ASPPH Fellow Spotlight: Former ASPPH/CDC Fellow Publishes in MMWR on Sexual Violence Among Sexual Minority Women

Former ASPPH/CDC Public Health Fellow Grace Liu (MPH, Columbia University Mailman School of Public Health), was recently published in the Morbidity and Mortality Weekly Report (MMWR). The report, “Nonvoluntary or Forced Sex Among Women, by Sexual Identity, Attraction, and Behavior — National Survey of Family Growth, United States, 2011–2017,” was based on research conducted during Liu’s ASPPH fellowship in CDC’s National Center for Injury Prevention and Control (NCIPC), Division of Violence Prevention. While based in the Research and Evaluation Branch, from July 2019 – September 2020, Liu focused her efforts on the intersection of social norms with sexual violence and child maltreatment.

Sexual violence is a highly prevalent social and public health problem with significant physical, psychological, and economic consequences. In the United States, approximately 44% of women reported experiencing some form of contact sexual violence (e.g., rape, sexual coercion, unwanted sexual contact) in their lifetime. An estimated 19 million women (16% of women) experienced sexual coercion, such as being worn down by someone who repeatedly asked for sex or being sexually pressured by someone using their influence or authority, at some point in life.

Using data from female respondents ages 18-44 years interviewed during 2011-2017 for the National Survey of Family Growth, this study estimated the prevalence of male-perpetrated nonvoluntary or forced sex, including lifetime forced vaginal intercourse (referred to as “forced sex”) and nonvoluntary first vaginal intercourse, among women in the United States. Recognizing sexual orientation is a multidimensional construct, Liu and her co-authors stratified analyses by self-reported sexual identity, attraction, and behavior to better understand disparities in female sexual victimization.

The study found that 36% of women identifying as bisexual reported experiencing nonvoluntary or forced sex, compared to 18% of heterosexual-identifying women and 18% of lesbian-identifying women. Compared to sexual majority (heterosexual) women, lesbian- and bisexual-identifying women and women who reported attraction to the same sex only or both the opposite and same sex were more likely to have endured non-voluntary first vaginal intercourse. In addition, sexual minority women (both bisexual and lesbian) first experienced nonvoluntary or forced sex at younger ages than sexual majority women.

Comprehensive approaches to preventing sexual violence and child sexual abuse—including changing norms and attitudes around gender and sexuality, improving bystander behaviors, empowering sexual minority women and girls, and creating protective environments—require tailoring to meet the needs of sexual minority women. Furthermore, engaging sexual minority women across the spectrum in primary prevention efforts could help ensure intervention effectiveness.

ASPPH would like to thank Liu’s CDC mentor, Dr. Laura Kollar, and co-authors, Drs. Christopher Harper and Michelle Johns, for working closely with Liu on this project and making this publication possible.