Author Affiliations: Program on Forced Migration and Health, Mailman School of Public Health, Columbia University, New York, New York.
Sexual violence during times of conflict has been historically viewed as a spoil of war or as an individual act of violence rather than one that is politically or ideologically motivated. Today, however, there is an increased understanding that rape—the forced vaginal, anal, or oral penetration of either a male or a female with either a person or an object—is used as a strategic and systematic tactic during armed conflict.1- 3 This Viewpoint examines why sexual violence is an effective weapon of war, its health and psychosocial sequelae, and its association with other forms of gender-based violence.
The concept of wartime sexual violence is examined from 3 perspectives: as a strategic, political, and ideological weapon; as a hyperexpression of machismo and gendered norms; and as a systematic form of aggression against communities. This article also explores how another form of sexual violence—intimate partner violence—may be a prevalent form of wartime violence that remains largely unrecognized and understudied.
Systematic sexual violence has been used in conflict as a means of ethnic cleansing. In Kosovo3 in the late 1990s, for example, Serbian paramilitaries used gang rape to terrorize the Kosovar population into fleeing their homes and land. During the Rwandan Civil War, extremist Hutus sought to eradicate Tutsis by sexually assaulting and impregnating Tutsi women.4 The use of sexual violence to force a vulnerable group of people to leave their homeland in fear for their safety and to eradicate other ethnic groups through insemination and reproduction has also been documented in civil conflicts such as those in Guatemala and the Sudan.4 Guided by a racist or supremist ideology, armed perpetrators may see sexual violence as a means of protecting their own ethnic group while dehumanizing another group. In the Democratic Republic of Congo (DRC), soldiers have been reputed to use sexual violence to dehumanize and destroy the dignity of the enemy as well as to vent their own discomfort and frustration.5 Thus, sexual violence in these contexts constitutes an attack on a cultural and ethnic group's identity, humanity, and ultimately their history.
Within armed groups, sexual violence has also been assimilated into norms of machismo and expressed through the sexual domination and degradation of females or weaker males.4,5 In conflicts such as those in Liberia and the DRC, men have been reported to engage in individual or gang rape as a means of displaying their masculinity, bonding with peers, and establishing their place in the armed group.4 In these settings, militarization and military training may encourage the development of violent, heterosexual masculinities.5 Research findings suggest that sexual violence in times of armed conflict reflects issues of power asymmetry, patriarchy, masculinity, and the devaluation of women that are pervasive even in settings not affected by armed conflict.4,5 In this respect, sexual violence in conflict settings is best viewed not as something completely new and extraordinary but as an extension of universalized power dynamics, gender norms, and discrimination against women that harm survivors on a large scale even in presumably peaceful situations.6
Despite the recent attention devoted to sexual violence in armed conflict, some evidence suggests that wartime violence also occurs within the family.7 Although valid prevalence rates of intimate partner violence before, during, and after conflicts are largely unknown and may vary significantly by context, recent studies have revealed high rates of intimate partner sexual violence in conflict and postconflict settings.8 Moreover, women who experience one form of gender-based violence are more likely to experience other forms of gender-based violence during their lives.6
The effects of wartime sexual violence are both individual and communal and pertain to both physical and psychological health. Well-known health consequences may include sexually transmitted infections, gynecological problems (including fistula), physical injuries, disability, and maternal mortality. Psychosocial consequences may include depression, suicidal ideation, social stigma and rejection by family or community or inability to marry, impaired ability to fulfill a parental role, exclusion from education and employment, increased risk of further violence, and social dysfunction.2,4 The psychosocial effect of sexual violence is greatest for survivors who experience multiple forms of gender-based violence. Recent evidence indicates that women who have been exposed to 3 or 4 types of gender-based violence experience high rates of mental disorder (77.3%), anxiety disorder (52.5%), mood disorder (47.1%), and substance abuse disorder (56.2%).6
Whether committed by armed soldiers, gangs, or civilians, sexual violence during conflict is intended to weaken the social fabric of families and communities. In many contexts, sexual violence is understood as a means of emasculating or disempowering local leaders and male community members who feel powerless to protect their families.5 Often, survivors of sexual violence are blamed, rejected by their husbands, and severely stigmatized by and isolated from their communities.2,4
Sexual violence will likely continue to be used as a weapon of war as long as perpetrators see it as a means of achieving ethnic cleansing and cultural degradation, dominating territory, dehumanizing and humiliating the enemy, and fulfilling hypermasculinized identities and roles in a militarized context. If perpetrators continue to act with impunity, the consequences of sexual violence are likely to persist in the memories of affected individuals and in the social constructs of their communities long after a conflict has ended.
Because wartime sexual violence affects individuals, families, and entire communities, prevention and response efforts must also target different levels of society. An important step forward in holding perpetrators accountable for their actions came with the recognition in 2008 by the United Nations that rape in war and conflict is a war crime.2 Equally important are local, context-specific, and grassroots efforts to support effective models of healing and justice for individuals and communities.
To aid prevention and support survivors, additional research is needed to address important questions. For example, in different conflict settings, what proportion of sexual violence is perpetrated by soldiers and armed groups as opposed to partners, spouses, and other family members? To what extent do these forms of sexual violence have common or interrelated causes? How can steps toward prevention build on what is known about changing norms of abuse, discrimination, and devaluation of women in nonconflict settings? Which interventions—individual and communal—are most effective in supporting survivors? Particularly needed are assessments of different approaches to reducing the severe stigma and isolation that typically follow wartime sexual violence and for enhancing survivors' coping skills. Answering these and related questions requires acknowledging sexual violence as a weapon of war and as a critical component of the public health research agenda in conflict-affected settings.
Corresponding Author: Lindsay Stark, DrPH, Program on Forced Migration and Health, Mailman School of Public Health, Columbia University, 60 Haven Ave, New York, NY 10032 (firstname.lastname@example.org).
Conflict of Interest Disclosures: Both authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Stark L, Wessells M. Sexual Violence as a Weapon of War. JAMA. 2012;308(7):677-678. doi:10.1001/jama.2012.9733