Cyber sexual harassment against women and impact on health. A cross-sectional study in a representative population sample.

BACKGROUND: This study focuses on the frequency of cyber sexual harassment (CSH) and examines its link with five health impact indicators (self-perceived health, medication, suicidal ideation, suicide attempts and use of health services). METHODS: Analyzing the data provided by the 2019 Macro-survey on violence against women in Spain, two items of which refer to CSH. It was conducted in Spain on a representative sample of 9568 women aged over 16 years old. RESULTS: A total of 9.15% of the women surveyed had experienced CSH at some point in their lives. Being under 25 years old, having higher education, not being in a relationship, having no religious beliefs and having a certified disability are sociodemographic characteristics associated with a higher risk of CSH. Women who have experienced other forms of gender-based violence also show an increased risk. Female victims of CSH reported higher rates of suicidal ideation (20% versus 9.79% in non-victims of CSH) and suicidal attempts (7.20% versus 1.74% in non-victims of CSH). CONCLUSIONS: These findings have significant implications for the design of preventive health polices, which should incorporate strategies to address CSH as part of the continuum of multiple interrelated forms of gender violence that affect women and girls throughout their lives.

Workplace sexual and gender-based harassment in Denmark: a comparison of the self-labelling and behavioural list method.

AIM: Knowledge about the prevalence of sexual and gender-based harassment is hampered by disagreements about definitions and measurement methods. The two most common measurement methods are the self-labelling (a single question about exposure to sexual harassment) and the behavioural list method (an inventory of sexually harassing behaviours). The aim of this paper was to compare the self-labelling and the behavioural list methods for measuring sexual harassment and assess the association with depressive symptoms. METHODS: The study is based on a convenience sample of 1686 individuals employed in 29 workplaces in Denmark. Survey data were collected from November 2020 until June 2021 and there were 1000 participants with full data on key variables. We used a linear mixed-effects model to examine the relationship between sexual harassment and depressive symptoms. RESULTS: In total, 2.5% self-labelled as being sexually harassed, while 19.0% reported exposure to at least one type of sexual and gender-based harassment using the behavioural list method. Both groups reported higher levels of depressive symptoms compared with non-exposed employees. The most common types of behaviours were: that someone spoke derogatorily about women/men (11.6%); being belittled because of one's gender or sexuality (4.7%); and unwanted comments about one's body, clothes or lifestyle (4.5%). CONCLUSIONS: The behavioural list method yielded a higher prevalence of sexual and gender-based harassment compared with the self-labelling method. Self-labelling and reporting at least one type of sexual and gender-based harassment was associated with depressive symptoms.

Prevalence of sexual harassment and its association with aspects self-reported health: A cross-sectional study in Sweden.

AIMS: Sexual harassment is common and may have serious consequences for well-being and health. We investigated the prevalence of sexual harassment in the general population of Stockholm County across socio-demographic groups and sexual identity, and its association with self-reported health. METHODS: Experiences of sexual harassment in the previous 12 months and its associations with self-reported health (depression, anxiety, suicidal ideation) were assessed in 2021/2022 among a random sample of 22,890 residents in Stockholm County aged 16 and older. Analyses were done using descriptive statistics and multivariate logistic regression (odds ratios and 95% confidence intervals (CI)). Calibration weights were used to estimate population-representative rates with 95% CI. RESULTS: The highest weighted prevalence was observed among 16- to 24-year-olds (18.9%, 95% CI 16.9%-20.9%). Women (9.5%; 95% CI 8.8%-10.1%) reported a higher prevalence than men (2.9%; 95% CI 2.5%-3.3%). Compared to heterosexual people, bisexual and homosexual people reported a higher prevalence of sexual harassment. No significant difference was observed related to country of birth. People who were students, unemployed or on sick leave were more exposed than employed people, although this was not significant when adjusted for age and registered sex. Experiences of sexual harassment was associated with higher odds of all aspects of self-reported health. CONCLUSIONS: Experiences of sexual harassment in the general population are common and associated with adverse self-reported health. There is a need for enhanced efforts to prevent sexual harassment in the general population and to empower specific risk groups such as women and sexual minorities.

Sexual harassment and implicit gender-career biases negatively impact women's life expectancy in the US: a state-level analysis, 2011-2019.

BACKGROUND: Despite some gains, women continue to have less access to work and poorer experiences in the workplace, relative to men. The purpose of this study was to examine the relationships among women's life expectancy and two work-related factors, sexual harassment and gender-career biases. METHOD: We examined the associations at the state level of analysis (and District of Columbia) in the US from 2011 to 2019 (n = 459) using archival data from various sources. Measures of the ratio of population to primary health providers, year, the percent of adults who are uninsured, the percent of residents aged 65 or older, and percent of residents who are Non-Hispanic White all served as controls. RESULTS: Results of linear regression models showed that, after accounting for the controls, sexual harassment and gender-career biases among people in the state held significant, negative associations with women's life expectancy. CONCLUSION: The study contributes to the small but growing literature showing that negative workplace experiences and bias against women in the workplace negatively impact women's health.

Gender-based violence and harassment at work and health and occupational outcomes. A systematic review of prospective studies.

BACKGROUND: Many people experience forms of gender-based violence and harassment (GBVH) in the context of their work. This includes a wide range of experiences, from subtle expressions of hostility to physical assault, that can also be of a sexual nature (e.g., sexual harassment or assault). This systematic review aimed to summarize findings about the prospective associations of work-related GBVH with people's health and occupational situation. METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Scopus, Web of Science, MEDLINE and PsycINFO were searched for prospective studies in English from 1990 to May 24, 2023. Studies were included if they concerned a working population, exposure to any form of GBVH in the work context, and a health outcome or manifest occupational outcome. Quality was assessed with a modified version of the Cochrane 'Tool to Assess Risk of Bias in Cohort Studies', and studies assessed as low quality were excluded from the narrative synthesis. For the narrative synthesis, we grouped the results by similar exposures and outcomes and reported the strength and statistical significance of the associations. RESULTS: Of the 1 937 screened records, 29 studies were included in the narrative synthesis. Studies were mainly conducted in the USA and northern Europe and investigated exposure to sexual violence or harassment (SVH). Only two included studies investigated non-sexual kinds of GBVH. Consistently, studies showed associations of work-related SVH with poor mental health and there were indications of an association with hazardous substance use. There was no consistent evidence for an association of SVH with subsequent sickness absence, and there were too few studies concerning physical health and occupational outcomes to synthesize the results. CONCLUSIONS: There is consistent evidence of work-related SVH as a risk factor for subsequent poor mental health. There is no indication that the health consequences of SVH differ between women and men, although women are more often affected. There is a need for conceptual consistency, the consideration of non-sexual behaviors and prospective studies that test clear hypotheses about the temporal sequence of events.

Sexual harassment, sexual violence and subsequent depression and anxiety symptoms among Swedish university students: a cohort study.

PURPOSE: To determine the gender-specific impact of recent exposure to different forms of sexual harassment and sexual violence (SHV) on depression and anxiety symptoms three, six, and nine months later. METHODS: We recruited 2229 women and 1274 men studying at Swedish universities and followed them with web-surveys every three months over one year. We estimated mean differences (MDs) of depression and anxiety symptoms between exposed and unexposed at each follow-up, adjusting for prior SHV, prior depression and anxiety symptoms and potential confounders. RESULTS: For women, sexual harassment (wide subjective definition) was associated with higher symptom levels of depression (MD 1.0 [95% CI: 0.3; 1.7]) and anxiety (MD 0.8 [95% CI: 0.3; 1.4]) three months later. Unwanted sexual attention was associated with higher symptom levels of anxiety three (MD 0.5 [95% CI: 0.1; 0.8]) and six months later (MD 0.4 [95% CI: 0.0; 0.7]). Exposure to sex against ones will was associated with higher depression symptoms three (MD 1.7 [95% CI: 0.1;3.4]), and six months later (MD 3.1 [95% CI: 1.0; 5.2]). Trends indicated that associations with subsequent mental health differed between forms of SHV among women, and that most associations were more pronounced in temporal proximity to the exposures. For men, we refrain from interpreting the results since they showed high variability and were not robust to sensitivity analyses using multiple imputation to account for missing outcome data. CONCLUSIONS: Among women, several forms of SHV were associated with higher subsequent depression and anxiety symptoms.

Safeguarding healthcare professionals from sexual harassment in the workplace: urgent need for effective training and education.

Sexual harassment (SH) is a particularly harmful type of harassment that can inflict lasting psychological harm on victims. Within the healthcare sector, it negatively impacts teamwork, communication, and potentially compromises patient care. While concerns about workplace SH, including in healthcare, are long-standing, the #MeToo movement has brought renewed scrutiny to this issue since late 2017. Despite increased awareness, evidence suggests that SH remains prevalent in healthcare settings and shows no signs of decline over time. Therefore, there is an urgent need for effective training and intervention measures to enhance the identification of potential sexually offensive behaviors, thus fostering a work environment characterized by respect and inclusivity.

Prevalence and Impact of Workplace Sexual Harassment Experienced by Medical Sonographers.

OBJECTIVE: To assess the prevalence and impact of sexual harassment among a nationwide sample of medical sonographers. METHODS: A survey was distributed anonymously to a convenience sample of medical sonographers via email contacts and sonographer-specific social media pages. Data were analyzed to determine respondent demographics, the prevalence of sexual harassment in the last 2 years, the type and severity of harassment experienced, demographics of perpetrators, personal and institutional responses to such experiences, and the impact of sexual harassment on sonographer physical and mental health and job satisfaction. RESULTS: Of the 220 sonographers (83% female) most (45%) were between 18 and 34 years and identified as white (81%). A total of 192 (87%) reported experiencing at least 1 incident of harassment within the last 2 years. Female respondents experienced higher harassment rates (76%) compared to males (50%, P = .02). The most common forms of harassment were verbal, including suggestive or sexist jokes (69%) and offensive sexist remarks (61%). Perpetrators were predominantly male (78%) and most commonly patients (89%) or their friends/family members (46%). The majority of respondents either ignored the harassing behavior (70%) or treated it like a joke (50%), with only a minority (12%) officially reporting incidents. Of those who reported, 44% were unsatisfied with their institution's response. Among respondents, 34% reported negative impacts of workplace sexual harassment, such as anxiety, depression, sleep loss, or adverse workplace consequences. DISCUSSION: Workplace sexual harassment is a common occurrence for sonographers and often leads to negative health and career outcomes. Further institutional policies to prevent harassment and mitigate its effects are needed.

Musculoskeletal pain among medical residents: role of workplace safety climate and sexual harassment.

BACKGROUND: Workplace factors are important predictors of occurrence of musculoskeletal pain among different occupational populations. In healthcare, a psychologically unsafe work environment can negatively affect the emotional, physical and psychological well-being of physicians. This study aimed to examine the relationship between workplace violence, sexual harassment and musculoskeletal pain among Egyptian physicians in their years of residency. METHODS: We distributed an online self-administered questionnaire to 101 residents working in various healthcare sectors in Egypt. It included sections on demographic data, working conditions, widespread pain index (WPI), pain interference short-form, workplace violence and harassment questionnaire, psychosocial safety climate questionnaire (PSC) and sexual harassment climate questionnaire. RESULTS: All residents had at least one painful site on the WPI (range 1-11). The mean WPI was 3.5 ± 2.4, and 39.6% satisfied the criteria of having widespread pain by having at least 4 pain sites. Widespread pain index showed a weak statistically significant negative correlation with workplace PSC score (rho = - 0.272, p = 0.006), and a statistically significant weak positive correlation with the calculated total abuse index (rho = 0.305, p = 0.002). Workplace violence and abuse, as measured by a calculated abuse index was the only significant predictors of widespread pain among residents. CONCLUSION: WPV was found to be a predictor of musculoskeletal pain among medical residents. Healthcare organizations need to address WPV by employing preventive strategies to minimize its hazardous effects and ensure a safe working environment for physicians.

'We need a culture change': military sexual trauma through the lens of rape culture.

Military sexual trauma remains a critical concern within the US military. One possible explanation for the persistence of this trauma is the presence of rape culture. This study examined perceptions of military sexual trauma within the framework of rape culture (i.e. traditional gender roles, sexism, adversarial sexual beliefs, hostility toward women, and acceptance of violence), in addition to associated factors, to address the US Department of Defense's call to focus on the role of culture on military sexual trauma. Focusing on culture is important as subtle norms in culture shape our behaviour and impact the excusal/perpetration of military sexual trauma. Identifying these norms may provide insight into factors to target in prevention efforts to reduce/eliminate military sexual trauma. Forty-two US service members responded to a series of open-ended questions. Standard content analysis procedures were utilised to determine themes. Results paint a complex picture of military sexual trauma, with participants demonstrating concern regarding military sexual trauma, but minimal acknowledgement of behaviour change to reduce military sexual trauma. These results are consistent with the observed increase in prevalence of military sexual trauma and decrease in reporting of it since 2018. Adding to the existing literature, participants noted the continued existence of rape culture within the military and the need for cultural change to address military sexual trauma.

Peer sexual harassment, appearance esteem, and emotional problems: Testing a mediation model across early adolescence.

This study used a longitudinal sample of early adolescent boys and girls (ages 10-12; N = 1113) to test a theoretically and empirically informed model suggesting that exposure to peer sexual harassment (age 10) predicts more emotional problems (age 12), and that lower appearance esteem (age 11) mediates this relation. On the within-person level, which is the level on which the processes theoretically should play out, we found no support for the proposed mediation model for boys or for girls. Unexpectedly, we found that following times of more exposure to peer sexual harassment than usual, early adolescents instead experienced higher appearance esteem and fewer emotional problems than usual. More research is needed to replicate and understand these unexpected findings.

Peer sexual harassment among 10-year-olds: Roles, genders, classroom occurrence, and associations with emotional problems.

This is the first study examining peer sexual harassment among 10-year-olds (N = 985), studying how being a victim, perpetrator, or witness relates to emotional problems, and how these associations are moderated by gender and class occurrence of sexual harassment. Results showed that 45% of the participants reported victimization, 17% perpetration, and 60% witnessing sexual harassment, with vast overlaps between roles. Victimization and witnessing were related to more emotional problems. Victimized girls reported more emotional problems than boys, but girls who perpetrated reported fewer emotional problems than boys. Associations between peer sexual harassment and emotional problems varied across classrooms. Our findings highlight the occurrence of peer sexual harassment in younger ages, emphasizing an ecological perspective when addressing it in school.

The Saturation- and Dose-Dependent Effects of a Teen Sexual Harassment Prevention Program: Findings from a Randomized Controlled Trial.

Using a randomized controlled trial, we investigated changes in both sexual harassment (SH) perpetration and victimization of 2104 middle school students in New York City who received divergent saturation and dosage levels of Shifting Boundaries, an SH prevention program, which was represented by the length of the program. We assessed the saturation effect of the program by comparing the outcomes across respondents from 26 schools in which there were varying percentages of students enrolled in the program. The data suggested that, overall, the program was effective in reducing sexual harassment victimization but achieved a null effect against respondents' SH perpetration and that neither the length nor the school-saturation level of the program exerted a significant effect on SH perpetration. Although the data indicated a significant difference in SH victimization between the treatment and control group, when comparing subgroups who received treatment with divergent saturation and dosage levels, no statistically significant difference was identified. Our results suggested that the program effect was not contingent on the portion of students in a school who enrolled in the program, nor was it contingent on the dosage.

The relationships of sexually harassing behaviors to organizational context factors and working men's dark personality traits.

This research examined the roles of organization contexts factors and dark personality traits in men's (N = 600) self-reports of sexually harassing behaviors toward women in the workplace. Four organization context factors (a permissive climate, a masculinized job/gender context, male/female contact, and Masculinity Contest Culture [MCC] Norms) and four dark personality traits (psychopathy, narcissism, Machiavellianism, and sadism) were examined. While only one organizational context factor, MCC Norms correlated with men's admissions of sexually harassing behaviors at work, all four dark personality traits evidenced significant correlations. In a multiple regression analysis, MCC Norms emerged again as the single organizational context predictor and psychopathy as the single personality predictor of men's admissions of sexually harassing behaviors at work. Moderation analyses showed that a masculinized job/gender context interacted with psychopathy to produce more admissions of sexually harassing behaviors. Mediation analyses showed that psychopathy, narcissism, and Machiavellianism had indirect relationships with admissions of sexually harassing behaviors through MCC Norms. Higher levels on these traits were related to higher levels of these workplace norms which, in turn, predicted more admissions of sexually harassing behavior. This research sheds new light on how both organizational contexts and enduring personal characteristics of men are related to sexual harassment in the workplace.

Individual and contextual-level predictors of progression in the bystander intervention model.

The situational model of bystander behavior is a validated 5-step process for understanding intervention in bullying and sexual harassment, yet the individual-level and contextual-level factors that facilitate the progression from one step to the next are not well understood. The purpose of the current study was to examine whether individual characteristics (social-emotional skills, affective empathy, cognitive empathy, and personal attitudes toward bullying and sexual harassment) and contextual-level factors (school climate and perceived peer attitudes toward bullying and sexual harassment) explained the association between subsequent steps of the bystander intervention model. A sample of 788 high school students completed several validated measures of these constructs. Structural equation modeling analysis revealed that each step significantly and positively predicted the next step, and the addition of a direct path from accepting responsibility to helping improved model fit. The mediational model indicated that individual-level characteristics had significant direct effects on interpreting bullying and sexual harassment as problems, accepting responsibility, and helping, and indirect effects from noticing the bullying and sexual harassment to all subsequent steps except knowing. In contrast, contextual-level effects contributed to accepting responsibility in an inverse direction.

Examining medical students' experience of gender-based discrimination and sexual harassment from clinical teachers at a UK medical school.

PURPOSE OF THE ARTICLE: To quantify the prevalence and characterise the nature of gender-based discrimination (GBD) and sexual harassment (SH) arising from clinical teachers towards medical students at one UK medical school. MATERIALS AND METHODS: A mixed quantitative and qualitative survey of medical students. Chi-squared analysis and logistic regression was performed on quantitative data, while an inductive thematic analysis of qualitative data was undertaken. These findings were compared to look for common patterns. RESULTS: Females were significantly more likely to report experiencing both GBD (χ2 = 38.61, p < 0.0001) and SH (χ2 = 19.53, p < 0.0001) than males (OR = 10.45 (CI 4.84 - 22.56, p < 0.0001)). These behaviours were more likely to be reported in specific surgical placements than medical placements (χ2 = 15.06, p < 0.001 and χ2 = 5.90, p < 0.05). Perpetrators were more commonly male, and more commonly consultants. Exposure to GBD or SH was significantly more likely to affect the choice of specialty in females compared to males (χ2 = 11.17, p < 0.001). Students noted a casual use of sexist language, inappropriate sexual advances, and gender-based microaggressions which create a pervasive discrepancy in educational opportunities between genders. Participants reported that concerns regarding anonymity, questioning the severity of the incident, and an ingrained medical hierarchy prevented students reporting these incidents. CONCLUSIONS: The rate of GBD and SH from clinical teachers to medical students remains high, affecting female students more than male students. This study highlights key areas that must be improved to achieve a more equitable teaching experience in UK medical schools. Developing robust reporting and support systems is an important step in eradicating these behaviours.

The nature and extent of youth sextortion: Legal implications and directions for future research.

Sextortion, the threatened dissemination of explicit, intimate, or embarrassing images of a sexual nature without consent, is an understudied problem. Despite a recent increase in reported incidents among adolescents in the United States, little is known about the nature and extent of sextortion among this population. The current research explores sextortion behaviors among a national sample of 4972 middle and high school students (mean age = 14.5) for the purpose of illuminating how many youth are targeted, and understanding various characteristics of the incident (including who was involved, what offenders wanted, what offenders did, and who targets told). About 5% of youth reported that they were victims of sextortion, primarily by people they knew. Many of those targeted did not disclose the incident to adults. Implications for future research and the law are discussed.

Sexual harassment and patterns of symptoms and functional abilities in a psychiatric sample of adolescents.

PURPOSE: To investigate how commonly adolescent psychiatric outpatients with symptoms of depression and anxiety report having been subjected to sexual harassment, and to explore how symptoms and functional abilities differ between adolescent psychiatric outpatients with symptoms of depression and anxiety who do report and those who do not report having been subjected to sexual harassment. METHODS: Swedish adolescent psychiatric outpatients with symptoms of depression or anxiety (n = 324; 66 boys and 258 girls, aged 12-19 years, M = 15.6, SD = 1.7) answered the PROMIS paediatric measures. Logistic regression analyses were performed to assess differences between the respondents classified as 'Sexually harassed' and 'Not sexually harassed' based on these self-report questionnaires. RESULTS: About 60% of the adolescents reported having been subjected to sexual harassment, and reported higher levels of suicidal ideation, disturbed sleep, fatigue, anxiety, depression, anger, and pain interference, as well as lower functional ability in terms of school problems, alcohol consumption, and poor family relationships. Logistic regression analyses showed that the strongest associations were with suicidal ideation, disturbed sleep, anger, and alcohol consumption. CONCLUSIONS: About 60% of the adolescents in the studied psychiatric cohort reported having been subjected to sexual harassment. Reported experiences were high in all three subtypes, with the most reports on having been subjected to verbal harassment. Clinicians should ask about experiences of sexual harassment and give information about the consequences of sexual violence and treatment options. Alcohol consumption should be addressed and tested for. Structured assessment of suicidality should always be done.

Development and validation of the nurses sexual harassment scale in Iran.

INTRODUCTION: In recent years, the prevalence of sexual harassment has become a global problem, and nursing, like other professions, has not been immune to this issue. By having a valid and reliable instrument, healthcare personnel can be helped in preventing and managing this problem and reduce its negative consequences on mental health and well-being. The aim of this study was developing and psychometrically measuring the Nurses Sexual Harassment Scale. MATERIALS AND METHODS: This study is the second phase of a mixed method study. Initially in the first phase, a qualitative approach with conventional content analysis was used to explain nurses' experiences of sexual harassment in the workplace. To design the Nurses Sexual Harassment Scale, qualitative data and literature were reviewed. In the quantitative phase (second phase), the target scale was psychometrically evaluated using content validity (14 experts), face validity (12 nurses with being sexually harassed), construct validity (316 nurses working in hospitals affiliated to Kerman University of Medical Sciences), and reliability (internal consistency and repeatability). RESULTS: A 15-item scale with two components: "latent sexual harassment" (9 items) and "manifest sexual harassment" (6 items), which explained 68.4% of the total variance was developed. Also, due to the strong correlation between the Nurses Sexual Harassment Scale and the Impact of Event Scale-Revised (r = 0.67), convergent validity was confirmed. Also, the scale of the present study had good reliability (Cronbach's alpha coefficient = 0.94, Omega coefficient = 0.94, and ICC = 0.92). CONCLUSION: Given the importance of sexual harassment among nurses, measuring the dimensions of this problem may allow professionals to plan interventions to prevent it. Overall, the results of the present study showed that the psychometric properties of the " Nurses Sexual Harassment Scale" with 15 items are acceptable and this scale can be used in the clinical environment. A further study within the nursing community is recommended to confirm the findings.

Risk factors of sexual violence perpetration and victimization among adolescents: A study of Norwegian high school students.

Sexual violence among adolescents represents a significant problem in society. In this study, we aimed to examine risk factors for sexual violence perpetration in adolescent men and victimization in adolescent women among a community sample of Norwegian high school students. The participants (560 men and 751 women, aged between 16 and 21 years) responded to online questionnaires covering physical and non-physical forms of sexual harassment and possible risk factors identified in the literature. Last year's prevalence rate of physical sexual perpetration reported by adolescent men was 7%. Comparably, the prevalence of physical sexual victimization reported by adolescent women was 30%. Path analyses suggest that sociosexuality was associated with adolescent men's sexual perpetration indirectly through sexual risk taking, alcohol intoxication, porn exposure, and sexual underperception that in turn was positively associated with undesirable non-physical solicitation from and toward women. In addition, rape stereotypes were associated with perpetration behavior in adolescent men. For adolescent women, sociosexuality was associated with being sexually victimized primarily through sexual risk behavior, alcohol intoxication, and sexual overperception. These factors were again positively associated with sexual derogation from adolescent women and solicitation from adolescent men. Prior sexual abuse victimization was only indirectly associated with victimization. The factors associated with adolescent men's perpetration and adolescent women's victimization were highly similar. Future work aimed at reducing sexual violence in adolescence within the educational context might find it more effective to specifically target non-physical forms of sexual harassment.