Characteristics of childhood sexual abuse in lesbians and heterosexual women.

Childhood sexual abuse (CSA) is a strong predictor of adverse physical and mental health outcomes (Koenig, Doll, O’Leary, & Pequegnat, 2004; Lalor & McElvaney, 2010). Recent research has found that CSA is reported more frequently by lesbians than by heterosexual women (Austin et al., 2008; Balsam, Rothblum, & Beauchaine, 2005; Stoddard, Dibble, & Fineman, 2009). Possible reasons for lesbians’ higher CSA rates include childhood maltreatment (e.g., physical and sexual abuse) because of gender atypical behavior (Tjaden, Thoennes, & Allison, 1999), and involvement in behaviors (e.g., substance abuse, running away from home) that increase risks of sexual victimization, following family and peer rejection due to same-gender orientation (Ryan, Huebner, Diaz, & Sanchez, 2009). More limited research suggests that lesbians may also experience more severe CSA than heterosexual women. Austin and colleagues (2008) and Balsam and colleagues (2005) found that lesbians exceeded heterosexuals to a greater extent in reports of more severe forms of CSA (e.g., forced sexual activity) than in reports of less severe forms (e.g., sexual touching). Hughes, Johnson, and Wilsnack (2001) found that lesbians reported more different types of CSA experiences than heterosexual women. Understanding CSA severity is important because the few studies that assessed CSA severity found a “dose-response” relationship between severity (e.g., genital CSA, physical coercion) and adverse outcomes (Bulik, Prescott, & Kendler, 2001; Zink, Klesges, Stevens, & Decker, 2009). Previous research is inconclusive about perpetrator characteristics that might be severity indicators. Some studies have found more negative long-term outcomes following abuse by a father figure (Casey & Nurius, 2005; Ketring & Feinauer, 1999) or by perpetrators who are strangers or authority figures, caretakers, or parents’ friends (Zink et al., 2009). Tomeo and colleagues (2001) found that lesbians were more likely than heterosexual women to be abused by a female perpetrator (cf. Stoddard et al., 2009). Although this research is neither extensive nor consistent enough to suggest specific hypotheses, we present descriptive information about CSA perpetrators for comparison with previous findings. Higher rates of CSA among lesbians may be at least partly related to their greater willingness to acknowledge this experience. In coming to terms with their sexual orientation, sexual minority women often spend considerable time reflecting about identity and authenticity. Research suggests that the majority of lesbians have been in therapy or counseling (Cochran, Sullivan, & Mays, 2003), which may increase their awareness of and comfort about disclosing painful and stigmatized experiences, including CSA. The present study tests the hypothesis that, among women reporting CSA, lesbians will report more severe CSA than heterosexual women. Because information is limited about CSA perpetrators among sexual minority women, we also present descriptive information about perpetrators reported by samples of lesbians and heterosexual women. Finally, we present exploratory analyses of associations between psychotherapy experience and self-perception of CSA among women who meet researcher-defined criteria for CSA.