 (2003): 262-273.

Spatz Widom, C., and S. Hiller-Sturmhöfel. "Alcohol Abuse as a Risk Factor for and Consequence of Child Abuse." Alcohol Research & Health 25.1 (2001): 52-56.

Switzerland. World Health Organization. Sexual Violence. In, World Report on Violence and Health 2002.

United States. National Institute of Justice. "Extent, Nature, and Consequences of Intimate Partner of Violence: Findings From the National Violence Against Women Survey." Washington, D.C.: National Institute of Justice and the Centers for Disease Control and Prevention, July 2000.

Violence Against Women Online Resources. "Ensuring Forensic Medical Exams for All Sexual Assault Victims: A Toolkit for States and Territories." Violence Against Women Online Resources, Dec. 2008.

Welch, J., and F. Mason. "Rape and Sexual Assault." British Medical Journal 334.7604 June 2, 2007: 1154-1158.

WomensLaw.org. "North Carolina Statutes." Feb. 2010.

Last Editorial Review: 11/23/2015

Reviewed on 11/23/2015
References
Medically reviewed by Avrom Simon, MD; Board Certified Preventative Medicine with Subspecialty in Occupational Medicine

REFERENCES:

American Association of University Women (AAUW) Foundation Sexual Harassment Task Force. "Harassment-Free Hallways: How to Stop Sexual Harassment in School. A Guide for Students, Parents, and Schools." Washington, D.C.: Library of Congress, 2004.

Garner, B.A., ed. Black's Law Dictionary, 9th edition. United States: The West Group, 2009.

Dukes, R.L., K.N. Borega, S.L. Clayton, C.K. Dukes, et al. "Tainted Love: Content Analysis of Documents Written by Accused Spousal Abusers to Their Victims." Psychological Reports 90.2 Apr. 2002: 679-684.

Insideprison.com. "Prison Rape: The Challenge of Prevention and Enforcement." May 2006.

109th Congress of the United States of America. Violence Against Women and Department of Justice Reauthorization Act of 2005; 1/4/05, HR-3402.

Richmond, J.M., A.N. Elliott, T.W. Pierce, et al. "Polyvictimizaiton, Childhood Victimization, and Psychological Distress in College Women." Childhood Maltreatment 14.2 May 2009: 127-147.

Sadler, A.G., B.M. Booth, B.L. Cook, and B.N. Doebbeling. "Factors Associated With Women's Risk of Rape in the Military Environment." American Journal of Industrial Medicine 43 (2003): 262-273.

Spatz Widom, C., and S. Hiller-Sturmhöfel. "Alcohol Abuse as a Risk Factor for and Consequence of Child Abuse." Alcohol Research & Health 25.1 (2001): 52-56.

Switzerland. World Health Organization. Sexual Violence. In, World Report on Violence and Health 2002.

United States. National Institute of Justice. "Extent, Nature, and Consequences of Intimate Partner of Violence: Findings From the National Violence Against Women Survey." Washington, D.C.: National Institute of Justice and the Centers for Disease Control and Prevention, July 2000.

Violence Against Women Online Resources. "Ensuring Forensic Medical Exams for All Sexual Assault Victims: A Toolkit for States and Territories." Violence Against Women Online Resources, Dec. 2008.

Welch, J., and F. Mason. "Rape and Sexual Assault." British Medical Journal 334.7604 June 2, 2007: 1154-1158.

WomensLaw.org. "North Carolina Statutes." Feb. 2010.

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