History of Past Sexual Abuse in Married Observant Jewish Women
Objective:
The authors examined instances of past sexual abuse and
related demographic characteristics in the self-reports of a select
group of married observant Jewish women.
Methods:
Orthodox Jewish married women (N=380) ages 19 to 58 responded to
advertisements asking them to complete an anonymous questionnaire about
sexual experiences, including sexual abuse.
Results:
Sexual abuse was reported by 26% of the respondents surveyed,
with 16% reporting abuse occurring by the age of 13. More ultra-Orthodox
Jews reported abuse than modern-Orthodox Jews. Women who were raised
observant reported significantly less childhood sexual abuse than those
who became observant later in life. Sexual abuse was associated with
increased treatment-seeking for depression, marital counseling, or other
emotional or psychological problems.
Conclusion:
While observant Jewish women live in a culture defined by a high
degree of adherence to specific laws of conduct, including rules
designed to regulate sexual contact, sexual abuse of various types still
exists among them.
Most studies investigating religiosity and sexual abuse have
examined whether religiosity ameliorates the negative consequences of
sexual trauma
(1 –
4)
, rather than whether religiosity affects the occurrence of
sexual trauma. There are currently no statistics regarding the lifetime
prevalence of sexual abuse within religious communities. Accordingly, it
is not possible to know whether cultures that constrain sexual activity
protect individuals from sexual abuse, increase occurrence of such
abuse, or have no effect at all. In Orthodox Judaism, there are major
constraints on sexual behavior compared with U.S. cultural norms,
including a strict prohibition of premarital and extramarital physical
contact of any sort
(5)
. We examined the lifetime prevalence of sexual abuse in a
group of self-reporting married Orthodox Jewish women. Data on abuse
were collected as part of a larger study investigating sexual behavior
and dysfunction. Because the subjects were recruited by advertisements,
they were more self-selecting than subjects in a sampling frame-based
survey. Thus, those who chose to participate may not be representative
of the population.
Participants were categorized
as either modern-Orthodox or ultra-Orthodox based on their self-reported
religious affiliation. This subdivision reflects a debate within the
Orthodox Jewish community. Unlike modern-Orthodox Jews, who actively
participate in the general culture,
haredi Jews,
or ultra-Orthodox Jews, embrace a theologically conservative outlook
that advocates substantial separation from secular culture (
haredi literally means “one who trembles before God”)
(6) .
This issue of openness versus insularity provided an additional basis for comparison within the
Respondents were Jewish married women (N=380) ages 19 to 58.
To be included in the study, the participant had to report regular use
of a ritual bath (i.e., Mikvah), reflecting adherence to Orthodox Jewish
law, which proscribes sexual contact during menstruation and for seven
days thereafter
(7)
. Subjects responded to a flier or advertisement asking
married women to consider participating in an important research study
conducted by the Mt. Sinai School of Medicine examining sexual life in
marriage among observant Jewish women. The advertisements emphasized
that the goal of the study was to gain a better understanding of sexual
attitudes and practices, and that the study investigators believed that
such knowledge could inform premarital education (Kallah) classes, as
well as be useful for medical, mental health, and rabbinic professionals
who treat and counsel observant Jewish women.
Design
This
study was approved by the Institutional Review Board of the Mt. Sinai
School of Medicine.
Participants completed the questionnaire anonymously
and without financial reward and returned it by postal or electronic
mail. To obtain a diverse group of observant Jewish women, subjects were
sought across a large range of religious Jewish communities by
advertising through synagogue bulletins, Jewish organizations,
newspapers, Jewish-oriented web sites and Listservs, and a network of
medical professionals (e.g., obstetricians/gynecologists, nurses, and
pediatricians) whose practices consisted of sizable numbers of Orthodox
Jewish women. The design of this study did not allow us to estimate the
number or characteristics of women who heard about the study and refused
participation.
Questionnaire
The questionnaire developed for the participants was
comparable to that used in the National Health and Social Life Survey
(8 ,
9)
, administered by the Sociometrics Corporation, with
additional questions regarding religious affiliation and other specific
questions related to sexual life within Orthodox Jewish communities.
These additional questions were based on questions described
comprehensively in documents available from the Sociometrics
Corporation. This section of the questionnaire began by asking
respondents the question “Did anyone ever touch you sexually in a way
that made you feel uncomfortable?” and, if so, requesting a brief
account of the incident. We excluded responses where the account itself
concluded that abuse had not occurred, such as 1) when the situation was
consensual, although uncomfortable (e.g., “Past boyfriends sometimes
pushed too much. I do not consider it abuse, so maybe my original answer
should be changed to no”), 2) when the account was of a nonconsensual
but inconsequential event (e.g., “My father’s friend wanted to have sex
with me,” or “A stranger fondled my backside on the street”), or 3) when
the respondent did not describe the event in the follow-up questions
used in the analyses (e.g., characteristics of the perpetrator[s],
number of times abused, age of respondent and perpetrator at the time of
abuse, and whether the abuse involved forced touching of genitals
and/or penetration).
The National Health and Social Life
Survey used examiners to ask further details about each experience; in
this study, the questionnaire asked for personal relevant details.
Statistical Analysis
Chi-square
tests were used to compare sociodemographic characteristics of the
participants based on religious affiliation (modern- versus
ultra-Orthodox) and whether the respondent was raised observant or
became observant later in life.
Three dichotomous variables
relating to sexual abuse were also considered: presence or absence of a
history of sexual abuse, whether genital contact occurred in the abuse,
and age at time of first abuse (“13 and below” versus “other”). We also
examined characteristics of the abuse itself and its disclosure. Sexual
behavior within the marriage was noted but not assessed for possible
abuse.
Table 1 shows the demographic characteristics of the respondents, as
well as subgroup comparisons between modern- and ultra-Orthodox Jewish
women and between women who were raised observant and those who became
observant later in life. There were no significant differences between
modern- and ultra-Orthodox respondents in age, birthplace, income, or
prior marriages. However, compared with modern-Orthodox women,
ultra-Orthodox women were more likely to have ended their education with
high school or 1 year of religious seminary and were less likely to
pursue graduate education, although the percentage of those with
graduate education was higher among ultra-Orthodox women who were not
raised observant.
The proportion of women who reported being raised observant did
not differ between modern- (63%) and ultra-Orthodox (65%) women (χ
2 =0.186, df=1, p=0.66). There were no
differences in birthplace or income between respondents who were raised
observant and who became observant later in life.
However, there was a
significant effect of age, as a greater proportion of younger
participants were raised observant, and a greater proportion of
participants between the ages of 35 and 49 reported becoming observant.
Women who became observant were also significantly older at the time of
marriage and had more often been married before.
Twenty six percent of respondents reported experiencing at least one
instance of sexual abuse. There was significantly greater reporting of
sexual abuse by ultra-Orthodox women compared with modern-Orthodox women
(χ
2 =5.88, df=1, p=0.015). The comparison
was repeated and the women reporting abuse were subdivided into two
groups: those abused by the age of 13 and those abused after this age.
More ultra-Orthodox women than modern-Orthodox women reported their
first abuse at or before the age of 13 (χ
2
=7.37, df=2, p=0.025). Report of sexual abuse was nearly twice as high
among Jewish women who became observant compared with those raised
observant (χ
2 =6.98, df=1, p=0.008). More
incidents of abuse were reported by ultra-Orthodox women than
modern-Orthodox women, both for those raised observant (χ
2
=4.06, df=1, p=0.04) and for those who became observant and for
whom the abuse preceded increased religiosity (χ
2 =4.23, df=1, p=0.04) (
Figure 1 ).
As seen in
Figure 1
, religious affiliation and being raised observant were not
related. When controlling for whether or not the subject was raised
observant, stepwise logistic regression showed a higher proportion of
sexual abuse for ultra-Orthodox women than modern-Orthodox women (χ
2 = 7.79, df=1, p=0.005), and a higher proportion
of abuse for those participants who became observant later in life,
whether affiliated with ultra- or modern-Orthodox Judaism (χ
2 =12.59, df=1, p<0 .0005="" nbsp="" p="">
<0 .0005="" nbsp="" p="">
Table 2
shows the characteristics of the sexual abuse for the
respondents who reported being abused. Among those who reported sexual
abuse, half reported a single incident of abuse and half reported
multiple incidents. Regarding the nature of the abuse, 48% reported
genital contact/penetration, whereas 52% reported incidents of
molestation (e.g., inappropriate fondling of the breasts and buttocks or
attempted rape, which the respondent reported successfully fleeing).
For 23% of sexually abused women, the abuse was perpetrated by a
stranger. For 40%, the abuse was perpetrated by someone known to the
respondent but not a family member, and for 30%, the abuse was
perpetrated by a relative. Only 35% of respondents disclosed the abuse
to another person, with 13% disclosing the event to their mother and 6%
to their father. When the respondents were subdivided on the basis of
whether they were raised observant, those raised observant were more
likely to have been abused by strangers and were more likely to report
incidents involving genital contact/penetration than those who become
observant later in life.
 |
Table
|
|
Fifty one percent of the respondents reported receiving mental
health treatment during their lifetime. The specific conditions for
which respondents sought treatment were depression (22%), anxiety
disorders (17%), eating disorders (4%), marital problems (21%), and
other emotional or psychological problems (14%). Analyses based on
religious affiliation and upbringing did not yield significant results,
with the exception that persons who became observant sought more
treatment for other emotional or psychological problems. Table 3
shows that respondents who reported sexual abuse were more
likely to report seeking mental health treatment than those who did not
report abuse, with significant differences for depression, marital
problems, and emotional or psychological problems in general. Whether or
not the abuse involved genital contact did not differ between those who
did and did not report mental health treatment.
|
Table
|
|
While observant Jewish women live in a culture with a clearly
prescribed set of laws designed to regulate sexual contact, sexual abuse
still exists in these communities. Indeed, 26% of the participants in
this study reported lifetime sexual abuse, with 16% reporting abuse
occurring by the age of 13.
Almost a third of the participants reported
sexual abuse perpetrated by relatives, and less than a quarter reported
sexual abuse perpetrated by strangers. These estimates are consistent
with data from several national surveys, in which 25%–27% of women,
regardless of marital status or religious affiliation, reported sexual
abuse (10 – 12)
. A meta-analytic study by Gorey and Leslie concluded that
approximately 22% of women report childhood sexual abuse, a figure
slightly higher than was noted in the present study, with about
one-third reporting genital penetration (13) . Additionally, more ultra-Orthodox women reported sexual abuse than modern-Orthodox women.
Although health professionals may be reluctant to inquire about
sexual abuse in order not to offend patients for whom such topics are
considered improper, it may be particularly important to screen for
sexual abuse, since only one-third of the participants in this study
reported disclosing the abuse to someone else. However, while the
possibility of past abuse should be probed, it is also critically
important to understand that the threshold at which someone may feel the
victim of sexual abuse may be lower for those living in a more
restrictive religious community. Approximately half of the reported
incidents of abuse in this study did not involve genital contact. Since
many researchers have historically defined sexual abuse as genital
contact or even penetration
(14)
, there might be a tendency to minimize the significance of
reported experiences that do not involve genital penetration.
Recent
observations—which found that the effect of sexual trauma may depend
less on the characteristics of the abuse itself and more on factors such
as the relationship of the victim to the perpetrator and the family and
community environment within which the abuse occurs—support the use of
less restrictive criteria, particularly if the goal of such studies is
to determine the impact and health consequences of sexual abuse
(15 ,
16)
. Indeed, for the respondents in this study, a history of abuse
was related to a greater prevalence of mental health treatment,
including treatment for depression, marital problems, and some other
emotional and psychological problems, consistent with reports
(17 ,
18)
. There were no differences in seeking mental health treatment
between sexually abused women who did and did not report abuse involving
genital contact.
The higher proportion of
reported abuse among women who became observant versus those raised
observant is also significant. For Jewish women, the decision to become
observant of the dictates of Orthodox Judaism involves a comprehensive
change in lifestyle, which almost always includes a manifest restriction
in sexual behavior. Furthermore, those who choose to affiliate with
ultra-Orthodox Judaism undertake an additional isolation from the
surrounding culture
(6)
. While the decision to increase religious observance may be
motivated by many factors, it is noteworthy that of the respondents who
became observant later in life and were not sexually abused, 60% were
affiliated with modern-Orthodox Judaism, while among those who were
sexually abused, only 43% were. Thus, women who are sexually abused or
threatened may be more likely to seek out a more structured and sexually
restricted lifestyle.
A major limitation of this
study is that it was not feasible to obtain a representative sample of
observant Jewish women, since no sampling frame was available. It was
also not feasible to limit a representative sample of the general
population to just observant Jewish women. This study used a wide
variety of recruitment methods to provide coverage of the target
population, which was married Jewish women who observe the strict laws
associated with Orthodox Judaism, namely proscribed sexual activity
except within marriage. We do not, therefore, claim that this study
group is representative of all observant Jewish women. On the contrary,
the high level of education, even among the ultra-Orthodox, suggests a
sampling bias that may be associated with a willingness to participate
in research. Furthermore, there was a high proportion of subjects
receiving mental health treatment in this group, which may also reflect
an openness to discussing sensitive topics with others.
Despite these
potential sampling biases, the respondents were unquestionably from a
population that is substantially different from normative Western
secular culture. To obtain a more complete picture of the role of sexual
abuse in the Orthodox Jewish community, it would be necessary to also
examine sexual abuse among unmarried observant women, since a history of
sexual abuse is known to affect the capacity for intimacy or trust in
close relationships
(14 –
16)
. Similarly, since more than half of Jews who were raised
Orthodox no longer affiliate with Orthodox Judaism as adults
(19)
, it would be necessary to examine the lifetime prevalence of
sexual abuse in Jewish women who were once observant but are no longer
so. For all of these reasons, the estimates of prevalence of sexual
abuse reported here are not the actual prevalence of sexual abuse among
Orthodox Jewish women.
Despite these limitations,
we are not aware of any other study examining sexual abuse in the
Orthodox Jewish community or in any other similarly insular religious
society. This may be due to laws governing modesty, which discourage
public or even private discussions of sexuality
(5)
. We have received numerous comments on the survey from
respondents expressing gratitude for this forum and suggesting support
for further discussion in this area (Participant Perspective).
Received
Dec. 3, 2006; revisions received March 7 and May 7, 2007; accepted June
7, 2007 (doi: 10.1176/appi.ajp.2007.06122030). From the Division of
Traumatic Stress Studies, Department of Psychiatry, Mt. Sinai School of
Medicine, New York; and the James J. Peters VA Medical Center
.
Address
correspondence and reprint requests to Dr. Yehuda, Psychiatry OOMH,
James J. Peters VA Medical Center, 130 West Kingsbridge Rd., Bronx, NY
10468; rachel.yehuda@va.gov (e-mail).
The authors report no competing interests.
