Female-Perpetrated Sexual Violence: A Survey of Survivors of Female-Perpetrated Childhood Sexual Abuse and Adult Sexual Assault

Abstract

Individuals who experience female-perpetrated sexual assault (FPSA) are underrepresented in the sexual victimization literature. Much of the existing research on FPSA centers on child welfare-involved families and convicted or incarcerated female sexual offenders, with limited research devoted to victims of FPSA. The current study included a diverse sample of 138 community adults who experienced one or more incident of FPSA, and sought to 1) describe individuals who experienced FPSA, including their overall trauma exposure, 2) describe perpetrator age and relationship to the respondent, 3) explore whether respondents labeled FPSA as sexual assault and disclosed it to others, and to 4) examine the prevalence of depressive and posttraumatic symptoms in this population. Of the respondents, 61.6% experienced childhood FPSA, 18.8% experienced adulthood FPSA, and 19.6% experienced both childhood and adulthood FPSA. Survivors of FPSA were highly trauma exposed; 71.7% reported a male-perpetrated victimization, over 90% reported any childhood sexual abuse, over 60% reported any adulthood victimization, 55.1% reported victimizations in both childhood and adulthood, and 78.3% endorsed any revictimization. Perpetrators of FPSA were often known individuals, including friends, family members, babysitters, and romantic partners. Incidents of female perpetrators co-offending with males accounted for only 5.5%−8.5% of FPSA events, contrary to myths about female offending. Incidents of FPSA were often labeled as sexual assault in retrospect, but only 54.3% of respondents ever disclosed an incident of FPSA. Depressive and posttraumatic symptoms were common. Results indicate FPSA is typically perpetrated by individuals acting alone who are known to and close to the victim. Incidents of FPSA may not be labeled as sexual abuse or assault at the time of the event, are not frequently disclosed, and may carry long-term mental health consequences for survivors. Significant research efforts are needed to better identify and help these under-recognized, highly trauma burdened survivors of violence.

Sexual victimization in childhood or adulthood is known to be associated with a broad range of negative short and long term consequences, such as psychopathology and revictimization (Dworkin et al., 2017). However, the majority of the extant literature focuses on, and implicitly assumes in its conceptualization and design, victimization dyads in which a female victim is sexually abused or assaulted by a male perpetrator (Denov, 2003). There is clear evidence that, although male perpetrators are responsible for the majority of sexual victimizations that occur, female-perpetrated sexual assault is far from rare and occurs much more frequently than initially documented during early empirical investigations of sexual victimization (Stemple et al., 2017). For example, data from the National Intimate Partner and Sexual Violence Survey (NISVS) indicates that as many as 20% of men who are sexually victimized report their perpetrators were female, and data suggest that specific forms of sexual violence (e.g., being “made to penetrate”) may be female-perpetrated over 80% of the time (Breiding et al., 2014). The limited research that explores the phenomenology of FPSA through qualitative and quantitative research on survivors indicates that significant short- and long-term sequelae exist (Deering & Mellor, 2011; Tsopelas et al., 2011), indicating a need for greater understanding of FPSA, victim and perpetrator characteristics, and long-term outcomes.

The existing literature on female-perpetrated sexual assault (FPSA) disproportionately relies on data drawn from formally reported suspicions of female-perpetrated sexual abuse, including cases reported to child protective services and the police, and incarcerated female perpetrators (Curti et al., 2019; Peter, 2009). Reliance on such a narrow subset of events further complicates understanding of FPSA, since focusing on suspected or convicted female perpetrators limits research to incidents that were 1) labeled as a potential victimization experience by the victim or an affiliate, and 2) deemed sufficiently severe to be reported through a formal channel. Incidents that were not formally reported, or incidents in which the perpetrator was not formally charged, are therefore not represented. Reliance on formally-reported cases of female-perpetrated abuse may result in minimization of the true prevalence and impact of female-perpetrated abuse for several reasons. First, victimization scenarios involving female perpetrators are consistently judged to be less inappropriate or serious relative to those involving male perpetrators by lay persons, though there is some evidence ratings may vary based on respondent gender (Banton & West, 2020; Leone et al., 2019). Second, FPSA is also minimized by professionals, who tend to judge female perpetrators as committing “less severe” abuse, and as being “less likely” to re-offend, relative to male perpetrators—even when the crimes described are identical (Clements et al., 2013; Hetherton & Beardsall, 1998; Mellor & Deering, 2010). Third, female perpetrators are typically charged with sexual assault less frequently and receive less severe punishments than do male perpetrators, even after accounting for severity of the crime (Patterson et al., 2019; Shields & Cochran, 2020). Furthermore, survivors of FPSA may face specific barriers to reporting that results in further underrepresentation of the true prevalence of FPSA (Denov, 2003; Nathan & Ward, 2001; Peter, 2009).

In summary, the existing focus on FPSA using child welfare- and justice-involved cases may both underrepresent the prevalence and range of the full spectrum of FPSA as it occurs in the general community. Cases that were formally reported and/or substantiated, and female perpetrators who are convicted of perpetrating sex crimes, may differ substantially from incidents that were never reported—especially given the evidence that female perpetrators are less frequently charged or convicted of sexual offenses relative to their male counterparts, indicating there may be a high threshold for their conviction (Patterson et al., 2019; Shields & Cochran (2020)). Overreliance on perpetrator data also results in a relatively underdeveloped literature on experiences and perceptions of victims themselves, resulting in poorly-developed methods for identifying and labeling FPSA, limited understanding of victim needs and outcomes, and little (if any) data that might inform appropriately tailored clinical intervention.

The literature on survivors of FPSA primarily consists of a narrow but growing body of work focusing on male survivors of sexual victimization, among whom female perpetration is more consistently documented (Lowe & Rogers, 2017). The literature on female victims of FPSA is predominantly qualitative in nature, and mainly focuses on victims of intrafamilial sexual abuse (Peter, 2008). Other, small bodies of quantitative research on FPSA focus on hypothetical vignettes in which laypersons or professionals evaluate written victimization scenarios that include female perpetrators (Hetherton, 1999; Hetherton & Beardsall, 1998; Leone et al., 2019). Across these approaches to understanding FPSA is a consistent acknowledgement of the role cultural norms and social scripts play in challenging the existence and credibility of FPSA victims. Specifically, the extant research cites cultural gender norms and expectations that conceptualize women as empathetic, nurturing, and sexually passive as being in conflict with conceptualizing women as capable of perpetrating sexual assault. This conflict may make it challenging for victims and others to reconcile female-perpetrated victimizations with deeply ingrained cultural beliefs about women (Denov, 2003; Hetherton, 1999; Peter, 2009).

These social scripts may be particularly salient for male victims of female perpetrators due to cultural assumptions that men experience any sexual experiences with women as unilaterally positive, and reaffirming of men’s power and masculinity, are described as leaving little space for interactions that were unwanted or exploitative. That is to say, FPSA may challenge gendered expectations that male victims are expected to adhere to in ways that are culturally stigmatized, as well as challenge social constructions of women as inherently benevolent and nurturing (Denov, 2003; Hetherton, 1999). Constructions of women as gentle and passive promulgate the denial and minimization of FPSA, and may particularly undermine the credibility of male victims due the shame and humiliation associated with men being perceived as weak. For these reasons, survivors of FPSA may be less likely to identify (i.e., “label”) these experiences as victimizations. In the event that an FPSA is disclosed, the survivor’s confidant may similarly fail to identify FPSA as true assaults due to reliance on the same social scripts regarding gender and victimization, further complicating processes of event labeling, support seeking, formal reporting, and accountability.

Extending the scope of research on FPSA to include victim and perpetrator characteristics, event labeling and disclosure patterns, and the psychological sequelae of FPSA is necessary to enable more comprehensive understanding of FPSA and its impact on victims. Additionally, utilizing a community sample will provide more accurate representation of FPSA as it occurs in the community, as it will include experiences that meet criteria to be considered FPSA but either were not formally reported, or that individuals did not consider to be traumatic or label as a victimization. Because individuals who report CSA may have greater exposure to other adverse childhood experiences, increasing their overall trauma burden (Dong et al., 2003), individuals’ broad exposure to ACEs in childhood will aid understanding of whether FPSA occurs in isolation from or in combination with other ACEs.

The Current Study

The current study seeks to 1) describe individuals who experienced FPSA, including their overall trauma exposure, 2) describe perpetrator age and relationship to the respondent, 3) explore whether respondents labeled FPSA as sexual assault and disclosed FPSA to others, and to 4) examine the prevalence of depressive and posttraumatic symptoms in this population, the prevalence of seeking mental health treatment, and whether treatment was related to the FPSA.

Method

Participants & Procedures

This project used a Qualtrics recruitment panel to identify potential participants. A recruitment e-mail was sent to invite potential respondents to participate in the survey, with a link to the study screener. The screener asked respondents to indicate whether they had ever experienced a series of behaviorally specific unwanted sexual experiences with 1) a woman, 2) a man, or 3) neither. Respondents were able to select multiple gender options for each experience, in the event that a given experienced occurred with both a man and a woman. If an individual reported that one or more experiences had occurred with a woman, they were directed to the study consent form and, if they consented to the study, were directed to the online questionnaire. All study procedures were approved by the university’s institutional review board.

Individuals who reported at least one female-perpetrated experience of sexual abuse in the survey were included in the sample. Initially, 140 individuals were recruited. After collection, it was determined that two individuals demonstrated response patterns that compromised interpretability of their victimization experiences, and their responses were removed from analysis. The final sample included 138 participants who ranged from 18–74 years of age (M = 34.68; SD = 12.64). For full demographic information, see Table 1. The sample was relatively diverse in terms of participants’ racial/ethnic identities, gender, and sexual orientation. Sexual minorities, and bisexual women in particular, were overrepresented; bisexual women comprised 16.7% of the sample. Slightly over 30% had completed an undergraduate degree or a graduate degree. Over half made less than $35,000 per year, and less than 50% were employed full-time. Of the 78 respondents who disclosed a disability, 37 (47.4%) reported an emotional/psychiatric disability, either alone or in combination with another disability/disabilities.

Table 1.

Descriptive Statistics for Sample Demographics

Variable	M (SD)/n (%)
Age	34.72 (12.64)
Race/Ethnicity
White	89 (64.5%)
Black	18 (13.0%)
Latinx	15 (10.9%)
Asian-American	5 (3.6%)
Native American, Native Hawaiian, Alaska Native, or Pacific Islander	4 (2.9%)
Bi-racial, Multi-racial, or Other	7 (5.1 %)
Gender
Woman	93 (67.4%)
Man	39 (28.3%)
Transgender/nonbinary	6 (4.3%)
Sexual Orientation
Heterosexual	94 (68.1%)
Bisexual/Pansexual	30 (21.7%)
Gay or Lesbian	5 (3.6%)
Queer	3 (2.2%)
Asexual	3 (2.2%)
Questioning or Did not Disclose	3 (2.2%)
Relationship Status
Married/Domestic Partnership/Cohabiting	54 (39.1%)
In a Relationship	27 (19.6%)
Single	52 (37.7%)
Divorced, Widowed, or Other	5 (3.6%)
Education
High School/GED or Less	28 (20.3%)
Associate’s Degree, Trade School, or Some College	66 (47.8%)
Bachelor’s Degree	24 (17.4%)
Master’s Degree or Higher	20 (14.5%)
Work Status
Employed Full-Time or Self-Employed	74 (53.6%)
Employed Part-Time	16 (11.6%)
Student	16 (11.6%)
Domestic Labor, Retired or Unemployed	19 (13.8%)
Disabled/on SSDI	13 (9.4%)
Self-Identified as Having a Disability (Yes)	78 (56.5%)

Measures

Sexual victimization experiences and disclosure.

Sexual victimization in childhood and adulthood, whether the respondent disclosed their victimization, and the response they received were assessed using a format similar to that utilized during phone interviews in the protocol for the Sexual Abuse and Violence in Ireland (SAVI) study (McGee et al., 2002). Although this study specifically recruited individuals who experienced FPSA, data regarding male-perpetrated sexual assault was collected to gain a comprehensive understanding of sexual victimization in this sample. Respondents were asked whether a series of behaviorally specific sexual experiences occurred 1) prior to, and/or 2) at or after the age of 18. For each of the eight childhood items and four adulthood items, respondents were able to check off whether the experience occurred with a man, a woman, or neither. Respondents were also able to select multiple genders to indicate an experience occurred with both a man and a woman. A final item asked whether “any other confusing or unwanted experience that hasn’t already been mentioned” occurred, in order to provide an opportunity for individuals whose victimization experiences were not reflected in the prior options to briefly describe this event in their response.

For both the childhood and adult sections, if any unwanted experience with a man or woman was endorsed, respondents were asked whether the events occurred with one or more than one person of that gender, with additional clarifying questions for those indicating multiple perpetrators to facilitate interpretability of the data. Participants were then asked to indicate which of the previously endorsed experience(s) occurred during the “most distressing” incident with a perpetrator of each gender endorsed, and responded to a series of questions about this incident. This resulted in detailed information on a maximum of four “most distressing” events (female perpetrated vs. male perpetrated X childhood vs. adulthood). These questions focused on the age at which the event occurred, the age of the other person(s) and the relationship of the other person(s) to the respondent, whether the event occurred once or more than once, whether the event was ever disclosed, and follow-up questions about disclosure.

Childhood trauma exposure.

Participants completed the Adverse Childhood Experiences questionnaire, a 10-item self-report questionnaire assessing the presence or absence of ten adverse childhood events, including physical and emotional abuse, physical and emotional neglect, sexual abuse, intimate partner violence between caregivers, loss/separation from a parent, parental mental health problems or suicide attempt, parental substance use problems, and parental incarceration (Felitti et al., 1998). Because childhood sexual abuse (CSA) was assessed using the modified SAVI questionnaire, making the ACE CSA item redundant, only the other nine items were included in the questionnaire. Childhood sexual abuse was coded as being present if the respondent endorsed any experience of CSA prior to the age of 18.

Labeling of victimization experiences.

Respondents were asked follow-up questions on the event they considered most distressing, including the extent to which they considered the event(s) to be a sexual abuse/assault both at the time of the incident, and currently. Of the 112 respondents who endorsed one or more incidents of FPSA in childhood, 108 provided information on the extent to which they thought the event constituted sexual abuse/assault at the time it occurred, and 111 about the extent to which they currently thought the incident constituted sexual abuse/assault, on a scale from 1 (not at all) to 10 (completely).

Posttraumatic symptoms.

Current posttraumatic symptoms were assessed using the abbreviated PTSD checklist, civilian version (PCL-6). The PCL-6 is an abbreviated version of the PTSD Checklist, Civilian (PCL-C), a validated self-report measure commonly used to screen for and track symptoms of PTSD (Lang & Stein, 2005). The PCL-6 assesses how often an individual has been bothered by 6 posttraumatic symptoms (e.g., intrusive recollections; hyperstartle) over the past month using a 5-point scale ranging from not at all (1) to extremely (5). Responses are then summed, yielding a total score ranging from 5–30. Total scores of 14 or more indicate probable PTSD (Lang & Stein, 2005). The PCL-6 has been shown to adequately assess whether an individual is likely to meet criteria for PTSD in primary care settings, with minimal burden for the respondent. In this sample, α = .89.

Depressive symptoms.

Depressive symptoms were assessed using the Patient Health Questionnaire-8 (PHQ-8), a validated 8-item self-report measure that captures the presence and severity of depressive symptoms over a two-week period (Kroenke et al., 2009). The items assess the frequency of eight depressive symptoms, reflecting the diagnostic criteria for MDD in the DSM-5 (American Psychiatric Association, 2013), omitting the item inquiring about suicidal ideation. Individuals indicate how often they experienced each symptom in the last 2 weeks on a 0–3 scale, with the response options, “Not at all,” “Several days,” “More than half the days,” or “Nearly every day.” Total scores range from 0–24. Individuals with scores <5 are considered to not be experiencing depressive symptoms, scores 5–9 mild depressive symptoms, scores 10–19 moderately severe depressive symptoms, and scores 20+ severe depressive symptoms (Kroenke et al., 2009). Because the PHQ-8 is short in length, it is able to establish whether an individual is likely to meet criteria for a current depressive episode and minimize participant burden and fatigue. In the current sample, α = .89.

Mental health treatment and attribution to FPSA.

Respondents were asked whether they previously received outpatient psychotherapy, intensive outpatient psychotherapy/partial hospitalization, psychiatric hospitalization, and/or residential mental health treatment, and were provided an opportunity to describe any other form of treatment received. If an individual indicated prior receipt of mental health treatment, they were asked whether this treatment was related to the FPSA.

Data Analysis

Prior to analysis, all data were inspected to ensure that respondents appropriately reported childhood victimizations in the “childhood” section of the survey and adulthood victimizations in the “adulthood” section of the survey, and all survey responses were reviewed for clarity. Individuals who reported long-term sexual abuse beginning prior to the age of 18 were reviewed to ensure that if the abuse had continued after the age of 18, it was not erroneously counted as a “revictimization” in adulthood.

Although survey directions requested that respondents indicate their relationship to the male and female perpetrator(s) involved in their “most distressing” childhood and adulthood victimizations, a number of respondents with complex victimization histories endorsed multiple perpetrator relationships (e.g., “aunt” and “neighbor”). In the event of multiple endorsements, qualitative responses and age of victim and perpetrator were first reviewed to determine whether they provided clarifying data. In the absence of such information, a coding decision tree “hierarchy” was implemented based on closeness of the perpetrator’s relationship to and power over the respondent. Thus, if a respondent endorsed 1) a family member, the “most distressing” event was coded as perpetrated by the relative indicated; 2) a caregiver or authority figure (e.g., babysitter; teacher; boss), the event was coded as perpetrated by the relevant caregiver/authority figure indicated, 3) a current/former dating partner, or 4) a friend, classmate, roommates, or co-workers. In the event of victimization in adulthood by someone who was both the respondent’s current/former dating partner and boss, the event was coded as being perpetrated by their current/former dating partner.

In the event that a respondent provided an estimated age range (e.g., “30s”) for their own or their perpetrator’s age at victimization, the mean of the range was inserted as the estimated age. All analyses were performed using SPSS version 25.

Results

Age at FPSA, Other Sexual (Re)Victimization, and Adverse Childhood Experiences

FPSA by victim age category.

Analyses indicated that most of the respondents were victimized in childhood, or both childhood and adulthood. One hundred and twelve (81.2%) of respondents reported FPSA in childhood, 53 (38.4%) reported FPSA in adulthood, and 27 (19.6%) reported both FPSA in both childhood and adulthood.

Across age at victimization, incidents of FPSA were typically perpetrated by females acting alone. Of the 112 FPSA incidents in childhood, 104 victimizations were perpetrated by one female perpetrator, one was perpetrated by two female perpetrators, and three victimizations were clearly indicated as multiple-perpetrator events with both female and male perpetrators. There were four respondents who indicated both female- and male-perpetrated victimizations in childhood whose responses did not clearly indicate whether they experienced single-perpetrator events with both females and males, or a multiple-perpetrator event(s) that were perpetrated by both females and males. Based on the data in our sample, at minimum, 105 (93.8%) FPSA events in childhood were perpetrated by female perpetrators only, challenging prior assertions that female-perpetrators typically co-offend with men. Regarding FPSA in adulthood, of the 53 individuals who reported one or more adulthood FPSA, 44 were perpetrated by one female perpetrator, two were perpetrated by two female perpetrators, and six were perpetrated by a male/female couple. One respondent who endorsed female- and male-victimizations in adulthood did not provide sufficient detail to conclude whether they experienced single-perpetrator events with both females and males, or a multiple-perpetrator event with both a female and male perpetrator. At minimum, 46 (85.2%) of the 53 victimizations in adulthood were perpetrated by female perpetrators, acting alone.

Incidents of childhood FPSA occurred when respondents were 11.69 (SD = 4.41) years of age, on average. Among the 51 respondents who provided their age at the time of their adulthood FPSA, the average age was 21.71 years (SD = 5.38). For a detailed description of FPSA by victim age category (i.e., childhood vs. adulthood), see Table 2.

Table 2.

Adverse Childhood Experiences and Victimization by Perpetrator Gender and Victim Age

Variable	n (%)
Adverse Childhood Experiences	--
Sexual Abuse	127 (92.0%)
Emotional Abuse	97 (70.3%)
Emotional Neglect	81 (58.7%)
Parent with Substance Use Problems	77 (55.8%)
Divorce/Separation	75 (54.3%)
Physical Abuse	74 (53.6%)
Parent with Mental Illness or Suicide Attempt	69 (50.0%)
Witness Intimate Partner Violence	58 (42.0%)
Physical Neglect	41 (29.7%)
Parent Incarcerated	35 (25.4%)
Any Male-Perpetrated Victimization (Yes)	99 (71.7%)
Any Revictimization (Yes)	108 (73.8%)
Female Perpetrated Events (N=138)	--
CSA only	85 (61.6%)
ASA only	26 (18.8%)
Both CSA and ASA	27 (19.6%)
CSA by Perpetrator Sex (N=127)	--
Female Only	43 (31.2%)
Male Only	15 (10.9%)
Female and Male Perpetrators	69 (50.0%)
ASA by Perpetrator Sex (N=87)
Female Only	27 (19.6%)
Male Only	34 (24.6%)
Female and Male Perpetrators	26 (18.8%)
Victimization Across Age & Perpetrator Sex	--
CSA Only	51 (37.0%)
ASA Only	11 (8.0%)
Both CSA and ASA	76 (55.1%)

Prevalence of MPSA and revictimization.

Ninety-nine (71.7%) of the sample reported one or more male-perpetrated victimizations. Of the 112 respondents who reported FPSA in childhood, 69 (61.6%) reported also experiencing childhood MPSA. Of the 7 respondents with confirmed or suspected multiple-perpetrator events with both female and male perpetrators, five indicated they were also victimized by other male perpetrators, and only 2 did not report additional male-perpetrated victimizations in childhood. Of these two, one respondent indicated the only MPSA in childhood they experienced was a victimization perpetrated by a female/male couple; the other respondent could not be determined to have experienced joint maternal/paternal childhood sexual abuse, or to have been separately victimized by their mother and father.

Regarding MPSA in adulthood, of the seven individuals whose responses indicated a confirmed or suspected multiple-perpetrator victimization with both a female and male perpetrator, four indicated that event was their only adulthood MPSA, two reported additional adulthood MPSAs with male perpetrators, and one respondent could not be determined to have experienced a single a joint female/male victimization, or one FPSA and one MPSA separately.

Sixty-one (54.0%) of the respondents who reported childhood FPSA also reported one or more sexual victimizations after the age of 18. Of these, 15 (13.4%) reported adulthood FPSA only, 34 (30.4%) reported adulthood MPSA only, and 12 (10.7%) reported both adulthood FPSA and MPSA. Over 90% of respondents reported at least one sexual victimization prior to the age of 18, across gender; only 11 (8%) of respondents reported their first victimization occurred in adulthood. Even among individuals who were first victimized in adulthood, victimization by multiple perpetrators was relatively common. Four (36.3%) of the 11 reported both male and female perpetrators in adulthood. Only 7 respondents, or 5.1% of the original sample, reported a single victimization in adulthood.

Overall revictimization, defined as reporting more than one perpetrator across the lifespan, after correcting for multiple-perpetrator events, was reported by 108 (78.3%) of the sample. Taken together, these findings indicate the presence of a single incident of FPSA is associated with childhood sexual victimization, as well as revictimization over the lifespan. For a detailed analysis of childhood and adulthood victimization by perpetrator sex and victim age category, see Table 2.

Adverse childhood experiences.

The sample’s reported exposure to ACEs is far higher than the observed prevalence in other research, and higher than mean ace exposure among individuals who experienced childhood sexual abuse documented in other samples (Dong et al., 2003). Only 1 (0.7%) participant reported 0 ACEs, 9 (6.5%) reported 1, 10 (7.2%) reported 2, 17 (12.3%) reported 3, 17 (12.3%) reported 4, and 84 (60.9%) reported 5 or more. The mean number of ACEs was 5.32 (SD = 2.54). For a full description of ACE exposure, see Table 2.

Perpetrator Age and Relationship to Victim

Respondents who endorsed an experience of childhood FPSA estimated their perpetrator’s age as 22.45 (SD = 9.82) years at the time of victimization, on average. The majority reported victimization by a friend, classmate, neighbor, or co-worker (56.6%); approximately 1 in 4 (23.2%) were victimized by a relative; and approximately 1 in 5 (18.8%) were victimized by a babysitter. Less commonly, perpetrators were dating partners or authority figures (e.g., teacher, coach, doctor, religious figure). Victimization by a stranger was quite rare (1.8%).

Forty-nine of the 53 respondents who experienced adulthood FPSA provided information on their perpetrator’s age at the time of victimization, which was estimated as 26.84 (SD = 8.03) years, on average. Over half of perpetrators were reported to be a friend, dormmate, roommate, classmate, neighbor, or co-worker (50.0%) of the victim. The next most common relationship was current- and ex-romantic partners (e.g., dating partner; spouse; 13.2%), followed by informal acquaintances (7.5%). For information on perpetrator-victim relationships, see Table 3.

Table 3.

Primary Female Perpetrator’s Relationship to Respondent

Childhood Sexual Abuse (n = 112)	n (%)	Adult Sexual Assault (n = 53)	n (%)
Friend, Classmate, Neighbor, Coworker	44 (39.3%)	Friend, Dormmate, Roommate, Classmate,	30 (56.6%)
Relative	26 (23.2%)	Neighbor, or Coworker
Mother	5 (4.5%)	Current or Former Dating Partner/Spouse	7 (13.2%)
Aunt	8 (7.1%)	Acquaintance (e.g., friend of a friend)	4 (7.5%)
Sister or Step-Sister	4 (3.6%)	Stranger	3 (5.7%)
Grandmother	1 (0.9%)	Boss/Supervisor	2 (3.8%)
Female cousin	6 (5.4%)	Boss/Supervisor and Former Spouse/Partner	1 (1.9%)
Other Female Relative	2 (1.8%)	Relative (Aunt)	1 (1.9%)
Babysitter	21 (18.8%)	Other	5 (9.4%)
Current or Former Dating Partner	4 (3.6%)
Teacher, Instructor, or Coach	3 (2.7%)
Acquaintance (e.g., family friend)	3 (2.7%)
Stranger	2 (1.8%)
Two female friends who co-assaulted participant	1 (0.9%)
Other	8 (7.1%)

Event Labeling and Disclosure Prevalence

Labeling.

Respondents’ median rating of the extent to which they considered childhood FPSA to be sexual abuse/assault at the time of the event on a scale from 1 (not at all) to 10 (completely) was 5.00 (IQR = 3.00–8.75), and 9.00 (IQR = 6.00–10.00) at the time of the survey. Respondents median rating of the extent to which they considered the adulthood FPSA to be sexual assault at the time of the event was 7.00 (IQR = 4.00–9.00), and 8.00 (IQR = 6.00–10.00) at the time of the survey (all 53 respondents who endorsed FPSA in adulthood provided data).

Disclosure.

Overall, 75 respondents (54.3%) disclosed at least one incident of FPSA to another person prior to study participation. Fifty-four (48.2%) of those who reported FPSA in childhood disclosed it to someone else, as did 27 (50.9%) of those who experienced FPSA in adulthood. Just under half of respondents indicated they disclosed FPSA occurring in childhood, and approximately half indicated they disclosed FPSA that occurred in adulthood. Disclosure data are presented in Table 4.

Depressive and Posttraumatic Symptoms, Treatment History, and Attribution to FPSA

Respondents’ reported psychological functioning and the prevalence of both depressive and posttraumatic symptoms were highly variable. The mean PHQ-8 score was 11.85 (SD = 6.19), indicating moderate depressive symptoms, on average. Seventeen (12.3%) respondents reported no depressive symptoms, 37 (26.8%) reported depressive symptoms falling in the mild range, 33 (23.9%) in the moderate range, 34 (24.6%) in the moderately severe range, and 17 (12.3%) in the severe range. The mean PCL-6 score was 18.31 (SD = 6.32), which is above the clinical cut-point for probable PTSD. Based on the scoring guidelines of the PCL-6, 98 (71.0%) met the clinical cut-point for a probable diagnosis of PTSD.

Regarding mental health treatment, 89 (64.5%) of the sample reported having sought some form of mental health treatment in the past. Of these, 70 (50.7%) reported receiving outpatient psychotherapy, 16 (11.2%) intensive outpatient therapy or partial hospitalization, 24 (17.4%) reported a prior inpatient psychiatric hospitalization, and 16 (11.6%) reported prior residential treatment. An additional 2 respondents (1.4%) indicated they engaged in “another” form of treatment, with one specifying self-paced research and self-help, and the other not providing additional information regarding treatment. Twenty-six (28.6%) of those who sought some form of mental health treatment indicated it was related to the FPSA.

Discussion

The goals of the current research were to identify characteristics of victims and perpetrators of FPSA using a community sample of self-reported survivors of FPSA. Overall, FPSA in childhood occurred at around the age of 11–12, and was most often perpetrated by individuals with an existing relationship to the respondent, such as friends, classmates, neighbors, and co-workers, family members, and babysitters. Victimization by other authority figures (e.g., teachers and coaches) and dating partners was less common prior to age 18, though it did occur. Adulthood FPSA occurred at age 22–23 years, on average. Over half of adulthood FPSAs were perpetrated by a friend, neighbor, roommate, dormmate, classmate or co-worker, followed by a current or former dating partner. Regardless of age the time of victimization, FPSA was typically perpetrated by females acting alone. In our sample, the theory that female perpetrators typically co-offended with men—a theory that largely maintains the narrative that women are nonviolent, and only perpetrate sexual violence in the context of male initiation and coercion—was not supported, consistent with other conceptual analyses of FPSA and research focusing on FPSA victims (Deering & Mellor, 2010; Hetherton, 1999).

Respondents typically did not label incidents of FPSA as victimizations at the time they occurred, but showed greater tendency to do so by the time of survey participation. Across age at victimization, disclosure of FPSA hovered at around 50%. Approximately 54% reported disclosure of any incident of FPSA to another person prior to study participation. Respondents were generally highly trauma exposed, overall. The average number of ACEs was 5, which is far higher than the observed prevalence in other research, and also higher than mean ACEs among individuals who experienced childhood sexual abuse in other samples (Dong et al., 2003). In addition, 71.2% experienced at least one MPSA, and 78.3% were revictimized once or more. Over 60% of the sample reported current depressive symptoms that could be described as moderately severe or worse on the PHQ-8, and just over 70% met the clinical cut-point for PTSD at the time of study participation, based on self-reported symptoms on the PCL-6. Despite significant current symptomology, only 64.5% accessed mental health treatment in the past. The significant mental health burden, and negative long-term impact noted by participants is consistent with those reported in qualitative research on FPSA (Deering & Mellor, 2011).

Implications

Research on victims of FPSA is in many ways in its nascency, and there is little quantitative research focusing on survivors of FPSA. One of the major implications of the current study is the finding that victims of childhood FPSA are often victimized by individuals they are in close relationships with, such as family members and other caregivers, including babysitters. Perpetrations by family members and babysitters accounted for just over 40% of the reported incidents, and these perpetrators’ roles as family members or trusted caregivers indicates a high degree of betrayal associated with these victimizations (Edwards et al., 2012). The relatively high prevalence of babysitter perpetration in the sample is concerning, given that caregivers may hire only female babysitters based on the belief that males, but not females, perpetrate sexual abuse and assault.

There is widespread minimization of female-perpetrated victimization, and clear evidence that FPSA is judged to be less violent, severe, and damaging relative to MPSA without empirical precedent for this assertion (Banton & West, 2020; Denov, 2003; Hetherton, 1999; Leone et al., 2019). The minimization of FPSA’s severity and effects are in stark contrast with the finding that FPSA victims report high levels of lifetime trauma, revictimization, and adverse mental health outcomes. The high trauma burden of this population underscores the need to comprehensively assess individuals’ trauma histories in clinical settings, with an awareness that FPSA is underrecognized and may be “missed” or not disclosed. The presence of an experience of FPSA may also be a meaningful indicator of a complex trauma history, given that revictimization in this sample was the rule, rather than the exception.

It is also important to note that both sexual and gender minority (SGM) individuals and individuals with disabilities were overrepresented in the current sample. These findings potentially indicate that SGM individuals are either differentially targeted by female perpetrators, or more often label victimizations as sexual assaults, relative to their heterosexual, cisgender peers. Similarly, the high prevalence of individuals with disabilities in the sample may indicate greater victimization risk among this population, or reflect long-term emotional and physical health sequelae associated with significant trauma exposure.

Strengths and Limitations

This study is one of the first to specifically focus on survivors of FPSA using mixed-methods and self-report methodology using empirically validated measures. The current project also uses a community panel sample, rather than focusing on cases that were formally reported, which may capture a broader range of victims and victimization experiences than prior research. This is especially true, since the rates of formal reporting were so low among victims of FPSA in our sample, indicating data drawn from formally reported victimizations represent only a small minority of cases. Other strengths of this study include the use of a diverse community sample that was varied in terms of race/ethnicity, sexual orientation, gender/gender identity, education and employment, annual income, and disability status, increasing generalizability of results.

Limitations of the study include the use of retrospective report, which may be subject to normative memory degradation over time, and self-report measures for depressive and posttraumatic symptoms. The study only collected data on up to four of the most distressing sexual victimizations an individual experienced based on the respondent’s age at victimization and the perpetrators’ gender. This methodology may have resulted in quite distressing victimizations being omitted, if for example someone experienced two separate sexual assaults in adulthood by individuals of the same gender, as well as limited reporting of sexual assaults that were not subjectively experienced as distressing. Although the utilization of a panel sample enabled broad community sampling, there may be qualities unique to survey panel data (e.g., high prevalence of respondents who work from home) that differ from those of the US population, overall.

Future Directions

Future directions include consistent assessment of FPSA among individuals who report MPSA, factors affecting disclosure, disclosure response, potential differential treatment of formal disclosure of FPSA vs. MPSA, and longitudinal research that enables ecologically valid assessment of FPSA survivors’ well-being and psychological outcomes over time. In addition, research assessing similarities and differences between FPSA and MPSA is needed to identify common and unique factors promoting risk and/or resiliency among survivors of sexual violence by perpetrator gender. Future research, consisting of individuals whose victimization experiences are varied across perpetrator gender, would benefit from identifying whether specific individuals and groups disproportionately experience FPSA, as compared to MPSA. For example, testing empirically whether racial/ethnic minorities, sexual/gender minorities, and other groups disproportionately experience FPSA vs. MPSA, and how victimization profiles differ based on identity. Although sexual and gender minority individuals were overrepresented in this sample, the reasons for this are unclear, and would benefit from further empirical investigation.

In this sample, individuals who experienced FPSA were highly trauma exposed. Though FPSA may not confer risk for repeated victimization, it may that the presence of one or more event of FPSA may be an indicator of significant trauma exposure. Research comparing individuals who experience FPSA, MPSA, and/or both would better disentangle whether FPSA is an indicator of significant trauma exposure, or creates unique vulnerability for victimization. Due to trauma exposure in the sample, it is unclear whether the depressive and posttrauma symptoms are associated with FPSA specifically, or the overall trauma burden of the sample. However, respondents who endorsed FPSA endorsed significant symptomology, indicating FPSA may have significant, long-term impact on survivors.