BMJ Medical Humanities Blog Publication

Josh Mizels, Lauren Holt, and Madeline Hooper -- all members of the TBSM General Board -- authored an opinion piece regarding the impact of social distancing practices of COVID-19 on homeless individuals and their healthcare.

You can find their publication on the BMJ Medical Humanities Blog here!

No door to lock, nowhere to hide: sexual violence and victimization of Tampa's unsheltered women

Life on the streets is hard, but it’s even harder for women. The well tossed-around statistic is that one in four women will experience sexual violence in their lifetime. Homeless females are no exception to this rule. In fact, they are particularly susceptible to multiple forms of victimization including being forced or manipulated into sexual activity. A large, racially diverse sample of homeless mothers found 92% of this population experienced physical and/or sexual violence at some point in their lives[i]. Another study found that 13% of a sample of homeless women reported having been raped in the past 12 months[ii]. Half of these women had been raped at least twice[ii]. These findings are staggering, and unfortunately hold true on the streets of Tampa.

One Friday night last spring, I was with a group of medical students on a street run. I was a little bit behind the rest of my group, but as I got closer, I could hear a lot of commotion. As I walked up, I saw a female client yelling, “I don’t want to talk to you, do not look at me!” at one of our male volunteers. Since I have spent the majority of my free time volunteering and working with victims of domestic violence, sexual abuse, and emotional trauma, I could tell right away that this woman was hurting. I quietly told the rest of the group to move on, and I went over to introduce myself to the woman. I asked if I could talk to her. She nodded her heard and as I sat down, she just leaned onto me, sobbing. She told me that it is impossible out here for women. She was constantly being put in compromising situations and feeling taken advantage of. She told me that she trusted me because I “looked clean” and she just wanted to look and feel clean again. I let her cry. I told her about all of the resources in the community that I thought would be able to help. She told me that these places wouldn’t care about her since she was homeless. I tried to tell her that it wasn’t true, but I knew I was battling against the many years of oppression she had faced.

I saw this woman about two months later while on another street run and she avoided talking to me. From my experience working with victims of trauma, I know that the mere sight of my face could have been triggering as I am associated with the circumstances that brought our paths together. I did not follow her or force her to talk to me, but I hope that she got the help that she needed.

Three months ago, I met another woman who had just fled from her abusive husband. According to the National Domestic Violence Hotline, it takes seven attempts before a victim is able to successfully leave an abusive partner[iii]. This woman had finally left her husband, but he had controlled all of her finances and medications, so she was now penniless and without her long-term seizure prevention medications. While I talked with her, I tried to get her into a shelter. The shelter I called told me that since she was not in immediate physical danger and without injuries, it would not take her. Does being at risk for a seizure at any moment not count as immediate physical danger? Does the emotional trauma from years of domestic violence not count as an injury?

Sexual assault is a highly-discussed topic in today’s culture. However, these conversations are not enough to bring a change to some of the most at-risk populations. Many victims have to make impossible decisions: stay and endure horrible abuse or run away to the streets and possibly face more victimization. How can we expect these victims to heal from deep emotional trauma if they do not even know when they will be able to have their next meal? A study conducted in San Francisco demonstrated housing was associated with a significant decrease in sexual and physical assault[iv]. So what can we do to get these women off the streets?

Reports show homeless women were viewed as “loud” and “unruly,” but I challenge everyone to look past these stereotypes and understand that this “unruly” behavior is many times the representation of a lifetime of unimaginable trauma and pain.

I will continue to be a champion for my fellow females and hope for a time that no one ever has to say #metoo again.

Lauren Holt is a second year medical student at USF Morsani College of Medicine and Director of Street Runs for TBSM.

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[i] Browne, A., & Bassuk, S. S. (1997). Intimate violence in the lives of homeless and poor housed women: Prevalence and patterns in an ethnically diverse sample. American Journal of Orthopsychiatry, 67(2), 261–278.

[ii] Wenzel, S L et al. “Health of homeless women with recent experience of rape.” Journal of general internal medicine vol. 15,4 (2000): 265-8. doi:10.1111/j.1525-1497.2000.04269.x

[iii] “50 Obstacles to Leaving: 1-10.” The National Domestic Violence Hotline, 12 Apr. 2019, www.thehotline.org/2013/06/10/50-obstacles-to-leaving-1-10/.

[iv] Kushel MB, Evans JL, Perry S, Robertson MJ, Moss AR. No Door to Lock: Victimization Among Homeless and Marginally Housed Persons. Arch Intern Med. 2003;163(20):2492–2499. doi:10.1001/archinte.163.20.2492

A Peek Into - First Presbyterian

Some photos from our February 15th clinic held at First Presbyterian Church.