Global figures estimate that around one in six women will experience sexual assault during their lifetime. These figures are not only high but also extremely concerning, given that sexual assault is a deeply traumatic experience for someone to go through.
The psychological consequences of sexual assault, such as post-traumatic stress disorder (PTSD), anxiety and depression, are well known. But most people are less aware that sexual violence can also affect a person’s physical health – for sometimes months or years to come.
Existing research in this area has mostly focused on pelvic pain, gastrointestinal problems, or short-term pain in the months following an assault.
But as we found in our recent study, survivors of sexual assault can often experience persistent physical symptoms across the entire body for many years after being attacked or assaulted.
These symptoms fall under what clinicians call functional somatic disorders. These are conditions with persistent physical symptoms that aren’t fully explained by other medical or mental health conditions. And they can cause significant distress and seriously affect a person’s daily life. These include conditions such as Fibromyalgia, ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome), and irritable bowel syndrome (IBS).
Hidden trauma
As part of our recent research, we used data from a large Danish health study that followed thousands of adults over several years, looking for how many of those people had a functional somatic disorder at a given time, and how many would develop a functional somatic disorder over time.
What we found in our study was that people who had experienced sexual assault were 69% more likely to report or develop ongoing physical health problems compared to those who had not experienced sexual violence.
The risk of developing more widespread health problems (meaning several persistent and bothersome symptoms affecting different parts of the body) was six times higher among survivors of sexual assault in our data.
Overall, survivors reported more symptoms. And these symptoms were often more severe and affected multiple parts of the body.
Findings from our earlier study also found that the more severe the assault, the greater the risk of developing long-term physical health problems.
pexels polina zimmerman, CC BY
In our research we also found that sexual assault appeared to have a particularly strong impact compared to other forms of abuse, such as emotional and physical abuse. This is probably because sexual violence can activate several stress‑related systems in the body.
Sexual trauma can disrupt emotional regulation and keep the body in a prolonged state of physiological alert. Over time, this may make pain and other bodily sensations harder to regulate. Trauma can also heighten sensitivity in the nervous system, so signals that would normally fade can instead become amplified. For some, it seems this can then become entrenched and may contribute to the development of functional somatic disorders.
Lasting impact
As our recent research shows, sexual assault is not only a severely traumatic experience for someone to go through. But it’s also an important public health issue. With potential long-lasting consequences for a person’s mental and physical health.
Indeed, these findings suggest that some people with unexplained pain or persistent somatic symptoms may carry a hidden history of trauma. Even if they do not disclose these experiences directly to a doctor.
It’s clear then that there needs to be a greater recognition of the connection between sexual trauma and physical symptoms within the medical system. At sexual assault referral centres, for example, professionals could make survivors of sexual assault aware of the possibility of long-term somatic symptoms as well as psychological ones.
This may help to normalise someone’s experience of sexual violence. It may also help to reduce shame and ensure that treatment encompasses the full spectrum of the trauma’s impact.
pexels/yankrukov, CC BY
On a wider level, sexual assault should be considered a significant risk factor for both mental and physical health difficulties. And more must be done to inform doctors and nurses in all areas of healthcare about the hidden health risks of sexual assault and rape.
Indeed, raising awareness and improving understanding would lead to more validation of survivors’ experiences and greater trust in healthcare systems for patients.
This is important because supporting someone after sexual violence means more than just treatment – it means care that understands trauma and that gives survivors the support they truly need.
This article was commissioned as part of a partnership between Videnskab.dk and The Conversation.
Sofie Abildgaard Jacobsen receives funding from The Danish Victims Foundation. She is affiliated with SundFornuft – Tænketanken for Sundhedspolitik (Common Sense – The Health Policy Think Tank).
