We asked a sexologist about the shocking, little-known consequences of sexual abuse

2016 has been an incredible year in terms of opening the conversation about sexual assault. Although the stories we both hear and tell are harrowing — and the frequency of them distressing — we can be thankful that we are talking about it. We’re at a point where we’ll continue to share powerful stories for a long time.

Although the conversation is, in many ways, more open than ever before, there’s still so much we’re unaware of. There are countless questions to be asked and a million answers to each question because no two sexual assault experiences are the same.

With this in mind, we caught up with Leigh Norén, a Swedish sexologist, to dip into her knowledge. As a sexologist, Leigh’s work focuses on sexuality issues, encompassing relationships and sexuality, partner sex and even masturbation. In her words, she’s “basically helping people as a sex educator and therapist.”

Primarily, Norén works with survivors of sexual assault and people who have been sexually abused to discover how they’ve been affected. She also primarily works to resolve their issues by helping them express their sexuality, rather than offering traditional psychological coaching or medical advice.

Talking about her work, Norén explained some of the consequences of sexual abuse that we’re not often aware of.

Compulsive and restrictive behavior

Typically, we’re inclined to think sex is off limits for most people who have been abused. And as much as this is sometimes the case, there’s a lot more to it. For people who have experienced sexual assault, there’s a spectrum from completely abstaining from sex to having loads of sex.

Some people become compulsive in their sexual behavior and engage in a lot of sex. Leigh explained this further, saying: “A lot of people say they feel like they’re not worth anything after abuse, so why would they say no to someone that wants to use their body for sex?”

Sadly, compulsive sex often incorporates going out and looking for sex wherever. However it’s not just about feeling good through an orgasm, it can also appear as a pathway to sexual control. “People think they’re only worth sex so they can’t really say who they have sex with,” Norén explains.

“And some people are trying to get a sense of their own control when they have sex even though they don’t want it. They seek after situations that are similar to the sexual abuse to get a sense of sexual control but they don’t obviously because they’re having sex that they don’t want to have.”

Physical effects

“Restricting from sex isn’t necessarily psychological,” Leigh notes. There are compounding physical effects involved too. “People experience pain problems such as provoked vulvodyina and vaginismus, which are problematic.”

These diagnoses are both extremely painful conditions affecting the in the vaginal region. Vulvodynia is a chronic pain, usually identified as burning or irritating feeling affecting the vulvar area, while vaginismus is when the pelvic floor muscles contract to specifically affect vaginal penetration as a result of an involuntary vaginal muscle spasm.

What’s shocking, however, is that these conditions don’t only effect women’s sex lives, but also their everyday lives. “Some people can’t wear jeans, ride a bike, or sit with crossed legs,” says Norén.

“It can become incredibly painful, especially if you have provoked vulvodyina because the sensitive nerve endings cause a burning sensation and a consequence is that in the end, you develop vaginismis because the body is like ‘whats going on I’m in pain all the time.'”

“This happens all the time when you try to put something in the vagina, even a tampon.”

Some girls continue to have sex despite pain

Due to the physical problems, such as vaginismis and vulvodyina, a lot of girls experience pain when they try to have sex after being sexually assaulted. In fact, nearly 75 percent of women say it hurts when they have sex sometimes, yet they continue to do it anyway.

Norén says that this has to do with education. “People don’t know its not meant to be like that,” she says. So they just deal with the pain that comes with it.

We don’t actually know the full extent of the consequences

Norén admits that there’s still far too much to find out about the effects of sexual abuse.

“Researchers have found diagnoses like low libido, difficulty reaching orgasm, difficulty saying no and finding sex scary — you can find these answers in any research, but there’s a lot we just don’t know,” she says.

With this in mind, Norén and her colleague Rebecca Sjöstrand are working on a project to gather knowledge and spread awareness of problems that can arise as a result of sexual abuse. The research is being gathered through a survey of anyone that’s been sexually abused, regardless of gender identity.

So far, Norén and Sjöstrand have discovered that there’s a lot more problems than we typically consider, and it’s so different for every respondent.

“First of all, the problems are quite varied, there are 17 different options and all of them have been answered. The most common ones are problems with saying no to sex and having problems being in a romantic relationship. People say they experience low libido, guilt and shame when they actually feel like they want to have sex because they don’t feel like they’re meant to have sex if they’ve been sexually assaulted.

“There’s a real stigma around it lots of trust issues. Basically, there are lots of problems.”