11 Sexual and gender based violence
11.1 Legal issues
The rights referring to sexuality are derived from human’s rights, which were signed by most countries oft he world (including Austria and Germany):
- Right of sexual self-determination
- Right of equal treatment
- Right to marry or not to marry
- Right to family planning (contraception is legal!)
- Right to be informed about contraceptives and to use them
- Rights for women and girls in case of (unwanted) pregnancy
- Right to be protected from sexual violence
Ad 1. The right of sexual self-determination:
* In Austria, sexual acts (both hetero- and homosexual) are allowed from the age of 14, provided that they are made voluntarily by both partners (exceptions: developmental delay).
* Sexual intercourse is legal from the age of 13, if the partner is not older than 3 years.
* From the age of 12 years, petting with a max. 4 years older person is legal (not sexual intercourse).
* Prohibited are sexual relations in the context of interdependency (as teacher-minor), pornography and prostitution.
à Very important to emphasize within the patient-doctor relationship is that violence in general (and also sexual violence) is banned by law in Austria (there might be a different view/handling of violent acts in other countries)!
à Note that violence occurs in all cultures and all social classes within a society!
11.2 Definition of sexual violence
“Any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic a person´s sexuality, using coercion, threats of harm or physical force, by any person regardless of relationship to the victim, in any setting, including but not limited to home and work.” According to the WHO World Report on Violence and Health, forms of sexual violence include: “physically forced or otherwise coerced sex, attempts at coerced sex, assault with a sexual organ, sexual harassment, including sexual humiliation, forced marriage or cohabitation, including marriage of children, forced prostitution and trafficking in women, forced abortion, denial of the right to use contraception, or protect self from disease, and acts of violence against women´s sexuality such as female genital mutilation and social virginity inspections.” (Krug et al. 2002)
11.3 Health risks of gender-based and sexual violence
Survivors of sexual violence are at risk for a range of physical, psychological and social consequences:
- Physical consequences: These may include sexually transmitted infections (including HIV), unintended pregnancies, unsafe abortions, menstrual disorders, trauma to the reproductive tract, and other injuries;
- Psychological effects: These may be considerable, such as post-traumatic stress disorder, depression, suicidal ideation (thoughts of suicide) and suicide attempts;
- Social consequences: Women who experience sexual violence are often stigmatised and/or rejected by their husbands, family, and community.
(Johns Hopkins and Red Cross Red Crescent 2008, 182-83)
11.3.1 Key facts
- Violence against women – particularly intimate partner violence and sexual violence – are major public health problems and violations of women’s human rights.
- Recent global prevalence figures indicate that about 1 in 3 (35%) of women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime.
- Most of this violence is intimate partner violence. Worldwide, almost one third (30%) of women who have been in a relationship report that they have experienced some form of physical and/or sexual violence by their intimate partner.
- Globally, as many as 38% of murders of women are committed by an intimate partner.
- Violence can negatively affect women’s physical, mental, sexual and reproductive health, and may increase vulnerability to HIV.
- Factors associated with increased risk of perpetration of violence include low education, child maltreatment or exposure to violence in the family, harmful use of alcohol, attitudes accepting of violence and gender inequality.
- Factors associated with increased risk of experiencing intimate partner and sexual violence include low education, exposure to violence between parents, abuse during childhood, attitudes accepting violence and gender inequality.
- There is evidence from high-income settings that school-based programmes may be effective in preventing relationship violence (or dating violence) among young people.
- In low-income settings, primary prevention strategies, such as microfinance combined with gender equality training and community-based initiatives that address gender inequality and relationship skills, hold promise.
- Situations of conflict, post conflict and displacement may exacerbate existing violence, such as by intimate partners, and present additional forms of violence against women.
(World Health Organization 2016)
A World Health Organisation (WHO) report published in 2013 demonstrated that more than 25 % of women and girls in the WHO European Region have been subject to sexual and physical violence by an intimate partner and 5.2% subject to sexual violence by non-partners – emphasizing the lack of data on men In the European Union (EU), lifetime prevalence is rated at 11% for women over the age of 15.
Research shows that compared to the general population, refugees, asylum seekers and undocumented migrants are at greater risk: up to 28.6% of male and 69.3% of female migrants have been subject to sexual violence since their arrival in Europe, by European professionals and citizens in a fifth and third of incidents respectively. They also face numerous challenges upon seeking care in the aftermath. In addition to general determinants such as age, gender, sexual orientation, prior victimisation or exposure to violence and other trauma, research has demonstrated that the pivotal determinant is their restricted legal status, which hampers their active participation in society, puts them at risk of exploitation and abuse, and inhibits their access to health care.
(Keygnaert and Guieu 2015)
More information on prevention of Sexual and gender based Violence can be found here [https://emergency.unhcr.org/entry/60283/sexual-and-gender-based-violence-sgbv-prevention-and-response]
11.4 First assessment
11.4.1 Honour-related violence
Accusation of having lost virginity, having had a relationship before marriage, having been raped, defending oneself against arranged marriage, wearing the wrong clothes, to run away/to separate/to divorce, etc.
Forms of honour-related violence
- Control/Surveillance (Prohibition of acting autonomously/leaving)
- Physical punishment
- Psychological punishment (the family behaves, as if the person did not exist)
- Forced marriage
- Forced suicide
11.5 School-based sexual education
- in the Arabic world, sexual education in school does not exist!
- In some Arabic countries discussion is held on whether sex education in school would be important; if yes, in what kind and who should perform it
- The most important motives are: prevention of AIDS-infections and addressing sexual abuse
Help and consultation:
- Frauennotruf (01/71 71 9) or
- Frauenhelpline (0800/222 555)
Help and consultation in terms of forced marriage:
Orient Express: consultation, education and culture initiative for women, service center for women; Schönngasse 15-17/Top 2, A-1020 Wien
Tel.: +43 (1) 728 97 25
Fax: +43 (1) 728 97 25-13