The essential conditions for positive sexual interaction—consent, equality, respect, trust, and safety—are absent in sexual abuse. Boys and girls who are sexually abused are robbed of the opportunity to explore and develop their sexuality at their own age-appropriate pace (Maltz, 2003). According to the NHSLS, 12% of men and 17% of women were sex­ually abused before adolescence (Laumann et al., 1999). It is important to note that not all sexual abuse results in sexual problems in adulthood. Research shows that women with a history of childhood sexual abuse have more negative feelings about sex, report less sexual satisfaction, and are two to four times more likely than other women to have chronic pel­vic pain and to experience depression, anxiety, and low self-esteem (Meston et al., 2006; Rellini & Meston, 2011; Rellini et al., 2011). Research on male survivors is very limited, but male survivors often have deep-seated concerns about their masculinity from having been a sexual victim (Lew, 2004). In addition, survivors of sexual abuse often experience aversion reactions to sexual behaviors that are similar to what was done to them during the abuse. They may have flashbacks—sudden unwanted memories of the smells, sounds, sights, feelings, or other sensations of past sexual abuse—that dramatically interrupt any positive feelings and sexual pleasure (Courtois, 2000a, 2000b; Koehler et al., 2000).

Even teenage girls who engage in unwanted sex because they fear their boyfriends will be angry if they say no experience subsequent anxiety and depression. One study found that almost 41% of girls between 14 and 17 had been sexual when they did not want to be, and 10% said their boyfriends forced them to have sex. In addi­tion, the teen girls who experienced unwanted sex were also more likely to have sexually transmitted infections and unwanted pregnancies, and their partners were less likely to use condoms (Blythe et al., 2006).

Research has also indicated serious sexual consequences for survivors of sexual assault during adulthood (Lutfey et al., 2006). One study of 372 female survivors of sexual assault found that almost 59% experienced sexual problems after the assault—with about 70% of this group linking these prob­lems to the assault. Fear of sex and lack of desire or arousal were the most frequently mentioned problems (Becker et al., 1986). In addition, the effects of sexual assault can be long-lasting; 60% of rape victims had sexual prob­lems for more than three years after the assault (Becker & Kaplan, 1991).

The problems following childhood sexual abuse and adult sexual assault are often difficult for partners of survivors to understand and to cope with effectively (Haansbaek, 2006). Wendy Maltz, a sex therapist, developed The Sexual HealingJourney and the DVD or video Partners in Healing specifically to help survivors of sexual abuse and their partners resolve problems origi­nating from that abuse.