Sexual Assault: A Crime Against Women's Health

Dr. Nancy C. LeeEd. note: This blog is cross-posted from The original post date was April 14, 2014. Read the original post.

Content warning: sexual assault

In 1974, the women's liberation movement was in full swing. My class at Baylor College of Medicine had over 30 female students, more than in previous years. We felt powerful — like trailblazers doing our share for women and equality. As part of a commitment to helping other women, many of us volunteered to support sexual assault survivors who came into the teaching hospital's emergency room. Several times a month during that year, I left my house in the middle of the night to hold a woman's hand as she recounted the details of one of the worst experiences of her life. Though I had never been assaulted myself, I could feel her terror and pain. Walking back into my dark apartment, with these women's words still in my ears, I felt real fear. Would it happen to me?

Sadly, this is a question every woman has asked herself, and with good reason. According to the Centers for Disease Control and Prevention, about one in five women has been raped in her lifetime, and more than one in three has experienced other forms of sexual violence. Of women who have been raped, almost nine in ten were assaulted by someone they knew — more than half by a current or former intimate partner. These numbers are shocking. For those of us who work in women's health, they strengthen our resolve to prevent sexual assault and reduce the pain of the victims.

Many of these women experiencing sexual assault are young. Of all women who had ever been raped, over one-third were between 18 and 24 when it happened. During a time when they should be establishing their independence and figuring out adulthood, they instead face fear, confusion and alienation from friends and family. That's one reason President Obama established the White House Task Force to Protect Students From Sexual Assault, which will identify and share evidence-based best practices with high schools, colleges and universities to help them better protect students and support those who are assaulted.

An uncomfortable issue when contemplating sexual assault on college campuses is alcohol use. Research shows that 45 percent of college students binge drink at least once per month, and almost 100,000 students each year experience a sexual assault perpetrated by another student who has been drinking. There are many opportunities to reduce the frequency and quantity of college drinking, and hence reduce the associated sexual assaults. Prevention, intervention and treatment strategies that target the individual student, the student body, the college administration and neighboring communities have shown success in reducing how much and how often college students use alcohol.

And we cannot ignore the very real health consequences of sexual assault. The immediate after-effects can include physical injury, anxiety, post-traumatic stress, pregnancy, sexually transmitted infections and strained relationships. But even years later, a woman's risk of hypertension, depression, obesity, migraines, heart disease, chronic pelvic pain, gastrointestinal disorders, substance abuse and many other chronic health problems are increased because of the trauma. We must continue our research into the long-term effects of trauma and, most importantly, how to mitigate them.

In the meantime, women and their health care providers should be aware that past trauma can affect current and future physical and mental health. Under the Affordable Care Act, women have access to a comprehensive set of preventive services, including screening and counseling for interpersonal and domestic violence, without having to pay a co-pay or deductible. Health care providers are encouraged to take an active role in addressing sexual assault by incorporating screening into routine care, such as during a well-woman visit. Not only does screening help women get any immediate crisis care they need, the information will inform their current and future health care.

As the director of the U.S. Department of Health and Human Services' Office on Women's Health (OWH), I'm all too aware of the public health — and personal — impact of sexual assault and sexual violence. I am proud of OWH's long leadership in the area of violence against women, and we will continue to do more to change the trajectory of this crisis. I also applaud the efforts of the White House Task Force to Protect Students From Sexual Assault.

To women who have been sexually assaulted: Please know that it's not your fault, no matter how or where it happened. Don't buy into the nonsense that you were wearing the wrong thing or were in the wrong part of town, or your behavior brought it on. Get the help you need to deal with the immediate and long-term consequences of sexual assault. You cannot change what happened to you, but you can take control of your health, both physical and mental.

Please share this post with the women — and men — you love. Together, we can pledge to put an end to sexual assault.