An SA Awareness Month reflection approximately 15 minute read - we hope you will stick with us

Content Warning: This post discusses sexual assault and mental health conditions

If you have been the victim of sexual assault there is help for you:
RAINN Sexual Assault Hotline homepage 

Call: 800-656-HOPE (4619)
Text: HOPE to 64673

TL;DR

Sexual violence affects millions of people, particularly, but not only women each year, and is strongly linked to PTSD and depression—conditions often managed with antidepressants.

With the unignorable backdrop of the Epstein Files, we can look at the millions upon millions of affected survivors who are currently being re-traumatized daily by the news and social media showing the lack of accountability or justice for these victims. 

Limitations of this blog: 

These figures also do not fully capture the impact of human trafficking and organized sexual exploitation. While trafficking victims are included when they report experiences like coercion or assault, these systems do not reliably track the context, frequency, or duration of abuse. As a result, the scale and intensity of harm—particularly in cases involving repeated exploitation—are likely underrepresented in national statistics. For this blog, we are focusing on the daily experiences of victims who are mostly outside of this context, so we know the problem is far bigger than even the statistics can say. 

This article looks at the facts and statistics in context, and what they point to. The facts are triggering and hard to look at all together. I ask that you take a deep breath with me and, if you can, choose NOT to avert your eyes. We cannot address this as a society if we remain ignorant of the broad implications of the system we have created. 

In countries we consider “civilized,” the scale of sexual assault is driving an economic engine we rarely examine in the pharmaceutical space. At the same time, women are still statistically less likely to be believed in medical settings. Their symptoms are more often interpreted as purely psychological, shaping treatment pathways and sometimes overlooking physical causes.

At scale, this creates a system that manages the symptoms of trauma after it happens, while prevention remains underfunded—and deeper forms of healing, including talk, somatic, and psychedelic therapies, remain under-resourced.

Pharmaceutical companies operate within—and benefit from—this structure.

Let’s take a look.

The larger patterns at play

Sexual violence touches far more lives than most conversations acknowledge.

In the United States:

• About 1 in 5 women and 1 in 31 men experience rape or attempted rape in their life

• About 45% of women and ~17% of men experience contact sexual violence, including coercion and unwanted contact

• Roughly 7 million women and ~2.5 million men each year are affected

These numbers already include estimates from victimization surveys—but even those are understood to be incomplete. Only about 1 in 4 sexual assaults are reported to police, meaning the true number is likely significantly higher. (NSVRC)

In England and Wales:

• About 3% of women and ~0.7% of men annually experience sexual assault

• Only ~10–15% of sexual offenses are reported to police (devonrapecrisis.org.uk)

Among children:

• More than 60,000 confirmed cases of sexual abuse are recorded annually in the U.S., widely understood to represent only a fraction of actual cases

Taken together, reported cases represent only a portion of what is actually happening. These numbers describe a steady, ongoing reality that is consistently undercounted.

 

---

 

The psychological impact is consistent

The aftermath of sexual violence follows a familiar pattern:

• 30–50% of survivors develop PTSD

• ~39% experience depression

• In one UK cohort, 80% of adolescent girls had at least one mental health diagnosis within months. Many of the treatment options rely heavily on medication over other forms of trauma healing. 

These outcomes emerge across different forms of sexual violence, including coercion and non-physical violations.

They also align directly with the conditions most commonly treated with antidepressants.

 

---

 

How the system responds

In the U.S.:

• About 15% of adult women are currently on antidepressants

• This is measured against a backdrop of 1:5 adult americans - 20% are on some type of psychiatric medication

In the UK:

• Estimates suggest 15–25% of girls presenting after sexual assault may receive them over time

A single pipeline, in numbers

• ~1 in 4–5 girls experience sexual abuse or assault before age 18

• Following sexual assault, up to 80% of adolescent girls develop a diagnosable mental health condition

• 30–50% develop PTSD, and ~39% experience depression

• These are the primary conditions treated with antidepressants

• Today, about 1 in 22 U.S. girls (≈4–5%) are prescribed an antidepressant

• Prescribing in adolescent girls has nearly doubled in recent years (~95% increase)

These are not separate trends, but rather describe a system that consistently moves girls from harm to diagnosis to medication without a lot of other support or a path to move off medication.

For many people, these medications are appropriate, helpful, and life-saving when used in a limited context but they do not fix the issue nor are they sufficient treatment for trauma healing.

At a population level, a pattern takes shape:

Trauma leads to diagnosis --> diagnosis leads to treatment. The pathway is familiar, repeatable, and well supported.

 

---

 

How symptoms are interpreted

There is also a difference in how symptoms are handled.

Women report higher rates of:

• Dismissal

• Delayed diagnosis

• Symptoms attributed to anxiety even when they have a physiological cause (like autoimmune disease)

About 1 in 5 women report being dismissed by a healthcare provider.

Cases like stroke symptoms labeled as panic attacks, or serious conditions attributed to stress appear regularly. Research reflects a broader tendency to interpret women’s experiences through a psychological lens. When trauma is part of the clinical picture, that framing can shape how quickly symptoms move toward diagnosis and medication.

These patterns don’t emerge in isolation; they exist within a broader context, in which women experience higher rates of sexual violence, are more likely to have their symptoms interpreted as psychological, and are more frequently treated pharmaceutically for the resulting distress. This reflects long-standing structural dynamics in medicine and society, where women’s experiences—especially those involving pain, emotion, or trauma—have historically been taken less literally and more often reframed as internal or psychological.

 

---

 

How markets move alongside medicine - an example

In 2000, Eli Lilly and Company released Sarafem, a reformulation of Prozac.

The change was not chemical. It was contextual.

• A new indication: Premenstrual Dysphoric Disorder (PMDD)

• A new patient population: primarily women

• A release timed just before Prozac lost patent protection

PMDD had already been described in earlier psychiatric literature, but its positioning shifted alongside the introduction of the drug. This is often cited as an example of how pharmaceutical companies extend product lifecycles by redefining use cases and expanding markets.

What happens after the prescription

Antidepressants are often started during periods of acute distress, but due to a combination of inadequately trained physicians, and withdrawal symptom mismanagement, people remain on them for extended periods.

• Most clinical trials focused on shorter-term use

• Long-term use is common but not studied

• Discontinuation can be difficult for most people (we strongly recommend running your prescription through the database at www.survivingantidepressants.org to familiarize yourself with the withdrawal symptoms so as not to overpersonalize your experience)

• Follow-up and tapering plans are not usually consistently structured or even intended by the General Practitioner. 

Prescribing largely occurs in primary care, where time and continuity can vary.

This leaves an open, ongoing question at scale:

How often are treatment decisions revisited once the immediate crisis has passed? When does symptom treatment stop and trauma healing begin?

 

---

 

Emotional tone, at scale

Some research suggests antidepressants can reduce emotional reactivity, including responses to others’ pain.

For individuals managing overwhelming symptoms, that shift can be stabilizing.

At a broader level, it raises an open question about how widespread emotional modulation might influence how people experience one another, given that millions (29-30MM adults in the US) are on these medications. There is no clear evidence connecting this to large-scale social change in empathy, but the question remains part of the larger picture.

 

---

 

The pattern that forms

Across these layers, a consistent structure appears:

• Sexual violence remains widespread

• Its psychological impact is well established

• Women’s symptoms are more likely to be interpreted reductively

• Antidepressants are a primary response

• Long-term use is common

• Pharmaceutical companies operate within profit-driven systems

The result is a system that is highly effective at managing the consequences of trauma.

Prevention operates on a different timeline. It requires cultural, legal, and institutional change, and receives less consistent investment.

Where attention goes

When trauma produces long-term treatment needs, and treatment generates sustained revenue, attention (and money) tends to follow the part of the system that is most scalable, rather than the method that cures or addresses the root cause, which would stop the flow of dollars coming from that particular subset. After all, cures are not profitable, management is. 

This reflects how incentives shape outcomes over time.

Final Thoughts

Sexual assault moves through systems as much as it does through individual lives.

Healthcare, mental health treatment, and pharmaceutical markets, all absorb and respond to its impact within a capitalist framework, where treatment is more scalable, more fundable, and more profitable than prevention. That shapes where attention, research, and resources go.

The result is a system that becomes increasingly efficient at managing the aftermath of trauma, while prevention remains uneven, underfunded, and slow to advance.

At the same time, cultural forces are not neutral. Public voices and media platforms continue to normalize rhetoric that marginalizes women, questions their autonomy, and, in some cases, openly challenges their rights—from voting to reproductive freedom, for example. These ideas do not exist in isolation. They influence policy, perception, and ultimately, risk.

Without confronting both the economic structures and the cultural narratives that allow harm to persist, the cycle continues.

 

---

 

Bibliography

Centers for Disease Control and Prevention. National Intimate Partner and Sexual Violence Survey (NISVS): Sexual Violence Brief.
https://www.cdc.gov/nisvs/media/pdfs/sexualviolence-brief.pdf

Bureau of Justice Statistics. Criminal Victimization, 2024.
https://bjs.ojp.gov/document/cv24.pdf

Office for National Statistics. Sexual offenses victim characteristics, England and Wales: year ending March 2025.
https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/articles/sexualoffencesvictimcharacteristicsenglandandwales/yearendingmarch2025

Office for National Statistics. Nature of sexual assault by rape or penetration, England and Wales.
https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/articles/natureofsexualassaultbyrapeorpenetrationenglandandwales

U.S. Department of Health and Human Services. Child Maltreatment Reports.
https://www.acf.hhs.gov/cb/research-data-technology/statistics-research/child-maltreatment

Khadr, S. et al. (2018). Mental health outcomes following sexual assault in adolescent girls. UCL / NIHR
https://www.nihr.ac.uk/news/most-young-women-have-mental-health-disorder-after-sexual-assault

Dworkin, E. R. et al. (2017). Sexual assault victimization and psychopathology: A review and meta-analysis.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6707905/

National Institute for Health and Care Excellence. Depression in children and young people: identification and management (NG134).
https://www.nice.org.uk/guidance/ng134

National Center for Health Statistics. Antidepressant Use Among Adults: United States, 2023.
https://www.cdc.gov/nchs/products/databriefs/db528.htm

PLOS Medicine. Trends in antidepressant prescribing in children and adolescents.
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003215

Chen, C. et al. (2019). Antidepressant treatment reduces neural responses to pain empathy. Translational Psychiatry.
https://www.nature.com/articles/s41398-019-0496-4

Business Insider. Panic attack or stroke? Young women misdiagnosed.
https://www.businessinsider.com/panic-attack-or-stroke-young-women-2023-5

People Magazine. Brain tumor symptoms dismissed as anxiety.
https://people.com/38-year-old-woman-discovers-she-had-brain-tumor-for-at-least-15-years-after-doctors-dismissed-her-headaches-as-anxiety-of-having-newborn-baby-11933886