After experiencing sexual violence, it can feel like nothing will ever be the same again. A violation of the body can leave people feeling perpetually unsafe — or becoming preoccupied with what happened and worrying that it may happen again. Close friendships, family, and intimate relationships can change dramatically as a result of what has happened. The way we view our bodies and the ability or desire to be intimate with a partner can change. Navigating fertility and trying to conceive can present unique challenges to a person who has experienced sexual trauma.

Though trauma doesn't manifest in every instance of sexual violence, and it certainly doesn't manifest in the same way for everyone, it's quite common for survivors to experience long-lasting emotional and physical effects after nonconsensual sexual encounters — and if you do, you’re not alone.

Sexual trauma history comes up a lot in preconception counseling in the clinic. Because it is so prevalent in general, I make it a point to screen all of my patients because trauma-informed care is key in the patient-physician relationship. While there isn’t a clear biological connection between sexual assault and fertility, there is absolutely a connection between past assault and subsequent intimacy or medical procedures required to conceive. Addressing and supporting someone through this is crucial.

People who experience sexual violence may internalize oppressive societal expectations, which can affect their belief about their worthiness as a parent. People with ovaries not only often experience the pressure of what it means to be the 'right' kind of sexual partner, but also to perform parenthood in a certain way. The pressure to be the "perfect" parent can be particularly complicated when there's a struggle to conceive — which could manifest in the belief that they deserve the struggle because of the sexual trauma they experienced. How our society treats survivors of sexual trauma can also contribute to grief, depression, and anxiety, which can in turn make the process of trying to conceive more difficult.

Discomfort with sex and intimate relationships

For survivors of sexual assault who want to try to get pregnant through sex, feelings and anxieties around sex may make the process more challenging. The University of Alberta Sexual Assault Center says that some of the more common sex-related symptoms after assault include:

• Avoidance or fear of sex

• Viewing sex as an obligation

• Associating touch with negative feelings

• Difficulties with arousal, sensations, or orgasm

• Vaginal pain

• Intrusive sexual thoughts and images

When we discuss sexual assault, it's imperative to recognize that everyone’s experience manifests differently. In some cases, people dissociate from their bodies as a coping mechanism to sexual trauma. Many of these traumatic effects can make sex — whether it's to get pregnant or connect with a partner — scary, painful, or uncomfortable. Processing past experiences with a trauma-informed therapist can help survivors better manage these symptoms and work toward an improved relationship with sex and intimacy.

It is important to reiterate that there's no evidence to suggest that surviving sexual trauma is connected to infertility. However, there might be a relationship between the psychological impact of trauma and physiological changes that could affect fertility outcomes.

When someone has experienced trauma, there can be changes to their stress response: a survival mechanism (commonly known as the "fight or flight response") in which hormones such as cortisol and adrenaline release into the bloodstream.

A trauma-informed therapist will use specific modalities that will help you to process and heal from the emotions that are held in your body as a result of traumatic events. Trauma therapy can provide the opportunity for your body to no longer hold the emotions that have been stored during a time when control was taken away or survival was necessary. Importantly working with a trauma therapist can give you relief from symptoms related to trauma, like flashbacks, reactivity, anxiety, depression, insomnia, and physical ailments.