"You are sexy."
These are the polite versions of catcalls men sometimes spew at me (I'm not even Beyoncé, mind you—I just have breasts and a vagina) in public spaces. To the catcallers, it's all fun and games. Patriarchy awards them the privilege to vocally assess and proposition women waiting for the train.
My friend Aba, 28, doesn't mind catcalling. Her response to it usually depends on whether she's in a good mood because she caught the green light while eating a Twix bar, or a bad mood (it's raining and she isn't wearing her rain boots).
Catcalls to her—although she still views them as uncalled for and sometimes annoying—are not a huge deal. She says, "[They] can give reassurance...it's a nice confidence boost."
But she's never been sexually assaulted.
While PTSD is a condition usually associated with war veterans, high rates of sexual assault victims have the disorder as well. This means people who have experienced sexual assault can relive their attack mentally anytime they are triggered. And any type of unwanted sexual advance is often a trigger.
In a revealing moment from Lady Gaga's visit to a center for homeless LGBT youth a few weeks ago, she told the young adults—many who have suffered physical trauma themselves as a result of coming out—that she struggles with PTSD. After she was raped at 19, Gaga has continued to battle mental illness from the trauma.
For women who don't feel comfortable being as open about past trauma, the struggle stays hidden, and the triggers can exacerbate it. According to one study, the lifetime prevalence of PTSD for women who have been sexually assaulted is 50 percent. Sexual assault is the most frequent cause of PTSD in women, and it's been reported that 94% of women experienced PTSD symptoms during the first two weeks after an assault.
From the ages of 10 to 17, Lelani, now 30, was molested by her stepfather. In 2004, after a suicide attempt, she was diagnosed by her primary care doctor with depression and PTSD.
Today she still feels anxiety when men who physically remind her of her stepfather get too close. "Big guys that are over six feet tall and really stocky that remind me of him—they make me feel uncomfortable. I automatically go into panic mode where I have to defend myself, " she says. Lelani experiences a symptom of PTSD called hyperarousal, in which she goes into fight-or-flight mode—a state that can be physically and emotionally draining.
It's common for catcalls to induce fear, anxiety and memories of trauma in sexual assault survivors. An episode can be triggered by anything that reminds the victim of the attack, says Aderonke Oguntoye, psychiatrist and founder of Evolve Psychiatric Services. "It can be a scent, the sound of someone's voice, walking down a street that looks similar to where the assault happened…it could be anything."
Jessica was raped by her uncle in a family member's home when she was 23. Seven years later, in January 2016, she was diagnosed with PTSD.
When men try to get her attention, it triggers an emotional attack. "My palms got sweaty and tears were coming down my face," she says of one night when she went to a bar to pickup her takeout order, and got unwanted attention from the male clientele. "Do I say anything back? How could I when I am outnumbered? Instead I went to my car and cried until my panic attack passed."
These episodes of intense anxiety tend to last only a few minutes, but have a ripple effect, explains Jeffrey Gardere, a psychiatrist practicing in New York City. The continued stress of being regularly sexually harassed can begin to take a physical toll due to the increase of stress hormones like cortisol, adrenaline, and epinephrine.
When a person with PTSD encounters a stimulus that triggers the disorder, the trigger is usually viewed as a danger or intrusion, causing the aforementioned stress hormones to be released in the brain and body. Excess cortisol can cause weight gain and physical illness, while the epinephrine and adrenaline can begin to wear the body down from constantly being maxed out on stress and hypervigilance.
Oguntoye, who specializes in treating trauma victims, teaches her patients different relaxation techniques that helps them cope in situations that trigger them. "Also acknowledging the PTSD," Gardere adds, "Is a good thing, in now that you can understand what is stressing the body, and the mind can actually get help."
However, there is no cookie-cutter treatment for every person who has PTSD from sexual assault, as the disorder can manifest itself in many ways. There is also no definitive recovery time span, which is why troubleshooting the problem is more complex.
Holly Kearl, founder of the non-profit Stop Street Harassment and author of Stop Global Street Harassment: Growing Activism Around the World, presents strategies for how to properly combat catcalling, putting control back in the hands of sexual assault survivors. One of her tactics encourage women (when it is safe) to calmly, firmly, and without insults, inform them that their actions are unwelcome, unacceptable, and wrong.
Gardere disagrees. "If you respond to the individual by expressing outrage or offense, you're giving attention to a behavior," he says. "It's still a response, and that's what catcallers want out of a woman—her attention."
In his professional opinion, the best way to handle the situation is to absolutely ignore the individual. That way, he says, "you are extinguishing their behavior."