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August 1, 2011 | by  | in Features |
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Student Health Service – Sexual assault: Potential Impacts

In my last article on sexual assault, I talked about a common scenario in respect of assaults reported to the Sexual Assault Assessment and Treatment Service (SAATS), specifically in regard to the experience of women. Today’s article will identify the multiple harms caused by sexual assault.

For instance, there are many potential physical health impacts. A variety of sexually transmitted infections (STIs), or alternatively the side effects of antibiotics given to prevent STIs, are possible. In the case of the female assault victim, there is the added risk of pregnancy, miscarriage, termination, or alternatively the (albeit mild) effects of the emergency contraception pill given to prevent pregnancy. In addition, a variety of injuries have been documented (but are not usual in presentations to SAATS) as being caused by sexual assault.

Of considerable concern are psychological harms which have been documented as being caused by sexual assault, but it is important to be clear that these are potential harms only because people react differently to different stressors.

Does it hurt or help to know about potential psychological harms? And again the answer is both. It helps because if we know that these effects have been documented as normal responses to a traumatic situation, then we know that with the right assistance we can work through them. It hurts because knowing about potential effects can have self-fulfilling outcomes and the knowledge itself can be oppressive.

Unsurprisingly, sexual assault may cause post-traumatic stress in the form of Rape Trauma Syndrome (RTS). For some, acute phase RTS symptoms, including fear and clinical shock, may be wide-ranging. These and other effects are exacerbated by:
• Social forces­ especially rape mythology
• Threats and force used during the rape and the commonly expressed fear of dying
• These may cause complete disorganisation of people’s lives in the immediate aftermath of rape.
Beyond the immediate psychological impacts, there is potential for long-term effects such as: sexual dysfunction, phobic reactions, intrusive thoughts and fear of solitude, or conversely withdrawal and social isolation. These can lead to compromised ability to function in usual work and social roles and therefore economic and social disadvantage.

Such disadvantage has also been clearly demonstrated in relation to childhood sexual assault/abuse. Children who have been sexually abused and leave home without the means of survival, in having been sexualised, may sell sex in order to live. If alcohol and drugs are accessed in coping with the consequences of this decision, this compounds the economic and social disadvantage.

Other long-term effects include the many possible somatically induced physical health effects which can occur due to the effects of severe stress on the immune system. These occur particularly if disclosures are inadequately responded to. It is evident then that sexual assault is a significant event warranting an equally significant systems response. I will talk about the medical/forensic response in my third and final article.

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