Coping With Sexuality Following Adult Sexual Violence

In This Post

Featured Article
Article Title
Authors
Abstract
Keywords
Summary of Research
Translating Research into Practice
Other Interesting Tidbits for Researchers and Clinicians

Featured Article

Traumatology | 2025, Vol. 31, No. 2, p. 325 - 336

Article Title

Coping With Sexuality Following Adult Sexual Violence: A Qualitative Interview Study of Adult Survivors’ Experiences

Authors

Dagmar Stockman; Familylab, Department of Experimental Clinical and Health Psychology, Ghent University; Expertise Network People and Society, Artevelde University College of Applied Sciences; Faculty of Psychology and Educational Sciences, Campus Kulak, Catholic University Leuven

Lesley Verhofstadt; Familylab, Department of Experimental Clinical and Health Psychology, Ghent University

Hanna Van Parys; Department of Psychiatry, Ghent University Hospital, Ghent University

Jan De Mol; Faculté de Psychologie et des Sciences de l’Education, Université Catholique de Louvain

Heather Littleton; Lyda Hill Institute for Human Resilience, University of Colorado

Ines Keygnaert; International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University

Gilbert Lemmens; Department of Psychiatry, Ghent University Hospital, Ghent University; Department Head and Skin, Ghent University

Kasia Uzieblo; Department of Criminology, Vrije Universiteit Brussel; Forensic Care Specialists, Van der Hoeven Clinic, Utrecht, The Netherlands

Abstract

Studies have shown that experiencing adult sexual violence affects female and male survivors’ sexuality in multiple ways, including leading to decreased sexual satisfaction, increased sexual dysfunction, changes in sexual frequency, and increased sexual risk behavior. The available evidence, however, fails to capture how female and male survivors learn to manage these challenges and even experience empowerment. Therefore, the aim of the current study is to utilize qualitative interview data to shed light on survivors’ post-assault sexuality experiences. A sample of four male and 10 female adult sexual violence survivors completed a semistructured interview about the psychosocial impact of sexual violence on their lives. A reflexive thematic analysis revealed that coping with post-assault challenges in sexuality was characterized by a process of becoming aware of their own sexual needs and trying to communicate these to their partners. This was demonstrated to be an ongoing and nonlinear process. Respondents explained how they alternately and simultaneously utilized different approaches to understand their needs, with some survivors’ experiences reflecting eventual empowerment with regard to their sexuality. The current study illustrates the importance of assessing survivors’ sexual experiences following an assault and supporting them in managing the sexual challenges they are faced with in an adaptive way that could facilitate future sexual empowerment.

Keywords

sexual violence, sexual trauma, sexual empowerment, reflexive thematic analysis

Summary of Research

“Sexual violence is defined as any sexual act against someone’s will… Survivors of adult sexual violence may experience both short- and long-term consequences (Jina & Thomas, 2013). They can suffer from immediate (e.g., [genital] physical injuries; K. M. Kennedy, 2013) and long-term physical consequences. Alongside the physical impact, survivors are often psychologically affected by the assault. Survivors may experience feelings of shock, disbelief, shame, and guilt immediately following the assault. They may experience increased vigilance and hyperarousal (e.g., an exaggerated startle response) as well as cognitive difficulties… Given the profound impact of sexual violence on survivors’ lives, as documented above, it is not surprising that sexual violence also affects survivors’ sexual health… Ample studies in mostly women have documented the impact of experiencing adult sexual violence on survivors’ sexuality. Insight into male survivors’ experiences and an understanding of survivors’ coping efforts to tackle this adverse impact and to develop a sense of sexual empowerment is, however, currently lacking” (p. 325 - 326).

“Taken together, myriad studies have shown that survivors’ sexuality can be affected by a sexual assault in multiple ways. Most studies suggest that the assault can negatively affect survivors’ sexuality (e.g., increased sexual dysfunction, decreased sexual assertiveness, using sex as an affect regulation strategy, and increased sexual risk behavior). At the same time, some studies suggest female survivors can experience sexual empowerment or growth. However, it remains unclear if men have similar experiences of postassault sexual growth. In addition, it is unknown what actions survivors undertake to adaptively cope with the impacts of sexual assault on their sexuality and how they can achieve feelings of sexual empowerment. Therefore, the current study sought to answer the following research question: “How do women and men cope with the adverse impact of sexual violence on their sexuality?” To this end, we carried out a qualitative interview study in survivors and conducted a reflexive thematic analysis on the interview data” (p. 327).

“Fourteen survivors participated in the interview study. All were White, lived in Flanders (i.e., the Dutch-speaking region of Belgium), and were between 19 and 61 years old. Ten were identified as women, and four as men. Seven were single, two were married, and five were in a dating/ romantic relationship… Alongside our inclusion criteria (i.e., individuals 18 years or older who experienced one or more instances of sexual violence after the age of 16), the definition of sexual violence (i.e., any sexual act against someone’s will, committed by any person regardless of their relationship to the victim, in any setting; WHO, 2015, p. 4) was provided… The interview was semistructured and included questions regarding the impact of their experience of sexual violence and participants’ meaning-making process” (p. 328).

“A first main conclusion is that coping with the assault aftermath on one’s sexuality is a nonlinear and iterative process. It consists of gaining self-knowledge about one’s own desires and boundaries and being able to communicate these actively. Survivors reported having gained insights into their own sexual behavior and undesired sexual patterns in multiple ways. Some, for instance, reported alternating periods of increased and decreased sexual frequency within sexual, dating, and romantic relationships, in both cases as a means to cope with their feelings of loss of control over their own body and feelings of distrust in others. In addition, survivors reported engaging in sexual relationships to avoid feeling alone… However, over time, respondents realized they regretted these sexual relationships more often than they actually enjoyed them” (p. 332).

“For others, receiving psychotherapy and engaging in meditation techniques helped in identifying whether and how they wanted to experience their sexuality. In therapy, for instance, survivors gained insight into their sexual relationship patterns and in what way these sexual contacts were an actual reflection of their sexual desire rather than a reflection of another unfulfilled need (e.g., the need to be loved, the need to feel a sense of control or agency). Through meditation, survivors were able to more accurately identify the emotions and needs underlying their sexual actions (e.g., having sex with multiple sex partners). Some then tried fulfilling these needs in other ways. For instance, the need for control and agency can be met by experiencing their sexuality within a predetermined context, such as within a polyamorous community, by engaging in BDSM, and by visiting sex workers” (p. 333).

“A second main conclusion we can draw from our thematic analysis is that some respondents have, at one point during their search process, succeeded in finding a way to reclaim their sexuality in a positive manner and felt sexually empowered. For some, sexual violence also contributed to a process of acceptance and constructively understanding themselves better in order to obtain a sense of agency. The process of gaining agency over their own sexuality can be considered a process of posttraumatic growth or growth following adversity” (p. 333).

“Our third main conclusion is that meaning-making processes and perceptions, and experiences of sexuality are interrelated. More specifically, how survivors perceived the assault influenced the way they experienced their sexuality and vice versa. This indicates the importance of continuing meaning-making processes in the aftermath of the assault” (p. 333).

Translating Research into Practice

“This study identified survivors’ coping efforts to manage their negative experiences with sexuality and engage in satisfying sexual experiences as well as experience empowerment. Several important clinical implications can be derived from our study results. First, it is important to assess how survivors experience their sexuality following an assault and how they perceive themselves sexually (i.e., their sexual self-schemas). In addition, attending to how survivors give meaning to the assault experience and postassault factors which influence this meaning making process is vital, as this can provide information on how certain sexual self-schemas developed postassault. Second, when working with survivors, it is essential to normalize feelings of loss of control to aid in acknowledgment regarding this loss. Additionally, clinicians can aid survivors in developing healthy sexual self-schemas and coping strategies that serve to increase their sense of control to reduce the likelihood survivors engage in sexual activities they regret afterwards (and which may increase their risk for further victimization). Third, helping survivors identify their own needs and assisting them in communicating their needs to intimate partners is crucial. In addition, clinicians can support survivors in gaining insight into the various factors (e.g., societal ideas) that play a role in these needs. It is vital for survivors to be able to create a safe, trusting context in which they can experience their sexuality. Fourth, supporting already existing coping efforts that are helpful for survivors is important. Since each survivor’s way of coping is personal, their coping efforts might be less common or even labeled unconventional. However, as long as these are not harmful for their well-being or that of others, clinicians should keep an open mind. A thorough assessment is, however, necessary to avoid harmful effects of seemingly helpful coping efforts” (p. 334).

Other Interesting Tidbits for Researchers and Clinicians

“Some limitations of the current study need to be addressed. First, our interview study’s focus was broader than sexuality, as evidenced by our interview guide. Therefore, it is possible we did not identify important processes regarding survivors’ sexual experiences following an assault. Nevertheless, by considering contextual influences that might also play a role in respondents’ sexual experiences, we were able to view the respondents’ sexual experiences from an ecological perspective. However, we acknowledge that conducting an interview study that is mainly focused on the sexual impact following sexual violence might be beneficial to identify more in-depth patterns regarding survivors’ sexual relationship experiences.

Second, although we tried to obtain a homogeneous sample, our respondents had a diverse background regarding gender, time since the last sexual violence experience, history of child abuse, etc. Therefore, it is possible we were not able to gain a thorough in-depth understanding of the impact of adult sexual violence on survivors’ sexuality. This diversity is, however, a reflection of reality and might contribute to the richness of our data. At the same time, our sample consisted of all White, all cisgender, mostly heterosexual survivors who had experienced sexual violence more than 2 years ago. Therefore, our findings are unlikely to generalize to the relationship experiences of survivor populations of different cultural backgrounds, lesbian, gay, bisexual, transgender, queer or other survivors, or survivors of more recent violence (Lincoln & Guba, 1985). To address this limitation, a purposeful sampling strategy aimed at including survivors from ethnic or sexual minority backgrounds could enhance our understanding of sexuality experiences within these specific groups (Palinkas et al., 2015). Additionally, our sample primarily consists of survivors who underwent (attempted) rape incidents more than 2 years ago, perpetrated by individuals of various types. This raises concerns about potentially overlooking patterns in sexuality experiences associated with victimological characteristics. To address this, future research could benefit from adopting a purposeful sampling strategy to explore how sexuality experiences differ among survivors with distinct assault backgrounds, such as stranger assault versus incidents involving a dating partner.

Third, and typical for research with sexual violence survivors, we only obtained interviews from survivors who were willing to disclose and discuss the experiences our study aimed to research. Individuals who are unable or unwilling to discuss their experiences with sexuality after sexual violence likely hold a substantially different perspective on posttraumatic sexuality and coping mechanisms for the challenges they face.

Fourth, the data analysis was primarily conducted by Dagmar Stockman. Reflexive thematic analysis assumes that researchers themselves are the medium by which meaning is derived from the data (Braun & Clarke, 2021b). Therefore, having only one perspective that is in responsible for the entire data analysis process might affect the results. However, the current study addressed this issue by paying particular attention to issues related to reflexivity and triangulation of the data by multiple individuals with diverse experiences and perspectives (Guion et al., 2011; Tufford & Newman, 2012)” (p. 334).