The current sample consisted of 393 women who reported having sex in the last 12 months and experienced lifetime sexual violence. Participants were recruited via advertisements on social media (i.e., Instagram, Facebook, and Twitter) as part of a larger study on disclosures of unwanted sexual experiences that was motivated by the #MeToo movement (n = 767). Data was collected from February 2020 to February 2022. Participants were eligible for the larger study if they lived in the United States, were at least 18 years old, and endorsed having an unwanted sexual experience on the Sexual Experiences Survey—Short Form Victimization (SES-SFV; Johnson et al., 2017; Koss et al., 2007). Participants were only included in the current study if they endorsed having sex within the last 12 months (n = 393) and identified as a woman.

The racial/ethnic composition of the sample was 69.5% White (n = 273), 5.9% Black or African American (n = 23), 8.9% Latinx or Hispanic (n = 35), 7.9% Asian/Pacific Islander (n = 31), 3.6% Multiracial (n = 14), 3.1% Native American or American Indian (n = 12), and 1% other (n = 4)—with 0.3% reporting they preferred not to answer (n = 1). Most of the sample identified as straight/heterosexual (45.3%; n = 178). Additionally, 35.4% identified as bisexual (n = 139), 10.9% identified as pansexual (n = 43), 5.6% identified as lesbian (n = 22), 1.5% identified as other (n = 6), 0.3% as gay (n = 1), and 1% reported they preferred not to answer (n = 4).

The survey was administered online. Informed consent was obtained from participants before being directed to the survey. The survey lasted approximately half an hour, and participants were provided with a $10 Amazon gift card upon completion. To prevent data corruption (e.g., bots completing the study), a two pronged approach to data quality control was implemented: (1) a reCAPTCHA box was used to verify participant was human and (2) survey responses were manually reviewed, and suspicious data was flagged by the research team (e.g., inconsistent responses, multiple responses from same participants, unlikely email addresses, and illogical responses to open-ended questions). Any participant with at least one characteristic of suspicious data was removed from the analysis. Of the 1191 responses collected, 767 (64.3%) were included in the larger study. Study procedures for the full project were approved by the institutional review board [blinded for review] and human subject review continued through the secondary analyses of data.

Consistent with expectations, many survivors endorsed high levels of sexual difficulties. The High Inhibition/Concerns (n = 83; 21.1%) profile was characterized by pronounced sexual inhibition, including both emotional (e.g., anxiety, shame) and cognitive (e.g., worries about orgasm or sexual performance) barriers that impede sexual functioning. In comparison to the other profiles, participants in the High Inhibition/Concerns profile exhibited elevated scores on Inhibitory Cognition, reflecting heightened sensitivity to factors that suppress arousal (e.g., self-consciousness, partner behaviors). These high inhibition scores were accompanied by the lowest scores on the Arousability (i.e., the tendency to become easily sexually aroused in a variety of situations), Partner Behaviors (i.e., arousal in response to the partner’s personality or behaviors), and Setting (i.e., arousal is enhanced when engaging in sexual behavior in an unusual or unconcealed setting) domains of sexual inhibition/excitation, indicating reduced arousal in response to various sexual stimuli. Although sexual inhibition and excitation are conceptually distinct from sexual functioning symptoms (Bancroft et al., 2009; Graham et al., 2006), this profile also had the most concerning scores on all sexual functioning subscales, indicating significant challenges across multiple dimensions of sexual functioning. Participants in this profile had significantly lower scores on the desire, arousal, orgasm, and lubrication sexual functioning subscales than the three other profiles. They also had significantly lower satisfaction scores and significantly higher pain scores on sexual functioning than participants in the Low Concerns and Inhibited but Satisfied profiles. Notably, participants’ scores in the High Inhibition/Concerns profile closely correspond to scores previously found in a sample of women with sexual dysfunction (Meston & Trapnell, 2005), and the profile’s average desire score of 3.12 was more severe than the clinical cutoff of five that indicates possible Hyposexual Desire Disorder (Meston et al., 2019). In addition, participants in this profile reported significantly lower satisfaction across multiple domains of their sex life than participants in the Low Concerns and Inhibited but Satisfied profiles. Overall, the High Inhibition/Concerns profile demonstrates a pattern of sexual functioning consistent with prior research documenting high rates of sexual problems and dissatisfaction among survivors of sexual violence (e.g., Kelley & Gidycz, 2015; Kilimnik et al., 2016; Turchik & Hassija, 2014). The pattern of scores in this profile also illustrates the interconnectedness of sexual and relational constructs, including sexual inhibition/excitation, sexual functioning, and subjective satisfaction (Freihart et al., 2020; Velten et al., 2017), with all of these constructs aligning closely in this group.

Further aligned with our predictions, a substantial proportion of survivors endorsed low sexual difficulties. Compared to all other profiles, individuals in the Low Concerns profile reported significantly higher levels of satisfaction across all sexual satisfaction subscales; significantly higher degrees of arousal, orgasm, lubrication, and satisfaction across sexual functioning subscales; and significantly lower scores on sexual pain. Compared to the High Inhibition/Concerns profile only, the Low Concerns profile also had significantly lower scores on the Inhibitory Concerns and significantly higher scores on Arousability and Desire. This pattern of responses indicates optimal sexual functioning across multiple domains. In fact, this profile’s scores on sexual functioning (FSFI) and sexual satisfaction (SSS-W) closely mirror those of a control sample (i.e., women without sexual dysfunction) used during the SSS-W’s development (Meston & Trapnell, 2005). Importantly, this profile included more participants (n = 100; 25.4%) than the High Inhibition/Concerns profile (n = 83; 21.1%), suggesting that optimal sexual functioning and satisfaction are not only possible, but also likely after sexual victimization. These findings are consistent with the results of prior research that has failed to find significant relationships between sexual violence victimization, as well as research suggesting that specific psychological mediators (e.g., depression, anxiety) may be uniquely linked to specific domains of sexual functioning (Kelley & Gidycz, 2017. Future research should investigate additional protective factors that foster this resilience to adverse sexual outcomes. For instance, individuals in this profile may benefit from greater relationship closeness, community connectedness, engagement in therapy, adoption of empowerment narratives, or reliance on broader social support networks.

The additional profiles—Casual Sex and Satisfied but Inhibited—illustrate nuanced (and even paradoxical) patterns of sexual functioning and behaviors among survivors. Members of the Casual Sex profile (n = 61; 15.5%) exhibited a distinct approach to sexuality, marked by high levels of sexual excitement and arousal, without a need for trust or commitment within intimate relationships to facilitate sexual behavior. Participants in this profile had significantly higher scores on the desire, arousal, lubrication, and orgasm sexual functioning subscales than the High Inhibition/Concerns profile. Compared to all other profiles, members of the Casual Sex profile had significantly higher scores on the Arousability and Setting subscales and significantly lower scores on the Relationship Importance (i.e., a higher need for trust and commitment to get aroused) subscale. These reports are consistent with recent literature suggesting that many survivors exhibit high levels of desire, excitation, and sensation-seeking (Bogen et al., 2022; Jones & Lorenz, 2022). For some survivors, elevated arousal may be a product of trauma-related “reenactment” (e.g., Lahav et al., 2019), wherein engaging in sexual behavior serves as a way to regain a sense of control and mastery over past experiences. For others, heightened sensation-seeking may function as a coping strategy, providing distraction from trauma-related distress or numbing/dissociative symptoms. However, despite their heightened excitation and desire, individuals in this profile also reported lower sexual satisfaction on all sexual satisfaction subscales (except Relational Concerns) compared to the Low Concerns profile, and their scores on satisfaction were comparable to the High Inhibition/Concerns group. Thus, high excitation or desire among survivors may not necessarily serve as a catalyst for satisfying or fulfilling sexual experiences, or alternatively, there may be a divergent relationship between arousal/sexual functioning and satisfaction among this group.

In contrast, the Satisfied but Inhibited profile represents individuals who reported moderately high levels of sexual satisfaction in tandem with moderately significant inhibitory concerns. Members of this profile had significantly higher scores on the sexual satisfaction subscales than the High Inhibition/Concerns and Casual Sex profiles, but significantly lower scores on the sexual satisfaction subscales than the Low Concerns profile. Similarly, they had substantially more favorable scores on all sexual functioning subscales than the High Inhibition/Concerns profile, but less favorable scores than the Low Concerns profile. On the SESI, the pattern of scores for this profile was mixed. Compared to the Low Concerns group, Satisfied but Inhibited individuals had similar levels of arousability, but higher levels of inhibitory concerns. Overall, the Satisfied but Inhibited profile indicates that many survivors experience moderate sexual satisfaction, despite some underlying anxiety concerns. Interestingly, this profile had the highest membership rate (n = 146; 37.9%) among all profiles, indicating that the negative effects of sexual violence are real and that many survivors exhibit resilience and can achieve a satisfying and enriching sexual life. However, contextual factors not assessed in this study—such as emotional closeness, relationship satisfaction, or social support (e.g., Henderson et al., 2009)—likely play important roles in facilitating sexual satisfaction in the context of higher levels of inhibition.

Overall, the emergence of four profiles and their correspondence with a range of sexual health variables reinforce the idea that there are meaningful variations in multiple domains of survivors’ sexual lives. In light of research that has reached competing conclusions about the relationship between sexual violence and sexual functioning (e.g., Bogen et al., 2022; Kelley & Gidycz, 2015; 2019), findings suggest that there is no universal way in which sexual violence impacts women’s intimate lives. Future research should thus examine moderators that explain variation in sexual functioning outcomes in order to predict which survivors may be most at risk for sexual difficulties and to provide access to prevention/intervention efforts.

The Dual Control Model (Janssen & Bancroft, 2007) provides a useful lens for understanding the diversity of the profiles identified in the current study. According to this model, sexual excitation and inhibition operate as independent, interacting systems that influence sexual outcomes. For survivors in the Casual Sex profile, elevated excitation did not translate into greater sexual satisfaction. This finding highlights how high arousal, when insufficiently regulated by inhibition, may contribute to risk-taking or less fulfilling encounters. Conversely, survivors in the Satisfied but Inhibited group reported moderate inhibition yet still achieved relatively high satisfaction, suggesting that relational or contextual resources may buffer inhibitory concerns. Thus, the Dual Control Model helps explain how different balances of excitation and inhibition, in combination with relational resources or environmental characteristics, can produce diverse profiles of sexual outcomes among survivors.

When examining profile differences in PTSD symptoms, hypotheses regarding the relationship between sexual functioning concerns and PTSD symptoms were supported. The High Inhibition/Concerns group reported elevated PTSD symptom severity. The Low Concerns group reported low levels of PTSD symptoms, similar to the Satisfied but Inhibited group. The Casual Sex profile also reported high levels of PTSD symptoms, a pattern that we did not hypothesize. Taken together, these findings imply that trauma history may be related to both sexual inhibition and the pursuit of casual encounters (or “risky” sex) as coping mechanisms for PTSD symptoms. This paradox is consistent with prior research suggesting that specific clusters of PTSD symptoms arising from experiences of abuse, rather than abuse itself, play a crucial role in understanding survivors’ sexual lives (Kelley & Gidycz, 2019).

When we tested group differences in binge drinking and substance use prior to sex, both the Casual Sex and Satisfied, but Inhibited profiles reported higher instances of binge drinking compared to the Low Concerns profile. The Casual Sex and High Inhibition/Concerns profiles also exhibited a greater likelihood of using substances prior to sex compared to the other two profiles. The higher levels of substance use in these groups (both during and outside of sex) are consistent with prior research linking sexual behavior and substance use, which may include both the use of alcohol as a coping strategy to mitigate anxiety generally (e.g., Bird, 2020) and/or the use of alcohol as a strategy to enhance sexual functioning and pleasure, a practice that is common among women generally (Lorenz, 2021). Alternatively, the Low Concerns and Satisfied but Inhibited profiles’ lower likelihood of using substances during sex suggests that these individuals may experience sufficient satisfaction in their sexual encounters without the need for substance use to avoid discomfort or enhance pleasure. These results have implications for understanding risk factors associated with sexual health and revictimization, as elevated alcohol use can often put survivors at risk for additional victimization (Abbey, 2011). Future research would benefit from exploring moderating factors (e.g., sensation seeking) that may predict how motivations for substance use (e.g., coping vs. enhancement) may differ between these profiles.

Finally, group membership did not differ in terms of the severity of sexual violence history (i.e., whether survivors experienced sexual coercion, sexual contact, or attempted/completed rape). Therefore, sexual symptoms may not necessarily be related to the severity of the sexual assault experience as it is traditionally conceptualized (i.e., hierarchical severity score), but instead may correspond with individual differences in the subjective experience of the assault itself. Clinicians/researchers should be wary of discounting the effects of sexual violence, simply because it was “not rape.” Such a finding reflects trends in recent research suggesting that sexual coercion may similarly, if not more strongly, be related to harmful outcomes as forcible assault (Shaw & Read, 2021)

Although this study is the first to our knowledge to conduct an LPA on sexual functioning among survivors, it is not without its limitations. The cross-sectional design and reliance on retrospective reporting restrict our ability to draw causal inferences, and the use of self-report measures may introduce bias through common method variance (Podsakoff et al., 2003). Additionally, we recruited our sample through online social media platforms, which may have introduced self-selection bias that influenced our results. Our sample was also limited in terms of racial and ethnic diversity (70% white), which restricts its generalizability. Future research should address these limitations more thoroughly by examining these relationships in longitudinal designs and collecting data from representative samples with diverse sexual and racial or ethnic identities, given that sexuality is deeply embedded in sociocultural variables, including cultural beliefs (e.g., conservatism) and practices (e.g., stigma associated with sex) that lead to greater or lesser degrees of excitation or inhibition (Heinemann et al., 2016). We also recommend incorporating qualitative methodologies in future studies to gain a deeper understanding of how these profiles evolve over time and their implications for interventions aimed at enhancing sexual well-being among sexual assault survivors. Finally, it should be noted that one of the outcome subscales—sexual contentment—demonstrated poor reliability (α = .59), and therefore, results related to this subscale should be interpreted with caution. However, given the consistency of the results across multiple measures of sexual functioning, the inclusion of this scale likely does not affect the broad pattern of results found in the current study.

Beyond limitations, these results also carry clinical implications that should be evaluated in future research future research. For survivors in the High Inhibition/Concerns profile, interventions that target anxiety and maladaptive cognitions about sexuality (e.g., trauma-focused CBT, cognitive restructuring, or mindfulness-based approaches) may be most beneficial. Survivors in the Casual Sex profile might be most appropriate for interventions that address PTSD symptoms and substance use as coping mechanisms (e.g., Prolonged Exposure, dual diagnosis programs), in tandem with psychoeducation about the potential disconnect between sexual arousal and subjective fulfillment. In contrast, the Satisfied but Inhibited group may benefit from psychoeducation and couples-based therapies that highlight existing strengths or resilience factors within the relationship while also addressing inhibitory concerns. Future clinical research could evaluate a “match-based” approach to providing therapy to survivors based on their profile of sexual symptoms.