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Women whose first sexual encounter involved coercion appear to be at higher risk for some health problems, according to new research based at the Cambridge Health Alliance.
One in 16 American women reports that her first sexual encounter involved physical or emotional coercion, according to the study in the journal JAMA Internal Medicine.
Lead researcher Dr. Laura Hawks says the strongest health links were to conditions of chronic pelvic pain, "so that's sort of a signal that sexual trauma is often going to manifest itself later on, and it may present as chronic pain."
The study also finds that the average age of the women in those coerced first sexual encounters was 15, compared to age 17 among women who were not forced. The men in those cases of coercion were significantly older: 27 compared to 21 in the non-coerced encounters, the study finds.
"So there was a huge age discrepancy," Hawks says.
The health issues that were more prevalent among the women whose sexual initiation involved coercion included endometriosis, pelvic inflammatory disease, disorders of ovulation and menstruation and general poor health.
"We also found some adverse obstetrical outcomes," Hawks says, "including women reporting a younger age at their first pregnancy and a lower likelihood that their first pregnancy was wanted or desired, and also increased number of women who had reported having an abortion."
She cautions that the study does not prove that the sexual coercion actually caused any of the health conditions — it merely shows a correlation. But "I think when it comes to clinical practice, it's sort of a moot point," she says, "because if you can identify this as a risk factor, then it's probably something that should be taken seriously."
The study looked at survey responses from more than 13,000 women of child-bearing age and categorized them as having experienced "forced sexual initiation" depending on how they answered the question: "Would you say that this first vaginal intercourse [with a male] was voluntary or not voluntary, that is, did you choose to have sex of your own free will or not?"
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