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Most sexual violence is hidden and most victim/survivors remain silent.

The World Health Organisation estimates that 1 in 3 women experience physical/sexual violence during their lifetimes but these rates vary across countries, cultures, ethnicity, age, gender and sexual identity. What does not vary is that the majority do not report it.

How does this impact the mainly women and girls but also men and boys, who have gone through sexual trauma? Sexual assault can result in obvious physical impacts such as death, injury, sexually transmitted disease, pregnancy, sexual or gynaecological problems. Even greater and lasting harm is psychological as almost all sexual assault survivors experience significant post-traumatic symptoms. Perhaps more important is the legacy of that trauma throughout the rest of their lives.

The emotional echoes of sexual violence has been described as ‘rape trauma syndrome’, a recent overview of all studies on the topic (meta-analysis) concluded that sexual assault was strongly associated with suicide, post-traumatic stress disorder (PTSD), depression, anxiety, disordered eating, alcohol and drug use and potentially other forms of mental disorder such as obsessive compulsive disorder and bi-polar disorders. International research showed that the emotional impacts were more serious than being shot or stabbed.

Sexual assault in your past predicts sexual assault in your future, experience of sexual abuse before 17 is linked to being targeted again.

Despite the significant impacts on physical and mental health, most do not get help after a sexual assault.

For obvious reasons, finding out who remains silent is impossible, what we do know is most don’t tell formal agencies such as the police. Greater numbers may divulge within surveys but the figures we have are likely to be only the tip of the iceberg.

Being young is a risk factor (48% sexually assaulted under 8 told no one) but also the nature of the incident plays a role. Stranger attacks with physical violence fit societies ‘rape’ myth stereotype. Many women will only try to report to the police incidents which fall within popular notions of ‘rape’ because of fear of not being believed.

Nondisclosure can be both conscious, wanting to avoid shame or blame, but also unconscious as being coerced into sex (particularly within relationships) may be read as normal. Normal reactions to trauma may also block recall.

From research into sexual assault on university campuses in the US, 50% of victims said they said nothing as they were confused about what had happened and 40% felt they couldn’t as they had been drinking or using drugs (therefore fearing blame or blaming themselves).

Self-blame seems to silence many and the further you move from commonly held rape myths (especially being male) the less likely victims/survivors are to report.

However, most will eventually tell someone, this (especially in the young) is more likely to be an informal source. Friends and family reactions are more likely to mirror rape myths and victim blaming such as, ‘did you have to much to drink?’, ‘but he seems such a nice guy; or that focus on ‘helping’, pushing victims to formally report. Bad experiences of telling for the first time can stop someone taking the risk again, attempt to cope alone, blocking help and amplifying PTSD.

Sexual bullying mirrors the landscape of powerless in our societies. US research shows that African American women are even less likely to tell, with the expectation from experience that services will not listen and are racist.

What we know about sexual violence is based on the minority who report and those experiencing harm and trauma are cut off from the help available to prevent some of the longer term suffering.

Women’s account bare witness often to their own sense of confusion about what happened, how much they were to blame or how much others would blame them. High profile examples such as the testimony of Dr Christine Blasey Ford, evidence the pointlessness and personal cost of telling. It feels as if victim/survivors are put in an impossible position.

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