Sexual assault and infertility

Unfortunately, human civilisation has not yet evolved sufficiently to preclude the crime of sexual assault. This is demonstrated by the fact that, in the US, one out of every six women has been the victim of an attempted or completed rape in her lifetime1.

For the purposes of this article, I prefer the word victim to the perhaps more politically correct survivor, because victim implies that wrongdoing has occurred and that a perpetrator was involved2.

Each sexual assault victim whether female or male, is unique in their experience of the trauma. However, it can generally be agreed that many victims are impacted in combinations of the following ways3:

Feelings of shame

Some victims can, erroneously, think they are bad, wrong, dirty, or permanently flawed

Feelings of guilt

Sometimes people can feel that the abuse was their fault. For instance, often the offender can be a person close to them, leading to feelings of confusion about the nature of the assault.


This can be simply a coping mechanism, pretending that an assault didn’t really happen or trying to minimise the effect of it.


This is a broad category, which includes feelings of isolation arising from not being able to talk about an incident. It can also include actual isolation, where a victim can be shunned by a cultural community for disclosing a taboo subject

Arising from this psychological trauma are symptoms, many of which are long-term, that can be emotional such as anger, sadness, depression, fearfulness and anxiety. The symptoms can also be physical such as eating disturbances, sleeping problems and cognitive with amnesia, dissociation and long-term shock.

The signs and symptoms listed here are neither exhaustive nor exclusive and serve only to provide the briefest insight into the misery of the experience. It goes without saying that there must be other, unexposed, dark corners of sexual assault yet to be exposed.

One such dark corner may be infertility

This has come to light in a recent study of US veterans, who experienced a sexual assault during their military service. Sexual assault in the US armed forces is an ongoing issue which has, at times, been the subject of extensive media coverage.

To provide some idea, 20,500 service members were sexually assaulted or raped in 2018 including 13,000 women and 7,500 men4. Also note these were the reported assaults. Bear in mind, that surveys have shown up to 54% or females and 27% of males in the military do not report incidents of this type for fear of retaliation5.

Now, a team at the University of Washington School of Medicine (UWSM) has reported 15.5% of US armed services women experiencing a sexual assault throughout their life had an infertility diagnosis for themselves or their partner, compared to 11.3% for those who did not experience a sexual assault6.

Where the sexual assault occurred during military service, infertility was reported in 16% of female victims vs 12% in those who did not experience sexual assault during military service.

The UWSM team also found that the same relationship between sexual assault and infertility was observed for men. An increase in infertility diagnoses was observed among males who experienced sexual assaults. However, the relationship was not as statistically significant as it was for females.

Professor Ginny Ryan, one of the researchers on the UWSM team, presented the results at the recent American Society for Reproductive Medicine annual meeting this month October 2021.

She commented, “Alarmingly, more than half of women veterans have experienced one attempted or completed sexual assault and most of these had an assault in the military. What we are starting to see is that the negative repercussions of such a trauma may include infertility, at least as diagnosed by a medical professional.”

For the study, Professor Ryan and her colleagues investigated sexual assault and any association with infertility in 3,000 U.S. military veterans aged 19 to 45. Nearly 3,000 veterans, male and female, answered questions about sexual assault and took part in phone interviews where information was gathered about experiences of sexual assault together with information on infertility diagnoses.

Because of the way the study was set up it was not possible to determine an actual causal link between sexual assault and infertility. Part of the problem with this may be that the sensitive nature of the topic might discourage some participants from divulging certain aspects of their history. However, the fact that the relationship is proven to exist merits further research into this dark corner.

Professor Ryan comments that such future research will allow investigators to clarify how infertility develops over time in relation to an initial sexual assault, identify other factors of infertility, and drill down on causation.


Sources & notes

  1. Source: National Institute of Justice & Centers for Disease Control & Prevention. 1998. Prevalence, Incidence and Consequences of Violence Against Women Survey (1998)
  2. Victim is not preferred in some modern texts because, for those who experience sexual assault, use of the word victim in a general context may add to feelings of helplessness, which is not conducive to the healing process.
  3. Source: Washington Coalition of Sexual Assault Programs: The effects of sexual assault. https://www.wcsap.org/help/about-sexual-assault/effects-sexual-assault. Accessed October 2021
  4. Source: US Department of Defense. 2019. 2018 Fiscal Year Annual Report on Sexual Assault in the Military. https://www.sapr.mil/reports. Accessed October 2021
  5. Source: U.S. Commission on Civil Rights. 2013.  Sexual assault in the military.  https://www.usccr.gov/files/pubs/docs/09242013_Statutory_Enforcement_Report_Sexual_Assault_in_the_Military.pdf. Accessed October 2021
  6. Source: GL Ryan et al. 2021. Sexual assault and lifetime infertility diagnosis in male and female U.S. military veterans. American Society for Reproductive Medicine. ASRM 2021; Abstract o-10.