Assignment: Article Review and Critique

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Aggression and Violent Behavior

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Aggression and Violent Behavior 52 (2020) 10139

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A metasynthesis of qualitative studies on girls' and women's labeling of sexual violence

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Catherine Rousseaua,⁎, Manon Bergerona, Sandrine Riccib

a Sexology Department, Université du Québec à Montréal, Montréal, Québec, Canada b Sociology Department, Université de Québec à Montréal, Montréal, Québec, Canada

A R T I C L E I N F O A B S T R A C T

Keywords: Sexual violence Labeling Victims Metasynthesis Qualitative

Many women do not label their unwanted sexual experiences as rape or sexual violence, but rather use various labels that suggest a different understanding of the events. This metasynthesis provides new insights and empirical evidence of how girls and women discuss their unwanted sexual experiences, and identifies factors that impede or promote such labeling. Qualitative data of 9 studies were synthetized using Noblit and Hare's (1988) framework. Results show that victims can frame sexual violence within rape scripts that may lead to minimization, normalization, self-blame or rationalization of the event. Some participants hold an ambivalent discourse, which suggests that labeling is a fluctuating process. Finally, seeking social support, or receiving educational information seem to facilitate the labeling of sexual violence. The implications for intervention and sexual violence prevention programs are discussed.

C. Rousseau, et al. Aggression and Violent Behavior 52 (2020) 101395

C. Rousseau, et al. Aggression and Violent Behavior 52 (2020) 101395

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Introduction

Sexual violence is a social problem, mainly affecting girls and women, that can lead to significant psychosocial consequences (Rhew, Stappenbeck, Bedard-Gilligan, Hughes, & Kaysen, 2017). In the United States, more than one-quarter of women experienced unwanted sexual contact in their lifetime, while one-third experienced some form of noncontact unwanted sexual experience in their lifetime (Basile, Smith, Breiding, Black, & Mahendra, 2014). The Centers for Disease Control and Prevention defines sexual violence as “a sexual act that is committed or attempted by another person without freely given consent of the victim or against someone who is unable to consent or refuse” (Basile et al., 2014, p. 11). Sexual violence includes rape, attempted rape, sexual assault, sexual harassment, sexual coercion without physical force and unwanted sexual contact (Basile et al., 2014). This term is inclusive of the various forms of sexual victimization that are not necessarily criminalized, especially since legal frameworks vary from one country to another. This definition allows for the conception of sexual violence on a continuum, as many feminist researchers have suggested, since the pioneering work of Kelly (1987) and Hanmer

(1977).

While research confirms the high prevalence of sexual violence, few events of sexual violence are reported to the authorities. According to the Truman and Langton (2015), 34% of rape and sexual assault crimes are reported to authorities in the United States. One possible explanation for this under-reporting is that victims may not identify or label the event as a form of sexual violence. For several decades, researchers have been interested in victims' unacknowledged sexual violence. Mary Koss was one of the first to identify this phenomenon, which she termed “hidden rape,” and developed the Sexual Experiences Survey, which is an instrument capable of reflecting hidden cases of rape (Koss, 1985, 2011). Her study, based on the Sexual Experiences Survey, shows that 43% of women who reported oral, anal, or vaginal non-consensual intercourse did not label their experience as rape (Koss, 1985). More recently, Wilson and Miller (2016) published a meta-analysis summarizing the results of their empirical work and presenting estimates of the prevalence of people who experienced rape, but did not label their experiences as such. Based on 28 studies, regrouping 5917 female rape victims, the results show that an overall weighted mean percentage of 60.4% of all victims do not understand their experience as rape.

⁎ Corresponding author at: Université du Québec à Montréal, Département de sexologie, CP 8888, succ. Centre-ville, Montréal, Québec H3C 3P8, Canada. E-mail addresses: [email protected] (C. Rousseau), [email protected] (M. Bergeron), [email protected] (S. Ricci). https://doi.org/10.1016/j.avb.2020.101395 Received 12 August 2019; Received in revised form 1 March 2020; Accepted 8 March 2020 Available online 12 March 2020 1359-1789/ © 2020 Elsevier Ltd. All rights reserved.

In this metasynthesis, we analyze the social vocabulary present in victims' narratives (Hlavka, 2014; Kavanaugh, 2013). We distinguish between elements that justify or excuse sexual violence by allowing victims to interpret what happened to them (Scott & Lyman, 1968). Because the labeling of sexual violence is embedded in culture, it can reflect rape myths or gendered stereotypes that make victims feel guilty and can take the blame off the perpetrator. For example, victims can minimize the severity of the experienced sexual violence. In fact, a study reveals that women who have experienced rape are usually considered responsible for the event in the current social context (Peterson & Muehlenhard, 2004). Different factors can influence the labeling of sexual violence. Some factors, as named above, appear to prevent the identification of sexual violence, while others may encourage it, such as verbally expressing non-consent (Cleere & Lynn, 2013; Peterson & Muehlenhard, 2007).

Many factors contribute to a social context that would denigrate and blame women for experiences of sexual violence, such as rape myths. These social discourses are understood as culturally situated and socially learned ideologies that excuse rape. Various rape myths have been documented, for example: the belief that a husband cannot rape his wife, that women enjoy rape, that women have asked to be raped and that women are lying about having been raped (Edwards, Turchik, Dardis, Reynolds, & Gidycz, 2011). It is possible to believe that these rape myths are more closely interwoven with a narrow conception of what sexual violence is and that this conception is reiterated in dominant social discourses. Also, rape scripts may influence victims' labeling of unwanted sexual experiences (LeMaire, Oswald, & Russell, 2016). They are defined as a social stereotype of what a “real” rape is and how victims and perpetrators of rape are viewed (Ryan, 2011). For example, a rape script usually implies a highly violent assault by a stranger, in a public space, with forced intercourse (Kahn, Mathie, & Torgler, 1994; Littleton, Tabernik, Canales, & Backstrom, 2009). However, most sexual assaults are perpetrated by a known man, in a private place, sometimes with no physical force used (Cantor et al., 2015). In such situations, there would be an inconsistency between the sexual victimization and the rape script, which can lead to the non-labeling of the event as sexual violence.

This metasynthesis is informed by feminist theory. We postulate that rape myths or rape scripts come from a patriarchal system discrediting women and girls' experience of sexual violence (Brownmiller, 1975; Burt, 1980; Edwards et al., 2011; Gavey, 2005). By adopting this framework, we do not assume that girls and women should immediately identify sexual violence after being victimized, but we believe that greater recognition of what is sexual violence would allow many girls and women to avoid self-blame, minimization or justification of the violence that they experience. It would also foster accountability for perpetrators of sexual violence regarding their behaviors. The way in which sexual violence is labeled is critical for the survivor's experience because it guides the perception of the event and its prevention. The social context, coming from patriarchal tradition, leads many women to take responsibility for the experienced sexual violence, which only accentuates the invisibility of this form of genderbased violence and, at the same time, dilutes the perpetrator's responsibility (Romito, 2006). This framework enables a more detailed and thorough understanding of the imbrication of labeling and subscribing to rape myths or scripts.

Studies on unacknowledged sexual violence mainly adopt quantitative methods because of the ethical and methodological challenges involved in interviewing people who have difficulties identifying their non-consensual sexual experiences as sexual violence (Johnstone, 2016). Although these quantitative results can estimate the prevalence of the phenomenon, they do not give us much information on how girls and women qualify the unwanted sexual experience. They also do not reflect the complex reality of this phenomenon and its possible variations over time (Johnstone, 2016). Recently however, there has been an increase in qualitative research on unacknowledged sexual violence that suggests new insights and useful in-depth information about how women label their experiences. Nevertheless, a synthesis of qualitative studies on the subject has not been published. This article aims to offer a more complete understanding of labeling in victims' narratives. We understand labeling both as women's acknowledgement of unwanted sexual experiences, and as the process whereby victims decide whether they label these experiences as sexual violence. Our contribution is based on a metasynthesis, which is a review of all qualitative studies published on the subject that fit certain inclusion criteria. Qualitative metasyntheses entail a systematic approach to the collection and analysis of qualitative studies to allow the “enlarging of the interpretive possibilities of findings and constructing larger narratives of general theories” (Sandelowski, Docherty, & Emden, 1997, p. 369).

For this research, the objectives are: 1) to examine how girls and women perceive their unwanted sexual experience and 2) to identify a variety of factors that seem to impede the labeling of sexual violence and factors that seem to encourage it.

Method

This metasynthesis aims to provide a comprehensive and qualitative overview of girls' and women's labeling of their experienced sexual violence.

2.1. Procedure and sample

A review of qualitative studies on victims' labeling of sexual violence was done using SAGE journals online, PsycINFO, Taylor and Francis Online, Google Scholar and a review of found articles' references. We searched qualitative papers in April and May 2018, using keywords including: labeling, accounts, normalizing, sexual violence, unacknowledged rape, self-blame, qualitative, and mixed methods.

The inclusion criteria for studies were (a) to have a qualitative component as structured, semi- or unstructured interviews or focus groups, (b) to relate to the narrative of girls and women who experienced sexual violence, (c) to address the issue of unacknowledged sexual violence, (e) to have been carried out in Western countries where rape myths and rape script are similarly integrated and shared, and (f) to be written in English. Thus, studies published before 2000 or that only addressed the point of view of non-victims were excluded.

Nine studies were retained for this metasynthesis and 11 were excluded because they did not meet the inclusion criteria. The design of all the selected studies was exclusively or partially qualitative and subscribed to different approaches to data analysis. One is a phenomenological study, five are based on an inductive approach, two have a descriptive approach and one is outlined by the Listening Guide methodology. Demographic and methodological characteristics of selected articles are shown in Table 1. All studies were conducted in United States, except for one in Canada and one in Australia. Participants' ages ranged from 11 to 47 years old. Five studies focused on undergraduate students. All the studies exclusively involved women who were victimized by male perpetrators, most often someone they

knew.

2.2. Analysis

All studies were transferred to NVivo 11 (QSR International Pty Ltd.) for synthesis and management of the emerging themes. The approach used for this metasynthesis was based on Noblit and Hare's framework (Noblit & Hare, 1988), which is divided into seven phases. First, researchers choose a phenomenon and must define it. In our case, we selected unacknowledged sexual violence and labeling in girls and women narratives. Second, researchers determine which qualitative studies are relevant to their initial interest. Nine studies met our inclusion criteria. Third, researchers read the qualitative studies several times to identify keywords, themes or concepts. Fourth, they evaluate how these studies are related to each other by synthetizing previous keywords, themes or concepts. Fifth, researchers transpose the studies into one another. This phase enables comparison and maintains the central concepts of each label in their relation to other concepts. An open coding then leads to codes that are grouped to form conceptual categories. In line with Glaser and Strauss' (2009) axial coding, we compared conceptual categories to explore interactions between studies and to build conceptual categories that are mutually exclusive. These

Table 2

Categories, subcategories and data from studies that refer to these categories.

Categories, subcategories and data from studies that refer to these categories

Categories Subcategories Studies related

1. Self-blame occurring because of something done or not done 1.1 Feeling that sexual violence could have been stopped 1, 6, 7, 8, 9

1.2 Holding oneself at least partially responsible for the 1, 3, 5, 6, 7, 8, 9

event

2. Normalization of sexual violence 2.1 “The event was no big deal”: reduction of severity 1, 2, 4, 7

2.2 “It happens all the time”: everyday behaviors 1, 2, 3, 6

2.3 “He didn't mean it”: perpetrators held unaccountable 1, 3, 4, 5, 6, 8, 9

3. Rejection of the term “sexual violence” 3.1 Recognizing oneself as a victim goes against a strong 3, 5, 8

self-image

4. Understanding sexual violence according to rape scripts 4.1 Lack of behaviors deemed problematic blurs the 1, 2, 3, 5, 6, 8

labeling of sexual violence 1, 3, 5, 9

4.2 Perpetrators do not fit the victim's image of a 1, 5, 8, 9

perpetrator

4.3 Believing that consent may not be withdrawn

5. Ambivalence: avoiding labels or using alternative terms 5.1 Evading a label that refers to sexual violence 1, 3, 4

5.2 The use of alternative terms to describe their 1, 3, 4, 5

experience

6. Labeling of sexual violence through the perpetrator's violent behavior, the consequences 6.1 Physical violence and its repetition 1, 3, 4, 9

suffered or the failure to comply with the consent 6.2 Negative psychological impacts 1, 2, 3

6.3 Not having consented and not being able to say no 1, 3, 4, 9

7. Seeking social support or having educational information 1, 4, 5

categories must allow for a better understanding of the phenomenon, each of them taking into account the key concepts identified in the source studies (Paillé, 1994). Each category took into account the key concepts identified in the source studies. However, the saturation of each category might not be achieved because of the diverse topics covered in the corpus. Generally, researchers would then synthesize transpositions by producing an overview rather than simply analyzing them individually and extracting separate conceptual categories (Coffey, 2006). Sixth, translations are compared to find similarities and differences. In this phase, conceptual categories are linked together to develop a storyline or theory, according to Glaser and Strauss' (2009) grounded theory. Nonetheless, this was not the goal of this present metasynthesis. Seventh, researchers adapt the synthesis to their audience. Thus, this metasynthesis takes a written form and adopts a language that is adapted to academics and practitioners so that they can benefit from its results.

Results

The analysis of our corpus resulted in the creation of seven conceptual categories, each containing several sub-categories (see Table 2). 3.1. Self-blame occurring because of something done or not done

In this first category, sexual violence is not identified as such because participants feel they have failed to have their non-consent respected or to stop unwanted sexual behaviors. Some believe that being intoxicated has put them in a position deemed to be at risk, which leads them to consider that they are responsible for unwanted sexual acts.

3.1.1. Feeling that sexual violence could have been stopped

Some participants felt like they failed to say they did not want to engage in sexual activity. Two women in Harned's (2005) study said: “[B]ecause [I] never told the person not to, even though [I] didn't want them to”; “I should have been more vocal” (p. 397). Another woman stated that she did not resist enough to prevent the event: “…a young man who respondent had met that night forced her into having sexual intercourse. She said ‘no’ many times, but he physically forced himself on her. He was much bigger than her. She was ashamed and felt she was partly to blame because she couldn't stop him” (Weiss, 2009, p. 827). Weiss (2011) discussed that women can feel more self-blame for the event and be more reluctant to label it as rape when they consider themselves to have surrendered to sexual activity.

3.1.2. Holding oneself at least partially responsible for the event

Another reason evoked is the victim's intoxication: “I was drunk and didn't put up a fight and gave in. Therefore, I feel I am partially responsible for what happened” (Participant in Harned, 2005, p. 396); “I don't want to label it rape because I feel it was my fault to be that intoxicated” (questionnaire response from non-labeling participant in Peterson & Muehlenhard, 2011, p. 563). For some participants, they consider that they did not communicate clearly enough: “I didn't really communicate that I didn't want it to happen. I just kind of tensed up and didn't move.” (Dardis, Kraft, & Gidycz, 2017, p. 13). Johnstone (2016) states that the impact of self-blame is weighed in the larger context of rape culture which holds the victim responsible for what happened, instead of placing responsibility and accountability on the perpetrator.

3.2. Normalization of sexual violence

The minimization of sexual violence is frequent among the participants of the various studies. The frequency of these acts of violence – such as sexual harassment, is sometimes reported as being daily, to the point that participants and even some friends see sexual violence as nothing serious or as not even worth disclosing.

3.2.1. “The event was no big deal”: reduction of severity

Some participants consider the event as something that is not very serious. For a participant in Hlavka's (2014) study, the event deserved to be forgotten since “not much happened”:

“I was going to the bathroom and he wouldn't let me go in. He put his foot in front of [the door], and he's a really strong person, so I didn't really, like, I couldn't open the door. And he said, ‘I'll let you in if you give me a kiss,’ and I said, ‘No.’ And I was going back to the classroom and he pinned me against the wall and tried to, like, lift up my shirt. And, like, touched me, and then I… I got up… I started to scream, and I guess someone heard, 'cause then, um, someone started coming. So he got away from me, I just went back in the classroom and forgot about it. I just didn't think it was really anything”.

(Hlavka, 2014, p. 346)

3.2.2. “It happens all the time”: everyday behaviors

3.2.2.1. Peer reactions can alter the inclination to recognize the experience as rape. A participant in Johnstone's (2016) study states that her friend's reaction lead her to reconsider the event as something normal because her feelings were delegitimized: “So yeah, I told my friend what happened and then, I don't know, at first she started laughing and I was, I was like ‘this isn't funny,’ and she's like, ‘it's happened to me so many times’” (SchoolGirl [pseudonym], 20-year-old European-Canadian, p. 280).

3.2.2.2. Unwanted sexual experiences are commonplace and expected behaviors because they happen all the time. Sexual harassment and violence appear to be a part of women's daily lives. Thereby, unwanted sexual experiences are normalized because of their frequency. Patricia (age 13), in Hlavka's (2014) study, said: “They grab you, touch your butt and try to, like, touch you in the front, and run away, but it's okay, I mean… I never think it's a big thing because they do it to everyone” (p. 344). In addition, men are seen as natural perpetrators because they appear unable to control their sexual drive and desires (Phillips, 2000).

3.2.2.3. Sexual violence is seen as normal dating behavior within heterosexual relationships. Violence against women is a part of a continuum where the most extreme form is rape (Kelly, 1987). Some manifestations of violence tend to be normalized because they are a part of what is expected in a heterosexual relationship (Gavey, 2005). Such social representation is largely informed by the naturalization of male desire, seen as uncontrollable: “He'd just rub his hand across my butt, and then one time I was sitting there and he—I was, like, laying on the couch watching TV—and he came home. He was kinda drunk, then he, like, literally just, like, laid on me. That's what he… well, guys always try to get up on you, like just normal” (participant in Hlavka, 2014, p. 347). Although coercive experiences are unpleasant, some participants did not view them as more than an aggravation, characterized as “annoying male behavior” or “just an annoyance of a sexually energized young man” (participants in Harned, 2005, p. 404). One young woman perceives the event as a game with the boys, although she did not like it (Weiss, 2009).

3.2.3. “He didn't mean it”: perpetrators held unaccountable

3.2.3.1. The event was accidental: denying their perpetrator's intentions to harm them. Some participants referred to the perpetrator's intentions to label their unwanted sexual experience. They maintain that their partner's behavior was accidental: “I just don't think he understood that I didn't want him to keep on doing that and that it didn't feel good” (participant in Harned, 2005, p. 398). Another participant refers to the fact that the perpetrator was not aware of what he was doing and therefore that it was not sexual violence:

“While riding in the car with several friends, one of the male occupants in the car sexually assaulted the respondent. The offender was grabbing and fondling her, and would not stop when she asked him to. The respondent screamed and fought him off. The other passengers were screaming at the offender to stop. There was no actual rape but an attempt was made. The respondent decided not to report it because she was not sure the offender understood he was committing a crime.”

(Weiss, 2011, p. 453)

3.2.3.2. Blaming the effects of alcohol or drugs instead of the perpetrator. An additional struggle that participants can face is recognizing sexual violence when alcohol or drugs are involved. The difficulty in identifying the violent character of the unwanted sexual experience is exacerbated when the perpetrator is intoxicated because it is seen as a mistake, as the report made by this 18-year-old participant states: “At a friend's house, a drunk male made unwanted sexual advances. He apologized and said he didn't know what he was doing and it wouldn't happen again. Respondent did not report since she did not want to get him in trouble, and because he promised it wouldn't happen again” (Weiss, 2009, p. 823). In Dardis et al. (2017), nearly half of miscommunicationlabeled victims blame the consumption of alcohol or substance: “I don't think he would have done it if he was sober.” (p. 13).

3.3. Rejection of the term “sexual violence”

Being a victim of sexual violence seems to be incompatible, for some participants, with being strong or perceiving oneself as such. Thus, to name having been victim of sexual violence negatively impacts their perception of themselves.

3.3.1. Recognizing oneself as a victim goes against a strong self-image

Acknowledgement of having experienced sexual violence can have several implications, particularly in terms of one's identity. As Peterson and Muehlenhard (2011) state, not using the label “rape” can allow participants to maintain their self-image as proactive and strong:

“[If it had been rape] I would probably have done something about it. I wouldn't have just let it go. I mean I don't think that's right… I would have told my parents right away and gone to the doctor to prove it. A lot of girls just let it go, and then 5 years later they say, ‘Well, how are you going to prove it?’ So, it wasn't rape, but if it was, I definitely would have done something about it.” (interview response of a non-labeling participant, Peterson & Muehlenhard, 2011, p. 565).

3.4. Understanding sexual violence according to rape scripts

Here, we deconstruct the rape script into three main themes. First, the idea of rape is often associated with physical abuse, vaginal/anal penetration, and injury. In the absence of these components, many participants do not use the term “sexual violence” to describe what happened. Furthermore, the rape script usually portrays an unknown and scary perpetrator. If the abuser is then a friend or partner – which is often statistically the case (Fisher, Cullen, & Turner, 2000), this label seems difficult to apply. Finally, consent is not usually a part of the rape script. When sexual consent was given at the beginning of sexual intercourse, some participants do not feel legitimized in withdrawing it. They do not identify the situation as sexual violence since they gave their consent at some point, even though they may not have consented to each component of the experience.

3.4.1. Lack of behaviors deemed problematic blurs the labeling of sexual violence

If some elements are absent from the victim's unwanted sexual experience, it may not be labeled as sexual violence because it did not fit the rape script. This type of re-evaluation, as discussed by Frohmann and Mertz (1994), may lead victims to compare the event with an aggravated rape. This refers to the rape script as socially designed: if the event did not match this idea, it may not be labeled as rape.

3.4.1.1. Absence of physical violence or physical harm. The absence of physical violence committed by the perpetrator or the absence of injury to the victim may move the event away from the victim's rape script. The following narrative illustrates the difficulty in defining what happened: “Although she did not consent to sex with her exboyfriend, she claims there was no violence and therefore does not see it as ‘rape exactly’” (In Weiss, 2009, p. 824). Other participants in Weiss (2011) and Peterson and Muehlenhard (2011) minimized their injuries by comparing their situation to extreme crime scenarios with worse outcomes. Grace (19-year-old, European-Canadian), a participant in Johnstone's (2016) study, said: “So… just, when I think of rape I think of maybe a weapon being used, like something more like forceful than just alcohol, or like drugs… kidnapping, like things like that. Like I think of much more scarier things than whatever happened to me” (p. 281).

3.4.1.2. Absence of penetration. Concordant with the rape script's presumption that rape implies a vaginal or anal penetration, its absence blurs the identification of the violent nature of the event. As Hlavka (2014) mentions: “Young women constructed classic boundaries between “real rapes” and everyday violence or “little rapes.”” (p. 346). Terri (age 11) was interviewed because she told a friend she was forced to perform oral sex on a 17-year-old neighbor: “He forced me, he, uh, he grabbed me tighter, and he said if I didn't do it he was gonna rape me” (Participant in Hlavka, 2014, p. 346). About 5% of women of Harned's (2005) study did not consider the event as rape because there was no intercourse.

3.4.1.3. Absence of psychological wound. For some participants, the absence of psychological distress or trauma is an indicator that the event was not severe enough and therefore should not be considered as rape:

“I know it was kind of rape. I know in a general sense that is kind of what it is, but I have a really hard time coming to reality with that, like I have a hard time… cause I know people, most people who have been raped, it's been a lot more traumatic. So I can't really call it that because it didn't, like affect me that badly in the long run, I don't think. Like it's obviously really sucked at the time, but I'm ok now, like I don't have a fear of men, or … like, I don't have any long-standing problems from it…”

(Grace in Johnstone, 2016, p. 286)

3.4.2. Perpetrators do not fit the victim's image of a perpetrator

The perception of the perpetrator is often related to the image of an unknown person. However, in the selected studies, a man known to the victim committed much of the experienced sexual violence. Acknowledging one's partner or friend as a rapist has significant implications for the victim, as presented by this participant: “I liked the person I was with. Although I sometimes felt pressured into sexual intercourse, we were friends and it wasn't a horrible situation” (Participant in Harned, 2005, p. 399). In some cases, the image of the man is not consistent with the stereotypic rapist image as cruel and rough: “I don't think that he was that bad of a guy that he would have just totally taken advantage of me. Because he really wasn't that bad of a guy, just a mean, vindictive person or anything. But … I mean, he should have known to back away. I wouldn't consider it like exactly rape” (interview response by nonlabeling participant in Peterson & Muehlenhard, 2011, p. 562). In some cases, participants do not consider the perpetrator as a criminal: “He is a pig, but no rapist” (participant in Dardis et al., 2017, p. 17).

3.4.3. Believing that consent may not be withdrawn

When girls and women make sexual advances, they are less likely to acknowledge their legitimacy in wanting to stop sexual intercourse. This leads some to believe that they put themselves in a risky situation by agreeing to fondling with the man: “If I hadn't been ‘messing around’ with him at all before, then I would consider it rape, probably, but since I was kind of into it in the beginning, then I just don't consider it rape” (interview response from non-labeling participant in Peterson & Muehlenhard, 2011, p. 563). Fear of worsening the situation leads many women not to withdraw their consent: “I didn't want to make him mad by saying no, so I did what he wanted” (participant in Dardis et al., 2017, p. 18).

3.5. Ambivalence: avoiding labels or using alternative terms

This category refers to narratives suggesting ambivalence. Participants do not know how to name the event, sometimes because it does not seem to fit their idea of what sexual violence is, and therefore must not be sexual violence per se. For others, as previously stated, the term “sexual violence” holds too much negative connotation and participants will prefer using other words that appear less strong or may be less connotated. This may act both as a result of being unwilling or unable to characterize their experience as sexual violence or rape, and as a way to minimize the event's impact and the likelihood of it being understood as sexual violence or rape as they reappraise the situation in the future.

3.5.1. Evading a label that refers to sexual violence

Madison and Minichiello's (2000) study reveals that evasive strategies are used in participants' narratives when describing the event. For example, a participant avoided labeling what happened altogether. Some participants were unsure how to label the event: “I'm not quite sure what to call what happened”; “I don't really think it has a term”; “I don't know how I would define this situation” (participants in Harned, 2005, p. 405).

3.5.2. The use of alternative terms to describe their experience Some participants used synonyms to describe their experience. These labels do often have a softer connotation: “[I] see it more as emotional and psychological abuse and manipulation rather than sexual abuse” (participant in Harned, 2005, p. 405). Also, some participants avoid using the label “rape,” judged negatively, too strong, and upsetting: “[It was] not rape, but [it was] unwanted, forced sex… [R]ape is a strong word, but I definitely did not want sex” (questionnaire response from non-labeling participant in Peterson & Muehlenhard, 2011, p. 564). The label “rape,” in these cases, is judged inappropriate for their experience and participants consciously refuse to use it.

3.6. Labeling of sexual violence through the perpetrator's violent behavior, the consequences suffered or the failure to comply with the consent

Some participants engage in a labeling process when they clearly identify the perpetrator's problematic behaviors. Alternatively, some recognize sexual violence due to the experienced consequences. Lastly, some participants label the situation as sexual violence because their consent was not respected.

3.6.1. Physical violence and its repetition

Coherent with rape scripts, some participants labeled the event as sexual violence because physical violence was involved: “[B]ecause he used his physical strength to make me do something that I didn't want to do” (participant in Harned, 2005, p. 389); “He held down my arms and choked me so I would cooperate” (participant in Dardis et al., 2017, p. 15). Injuries resulting from the event also facilitate the labeling of sexual assault: “[L]ooking at my bruises made me realize that there had to be some force involved and that [I] was not just letting him do it. There were bruises everywhere” (participant in Harned, 2005, p. 392). The repetition of violent events perpetrated by the same man is also a clue, for some participants, that something was wrong: “At first it… appeared to be accidental, but it wasn't accidental, because after a series of the same sort of gestures you kind of get the picture that… it was premeditated” (participant in Madison & Minichiello, 2000, p. 408).

3.6.2. Negative psychological impacts

Participants can feel negative emotions following an unwanted sexual experience, such as anxiety, fear, anger, and disengagement. In some cases, these harmful psychological impacts lead to the labeling of sexual assault. Negative impacts can also affect sexual health and sexuality in general: “[T]hat experience took away the meaning that sex used to have for me. [N]ow, [I] don't feel it means as much, if anything, at all” (participant in Harned, 2005, p. 390). For Sarah (18, EuropeanCanadian), loss of control was a factor of distress: “Well it's, uhh… I don't know, it's like, I think it's the whole thing about, like, it's… your own body, and it's like… not having… not having your say in what's going on” (Johnstone, 2016, p. 282).

3.6.3. Not having consented and not being able to say no

Issues of consent explain, for almost all labelers of Harned's (2005) study, why they consider the event as sexual violence. Some of them suggest the absence of consent as a determinant component: “I was not consenting to what occurred. I was not asked before penetration occurred if I wanted penetration to occur” (participant in Harned, 2005, p. 387); “I said no and tried to leave. Despite this he continued” (participant in Dardis et al., 2017). For others, the inability to give consent because of intoxication confirms the sexual violence: “I'd have to classify it as rape because… if I was not conscious, you're not consenting” (participant in Johnstone, 2016, p. 283). Finally, some participants clearly state that they did not want sexual activity: “[B]ecause [I] clearly said no and told him to stop, and he continued with his actions and raped me” (participant in Harned, 2005, p. 388).

3.7. Seeking social support or having educational information

External elements may also lead participants to redefine their experiences. In Harned's (2005) study, seeking social support triggered participants to label their victimization as sexual assault: “[I] felt it was my fault, for drinking and flirting and leaving the party, but a close male friend of mine convinced me that it was sexual assault” (p. 390). Receiving a warning from a colleague made a participant realize what was going on: “Someone had said to me, ‘Don't get near that guy, he's a sleaze bag,’ you know? ‘He's sleazy,’ or ‘he's strange,’ […]” (participant in Madison & Minichiello, 2000, p. 407). Also, being exposed to educational information facilitates the labeling of the event: “I read an article on sexual assault or harassment, and the situation I had been in was listed as a form of it” (participant in Harned, 2005, p. 392).

The in-depth analysis of this corpus allowed us to expose a variety of factors that lead a victim to label or to refuse to label her experience as sexual violence. These factors predominantly include self-blame, normalization, rejection of the term “sexual violence”, adherence to rape scripts, ambivalence, characteristics of the experience deemed problematic, and social support or educational information.

Discussion

The purpose of this study was to examine how girls and women perceive their unwanted sexual experience and to identify a variety of factors that seem to impede or promote the labeling of the event. Results allowed the identification of three main representations in participants' narratives: most would not label the event as sexual violence (categories 1 to 4), others would be ambivalent about it (category 5), and some would explicitly label the event as sexual violence (categories 6 and 7). All participants had experienced a situation that was concordant with the Centers for Disease Control and Prevention's (2014) definition of sexual violence, which includes sexual harassment, sexual assault, attempted rape, rape, sexual coercion without force, sexual contact and unwanted sexual advances.

The first group of categories (categories 1 to 4) portrays the complexity of the labeling process as greatly influenced by the social context in which these events occur. Analysis confirmed that adherence to rape scripts and rape myths impact the victims' propensity to label and understand the event as sexual violence. Thus, not only does this adherence deny the presence of sexual violence, but it also leads to types of labeling that trivialize the violent nature of the interaction (Kavanaugh, 2013). This finding raises concerns since it suggests a tolerance towards of forms of violence that can be modulated by minimization, normalization, and rationalization of the perpetrator's behavior, who is very often a man known to the victim. Comprehension of these labels is illuminated when understood in conjuncture with heterosexual relationships (Rich, 1981). In the context of patriarchy, sexual assault in heterosexual sex is not represented as a distinctive act of violence, but rather as the end of a continuum of sexual activities between men and women (Gavey, 2005). Social representations often present the male sexual drive as uncontrollable, prompting many men and women to adhere to this idea of sexual violence as normal, banal, or commonplace experiences. In this traditional sexual script, a man's role is to initiate sexual activity, while a woman's responsibility is to refuse his sexual advances if she is not willing (Wiederman, 2005). However, the masculine script further suggests persistence despite protests or vocal non-consent (Harned, 2005; Littleton, Rhatigan, & Axsom, 2007).

As a result, it is not surprising to find that many events of unwanted sexual experience are not represented as sexual assault or rape by victims or by perpetrators. This representation of unlabeled sexual violence or rape as natural or expected is the most common discourse in this study. Rape attribution research has shown that many unwanted sexual events are not defined as sexual violence, particularly if they contain elements that fit the traditional heteronormative sexual script – within the context of intimate relationships, when there is low physical force used by the perpetrator (Boyle & McKinzie, 2015; Cleere & Lynn, 2013; Littleton et al., 2007) or victim's low use of verbal or physical resistance (Harned, 2005; Littleton, Axsom, Breitkopf, & Berenson, 2006).

The second type of representations (category 5), suggests that labeling may be a process, as depicted by showing the ambivalence in narratives. Results show that participants are questioning the event by using terms that seems less threatening than “rape.” These participants mainly reported recent experiences of victimization. This is concordant with studies that found that victims who do not label sexual violence as such were more likely to relate a recent assault (Boyle & McKinzie, 2015; Cleere & Lynn, 2013; Littleton et al., 2006), which suggest that time may influence labeling process. As reported by Harned (2005), labeling seems to be a gradual process that is influenced by different factors: seeking social support, thinking about it, personal growth, sobering up (when the sexual violence occurred while she was intoxicated), negative impact suffered, educational information and repeat offender (when the perpetrator has multiple victims). However, more studies need to be done on this specific process since this interpretation remains speculative in nature.

The third group of categories (categories 6 and 7) applies to participants that do label the event as sexual violence. Results show that some elements promote the labeling of sexual violence: non-respect of consent, severity of consequences, perpetrator' social behavior and educational information or social support. These elements also seem to be linked to rape scripts. As suggested by some researchers, women that report emotional distress following sexual violence are more likely to label the event as such because it fits the “real rape scenario,” which states that a high level of physical violence and psychological distress must have been experienced either during or after the event (Boyle & McKinzie, 2015; Littleton et al., 2006). However, a considerable proportion of the participants rely on their lack of consent to label the event, more than they rely on the perpetrators' behaviors in and of itself. It is consistent with the many prevention programs in the United States and Canada that promote communication of sexual consent. Bedera and Nordmeyer (2015) have identified the different prevention tips that are addressed to college students, most common sexual violence prevention tip being to “communicate sexual limits.” Although it seems to help some women in labeling their experience as sexual violence, the fact that these interventions place the emphasis on communication (and, more specifically, on a victim's role in that communication) leads some of them to blame themselves by implying that they were not clear enough in their rejection of sex, and therefore are responsible for being a victim of sexual violence.

4.1. Limitations and future research

This metasynthesis has limitations. First, the data analysis did not result in the achievement of theoretical saturation, since there is a dearth of documentation regarding certain categories. Unlike a typical qualitative research process based on research interviews, this secondary analysis prevented a direct conversation with the participants themselves to look for missing elements in our analysis. Rather, it is better understood as an exploratory study of the phenomenon.

Second, the internal diversity of the participants in this research was limited to the characteristics of selected studies' samples. Although there was a great diversity of age between the participants, little racial diversity was observed. Thus, the stakes of social class, racialization, or other forms of marginalization are not represented. Populations from diverse economic and racial backgrounds should be further studied to document a broader and less ethnocentric comprehension of the phenomenon.

Future research should validate, qualify and adapt labeling categories with other under-represented groups, such as people of sexual and gender diversity, and cultural, religious, ethnic or racial diversity. It would also be necessary to explore labeling regarding other forms of sexual violence such as online sexual violence.

4.2. Practice implications

These results have implications for research, and for intervention and prevention. In research studies, the methodological operationalization of sexual violence appears to be a feminist issue. It is important to study the labeling of sexual violence in sociologically operational terms in an effort to make it visible, allowing women to identify the violent nature of the situation experienced. In order to obtain the most comprehensive portrait of sexual violence, it is critical to adopt a vocabulary that echoes women's experiences, while identifying the indicators that reveal or obscure the presence of violence.

In intervention and prevention, professionals working with sexual violence victims must tackle rape myths and deconstruct rape scripts that may be present in victims' narratives. Such strategy may allow the victims to avoid feelings of shame or guilt, and thus better process the events that they have experienced. It is important to embrace the fact that some people label sexual violence, while others do not. As Johnstone (2016) states, the process of labeling an assault can come with ambivalence. This ambivalence should be addressed to support each victim in concordance with how she conceptualizes the event.

Most importantly, we must aim for a better recognition of the different manifestations of sexual violence among various groups. By adopting an inclusive definition of the varied types of sexual victimization, intervention programs will be able to address myths more broadly. These programs should also address more insidious and covert forms of sexual violence, such as inappropriate sexual comments or sexual jokes, so as to be in line with an approach that places sexual violence on a continuum. Prevention programs must deconstruct rape myths and different gender stereotypes that negatively affect heterosexual relationships, from childhood to adulthood, for both heterosexual individuals and those from sexual and gender diverse communities. Intervention programs should criticize the traditional gender socialization of women to enable them to overcome emotional barriers that promote always being nice (physically or emotionally) to others and to defer to men's desires. Finally, prevention programs, such as the Enhanced Assess Acknowledge Act Education program (Senn et al., 2013), should focus on women's knowledge of sexual violence to contrast it with positive and healthy sexualities and intimate relationships. Acknowledgements

The authors thank Mylène Fernet for her helpful comments on an earlier draft of the manuscript, Carl Rodrigue for the guidelines needed to conduct a metasynthesis.

Funding information

This research was assisted by fellowships from the Fonds de Recherche du Québec - Société et Culture (FRQSC).

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