When Rebecca Thurston read the accounts of 150 women and girls sexually abused by a Michigan athletic doctor, one of the first things she worried about was their health – not the psychological effect of the abuse, but the long-term physical toll it could take on their bodies.
An epidemiologist, Thurston has spent the past four years studying women who have suffered sexual abuse and harassment. Over time, she discovered, sexual harassment can work like a poison, stiffening women's blood vessels, worsening blood flow and harming the inner lining of their hearts.
"People need to understand that trauma is not just something that happens in the mind," said Thurston, who published her cardiovascular findings this winter in the scientific journal Menopause. "It has real implications on the body."
After being dismissed for decades, denied funding and greeted with skepticism, researchers studying sexual harassment say their field is undergoing a renaissance - injected with newfound energy and relevance amid the growing #MeToo movement.
In particular, recent studies like Thurston's research on cardiovascular health have begun to quantify the vast toll of harassment, which detractors - often men - have tried to play down for decades.
"The field suddenly feels alive and vibrant," said Louise Fitzgerald, who pioneered much of the earliest work in the field.
In more than a dozen other studies over the past decade, researchers have documented other physical symptoms caused by sexual harassment, such as headaches, gastrointestinal problems and disrupted sleep.
"People often think of harassment as a single event, but much more commonly, it's a process that happens over time. You keep going to work day after day while this stuff keeps happening," said Fitzgerald, who has studied harassment in utility workers, office settings and factories. "It's that prolonged exposure to stress that turns into a physiological reaction."
In her most recent work, Thurston and a team of researchers at University of Pittsburgh's School of Medicine measured the cardiovascular health of 272 women who also completed detailed surveys about trauma they had experienced in their lifetimes, including car crashes, natural disaster and the death of a child.
Most women, roughly 60 per cent, reported experiencing some form of trauma. The most common, reported by 22 per cent of the women, was unwanted sexual contact. Roughly 20 per cent had experienced sexual harassment, with some overlap between the two groups.
Healthy blood vessels are able to expand and contract to transport the right amount of blood. But women who experienced trauma, Thurston found, had decreased flexibility in their blood vessels. The more trauma each woman experienced, the more impaired their blood vessels were.
This held true even after her team accounted for other factors like diet, exercise, cholesterol, depression and anxiety. "We kept looking at other explanations. Is what we're seeing due to education, race, ethnicity? There was very clear link to trauma," Thurston said.
Thurston and others have replicated the cardiovascular findings in three large surveys, including two national studies. She and others are now doing more research to try to pinpoint how and why trauma has this effect.
She suspects sleep may play a pivotal role. In her team's studies, women who slept more than six hours a night seemed to create a buffer of sorts against the cardiovascular harm of trauma. "We need to help women cope with this trauma and protect their health because this is happening on such a wide scale," Thurston said.
Sexual harassment often lasts for longer than six months in more than a quarter of cases, according to surveys of harassment in the military, which are required by law and therefore among the most comprehensive.
During that period, researchers say, a woman's body reacts as if to high stress: Immune systems function more poorly. Inflammation increases. The body begins secreting higher levels of the hormone cortisol, which contributes to high blood pressure, high cholesterol, weight gain, impaired memory function and depression. The negative effects can linger for years.
One of the most comprehensive studies tracked 1,654 employees at an unnamed Midwestern university over the course of six years. The 2005 study, published in the Journal of Business and Psychology, found that those who experienced sexual harassment were more prone to sickness, illness and accident, and not just around the time they experienced the harassment. When researchers surveyed the group again years later, the harassment continued to have an enduring effect on their rates of illness, injury and accident.
The mental strain of harassment also often leads to depression, anxiety and other disorders. In recent years, studies have shown sexual harassment makes women more likely to drink as a way of coping. Harassed women are also more likely to develop eating disorders. Researchers have shown the harmful effects even trickle down to co-workers who witness or hear of the harassment, a phenomenon analogous to secondhand smoke.
Among the most debilitating effects is post-traumatic stress disorder. A 2015 study found that 20 per cent of female veterans of the Vietnam War suffered from PTSD – not because of the war itself but largely due to sexual harassment they suffered from their male counterparts.
The study – commissioned by the Department of Veterans Affairs in the United States – shocked military researchers because a similar study of male Vietnam veterans had shown a PTSD incidence of just 17 per cent – a rate already considered high.
"The numbers for the women were mind-boggling. We couldn't understand why," said Kathryn Magruder, the epidemiologist who led both surveys. Among female veterans, nearly 16 per cent were still suffering from PTSD some 50 years after the war.
Because most of the female veterans had served as nurses, researchers at first assumed the PTSD was caused by exposure to gruesome injuries or danger. But after surveying the experiences of more than 4,219 women, they found that sexual harassment and gender discrimination were the leading causes.
"For the most part, these were not necessarily major traumas like rape. It was touching and fondling, snide remarks, constant comments, pressure to fraternise," said Magruder, who has since retired as a researcher.
"The awful thing is that we often think of the horrors of war as unavoidable," Magruder said. "But this PTSD came from something that's completely avoidable, and it was troops from our own side doing it."
Harassment researchers have had to overcome a lot of obstacles. When Louise Fitzgerald began her first study on the topic in 1983, she knew of only one other researcher working on the issue. Many weren't even familiar with the term "sexual harassment".
Now a professor at the University of Illinois at Urbana-Champaign, Fitzgerald said that when she focused her research on sex harassment among students, professors and employees earlier in her career at two other institutions, administrators tried to shut her work down.
Men in her department, she said, spread rumours that she was making up data. And almost every company and workplace she approached refused to cooperate.
"In the early days, people either didn't take it seriously or they took it as a threat," said Fitzgerald, who said she witnessed two female colleagues studying campus harassment and assault be pushed out of research positions.
"I remember thinking that the cultural moment had come and everything would change," she said. "But here we are, 20-some years later when people are suddenly rediscovering yet again that sexual harassment exists."
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