Public Health Concerns for Youth and Young Adults (Both Female and Male): Coercion of Involvement and Negative Health Outcomes

 JAMA reports in an article AMA Intern Med. 2019;179(11):1551-1558. doi:10.1001/jamainternmed.2019.3500 called "Association of Forced Sexual Initiation  and Health Outcomes Among US Women" (particularly with regard to reproductive health, abortion, HIV or STDs etc.) The study was done with interviews of women aged 18-44 and was done in 2011-2017 with about 13 women.

The results of the stud were extrapolated to indicate that about 3 million 15 year old females (on average) were forced to have intercourse by a male about 6 years older, often with the use of drugs, threats or being held down and by larger or stronger male.

There are not ongoing studies, although mention was made that males are also victims of forced sexual initiation. For females not reporting first sexual initition but rather 'voluntary', the average age was 17 and a half.

My reflections on this as I came across it in a search about current NY Laws being extended to allow victims of sexual assault and child abuse to have a new window of opportunity to have pursue legal concerns and possibly obtain compensation were initially shock (in this day and age...and concern, especially that there do not seem to be clear ways to warn potential victims in a systemic manner.

All children and youth need to be warned about 'tricky people' and being in compromising situations even with people they may usually trust or feel would be okay to travel with or be alone with. If something happens they need to have a clear person or way to report things without having their life turned upside or be punished which often happens in many social circles, whether family, friends or others.

It would be helpful to consider however that many victims of abuse do not understand themselves to be in a controlling, manipulative, pressured relationship "giving in, or going along to get along' and so forth even if it is not stated in that manner. If a person is an aggressor, there should be a careful set of options set up in every state and town to address the impact on the victim, as well as on the other people in an aggressor's life such as their partner or spouse, the other parent of any children and so on, siblings, workplace and school  and faith connections.

Each type of person in the aggressor's life may merit an intervention even through a series of videos or articles on line to help them consider the person's problem behavior (crime, words,deeds, manipulations, etc) as separate from their actual being. Considering the person may have a mental health, personality or life stress disorder even though they made a choice to violate someone else is important to help those in their social circles not turn on the victim, deny the truth and leave everyone in more danger.

The old societal mixed responses from police or legal agencies are being held up in a wider societal light but many judges and 'good ol' boys' mentality in many fields would still err on the side of 'doing nothing' until something worse happens. There can possibly be an alternative route for victims to report concerns to key members of a family or social circle but ideally not directly to avoid backlash including 'silencing for good.'

Without societal expectations lining up over time and many people being 'mandated reporters' it would seem there would be clear consensus that matters need to be handled 'above board' However often times because the only response seems to be reporting a crime and not exploring alternatives that could address safety and mental health concerns of the victim and others hurt subsequently by the fractures in the social network, people often feel they want to 'not get involved', sweep it under the rug, hope that there are no more victims and so on. The idea of learning about the seriousness of a violation of one or more people (even sometimes resulting in a perpetrator self-harming or being the victim of retaliation by someone else) throws one monkey wrench after another into a situation.

If cutting ties socially and so on is an option that may be pursued, but if there are common social ties whether through family or another group or local area, that can be challenging at best. More caution can be taken to have support for the victim and secure transportation and places to live or visit with separate housing etc. With all of that kind of 'behind the scenes' managing life, the world can seem more complicated.

Often that is how it goes whether due to trying to keep the peace, not inform more of the social circle of what the problem was or find ways to monitor any concerning people. Likely anyone who has a problem with an addiction or dysfunctional behavior that is more 'acceptable and acknowledged' like substance abuse, mental health or even personality disorders or dicey relationships and concerns for living etc' are treated in  a similar way.

Much is orchestrated like the music in psychodrama or ongoing mixed message ongoing play..where some actors know more than others about the plot and sub-plot. Someday the hope and sense is 'it will all make sense,resolve or not matter' but often new dramas covering up the old, possibly with very new players asserting their conflicts or even rewarding abusers to cover up the idea that something was amiss can emerge. Some things are stranger than fiction...such as Real Life.

But as most survivors know, that BeeGees Song 'Stayin' Alive' is not only used for doing CPR compressions quickly but for reminding oneself what the goal of life is not only on the outside, but in one's heart and mind...Knowing What's What and hoping the world will wake up and keep more people safer Before A Crime is Committed rather than expend much of the resource people and funds on locking people up and putting band-aids on the wounds of someone's psyche and "I'm so sorry for your loss' if someone actually passes due directly or indirectly to the crimes that were covered up so tidily and with many people holding their breath, hoping for the best or figuring the victims were 'collateral damage' for some abuser's success or even his psychic survival...even though that is the lie that is taking not only him but many others down one rabbit hole after another, from the personal to the societal and pretty much around the world.

For those who do time for their crime, there's not much gained in terms of therapy and making amends. Again the funds to lock someone up are not directed to the victim for compensation. The social fall-out could be worse for the victim as well, if inot initialy then long-term, even if waiting years to inform those in a social circle.

That the option to allow for more cases to be heard and tried in NY State as well as others who are lifting the statute of limitations for a year or two or more is amazing. That may be the kind of breakthrough that could spur more victims to seek healing, and possibly recount who was committing crimes when and see if there's a need or way to intervene, even without legal channels, but more policies and letters going out that would advise and encourage people to 'make amends' and donate funds to victims directly or services that could help them.

Perhaps victims could let special agencies learn of their crime (such as Crime Victim Services may do for some in every state) without naming the perpetrator...or if naming, asking that they not be pursued if that's legal.

The hope eventually could be that more therapeutic programs for the many people affected in a family, social group, community and even state depending on the laws that disallowed intervention or contributed to silencing victims etc, would be spelled out clearly in videos modelling the kind of caring helpful responses for each person to get 'back on track' to a safe, respectful normal way of living and understanding what the hell happened back then if interested..and how to heal with current supports and practices.

The shame, blame and fear and so forth could fade in the distance, and new healing for each human could emerge with accountability and honest support realizing one or more people were caught in a struggle that has not been well-understood but somehow tolerated and possibly spreading from one generation to the next and one part of society to the next as well.

The ages, genders, roles, functions, social ties and so forth of all the people involved in the lives of a victim and perpetrator could be mapped out. Special attention to what would have been helpful to avoid the crime from occurring in the first place and prevent future violations could be spelledout. Then the impact on each person in their circles could be considered 'even when they didn't know it in the past' and since.

The options for being informed by a specialized care team, with each person addressed safey in a setting an hour from their home or at least not in their immediate hometown area would be ideal since 'where one hears bad news can be transferred to those around and tied to the place.' Plans for staying apart from a concerning person for weeks or even months may be appropriate, with more internet or phone support provided.

As appropriate the people could then interact with supervised skilled counselors, a safe panel between them and so forth, not to punish anyone but to handle the difficulty of 'what this might mean' for each of them and others close to them going forward. The experts and skilled healing support people could help each one understand the need to tend to the matters at hand in whatever ways are appropriate options, and if legal steps would be needed to be taken then those would be considered. That is the tricky part about getting help for the victim or even the perpetrator...and their families.

The whole thing can become a huge event and turning point. Possibly agreements that the violator would go to counseling, learn to review what was done after admitting those were choices made and consider ways to make amends to the victim as well as those in immediate family and social circles. That gets rather complicated and concerning, yet there are many who have faced dire consequences not knowing how to handle things 'otherwise'.

If a person is open to getting help, even if having a serious problem, ideally skilled people could guide them and help them be accountable and not allow for 'stinkin' thinkin' , lies and cover-ups to rule the day.' With many public cases of respectable institutions, faith groups and more allowing for widespread abuse,particularly in social groups, many points have been made clear that need attention and righting. Then in cult or family groups or remote places more concerns have been raised for patterns that have played out for decades. That is around the world, often in religious or doomsday type groups.

Then there is modern society with many 'loopholes' and challenging ways to understand what happened to whom and why..and how little was done to support victims even if not seeking prosecution for a crime done to them. When there are a huge percentage of divorces and custody disputes involving domestic abuse, more light is shed on the enormity of a problem even between a man and woman (or other configuration of a couple or parents etc) who cared for each other and may have reared children together. The problem is more than complex and widespread yet hardly discussed in any meaningful regular way in the more sophisticated countries or the world at large. Mainly women and children (and pets) are On Their Own but not given the news that is the case.

The courts and judges in the US have been found to be falling short for a variety of reasons, many of them intentional (to make money and get more money for Father's Rights groups for instance and to keep more people off government assistance even if their safety is in jeapordy.) There's lots more to say about that but for now, we've covered a lot of ground, just as the next US Presidential election is coming up in November 2020...Voting Democratic could help the country and save further harm befalling women and children and the American people at large from all I have seen and considered. Let's keep the basic rights of all people in mind for safety, health and survival with basic support as a way to invest and grow a strong, capable America.

Systems for identifying an aggressor to those in his or her social and family support in a careful manner to avoid 'shock, violence or even homicide (as happened it seems even if accidentally 'just wanting more information or an explanation' but holding a gun to keep someone in line as happened in a case of a grandmother learning of her husband assaulting her grand daughter in one case that happened long ago, or others I have heard of...)

Even a victim can go with an aggressor away from support to give him time to 'explain his mistake' or perhaps even be forced to take a ride with him by others who do not realize the danger or fear involved. Ideally a victim could always say she feels she needs to use the bathroom then lock herself in with a cell phone and call for help or a taxi,or a friend to do so.

Practicing reasons not to get in a car with someone should be part of driver's education..and really we need Rider's Education for understanding that many drivers use a car to take someone where they do not want to go, have to be alone with the person who then may drive to another location (secluded or otherwise) and even if there are others in the car, they may allow an assault or become part of it.

Those are all especially important points for youth, particularly young women but even men and children to review with care. With the Boy Scouts (and even a case recently brought up in the Girl Scouts of a leader's husband assaulting a girl repeatedly at meetings in a church basement..) there should be more ways to monitor any 'club activity' with clear oversight of all youth (and even adults who also can be victim of assaults even in familiar places.)

Basically there's a lot of 'what if's and what to do about closing the gap of understanding and practice for keeping everyone safe and sound, let alone less prone to disease, unwanted pregnancies and subsequent need or option for an abortion and more.

Thanks for each person trying to right these wrongs and help young women and men understand the risk inherent around some adults (whether drinking, drugging or not but of course those are additional risk factors, even for driving safely.

Same goes for other medical concerns of low blood sugar, side effects of medication or other stress factors around 'big events' such as weddings, funerals, graduations, parties and so on. Ideally there could be a reliable 'drive team' for the main players of an event...and extra hands on deck to handle concerns and tend to guests needs and have back up help, food, water, shoes and changes of clothes and so on for 'just in case'.

Plus some people lose stuff or don't realize how uncomfortable formal attire may be or even heavy (such as a large wedding dress that can weigh 20 lbs or more.) Just thinking out loud but even at proms, beach parties and more, best to stay with a trusted group of folks and know in advance what anyone is agreeing to, even if people know each other well and assume 'they know what's what.'

Spelling out terms of a relationship on paper and going over it with a third party and a third time to make sure everyone is in agreement would be wise whether 'just friends', dating, getting more serious, living together, having a child together, getting married, living with others in the same household and so on.

Those are not in order and of course, for changing lanes as it were, in terms of living apart to have space or more permanently look into legal ramifications and same goes if clarifying custody (which all parents would be wise to have in writing from the get-go and not wait until there is a conflict or need to file with a court, etc but to clarify who is in charge of the child/ren in terms of living and covering expenses, approving outings and programs and setting up reliable back-up and contacts to help avoid confusing transitions. Okay hopefully this is not just the worst thing ever so that more people will look carefully into such matters

. Also the topic of Gardisil and HPV vaccines is worth researching since it's being recommended to give to newborns but lasts for about 5-10 years so would likely need a booster. The safety studies may have been lacking and some countries are not providing it freely who were doing so. There is a series about vaccinations V-Revealed online for free for a few days or for purchase.

Lots to ponder and stay tuned in about in these times of 2020... Let's think and plan for safety and support for each person, especially young folks who would hope adults and others are looking out for them and Won't Blame a Victim!

See the resources online from LundyBancroft.com, DVSur5r.com and Safe&Together Institute and more over time to build up insights. Other topics on more posts also here on Livfully.org.