“What We’re Reading” is a new feature of Trauma Research Notes. Check back or follow us to explore connections between TSS Group research and the fiction and nonfiction we’re reading.
Surfing online news or social media means bumping into headlines about gender differences on a regular basis. Catchy claims, such as “Meet the neuroscientist debunking the age-old myth of the gendered brain” and “Gender-specific brain cells have just been discovered inside the brains of mice,” beckon us to click.
Despite all the headlines, many researchers caution against looking for gender differences unless you have a really good reason to do so – a specific hypothesis you want to test about gender. The reason for the caution is that when you carve the world up into one gender versus another, you often find differences. Figuring out if those gender differences matter in the real world is tricky. Figuring out what they mean is even trickier.
Gender differences can lull us into a deceptively simple view of the world. One in which complex issues get boiled down to biological or social differences between groups.
And that’s a real problem when we’re talking about trauma and violence.
I was thinking about this trouble with gender differences while reading a recent Washington Post article. The headline announced: “Women are more than twice as likely as men to suffer from PTSD. Studies are underway to find out why.”
The article informed readers that girls and women are more likely to be sexually assaulted and to experience violence earlier in life than boys and men. Both of these factors – sexual violence and the developmental timing of trauma – likely play a role in gender differences in posttraumatic stress disorder (PTSD).
The article then cataloged other differences between men and women that might be relevant to making sense of the fact that women have higher rates of PTSD than men. For example, men and women vary on sex hormones and genetics. They process emotions differently. Men seem better able to “unlearn” fear than women.
Pretty soon, readers are left wondering: What is it about women’s biology-emotions-thinking that causes them to end up with PTSD so much more often than men?
This focus on women’s bodies and minds has potential upsides. Focusing on what’s unique about women’s genes, learning, stress hormones, and so forth might lead to improvements in treatments for women. Developing and disseminating effective treatments for girls and women experiencing PTSD is, of course, incredibly important.
But, we risk getting lulled into think that PTSD can be reduced down to something about women’s bodies and minds.
When we do that, we miss how the contexts in which girls and women live affect their chances of being victimized and their responses to violence.
We know a lot about the contexts in which violence happens to girls and women. For example, perpetrators are most often someone known by survivors, even trusted and loved. When survivors seeks support from friends and family, they commonly face blame and disbelief.
We also know that violence is terribly common in the lives of girls and women. One in 16 girl’s first sexual experience will be rape. One in 5 will be sexually assaulted in college. Once victimized, girls and women frequently experience new incidents of violence – referred to as revictimization.
After violence, girls and women face systemic problems that block their access to justice and minimize the importance of stopping violence. For example, their cases rarely lead to guilty verdicts. Legislators have refused to advance much needed legislation, such as reauthorization of the Violence Against Women Act (VAWA). Some states, such as Maryland, have refused to close loopholes that make prosecuting marital rape difficult.
The sheer frequency of violence and lack of access to justice tells girls and women that it’s on them to avoid being victimized, as I discussed in a recent Denver Post Guest Commentary. Talking about biological or emotional differences across genders or sexes without speaking to the context in which girls and women live does nothing to correct that message.
Betrayal, belief/disbelief, lack of access to justice, and cultural messages about violence are all part of the fabric of violence against women in America. Talking about that fabric reminds us to keep asking how we help individuals while also working to change cultures and fix systems.
If we don’t ask questions about culture and context in tandem with asking how to help women diagnosed with PTSD, we leave the impression that the primary problem is with the women themselves — with how they respond to violence.
We have to keep talking about the systemic problems: That violence is common place and our society responds poorly when violence happens.
More than 20 years ago, Dr. Judith Herman wrote in her landmark book, Trauma and Recovery, that traumatic stress had gained legitimacy as an area of study. This was a huge achievement, given the tendency across history to ignore trauma, especially violence against girls and women. She cautioned, though:
In this new, more conventional phase of scientific inquiry, there is some cause for concern that integrative concepts and contextual understanding of psychological trauma may be lost, even as more precise and specific knowledge is gained. The very strength of recent biological findings in PTSD may foster a narrowed, predominantly biological focus of research. As the field of traumatic stress matures, a new generation of researchers will need to rediscover the essential interconnection of biological, psychological, social, and political dimensions of trauma (Herman, 1997, p. 240).
My colleague Dr. Kathy Becker-Blease echoed some of Herman’s concerns in a commentary on our new trauma-informed age (the commentary is available here). In the commentary, Becker-Blease explores the rise in popularity of trauma-informed, well, everything. She argues that some of what we’re calling trauma-informed is just common sense or competent practice – not necessarily specific to trauma.
Most importantly, she reminds us that much of the current focus of trauma-informed approaches is on individuals. We have to remember the culture and context.
There is an emphasis on responding more appropriately to individual pathology. This is in contrast to models of trauma-informed care, and a long history of clinical work and research, that emphasize connecting personal experiences to broader social systems that give rise to trauma and oppression, victim/survivor empowerment, and relationship building (Gómez, Lewis, Noll, Smidt, & Birrell, 2016; Rosenthal, Reinhardt, & Birrell, 2016). (Becker-Blease, 2017, p. 133)
Cheers to the Washington Post and the experts cited in the article for getting information about PTSD into public view. We need more dissemination and translation of science in newspapers and other media. We also have to make sure the conversation we have reflects the complexity of the phenomenon.
As scientists, practitioners, and policy makers, we have to keep using science to advocate for better interventions for all survivors. But we can’t let the conversation stop with a focus on women’s bodies and minds. Sexual assault and other forms of violence against women are, at their core, a civil rights violation – a human rights violation. From each of our platforms, we have to keep demanding societal change along with the best possible care for survivors.