What to do if you are sexually assaulted

• Tell someone you trust, immediately. Before you change your clothes or wash, call your local rape-crisis hot line or women’s center—look under “rape” in the telephone book. They will send someone to help you.

• Get medical help. Have someone you trust with you. You may need emergency contraception as well as treatment for any injuries or infections you may have received. You may also be asked to agree to be physically examined for rape evidence.

• Decide whether you want to report the rape to the police or other authorities. If you do, you may have to recount what happened in detail.

• Take time to recover. You may want to take a few days off from work or school and find a safe place to stay for a few days.

• Get counseling. Recovery takes time and lots of support. You may choose to join a rape recovery group as well.

• Don’t blame yourself for what happened. No matter how you behaved, no one deserves to be raped.

Recovering from Sexual Assault

The effects of sexual assault include physical and psychological problems. Psychological effects include loss of self-esteem, impaired body image, eating disorders, anxiety, depression, and sexual inhibition and conflict. The victim may lose interest in sexual contact, be unable to become sexually aroused, or have flashbacks of the assault while trying to have sex with someone who is loved and trusted. Victims may feel dirty, ugly, and unloved. These painful responses are common. They may stress the victims’ relationships with their partners.

Rape trauma syndrome is the physical and emotional pain that begins during sexual assault and continues afterward. The acute phase begins with the assault and can last for several weeks. A woman may appear calm and controlled, or she may be very expressive. Her feelings may include anger, sadness, shame, shock, fear, anxiety, guilt, and a loss of control.

The acute phase is followed by the long-term reorganization phase, which may last a year or more. During this time, a woman tries to reorganize and regain control of her life. She may want to move, change her phone number, or look for a new job.

The silent assault victim does not tell anyone about her experience and will go through the process of rape trauma syndrome without the support of professionals or friends. Survivors who express their feelings to supportive professionals, families, and friends may be able to recover more completely and quickly.

Some women go through rape trauma syndrome a long while after the assault. The trauma may cause the survivor to deny the incident, even to herself. She may not be able to deal with her memories and feelings, and they become hidden within her, unremembered. She may feel hurt, sad, angry, and sexually inhibited and not know why.

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Here are some ways to avoid sexual assault:

• Have and use locks on doors and windows, and change the locks in a new home.

• Do not open your door to strangers. Ask for identification when service people come to the

door, and call the company to verify that they are on legitimate business.

• Always show self-confidence with your body language and speech when you are in public.

• Have first dates with groups of friends or in public places.

• Do not tell new acquaintances that you live alone. Use only initials on your mailbox and in the

phone book.

• Avoid controlling or demanding men who may try to control your behavior by planning all the

activities and making all the decisions.

• Share dating expenses. Men who are willing to share expenses may be less likely to use sexual

coercion to “get what they pay for.”

• Lock your car when you drive and when you park.

• Avoid dark and deserted areas and always be aware of your surroundings so that you can try to

get away if someone pursues you.

• Have house or car keys in hand before coming to your door.

• If your car breaks down, attach a white cloth to the antenna, lock yourself in, and wait for a

uniformed officer in an official car. If other people ask to help, tell them to call the police or a

garage, but do not unlock the car door.

• Carry a device for making a loud noise. Sound an alarm at the first sign of danger.

• Don’t lead anyone to believe you are more sexually available than you want to be.

• Avoid using alcohol or other drugs when you definitely do not wish to be sexually intimate

with your date.

• If assaulted, try to get away, but don’t struggle if the struggle seems to arouse your assailant.

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Painful intercourse occurs in women and men. It is often caused by infection and conditions like vaginitis. It is much less common in men, who may experience painful intercourse because of a physical condition such as a tight foreskin.

Dyspareunia is painful intercourse for women that may be caused by hormonal imbalances, especially those that happen after menopause. Dyspareunia also happens in up to one out of five women because her partner tries to have intercourse with her before she is fully aroused. Some women are so sexually inhibited that they are unable to let their partners know that they are in pain. Some are in poor relationships and fear telling their partners. Others have such fears and anxieties about sex that they mistakenly suppose that sex is naturally painful.

Vaginismus occurs when a woman’s fear and anxiety about vaginal intercourse cause the muscles around her vagina to go into spasm when her partner tries to insert his penis. Vaginismus was extremely common in the nineteenth century when women were taught to fear intercourse. Today, it is much less common. It results not only from fearful attitudes toward sex but also from sexual abuse, rape, brutal early sexual experiences, or painful pelvic examinations.

Dyspareunia may be relieved by open communication with partners who are prepared to be more attentive to a woman’s need for complete arousal before intercourse begins. Physical causes may be relieved by the use of medication, lubrication, or estrogen therapy. Vaginismus may be relieved by psychosexual therapy.

Sexual dysfunctions are often a combination of physical and psychological problems. Those caused by physical conditions often develop psychological challenges. That is why psychotherapy is an important component of holistic treatment of sexual dysfunctions and inhibitions

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The inability to have an orgasm is very common in women and very uncommon in men. It is the most common reason for women to seek sex therapy. About one-third of women experience inhibited orgasm. Up to 10 percent of women have never had an orgasm. This is called anorgasmia. Most women with inhibited orgasm have previous; reached orgasm during sexual intercourse, but no longer can. They may be able to have an orgasm while masturbating, but not during intercourse with their partners. Some women may not even know they can have an orgasm. Many women with anorgasmia enjoy their sexual experience and do not feel that orgasm is important for their sexual pleasure. Often, women are unable to reach orgasm during intercourse because intercourse does not last long enough, stimulation by the penis is not effective, or there is not enough manual stimulation of the clitoris by the woman or her partner. Inhibited orgasm is the failure to reach orgasm even though there has been sufficiently intense stimulation.

Inhibited orgasm in men is often called retarded, or delayed, ejaculation. These are somewhat misleading terms, however, because ejaculation and orgasm are different events, although they most commonly occur at the same time. In fact, some men with inhibited ejaculation have orgasms without ejaculating. Inhibited ejaculation and orgasm can be very frustrating for both partners. It may take a man with delayed ejaculation up to 40 minutes of thrusting before he can ejaculate. For some men, ejaculation is entirely inhibited. Men with inhibited orgasm may “try harder” to ejaculate and reach orgasm. This will only make matters worse. Inhibited ejaculation is more common among gay men than it is among straight men.

Some women and men who have inhibited orgasm believe that the best way to end sex play or please their partners is fake orgasm. Ultimately, however, this kind of deception is not healthy, especially in a committed relationship. It may become a habit that leads to diminished sexual pleasure, and the partner of the “faker” may never learn how to help her or him reach orgasm.

Certain medications and physical conditions can also inhibit orgasm in women and men. The most common reasons for inhibited orgasm are sexual guilt, shame, performance anxiety, anger with the partner, and spectatoring. Fear of causing pregnancy can inhibit ejaculation and orgasm in men.

Masturbation can help anorgasmic women to reach orgasm. Fantasy, relaxed sex play, and open communication between partners may help some women and men overcome inhibited orgasm. Psychosexual therapy may be beneficial to others.

Most us will experience inhibited orgasm from time to time. Like occasional inhibited arousal, this as a normal part of our sex lives. We need not become so anxious about it that we make sex less pleasurable for ourselves than it might be.

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H-Y antigen

The Y chromosome programs the differentiation of the undifferentiated cells of the primitive gonads into testes, beginning at around the sixth week of gestation. Differentiation of the undifferentiated gonads into ovaries does not begin until the twelfth week and requires the presence of two X chromosomes and no Y.

The Y chromosome programs the undifferentiated gonads toward testicular development via a plasma membrane protein, the Y-linked histocompatibility (H-Y) antigen. Exactly how the undifferentiated gonads in XX individuals are programed into ovaries is not clear. Ohno suggests the possibility of an ovarian-organizing antigen similar to that of the H-Y antigen. This ovarian-organizing antigen has not yet been identified.

Having programed the differentiation of the gonads, the sex chromosomes have no other known direct influence on subsequent sexual behavior and psychosexual (gender identity/ role) differentiation. The program of gender identity/role differentiation and development is now carried forward by the presence or absence of secretions of the newly differentiated fetal testes. Without the secretions of the testes, morphologic differentiation is female.

Adam-eve principle

Prenatally, the program of gender identity/ role is carried forward specifically by the determinants of masculine morphologic differentiation, namely, mullerian inhibiting substance and androgen, secreted by the testes. Present knowledge of embryology indicates that fetal ovarian hormones are not essential to female morphologic differentiation. Whether or not maternal and placental hormones are essential is not known. Nature is predisposed first to make a female and only with the addition of testicular secretions does it make a male. The embryological fact that nature’s preference is female is epitomized as the Eve principle. The fact that something must be added to make a male is epitomized as the Adam principle.

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