"Coming out of the closet about sexual assault": Intersectional sexual assault stigma and (non) disclosure to formal support providers among survivors using Reddit.

Sexual assault is a pervasive, violent and often gendered crime that can result in significant negative consequences. Many sexual assault survivors consider disclosing to health and social care providers, therapists, and others who collectively fall under the banner of formal support, in order to access information, referrals, treatment and/or emotional support, however barriers to disclosure remain. This qualitative study is unique in its application of an intersectional sexual assault stigmatization framework to understand (non)disclosure to formal support providers among diverse sexual assault survivors. Through anonymous online narratives posted to the platform Reddit, survivors documented experiences of intersectional sexual assault stigma (perceived, internalized, anticipated, experienced) showing that they were not only stigmatized through negative gender stereotyping, but they were also marginalized through other structural inequities. The experience of multiple marginalization that arose from intersectional sexual assault stigma often impeded survivors in accessing and/or utilizing the formal support they wished for. The findings suggest that formal support providers could benefit from stigma reduction training related specifically to sexual assault survivors and that current models of stigma and discrimination training need to be expanded to include intersectional stigma. Further, the findings suggest that beyond training at an organizational level, a broader intervention aimed at reducing structural stigma and discrimination toward sexual assault survivors at a societal level appears warranted. Implications for future research related to the unique disclosure, health, and social care needs of diverse sexual assault survivors and support-seeking online alongside or in lieu of formal support are discussed.

Recognizing and Responding to the Commonly Misunderstood Reactions to Sexual Assault: Evaluation of an Online Curriculum.

Background: Sexual assault remains a serious public health issue with significant impacts on the health and well-being of individual women. Many women's reactions and behaviors post sexual assault are not well understood by the general public, or more worrying, among professionals to whom women frequently turn to for help. An innovative and evidence-informed online curriculum was developed to educate health and social service providers about the range of possible psychological responses and associated behaviors post sexual assault and to better equip them in supporting survivors in their recovery. Methods: The curriculum was evaluated using pre- and post-training tests designed to measure changes in fact-based knowledge, self-assessed knowledge, and procedural knowledge, that is, perceived competency. Results: A total of 759 participants registered to complete the curriculum between July 2018 and July 2019 and 175 completed both the pre- and post-training surveys. Data analyses showed significant improvement in the mean number of correct answers to the fact-based knowledge, self-reflection, and procedural knowledge questions from pre- to post-training. The response to the training was also very positive. Conclusions: The online curriculum was effective in improving participants' knowledge about and response to women who, in the aftermath of a sexual assault, may exhibit reactions or behaviors that are commonly misunderstood.

Examining Risk of Workplace Violence in Canada: A Sex/Gender-Based Analysis.

Objectives: Workplace violence (WPV) is a serious issue, resulting in significant negative health outcomes. Understanding sex/gender differences in risk of WPV has important implications for primary prevention activities. Methods: Utilizing two waves of the Canadian General Social Survey on Victimization (N = 27,643), we examined the likelihood of WPV, and sub-categories of WPV, for women relative to men. Using a sex/gender analytical approach, a series of logistic regression models examined how the associations between being a woman and each of the outcomes changed upon adjustment for work and socio-demographic characteristics. Results: After adjustment for work hours, women were at more than twice the risk of WPV compared to men (odds ratio = 2.12, 95% confidence interval 1.52-2.95). Adjustment for work characteristics attenuated, but did not eliminate this risk. Differences in associations were observed across sub-categories of violence, with adjustment for work characteristics attenuating sex/gender differences in physical WPV, but having minimal impact on sex/gender differences in sexual WPV. Conclusions: Work characteristics explain a substantial proportion of the sex/gender differences in risk of physical WPV. However, even after adjustment for work characteristics, women still showed an elevated risk relative to men for almost all types of violence (as defined by nature of the violence, sex of the perpetrator, and relationship to the perpetrator) examined in this study. Future investigations should examine why these differences between women and men remain, even within similar occupational contexts.

Responding to Delayed Disclosure of Sexual Assault in Health Settings: A Systematic Review.

Few adolescent and adult women seek out formal support services in the acute period (7 days or less) following a sexual assault. Instead, many women choose to disclose weeks, months, or even years later. This delayed disclosure may be challenging to support workers, including those in health-care settings, who lack the knowledge and skills to respond effectively. We conducted a systematic literature review of health-care providers' responses to delayed disclosure by adolescent and adult female sexual assault survivors. Our primary objective was to determine how health-care providers can respond appropriately when presented with a delayed sexual assault disclosure in their practice. Arising out of this analysis, a secondary objective was to document recommendations from the articles for health-care providers on how to create an environment conducive to disclosing and support disclosure in their practice. These recommendations for providing an appropriate response and supporting disclosure are summarized.