Reclaiming Gender and Power in Sexual Violence Prevention in Adolescence

Abstract

The Mentors in Violence Prevention (MVP) model seeks to address the root causes of gender violence using a bystander approach and leadership training to challenge structures of patriarchy. Emerging research on adolescent relationship abuse and sexual violence points to key modifiable targets—transforming gender norms, addressing homophobia, integrating with comprehensive sexuality education, and acknowledging the needs of youth already exposed to violence. A social justice–based bystander approach such as the MVP model should be part of a multi-level approach to sexual violence prevention that addresses gender and power, encourages healthy sexuality conversations, and provides safety and support for survivors.

Keywords

adolescent relationship abuse sexual violence gender-based violence prevention adolescence sexuality

Katz’s detailed history of the development and implementation of the Mentors in Violence Prevention (MVP) model highlights the need to address the root causes of gender violence. A core component of the MVP model is a bystander approach and leadership training to challenge existing structures of patriarchy. This approach is highly relevant to sexual violence prevention among adolescents. MVP has been implemented across a broad range of settings and age groups, including for almost two decades in high schools in Iowa where they have seen substantial reductions in violence perpetration (Katz, 2011). Here, I focus on the developmental aspects of adolescent relationship abuse and sexual violence, underscore the need for “gender transformative” programming for adolescents, and call for greater attention to gender performance, adolescent sexuality, and trauma in our violence prevention efforts.

Adolescence is a critical developmental period for exploring sexual and gender identity, sexual attractions, relationships, dating, and intimacy. The middle school years represent a particularly critical stage for relationship abuse and sexual violence education and prevention, as many youth start establishing romantic or sexual relationships for the first time (Noonan & Charles, 2009; Stein, 1995). The highly dynamic pubertal transition (the hallmark of middle school years) is a period of intense social-emotional learning, changes in thought regulation and reasoning, and empathy maturity (Baird & Fugelsang, 2004). For most tweens and young teens, new peer influences dominate, with pressures to conform felt in powerful ways.

It should come as no surprise then, in this developmental context, that relationship abuse and sexual violence are common among adolescents, beginning in early adolescence and peaking in young adulthood, with profound health and social consequences. Sexual harassment increases during middle school (Bentley, Galliher, & Ferguson, 2007; Manganello, 2008; McMaster, Connolly, Pepler, & Craig, 2002; Pellegrini, 2001), with studies identifying such experiences as early as sixth grade and persisting into high school (Callahan, Tolman, & Saunders, 2003; Eaton et al., 2010; O’Keefe, 1997b; Taylor, Stein, Mumford, & Woods, 2013). Nationwide, about one in 10 high school students has been hit, slapped, or physically hurt on purpose by a boyfriend or girlfriend. Sexual violence is also common in the context of adolescent relationship abuse. The most recent national Youth Risk Behavior Surveillance System survey findings of high school students included a question about sexual violence victimization in the context of a dating relationship with 14% of adolescent females and 6% of adolescent males reporting such violence in the past year (Vagi, O’Malley Olsen, Basile, & Vivolo-Kantor, 2015). A recent national study revealed that, among women reporting a history of rape, 40% were first raped before age 18, underscoring that partner and sexual violence are adolescent and young adult concerns (Breiding et al., 2014). Another nationally representative study of adolescents found that 19% of girls ages 12-18 experienced sexual violence (17% for boys) and 10% reported perpetrating such violence (13% for boys; Taylor & Mumford, 2016). Our reticence in the United States to discuss healthy sexuality and sexual and gender identity coupled with intense homophobia remains a core challenge for sexual violence prevention. Drawing on the foundational principles in the MVP model, I reflect here on these critical erasures in adolescent sexual violence (and relationship abuse) prevention.

I start with the critical role of changing gender norms: Several years ago, my colleagues and I published a commentary in this journal about the dangers of erasing gender in research on intimate partner and sexual violence (Reed, Raj, Miller, & Silverman, 2010), pointing to the increasing number of studies in the United States on female perpetrated intimate partner violence and mutual aggression and the push toward “gender neutral” violence research. Katz notes similarly, and pointedly, in his commentary on the history and theoretical underpinnings of the MVP bystander approach,

It is more than a little ironic that the bystander approach developed by MVP in the early 1990s as a gender-specific way for men to challenge other men’s sexist attitudes and behaviors was now being interpreted in such a way as to engage men (and women) without even mentioning gender.

Katz describes the origins of the MVP approach grounded in a social justice framework intended to promote social norms change through engaging men in challenging rigid masculinity norms. He distinguishes this bystander approach and leadership development from gender-neutral, individualistic, events-focused bystander intervention programs.

“Gender transformative” programs, briefly described by Katz, are highly promising public health strategies that have been found to reduce gender violence and improve both men’s and women’s health (Barker, Ricardo, & Nascimento, 2007; International Center for Research on Women, & Instituto Promundo, 2007; United Nations Population Fund [UNFPA], Promundo, & MenEngage, 2010). Such programs incorporate elements of the bystander approach as described by Katz, and are focused fundamentally on increasing young people’s critical analytic skills to recognize the detrimental effects of conforming to rigid gender norms and toxic masculinities and to disrupt such behaviors and attitudes within their peer networks. A key element of “gender transformative” strategies is challenging homophobia and “toxic masculinities”—rigid masculinity norms that constrain and delimit gender expression.

A growing body of adolescent interpersonal violence literature illustrates the overlap among sexual violence, adolescent relationship abuse, and bullying behaviors (Basile, Espelage, Rivers, McMahon, & Simon, 2009; Espelage, Basile, & Hamburger, 2012; Finkelhor, Ormrod, Turner, & Hamby, 2005; Finkelhor, Turner, Ormrod, & Hamby, 2009, 2010). Given the interactional and relational aspects of gender-based harassment and sexual violence, it is likely that these behaviors are developmentally linked. Sexual harassment and bullying behaviors are increasingly shown to be associated with the onset of relationship abuse. In a cross-sectional study of Canadian middle school youth, for example, students who reported bullying their peers also reported more violence against their dating partners than non-bullies (Connolly, Pepler, Craig, & Taradash, 2000). Furthermore, in a recent longitudinal study of U.S. students, bullying perpetration during middle school predicted verbal, physical, and sexual violence perpetration in dating relationships 4 years later in high school (Espelage, Low, Anderson, & De La Rue, 2013). Given these associations, it is imperative that prevention programs incorporate strategies to address overlapping and modifiable risk and protective factors that can reduce gender violence perpetration and related homophobic teasing and sexual harassment.

Homophobic teasing among adolescents is prevalent (among adolescent males in particular) and is a form of gender-based victimization and harassment that merits attention as an important precursor to sexual violence perpetration (Basile et al., 2009; Espelage et al., 2012; Espelage et al., 2013). Homophobia, the underlying attitude that informs this form of teasing, is the negative beliefs, attitudes, stereotypes, and behaviors directed toward gay, lesbian and bisexual people, often associated with gender inequitable attitudes that promote “traditional masculinity” (Bernat, Calhoun, Adams, & Zeichner, 2001). Examples of homophobic teasing include epithets that infer or otherwise expose the victim as gay, threats of physical violence, and social isolation. Homophobic teasing is a commonly reported experience among youth, particularly by students who identify as gay, lesbian, bisexual, or transgender. Rivers (2001) reported that gay and lesbian students frequently experienced incidents of name-calling (82%) and being teased (58%), and had incidents of assaults (60%). These students also experienced rumor spreading (59%) and social isolation (27%). But homophobic teasing is not only directed at sexual minority students. In California, a large-scale survey of students in Grades 7-11 found that 8% reported being bullied at school because of their actual or perceived sexual orientation (Furlong et al., 2005). Interventions focused on sexual violence perpetration reduction must therefore attend to addressing homophobic attitudes and associated homophobic teasing and gender-based harassment. As Katz notes, the promulgation of gender-neutral approaches in violence prevention programs not only fails to recognize these critical associations but also contributes to the continued marginalization of sexual and gender minority youth which increases their vulnerability to violence victimization.

Conceptually, the bystander approach is designed to teach individuals how to safely intervene to prevent sexual violence and to challenge sexist and homophobic attitudes rather than responding with apathy or tolerance. Bystander training provides individuals with the skills to reduce the risk for violence for themselves and those in their social networks by teaching youth to recognize situations or behaviors that may become violent or that reinforce social norms supporting violence and how they can safely and effectively intervene to change social norms and reduce violence. This approach is based on the social norms theory that individual behavior is informed by perceptions and misperceptions of others’ attitudes and behaviors (Fabiano, Perkins, Berkowitz, Linkenbach, & Stark, 2003). Perceived peer tolerance for relationship abuse and sexual violence and attitudes justifying such violence appear to not only promote individual likelihood of such behavior, but may reduce youth comfort and ability to intervene when faced with such negative behaviors among their peers (Avery-Leaf, Cascardi, O’Leary, & Cano, 1997). By diffusing these skills through trained youth’s social networks, community-level changes in social norms and modeled bystander behaviors may lead to broader violence reductions in the community.

Evidence suggests that bystander-based interventions can increase intentions to intervene as a bystander and positive intervention behaviors (Coker et al., 2011) and reduce interpersonal violence among college students (Gidycz, Orchowski, & Berkowitz, 2011) and high school male athletes (Miller et al., 2013). Other prevention programs have educated college students to intervene when faced with peers’ sexual violence perpetration, with increases in willingness to help as a bystander and decreases in rape myth acceptance (Banyard, Moynihan, & Plante, 2007). A bystander approach has been shown to reduce sexual harassment among middle school students (Taylor et al., 2013) and to increase positive bystander behaviors and reduce abuse perpetration among high school athletes (Miller et al., 2013).

Bystander programming should be incorporated into a more comprehensive community-wide approach to reducing sexual violence which seeks to transform rigid gender norms and promote healthy sexual relationships (DeGue et al., 2014). Attitudes and behaviors that denigrate women, endorse hypermasculinity and homophobia, and legitimize relationship abuse and sexual violence perpetration have been identified as key modifiable risk factors for male-perpetrated violence against women (Santana, Raj, Decker, La Marche, & Silverman, 2006). Prevention requires offering youth skills to challenge such social norms as well as the peer environment in which they are embedded (DeGue et al., 2014). Programs that directly address gender stereotypes and hypermasculine attitudes that condone violence against women have also been successful at reducing relationship abuse and sexual violence (Miller et al., 2013; Taylor et al., 2013).

Reticence to address homophobia combined with continued silence around adolescent sexuality is another major challenge for adolescent sexual violence prevention. Sexual violence and relationship abuse have profound consequences for adolescent health such as unintended pregnancy, sexually transmitted infections (including HIV), depression, substance abuse, and suicidality (Decker, Silverman, & Raj, 2005; Exner-Cortens, Eckenrode, & Rothman, 2013; Foshee, Reyes, Gottfredson, Chang, & Ennett, 2013; Miller et al., 2010).

In addition to gender transformative programming that incorporates a bystander approach, then, sexual violence prevention programs should address adolescent sexuality including sexual attraction, intimacy, and affirmative consent. A recent review of sexual health programs to address pregnancy and sexually transmitted infections prevention for adolescents found significantly greater reductions in sexual risk behaviors among youth who received programs that discussed gender, power, and relationship skills building (Haberland, 2015). In global health settings, programs that focus on gender equity and healthy sexuality have been associated with reductions in sexual violence. Our team is currently testing a sexual violence perpetration prevention program that combines elements of gender transformation with comprehensive sexuality education (inclusive of gender and sexual identity).

Finally, in addition to the erasures of gender and sexuality in gender-neutral approaches to sexual violence prevention, it is critical to note that sexual violence prevention programs have also historically not addressed trauma. Sexual violence and relationship abuse perpetration is associated with multiple individual- and contextual-level factors including exposure to adverse childhood experiences, and poor conflict resolution and relationship skills (Basile et al., 2016; Miller et al., 2011; Tharp et al., 2013). Multiple studies suggest that teens’ experiences with violence and violence-supportive or accepting attitudes are linked with the perpetration of relationship abuse (Malik, Sorenson, & Aneshensel, 1997; O’Keefe, 1997a, 1997b; O’Keefe & Treister, 1998; Wolfe, Scott, Wekerle, & Pittman, 2001; Wolfe, Wekerle, Reitzel-Jaffe, & Lefebvre, 1998; Wolfe, Wekerle, Scott, Straatman, & Grasley, 2004). Our work has found that exposure to adverse childhood experiences (childhood sexual abuse, witnessing interparental violence, and parent mental illness, in particular) contribute to over half of the cases of physical dating violence victimization and perpetration (Miller et al., 2011), underscoring the need for tailored interventions for youth exposed to such adversities. A recent controlled evaluation of a prevention program that focuses on youth exposed to violence found incremental declines for boys on multiple outcomes, including perpetration and victimization of psychological and sexual dating violence, physical dating violence victimization, and reactive and proactive aggression (Reidy, Holland, Cortina, Ball, & Rosenbluth, 2017). Identifying ways to integrate trauma-focused interventions for youth who are already exposed to violence by the time they reach adolescence into sexual violence prevention programs remains a critical task not well addressed by bystander approaches alone.

In summary, the research on adolescent relationship abuse and sexual violence prevention point to key modifiable areas and approaches related to transforming gender norms, addressing homophobia, integrating with comprehensive sexuality education, and acknowledging the unique needs of youth already violence exposed. A bystander approach such as the MVP model can and should be part of a comprehensive, multi-level approach to sexual violence which addresses gender and power, encourages healthy sexuality conversations, provides safety and support for survivors, and, ultimately, prevents perpetration of such violence.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biography

Elizabeth Miller is a professor in pediatrics and director of the Division of Adolescent and Young Adult Medicine, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine. Trained in internal medicine and pediatrics and medical anthropology, she has over a decade of practice and research experience in addressing interpersonal violence in clinical and community settings.

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