Saturday, 7 January 2012

Personal Health: The Twice-Victimized of Sexual Assault

AppId is over the quota
AppId is over the quota

Yet few told anyone about it at the time, or reported it to the police.

I have clear memories of three such episodes from my childhood, one of which involved a man who owned a store in my neighborhood. Not knowing at age 11 anything about reproduction (in 1952, expectant teachers had to take leave when they “showed”), I was terrified that I could become pregnant from having been forced to touch his penis.

I had trouble sleeping, and I avoided the block where the store was. Yet, fearing that the assault was somehow my fault, I said nothing to my parents.

Experts on sexual assault and rape report that even today, despite improvements in early sex education and widespread publicity about sexual assaults, the overwhelming majority of both felony and misdemeanor cases never come to public or legal attention.

It is all too easy to see why. More often than not, women who bring charges of sexual assault are victims twice over, treated by the legal system and sometimes by the news media as lying until proved truthful.

“There is no other crime I can think of where the victim is more victimized,” said Rebecca Campbell, a professor of psychology at Michigan State University who for 20 years has been studying what happens legally and medically to women who are raped. “The victim is always on trial. Rape is treated very differently than other felonies.”

So, too, are the victims of lesser sexual assaults. In 1991, when Anita Hill, a lawyer and academic, told Congress that the Supreme Court nominee Clarence Thomas had sexually harassed her repeatedly when she worked for him, Ms. Hill was vilified as a character assassin and liar acting on behalf of abortion-rights advocates.

Credibility became the issue, too, for Nafissatou Diallo, an immigrant chambermaid who accused the head of the International Monetary Fund, Dominique Strauss-Kahn, of forcing her to perform fellatio in a Manhattan hotel room. Prosecutors eventually dropped the case after concluding that Ms. Diallo had lied on her immigration form and about other matters, though not directly about the encounter with Mr. Strauss-Kahn.

When four women, two of whom identified themselves publicly, said they had been sexually harassed by Herman Cain, the Republican presidential hopeful, they, too, were called liars, perhaps hired by his opponents.

Charges of sexual harassment often boil down to “she said-he said” with no tangible evidence of what really took place. But even when there is DNA evidence of a completed sexual act, as there was in the Strauss-Kahn case, the accused commonly claim that the sex was consensual, not a crime.

“DNA technology has not made a dramatic change in how victims are treated,” Dr. Campbell said in an interview. “We write off a lot of cases that could be successfully prosecuted. It’s bunk that these cases are too hard to prosecute.”

Victims must be better supported with better forensics, investigations and prosecutions, Dr. Campbell said. “This is a public safety issue. Most rapists are serial rapists, and they must be held accountable.”

In one study, published in 1987 in the Journal of Interpersonal Violence, 126 admitted rapists had committed 907 rapes involving 882 different victims.

Rapists are not the only serial sexual offenders. Witness the all-too-frequent revelations of sexual abuse of children involving multiple victims and persisting for decades even when others in positions of authority knew it was going on.

In the latest such scandal, an assistant football coach at Penn State University stands accused of molesting 10 boys. The charges led to the firing of a revered head coach, Joe Paterno, and forced the resignation of the university president for failing to take more immediate action.

The Risks

Last year, according to the Department of Justice, 188,280 Americans were victims of sexual violence.

Among female victims, nearly three-quarters are assaulted by men they know — friends, acquaintances or intimate partners, according to federal statistics.

But fewer than 40 percent of rapes and sexual assaults are reported to the police. Underreporting is more common among male victims and women raped by acquaintances or domestic partners. Only one-quarter of rapes are committed by strangers.

The result of underreporting and poor prosecution: 15 of 16 rapists will never spend a day in jail, according to the network. Dr. Judith A. Linden, associate professor of emergency medicine at the Boston University School of Medicine, reported in The New England Journal of Medicine in September that in the United States, “fewer than half of rape cases are successfully prosecuted.”

Victims may be reluctant to report a rape because they are embarrassed, fear reprisals and public disclosure, or think they won’t be believed. “Victims often think they somehow brought it on themselves,” said Callie Rennison, a criminologist at the University of Colorado in Denver. “Rape is the only crime in which victims have to explain that they didn’t want to be victimized.”

These feelings are especially common among college women who may have been drinking alcohol or taking illicit drugs when raped by a date or acquaintance.

Victims may not realize that any form of sexual behavior that is not consented to and that causes discomfort, fear or intimidation is considered sexual assault in most jurisdictions. That includes indecent exposure, unwanted physical contact (including kissing and fondling) and lascivious acts, as well as oral and anal sex and vaginal rape, whether with a body part or an instrument.

A minor — in general, 16 or 17, depending on the state — can legally consent to sexual activity. A person of any age who is forced or threatened, developmentally disabled, chronically mentally ill, incapacitated by drugs or alcohol, unconscious or preparing to undergo a medical procedure cannot legally consent to sexual activity.

Among young children, girls and boys are equally at risk of being sexually abused. But as they age, girls increasingly become targets; among adults, women represent about 90 percent of cases.

Experts have long debated whether rape should be seen as an act of aggression and control or the product of an irresistible sexual urge. To the victim, the distinction is moot.

The consequences can include pregnancy and sexually transmitted disease; feelings of helplessness, hopelessness and low self-esteem; self-blame and depression; substance abuse and eating disorders; fears of intimacy; numbness; post-traumatic stress disorder (nightmares, flashbacks, anxiety attacks, difficulty functioning); borderline personality disorder; unexplained physical problems; and even suicide.

Thus, even if rape victims choose not to report the attacks, prompt medical attention and psychological counseling can be critically important to their long-term well-being.

Next week: care for victims of sexual assault.

This article has been revised to reflect the following correction:

Correction: December 15, 2011

The Personal Health column on Tuesday, about factors that stifle the reporting of sexual assault, described the law on sexual activity involving minors incorrectly. The legal age of consent in many states is 16 or 17, so it is not the case that “a minor cannot legally consent to sexual activity.”

This article has been revised to reflect the following correction:

Correction: December 17, 2011

The Personal Health column on Tuesday , about factors that stifle the reporting of sexual assault, using outdated information from an advocacy group’s Web site, misstated the number of Americans who were victims of sexual violence last year, according to the Department of Justice. It is 188,830 — not 272,350, the corresponding figure from 2006. (The error was repeated on Thursday in an article about a survey by the Centers for Disease Control and Prevention on sexual violence and domestic abuse.)


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