"You Can Get Away with Anything Here… No Justice at All"- Sexual Violence Against U.S. Indigenous Females and Its Consequences.

Sexual violence against Indigenous women has long been used as a tool of colonial violence and conquest. As a contemporary form of historical oppression that may drive associated health and mental health inequities, Indigenous women in the United States experience sexual violence at greater levels than the general population and at and twice the rate of Indigenous men. We use the Indigenous framework of historical oppression, resilience, and transcendence (FHORT) to understand Indigenous women's experiences of sexual violence and how it differentiates across ecological outcomes related to health and wellness. This exploratory sequential multimethod study with 563 participants (n = 436 qualitative and n = 127 quantitative survey participants) qualitatively explores how Indigenous peoples describe sexual violence and quantitatively investigates key differences across ecological outcomes of wellness related to sexual violence, including alcohol use and post-traumatic stress disorder (PTSD). Results indicated that all participants (100 percent) who reported sexual violence were women. Thematic analysis of qualitative results revealed the themes related to familial, non-familial, and the historical oppression of a lack of accountability for perpetrators. Quantitative t-Tests results revealed that experiencing sexual violence was associated with significant differences across ecological dimensions of wellness including (a) structural: higher historical oppression, historical loss, oppression, and discrimination; (b) relational: higher adverse childhood experiences and stressful life events and lower family resilience and social support; (c) spiritual: lower spiritual-well-being and life satisfaction; and (d) psychological/behavioral: higher levels of alcohol use, PTSD, and lower levels of psychological resilience. Thus, sexual violence profoundly affected Indigenous women.