By Lisa Goodman, Katya Fels, and Catherine GlennWith contributions from Judy Benitez Despite over two decades of media and public policy attention, homelessness remains an enormous social problem in the United States, due in large part to the continual closings of institutions for people with mental illness, persistent poverty, a shortage of affordable housing, changes in welfare and mental health policy, and economic trends that favor the wealthy (Burt, Aron, Lee, & Valente, 2001; Evans & Forsyth, 2004; Haber & Toro, 2004; Lee & Schreck; Wolch & Li, 1997). Although women without custodial children and mothers taking care of young children represent two of the most rapidly growing subgroups of this population (Burt, Aron, Douglas, Lee & Valente, 2001; National Coalition for the Homeless, 2001; Urban Institute, 2000; U.S. Conference of Mayors, 1990, 2000), their needs remain relatively unexplored and largely unmet. Furthermore, these women are particularly vulnerable to multiple forms of interpersonal victimization, including sexual and physical assault at the hands of strangers, acquaintances, pimps, sex traffickers, and intimate partners on the street, in shelters, or in precarious housing situations.
All forms of victimization endured by homeless women and children deserve our immediate attention and action. In this paper, we summarize available research on sexual violence in particular — that is, unwanted sexual activity that is forced, coerced or manipulated — and we suggest ways of understanding and responding to the varied, critical needs of homeless survivors of such violence. We focus on adult women only, leaving for another paper the enormous problem of violence against runaway children and teenagers. Our goals are to consolidate knowledge about the damaging interplay between homelessness and sexual violence, and clarify what steps researchers, policy-makers, and service providers might take to intervene with victims and prevent future sexual assaults from occurring.
Although prevalence rates of homelessness have been estimated at up to seven to eight percent among adults (Haber & Toro, 2004), these statistics are based on studies of the “literally homeless” (Toro, 1998); that is, people who have spent nights in homeless shelters, on the street, or in other settings not intended for human habitation. This narrow definition leaves out the much larger population of the hidden homeless : women and children who may stay on friends’, neighbors’, and family members’ couches night after night (“couch surfing”) or return to their abusers when emergency shelters are full, women in rural areas where no shelters are available, and women who trade sex for a place to sleep (Evans & Forsyth, 2004). As cuts to welfare and social services have deepened over the last decade, the hidden homeless population has grown steadily, with African-American women and female heads of households at greatest risk (Wolch & Li, 1997). Although most research on sexual assault among homeless women focuses on the narrower definition of homelessness, we will include information on the hidden homeless where possible in this review.
General prevalence of sexual assault and its consequences among homeless women
There are many limitations to the available research on homeless women who have experienced sexual assault (Nyamathi, Wenzel, Lesser, Flaskerud, & Leake, 2001; Wenzel, Leake, & Gelberg, 2000), We focus on recent studies that are methodologically sound and that approach the issue with an awareness of the complex and inter-related factors so often present in homeless women’s lives.
The most comprehensive and rigorous studies on homeless women conducted to date continue to note the extraordinarily high levels of abuse and victimization that homeless women endure before, during, and after episodes of homelessness. In fact, although rates of victimization in this country have decreased overall, rates of victimization among homeless women remain relatively unchanged (Lee & Schreck, 2005). Research also highlights the grim finding that homeless women often report multiple episodes of violent victimization at the hands of multiple perpetrators, beginning in childhood and extending into adulthood (Browne & Bassuk, 1997; Goodman, 1991; Goodman, Dutton & Harris, 1995; Felix, 2004; Lee & Schreck, 2005; Stermac & Paradis, 2001; Wenzel et al., 2004). Indeed, homeless women have been described as enduring a “traumatic lifestyle” (Goodman, et al., 1995)– one in which traumatic incidents such as sexual assaults are layered upon ongoing traumatic conditions such as struggling to meet basic survival needs and living with ongoing dangers and threats.
Many large-scale studies report findings that repeatedly emphasize the violent and traumatic lives of homeless women. One of largest and most in-depth studies on this topic found that 92% of a racially diverse sample of homeless mothers had experienced severe physical and/or sexual violence at some point in their lives, with 43% reporting sexual abuse in childhood and 63% reporting intimate partner violence in adulthood. Over half (57.6%) reported experiencing violence in at least two out of four age periods (0-5; 6-12; 13-18, 18+) (Browne & Bassuk, 1997). In another study, 13% of homeless women reported having been raped in the past 12 months and half of these were raped at least twice (Wenzel, et al., 2000). In yet another study, 9% of homeless women reported at least one experience of sexual victimization in the last month (Wenzel, Koegel & Gelberg, 2000). Women who do not have children with them are at particularly high risk for sexual violence after the age of 18 (Zugazaga, 2004), in part because they are more likely to sleep outside than are women with children, who might fear for their children’s well being or worry about the intervention of child protective services. Also disturbing is the finding that compared to their low-income housed counterparts, the sexual assault experiences of homeless women are more likely to be violent, and to include multiple sexual acts (Stermac & Paradis, 2001).
Homeless women who experience sexual assault may suffer from a range of emotional and physical challenges (D’Ercole & Streuning, 1990; Goodman, Saxe & Harvey, 1991; Ingram et al, 1996; Padgett & Streuning, 1992; Rayburn, Wenzel, Elliot, Hambrasoomians, Marshall, & Tucker, 2005; Salomon, Bassuk, & Huntington, 2002). In one study of homeless women who had been victimized (Browne & Bassuk, 1997; see also Bassuk, Buckner, Weinreb, Browne, Bassuk, Dawson, & Perloff, 1997) most participants reported mental health problems ranging from suicide attempts (45%) and depression (47%) to alcohol or drug dependence (45%) and posttraumatic stress disorder (39%). Other studies report similar types of psychological difficulties (e.g., Nyamathi et al., 2001; North & Smith, 1992; North, Smith & Spitznagel, 1994; Wenzel, Leake, and Gelberg, 2000).
Sexual assault also effects homeless women’s physical health. For example, in one study of homeless women, those who reported a rape in the last year were significantly more likely than nonvictims to suffer from two or more gynecological conditions and two or more serious physical health conditions in the past year (Wenzel et al., 2000). They were also significantly more likely to report that although they needed to see a physician during the past year, they could not manage to do so, and that although they desired treatment for substance abuse they were unable to obtain appropriate services.
Homeless victims of sexual assault must contend with these psychological and physical difficulties within the context of poor access to legal, mental health and medical resources, social alienation and isolation, unsafe living environments, constant exposure to reminders of the experience, and lack of transportation and information about available services (Goodman, Saxe, and Harvey, 1991). Homeless women of color, lesbians and bisexuals, and women with physical, emotional, and developmental disabilities face even greater barriers. Those who are mothers must take care of their children in chaotic situations while under the scrutiny of a range of social service providers in shelters, food pantries, and other settings. It is no wonder, then, that homeless women are at high risk for state involvement in their parenting, and the potential removal of their children (Cowal, Shinn, Weitzman, Stojanovic, & Labay, 2002; Zlotnick et al., 2003).