Recently released national research showed that one in sixteen adolescent girl’s first sexual experience is rape. In a new Denver Post Guest Commentary, Anne DePrince talks about the messages conveyed when violence is so common. And the messages we need to send instead.
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“Starless” and the non-fiction reality of violence against women: #couldbemetoo
Since my day-job focuses on trauma and violence, my off-the-clock reading tends towards fantasy and science fiction. I tell people this is my escape, though fantasy and science fiction often reflect back our day-to-day world in stark and profound ways. I was reminded of this recently while reading Jacqueline Carey’s Starless.
Starless opens as you meet Khai, who has been raised as an “honorary boy” in a brotherhood of warriors. At birth, a set of circumstances (read the book) revealed that Khai’s destiny would require him to be a warrior. Raised by the brotherhood, he becomes a skilled fighter by a young age, and a blooded-warrior after killing in battle.
Not until after he becomes a blooded-warrior does Khai learn that he was born a girl and raised a boy. While the length of the novel grapples with what this means to Khai, one particular sentence captivated me. Khai describes:
…I hugged my knees to my chest, unconsciously protecting a body that felt considerably more vulnerable than it had yesterday.”
Khai’s observation reveals much about the gendered nature of vulnerability in our non-fiction world. Vulnerability isn’t inherent to a female body. Rather, it is born of the historical and current reality that violence against girls and women is horribly common. One in four girls are sexually abused in childhood. One in five women are raped in their lifetimes. An average of 137 women are killed each day by family members or partners around the globe. Black trans women are disproportionately likely to be killed. And gender-based violence often goes without accountability for offenders or justice for survivors.
These statistics are brought to life in stories that have been shared for centuries among girls and women, once over clotheslines and today across #metoo posts. Each #metoo is a testament to survival and a reflection of a persistent reality for girls and women: that it could be you too.
What happens if we name this vulnerability? Maybe something like #couldbemetoo.
With a name, we can start to see the long shadow cast by growing up with awareness that it #couldbemetoo, affecting how girls and women organize their lives. From opportunities they do and don’t take to how they navigate homes, schools, and offices.
When women are victimized, they are often blamed for the violence they experienced. The implication is that they were supposed to know the #couldbemetoo risk and plan accordingly to avoid being victimized. They shouldn’t have dated that guy, had that drink, taken that job, gone to that school, worn that outfit, worked at that time of day. The list is wearying and suffocating.
All this got me thinking about questions I sometimes get when I talk about gender-based violence that go something like: Aren’t boys and men victims too? (Spoiler alert: Yes.) Then, why talk about gender-based violence? What’s gender got to do with it anyway?
Boys and men are victims of violence – and all intimate violence, regardless of the survivors’ gender, is preventable and unnecessary. Focusing on girls and women is not a negation or effort to ignore boys’ and men’s experiences. Rather, it’s a recognition that girls and women are disproportionately victimized by intimate partners. And that there are dynamics — due to the gendered nature of intimate abuse and the gendered nature of the world in which we live — that warrant attention.
Naming gender helps us recognize the vulnerability of living life knowing it #couldbemetoo, borne primarily by girls and women.
In fact, our country communicates every single day to girls and women that #couldbemetoo is a routine part of life and a burden they must shoulder. We communicate this each time that under-resourced communities can’t offer prevention programming. Or waitlists drag on for crisis services and interventions. Or offenders are not held accountable. Or Congress fails to re-authorize the Violence against Women Act (VAWA) to expand protections for Native, immigrant, and LGBTQ women.
The effect of our collective action (and inaction) is captured so poignantly in that moment when Khai expresses that to be a girl is to be vulnerable to assault, no matter how strong and well trained you are. Even if you’re a warrior.
In tolerating gendered violence, we let the shadow of knowing it #couldbemetoo stretch into the future, dimming the potential of a new generation of girls. We have to do better.
Of course, re-imagining and re-creating a world that is intolerant of violence against girls and women is daunting. Don’t worry, though – Khai has plenty to teach us about working together to change the world. So go ahead, read the book. And take some notes because tomorrow we have to get up and start building a new world where girls get to grow up expecting to be safe in their bodies.
Acknowledgements: Starless by Jacqueline Carey was published in 2018 by Tor Books; quote p. 127. Thank you to Naomi Wright, Susan Buckingham, Julie Olomi, and Lindsey Feitz for comments on an earlier draft.

Launching New Study: Intimate Partner Abuse (IPA) and Traumatic Brain Injury (TBI)
Blows to the head are common among women experiencing intimate partner abuse (IPA), as documented in recent research nationally (e.g., Corrigan, Wolfe, Mysiw, Jackson, & Bogner, 2003; Wilbur et al., 2001) and from the Traumatic Stress Studies Group (Gagnon & DePrince, 2017). Despite prevalence data, traumatic brain injury (TBI) and IPA have received scant policy and research attention. For example, the Centers for Disease Control and Prevention’s 2015 report to Congress, Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation, failed to even mention IPA.
Victim service providers, recognizing the occurrence of TBIs among clients, have begun to integrate traumatic brain injury (TBI) screenings into practice. Unfortunately, the lack of research on TBI and IPA means that there is not yet an adequate empirical base to inform practices for the use of TBI screenings in decision-making and treatment-planning for women experiencing IPA.
We plan to address these gaps in a new study.
With funding from MINDSOURCE Brain Injury Network (Colorado Department of Human Services), the Traumatic Stress Studies Group will collaborate with Drs. Julia Dmitrieva (Department of Psychology, University of Denver), Kim Gorgens (Graduate School of Professional Psychology, University of Denver) and the Rose Andom Center to answer key questions about TBI and IPA.
In particular, we have designed a study that promises to result in an empirically-informed approach to screening for TBI among women experiencing IPA. By partnering with the Rose Andom Center — a multidisciplinary facility that serves women who have experienced IPA — we will ensure that the research conducted is relevant to providers and ready for their use. We also hope that this research will advance understanding and awareness of links between IPA and TBI in Colorado — and nationally.
Stay tuned for more on this new study as we begin data collection later this year.

Supporting Survivors of Sex Trafficking
With the widely-reported sex crimes charges against Jeffrey Epstein, people are talking about sex trafficking and expressing outrage. We need to harness those conversations and that energy to work towards ensuring that our communities are prepared to respond to the trauma-related needs of sex trafficking survivors.
Here are a few lessons from a study involving in-depth interviews with eleven women who survived sex trafficking, which can be harnessed by communities to support sex trafficking victims and survivors:
Recognize the far-reaching consequences of trafficking as a betrayal trauma. Among the women interviewed, the most frequent trafficker was a family member or intimate partner, highlighting the role that betrayal by someone close plays in sex trafficking. Women commonly reported feelings of shame and alienation in relation to the trafficking. Thus, getting away from the trafficker may mean escaping abuse and losing a family member or partner at a time when women are alienated from other supports.
Traumas that involve betrayal can have far-reaching health and social-relationship consequences (e.g., Gagnon, Lee, & DePrince, 2017). Post-traumatic feelings such as shame and alienation are linked with psychological distress (e.g., DePrince, Chu & Pineda, 2011). Thus, supporting women as they heal from the consequences of betrayal trauma, including as they build new social support systems, may be particularly important. Social support plays a critical role in coping with traumatic stress (e.g., Schnurr, Lunney, & Sengupta, 2004; Brewin et al., 2000; Ozer et al., 2003).
Recognize the cumulative impact of traumas beyond sex trafficking. The women interviewed described having experienced many forms of trauma, such as experiences of forced sex, witnessing other people being seriously injured or killed, robberies, and physical abuse. Cumulative trauma exposure is linked with more severe traumatic stress symptoms (e.g., Martin et al., 2013)
Build referral networks that facilitate connecting women with services to meet complex psychological and physical health needs, regardless of the services that agencies themselves provide. Trafficking survivors interviewed in this pilot study reported high levels of posttraumatic stress disorder (PTSD) and depression symptoms. When asked about sixty different kinds of physical health symptoms, women reported experiencing an average of more than 18 different symptoms over the last year alone. Women’s health can affect their ability to engage with services and providers, even for things that seem unrelated to health, such as legal services.
Design communications to anticipate potential attention and memory problems. Nearly all of the women interviewed reported being struck in the head in their lifetimes, including multiple blows to the head resulting from violence. All of the women who had been struck in the head reported losing consciousness and/or being dazed/confused as a result. Head injuries as well as posttraumatic symptoms (e.g., PTSD, depression) can affect attention and memory. As a result, being clear in communications with survivors may be especially important as well as taking opportunities to repeat information over time. For more on such recommendations, check out a recent article on attention and domestic violence from our team (Lee & DePrince, 2017).
Leverage interactions to validate and support survivors. Women in this pilot study echoed what we have learned from survivors of other forms of intimate violence about interactions with service providers. For example, women in this sample described things that law enforcement officers did that were validating, such as:
- Letting survivors talk
- Believing survivors
- Asking survivors what they need
- Letting survivors know about resources
- Saying things such as: “It takes courage to come forward”
- Helping survivors feel protected and safe
- Providing clear explanations of what to expect
Take-Aways
Communities have a role to play in ensuring services are available and responsive to sex trafficking survivors’ trauma-related needs. Trauma-informed responses should take into account the potentially far-reaching psychological, physical health, and social-relationship consequences of sex trafficking. Agencies and providers can play an important role in conveying support for survivors and connecting them with resources.
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Study Notes
Study Background: The Denver Justice Project was a pilot study designed to assess the feasibility of doing research on the trauma-related needs of women who had survived sex trafficking. Eleven women who had been trafficked were interviewed by a woman-researcher. About half of women identified with one or more ethnic/racial minority groups and the majority had children; their average age was 37 years.
Study Limitations. The sample size was small. While results from samples with few people should be interpreted with caution, the findings are consistent with other studies from our team and nationally (e.g., Gagnon et al., 2018).
Acknowledgments: The study was funded by Campus Compact of the Mountain West (formerly Colorado Campus Compact). Thank you to community-and criminal justice-based agencies who assisted with participant recruitment. Thank you to student collaborators from the Traumatic Stress Studies Group, particularly Julie Olomi, Kerry Gagnon, Adi Rosenthal, Tejas Srinivas, Naomi Wright. This research has been presented at professional conferences and summarized in a past newsletter from the TSS Group.

Community-Based Providers Open Doors to Law Enforcement Reporting after Sexual Assault
by Anne P. DePrince & Naomi Wright
Sexual assault remains one of the most under-reported crimes to law enforcement. Communities need information about practices that support women’s autonomous decision-making, particularly given how deeply personal and complex such decisions can be. In a forthcoming Violence against Women article, we asked whether women’s reporting decisions were affected by the kinds of social reactions they received after disclosing the assault to other people.
Here’s the short answer: Women who received more practical help from community-based service providers were more likely to report to law enforcement. The longer version of the answer is important, too, because this finding has implications for community-coordinated responses to sexual assault (that is, responses that involve community-based and criminal justice agencies). So, let’s dig in further.
As Dr. Sarah Ullman and others have documented, women who disclose sexual assault can be on the receiving end of both positive and negative social reactions from other people. Positive social reactions can include emotional support and tangible aid. Tangible aid involves actions such as helping women obtain information about coping, helping them access healthcare or the police, and providing information and options. Negative social reactions can include blaming women, taking away their control to make decisions, and treating them differently because of the assault.
Earlier work from the Traumatic Stress Studies Group documented that women get more negative social reactions after disclosing sexual assault to friends and family, compared to criminal justice system personnel or community-based service providers. Community-based service providers offered the most positive social reactions.
One of the questions we asked in the forthcoming study was whether positive or negative social reactions to sexual assault disclosures were linked to women’s decisions to report to law enforcement. To answer this question, we turned to interviews with approximately 200 women who were sexually assaulted in the last year who also disclosed the assault to a community-based service provider, such as a medical professional or counselor. Just over half (56%) of women had reported the assault to law enforcement.
When we first interviewed women, those who had reported the assault to law enforcement also said they received greater tangible aid from both informal supports as well as community-based providers. Because we measured whether they had reported the assault and the social reactions at the same time, at least two interpretations were possible. Practical help from family and friends or community-based providers might have increased women’s likelihood of reporting to law enforcement. Or, friends and family as well as community-based providers might have rallied to provide practical help after women have made a report to law enforcement.
Next, we tried to untangle whether tangible aid leads to law enforcement reporting or if it might work the other way around. Recall that 46% of women had not reported to law enforcement when we first interviewed them. Over the next nine months, about 10% of women made a report to law enforcement. For these women, we were able to ask: does earlier tangible aid from family and friends or community-based providers increase the likelihood that women will report the sexual assault to law enforcement later?
Women receiving more tangible aid from community-based providers were more likely to report the sexual assault to law enforcement at some point over the next nine months. This finding is a big deal for policy and practice: Despite sexual assault being drastically under-reported, when community-based providers provided practical help in the aftermath of the assault, women’s engagement with the criminal justice system increased through reporting. These findings validate the importance of investing in community-coordinated responses to intimate violence that bring criminal justice and community-based professionals together.
While our study doesn’t answer why more tangible aid from community-based providers led to law enforcement reporting, we see several possibilities. The tangible aid that community-based providers offer might include information women need about reporting (what’s involved, where to go, how to make a report). In addition, positive experiences with community-based providers may demonstrate to women that formal responses to the assault can be useful, which might encourage women to try engaging with the criminal justice system. Further, the practical help women receive from community-based providers may reduce barriers to reporting. (For women’s advice to providers from their help-seeking experiences, see our earlier post)
Communities need victim-focused, trauma-informed practices that facilitate women’s autonomous reporting decisions following sexual assault. This research points to the important role that community-based providers can play in keeping doors open for women to engage with the criminal justice system if and when they choose to do so.
P.S. We’ll update this post with a link to the forthcoming article when it is available!
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Acknowledgements
This research was funded by the National Institute of Justice [Grant #2012-W9-BX-049]. The views expressed are those of the authors and do not necessarily represent the views or the official position of the National Institute of Justice or any other organization.
Thank you to our community partners who made this research possible, particularly Denver’s Sexual Assault Interagency Council.
The citation for the forthcoming article is DePrince, A.P., Wright, N., Gagnon, K.L., Srinivas, T., & Labus, J. (in press). Social Reactions and Women’s Decision to Report Sexual Assault to Law Enforcement. Violence against Women. Co-authors on the forthcoming article included TSS Group member Naomi Wright as well as TSS Group alums Kerry L. Gagnon and Tejas Srinivas.

The Wrong Lesson: The Radical Re-Write of the Definition of Sexual Harassment in the Proposed Title IX Rules
Only a handful of days remain to make public comments on the problematic Title IX rules proposed by Secretary of Education Betsy DeVos (comments have to be submitted by January 30). If you’re thinking about submitting a comment, there are resources available on writing an effective comment and plenty of reasons to get your keyboard. For example, the proposed rules will require survivors to submit to cross-examination by an advisor of the accused’s choosing and create significant barriers to reporting.
The proposed rules also include a radical re-write of the definition of sexual harassment that has serious implications for what we teach this country’s young people about why sexual harassment and assault matter.
The new rules require that schools dismiss complaints that do not involve “unwelcome conduct on the basis of sex that is so severe, pervasive, and objectively offensive that it effectively denies a person equal access to the [school’s] education program or activity” (§§ 106.30, 106.45(b)(3)). According to the new rules, then, sexual harassment only matters after severe harm has already occurred – such as after a survivor has already left school entirely. In this, the proposed rules say that harassment matters only because of the consequences to an individual survivor and not the occurrence of sexual harassment.
Here’s the problem – or at least a problem – with this approach. Imagine a man uses the same sexually explicit words and graphic images to abuse two different women. One woman leaves college; the other does not. Though the man engaged in the same behavior, what he did can be investigated as sexual harassment in one instance and not in the other. The proposed rule reverse-engineers the definition of harassment based on the way survivors react rather than the behavior of the harasser. This puts the onus of defining why sexual harassment matters on the shoulders of survivors: If they can’t demonstrate severe harm, it doesn’t matter that they were sexually harassed.
An enormous body of research clearly establishes that, on average, sexual harassment and assault result in short- and long-term physical, cognitive, emotional, interpersonal, and behavioral harm. Research also documents that the impact of sexual harassment and assault on survivors varies. Some women experience physical and mental health consequences; others don’t. Some women are aware of and able to describe the immediate impact of abuse, others aren’t. Saying sexual harassment matters only after survivors can demonstrate severe harm fails to recognize the diverse responses humans have to traumatic stress and perversely penalizes resilience in the face of abuse.
This is not to say that harm should not be considered in some contexts. For example, victims have to demonstrate that they suffered harm to get monetary restitution through the civil legal system following sexual harassment or assault. Having to demonstrate harm when asking for monetary restitution for harm makes sense. However, students who report sexual harassment and assault to their schools are not asking for financial damages – they are asking to learn in an environment where they are not sexually abused.
In my own field of traumatic stress, we have used research on the harm that results from trauma to make the case that that practitioners and policy makers should pay attention to traumatic stress. Studies in the 1980s and early 1990s, for example, were critical to documenting the psychological symptoms people often experience in the aftermath of traumas. That research led to establishing posttraumatic stress disorder (PTSD) as a diagnosis as well as increased policy, practice, and research attention to trauma.
So, documenting the harm that results form sexual harassment and assault to survivors has helped make the case that health and legal systems should pay attention to these forms of abuse. However, the new Title IX rules throw into sharp relief the limits of harm-based arguments, particularly when applied to individual students. For example, we know from work on trauma-informed schools that narrowly thinking about the impact of trauma on one student fails to recognize how trauma affects the learning environment for all. If sexual harassment matters to our schools only because it causes severe harm, and a particular student does not experience severe harm, then the new rules say sexual harassment doesn’t matter. That doesn’t make any sense.
In our larger national conversations, it’s time to step back from harm-focused reasoning to re-ask: Why do sexual harassment and assault matter to our schools?
Our educational system plays a critical role in socializing young people into the norms and values upon which our communities and democracy depend. Sexual harassment and assault violate a fundamental social contract between human beings who share the halls of schools and streets of neighborhoods: that we will not abuse each other in the most intimate way possible. If our educational system defines sexual harassment as mattering only when it causes harm to a specific person, we teach that abusing a person isn’t the wrong part. Abusing a person who is harmed is. That’s the wrong lesson – for schools and for society. And the wrong policy.