Women and Sexual Trauma Women are twice as likely to develop PTSD as men are. This may occur because women are also more likely to have sexual trauma both as children and as adults. Sexual trauma is considered to be an extremely adverse and traumatic event whenever it occurs and it is estimated that 1 in every 3 women will experience a sexual assault in their lifetimes. Effects of Childhood Sexual Trauma Women who experienced sexual abuse as children may find themselves having difficulties later in life if that trauma was not thoroughly addressed before. Many will seek counseling as adults when relationship issues and other difficulties related to having been abused arise. Childhood sexual abuse can affect self-image, self-esteem, body-image and the ability to manage intimacy in healthy romantic relationships. Consequently, these are often the issues that will cause women to seek counseling. Depression, anxiety, substance disorders and eating disorders are other common problems for which women who have been sexually abused will seek help. Parenting A history of childhood sexual abuse can also negatively impact parenting. Women who were abused as children may find themselves excessively preoccupied with their children's safety. Their vigilance may interfere with their children\u2019s development of age-appropriate autonomy, confidence and security. Women who were sexually abused may also have conflicted feelings about showing their own children physical affection or allowing others to do so. Since sexual abuse distorts the experience of touch, affection and adult\/child relationships, women may need support in determining healthy and appropriate parenting strategies. Related Disorders Many women suffer from chronic depression and anxiety which began during or shortly after periods of abuse. Some turn to the use of substances or food-related behaviors to cope with thoughts, feelings and memories that are distressful and persistent. If trauma-related symptoms occur for some time, women who consistently use unhealthy behaviors to cope are likely to also develop other disorders. Such women, if they must eventually seek recovery from coexisting substance disorders or eating disorders, may find that trauma symptoms initially recur or increase until different coping skills are in place. Relationships Sexual abuse survivors have experienced violations of their personal boundaries, trust, psychological and physical safety and sense of self. It is common for survivors to feel deep shame, guilt and even responsibility for their own victimization. It is also often difficult for survivors to understand and have healthy interpersonal boundaries. Some will become distrustful, keeping others at bay, while others will find any limit-setting or assertiveness difficult. Survivors of sexual abuse may not know how to navigate more balanced and less extreme ways of relating to others. Symptoms Sexual trauma experienced by both children and adults can cause a severe trauma reaction for a time or a more lasting one that will result in PTSD. Many survivors of sexual trauma are easily startled, reluctant to be touched (even lovingly), fearful and preoccupied with distressful memories and thoughts about the event. For some, touch, even in wanted physical intimacy, can trigger such symptoms as flashbacks, revulsion and fear. Other instances of appropriate touch such as medical exams can as well. Some survivors have an opposite response and become numb, apathetic or under-responsive to intimacy and touch. Periods of dissociation or extreme detachment may occur. Shame, Guilt and Internalized Blame It is common for both child and adult survivors of sexual trauma to blame themselves for their victimization and to feel profound guilt and shame about having been victimized. As a result, some children will conceal their abuse feeling themselves to have been bad or at fault. Additionally, perpetrators of abuse may convince children that they would get in trouble if others found out about the abuse. Adult victims may choose not to report an incident to the authorities or to pursue court protection or prosecution because of feelings of shame and guilt. This is especially true for women who are victimized by family members or intimate partners. Domestic Violence and Sexual Assault Women who are sexually assaulted by their intimate partners during an episode of domestic violence experience sex\u2014a healthy expression of affection and love, as an act of dominance, control and violence. Sexual aggression, such as rape or psychological coercion to participate in unwanted sexual behaviors, is a tactic of power and control used in battering. When this occurs within the context of intimate relationships, one's sense of trust and safety can be profoundly and adversely affected in all realms of daily life. Being victimized by others from whom protection, affection, respect and commitment are expected also creates a negative and distorted sense of one's own identity and self-worth. Feelings of abandonment and betrayal are common in such situations as is ambivalence about the \u2018love-hate\u2019 relationship with the abuser. Victims often blame themselves for the abuse, looking for personal faults and mistakes that can be corrected in order to prevent further abuse.