The Call for a National Strategy to Raise Awareness of, and Increase Supports for, the Life-Threatening Physical and Emotional Health Impacts of Sexual Violence and its Frequently Harmful Aftermath

Sexual violence is a curse that inflicts its harm long after the traumatic event.  Much of it is caused by lack of awareness of the profound emotional and physical conditions that can arise, even to the extent of being life-threatening.  But much of the harm is intentional and inflicted by bad actors with the purpose of punishing or discrediting the victim and preserving a culture of fear and silence that allows predators and enabling institutions to thrive. We need to have zero tolerance for both situations. And we need it now.


In 2010, 19-year-old college freshman Lizzy Seeberg committed suicide after being sexually assaulted by a Notre Dame University football star. The aftermath and mishandling of the incident caused her to slip into a deep depression. Following Lizzy’s tragic passing,  her family felt completely betrayed by the university’s inept and insensitive response, and failures in the police investigation. 

In 2018, former RCMP constable Krista Carle took her life after repeated incidents of sexual misconduct and then the emotional harm that was added by the way the Force responded to her coming forward .  


Sexual violence, including threatening or aggressive forms of sexual harassment, is one of the most traumatic and humiliating experiences any woman can face. In addition to profoundly violating a victim’s dignity and fundamental human rights, it can produce a wide-range of detrimental emotional and physical health outcomes.  Some can last for years, even decades.  Some can be life-ending

I know all too well the profound toll this social scourge takes on its victims at every level — especially the emotional and other medical consequences it leaves.  I hear it in their broken voices. I see it in their tear-soaked words.

Over the years, many women have reached out to The ZeroNow Campaign™ to share their ordeals involving sexual violence, sexual harassment and workplace bullying. They began to do this long before #MeToo’s arrival.

I know all too well the profound toll this social scourge takes on its victims at every level — especially the emotional and other medical consequences it leaves.  I hear it in their broken voices.  I see it in their tear-soaked words.  

Their narratives confirm, on a human level, what researchers have discovered on a clinical basis. 

  • Women in the study who reported prior sexual assault were three times more likely to experience depression and twice as likely to have elevated anxiety than women without a history of sexual trauma;
  • Those who experienced either sexual assault or harassment were twice as likely to have sleep problems, including insomnia;
  • Women who reported workplace sexual harassment had higher blood pressure than women who did not, at levels significant enough to put them at risk for stroke, aneurysms, kidney disease, heart attacks and other forms of heart disease;
  • Sexual harassment was also linked to higher levels of triglycerides, a key risk factor for heart disease, which is the leading killer of women in the United States (and Canada).


. . .

Our call for a national strategy is intended to create a culture of healing, among all those who interact with victims, that avoids creating harm and helps with the process of recovery.

This is one of countless studies that confirm the shattering emotional and physical impact that sexual violence and threatening forms of sexual harassment have on victims.

Yet not all healthcare professionals are skilled in treating victims, or possess the necessary clinical information to make the right kind of assessment, according to experts. Some, by their cold demeanor and skeptical responses, fail to create a comfort level that enables already humiliated patients to share the full extent of their experience. 

Acclaimed Yale psy­chol­o­gist Joan Cook, Ph.D notes,

“Research on the preva­lence and effects of trau­ma is large and grow­ing. How­ev­er, most health care pro­fes­sion­als, such as psy­chol­o­gists, still only have a cur­so­ry knowl­edge of this sci­ence and lit­tle to no for­mal train­ing in evidence-based psy­choso­cial treat­ments for trauma-related dis­or­ders.”

Toronto’s Women’s Col­lege Hos­pi­tal echoes a sim­i­lar view of the gaps in health­care for women, includ­ing those aris­ing from sex­u­al vio­lence.

“Half of all women in Cana­da have expe­ri­enced at least one inci­dent of phys­i­cal or sex­u­al vio­lence since the age of 16, yet not all health­care providers have the knowl­edge or skills to deliv­er sen­si­tive care to these women.”


HealingNow™ was created in collaboration with The Center for Patient Protection’s Safer Women Health Initiative to raise awareness about the emotional and physical health risks associated with sexual violence and sexual harassment. An important part of our focus is on the harm caused by defective and ill-informed post-trauma responses and the need to combat the damage caused by what Jennifer Freyd, Ph.D, calls institutional betrayal.

Clinical work by Dr. Freyd in betrayal trauma theory led to the development of her concept of institutional betrayal. Her findings confirm that when a traumatic incident is followed by insensitive or abusive responses by trusted players like healthcare professionals, public institutions, government agencies, judges, private corporations or law enforcement authorities, the risk to a victim’s well-being rises sharply.

Depression, anxiety, PTSD, self-harm and adverse physical outcomes are among the recognized sequelae of betrayal trauma identified by Dr. Freyd. The high-profile deaths by suicide involving 19-year-old college freshman Lizzy Seeberg, to which Dr. Freyd refers in her research, and former RCMP constable Krista Carle, which I have written about, are a vivid, and so heartbreaking, reminder of the catastrophic risks associated with institutional betrayal following sexual violence.

In reaching out to The ZeroNow Campaign™ over the years, many woman have recount­ed being shocked, and harmed, by the insen­si­tive and inad­e­quate medical care they received. A gen­er­al lack of trauma-informed aware­ness dis­played dur­ing clin­i­cal vis­its, particularly at the pri­ma­ry physi­cian lev­el, was a dis­turbing­ly recur­ring theme. When women, and especially victims of sexual violence, do not have an ade­quate com­fort zone and lev­el of con­fi­dence in their inter­ac­tions with health­care pro­fes­sion­als, they are less inclined to be ful­ly can­did. Any bar­ri­ers that con­tribute to a dys­func­tion­al rela­tion­ship or a break­down in trust and com­mu­ni­ca­tion in the health­care set­ting are an open invi­ta­tion to diag­nos­tic errors.

Another reported abuse of victims by the healthcare system has been the use of the so-called independent medical examination (IME).  These have been required by employers and health insurance carriers in certain situations where victims report post-trauma symptoms.  The reality is that many IMEs are far from “independent.”  It is not uncommon for such examinations to be the paid product of cash-and-carry doctors who make a profit center out of serving the interests of private companies, health insurance providers and law firms.  This kind of rigged investigation can become a quick launching pad for institutional betrayal. 

Over the years, a number of victims have shared those reports with me.  They paint a telling picture of yet another layer of harm thrown upon a victim, which can take the form of denying her medical leave benefits or forcing her to return to work to be confronted by her harasser, who was also her boss.  

We need to create a culture of healing among all those who interact with victims, and especially among healthcare professionals, that avoids creating harm and helps with the process of recovery.  It is important that primary care physicians acquaint themselves with the growing knowledge base of trauma-informed practices and begin to screen patients for possible sexual violence in the same way healthcare practices screen for smoking and other high-risk behaviour.

Victims, and their families, also need to become informed, early in the post-trauma period, of the complex range of emotional and medical issues that can confront them as they journey through this life-altering ordeal.

Policy makers and public authorities, including law enforcement agencies, need to gain a better understanding of the potential for serious emotional and medical reactions that can occur, especially when victims are confronted by insensitive or disbelieving words or actions.

The need for trauma-informed thinking on the part of judges was recognized by Canada’s parliament with the passage by the House of Commons of Bill C-337.  The legislation would have required training of judges on the neurobiological dynamics of the traumatic sexual violence experience and its impact on the brain. The need is well documented in other jurisdictions.  Outrageously, the bill died in the Senate and never became law. You can read my recent comments on that subject here

Insensitivity and inappropriate remarks from the bench, which many experts interpret as an underlying ignorance of trauma-related facts that militate against a victim’s ability to recount events in a linear fashion — and which thereby distort reasonable judicial outcomes — are a recognized factor that prevents women from entering the doors of justice. No woman who has experienced sexual violence wants to be made a victim all over again by a rigged or unfair system. 

The media also has an important role in raising awareness about the longer term dangers of sexual violence and related abuse. Recently, The Globe and Mail focused on the victim trauma experienced by several women resulting from incidents of sexual abuse at the hands of a Toronto-based physician. The article made the point that not only did devastating harm occur during the incidents of sexual misconduct, but the emotional impact was magnified by the mishandling of the disciplinary process that is supposed to protect patients from harmful professional conduct. 

When the quest for healing in a relationship of professional trust is broken, and perverted into an encounter with harm, the damage is particularly acute. Similar to the experience patients and families recount in the healthcare setting when dealing with the aftermath of medical errors, victims of sexual violence often say that the way the system handled their concerns after they came forward made the situation so much worse. That is the curse of institutional betrayal.

Leaving a victim worse off has no place in any process that purports to deal in a responsible fashion with women facing the most devastating time of their lives. 

Leaving a victim worse off has no place in any process that purports to heal, or deal in a responsible fashion with women facing the most devastating time of their lives. 

Our HealingNow initiative calls for the creation of a national strategy and awareness campaign to address the profound emotional and physical conditions that can arise from incidents of sexual violence, especially when they are mishandled. Only when there is a fuller understanding of the acute harms that are inflicted on victims can there be any hope that the actors who compound that harm, whether by ill-intention or by ineptitude, will change their ways. 

The healing principles that guide our approach are captured with these timeless virtues: listen, believe, respect, support and care. We believe that when it comes to the handling of sexual violence and related abuses, nothing less than a do no harm creed is acceptable. This applies not just to the medical profession, the traditional adherents to this ancient injunction, but to everyone else who has responsibility for interacting with and responding to victims who come forward, including bystanders and co-workers. Trauma-based practices need to inform and guide all those who hold a victim’s well-being in their hands.

If you are a lawmaker, policy leader, scholar, healthcare professional and, especially, if you are a victim or survivor, please support our call.  You can contact me directly here.


Kathleen Finlay
Founder, The ZeroNow Campaign™


Stop Letting the System Assault Victims of Sexual Violence Over and Over 

When Toxic Work Culture Adds to the Trauma of Sexual Misconduct

Stop Sexual Misconduct from Being Fatal

Sexual assault and harassment linked to long-term health problems for women

About The ZeroNow Campaign™

The ZeroNow Campaign™ works to combat the conditions that lead to sexual violence and sexual harassment.  We champion legislation, policy changes and initiatives to make the workplace, the community and the campus safer and reduce the harm caused by institutional betrayal, and we interact directly with victims in supporting their journey to heal.



About The Center for Patient Protection™

The Center for Patient Protection™ works to improve patient safety and reduce medical harms in the hospital setting.  We advocate for greater transparency to empower patients and families in their decisions, champion healing virtues like compassion and respect at all levels of care, and use patient experiences to assist providers in the delivery of safer outcomes.  HealingNow™ is an outreach of The Center’s Safer Women’s Health Initiative™, which focuses on the unique healthcare needs of women, particularly as they relate to ageism, caregiving, sexual violence and the sexual abuse of patients by healthcare practitioners.