Rethinking the “Rough Sex Defence” in Canada: Replies to Sheehy et al.

<p dir="ltr"><b>Background</b><b>:</b> Sexual violence remains a major public health concern in Sweden despite increased awareness following #MeToo and the 2018 consent law. Young people are disproportionately affected, and men's experiences are often overlooked. Emerging practices such as "rough sex" raise questions about consent, communication, power dynamics, and potential harm. Strengthening evidence in these areas is critical for clinical care, psychosocial support, and prevention.</p><p dir="ltr"><b>Aim:</b> To improve understanding of how young women and men experience physical violence in sexual situations, both consensual and non-consensual, and how consent is negotiated.</p><p dir="ltr"><b>Methods: </b>A mixed-methods design was applied. The quantitative component (Study I and II) comprised retrospective analyses of anonymized medical and forensic records from the Emergency Clinic for Rape Victims at Södersjukhuset. Study I included young women aged 16-29 who attended the clinic in 2012, 2017, and 2022 (n=1,074). Study II examined men seeking care between 2015 and 2022 (n=245), with a sub-analysis of younger men aged 16-29 (n=149). Severity of violence was assessed using an adapted NorVold Abuse Questionnaire, and data were analyzed using descriptive statistics and regression models. The qualitative component (Study III and IV) included 24 in-depth interviews with young people aged 16-24 (12 women, 12 men), analyzed using content analysis informed by sexual script theory and a socioecological framework.</p><p dir="ltr"><b>Results:</b> Among young women, physical violence during sexual assaults remained high across cohorts, with a marked increase in severe violence between 2012 and 2022, including non-fatal strangulation. Non-fatal strangulation was associated with assaults in private settings, combined vaginal penetration and other acts, and blunt force trauma. Genital injuries also increased over time (Study I). Among men, moderate to severe physical violence during sexual assaults was statistically associated with assaults involving multiple assailants. Among young men, attempts at self-defense were also significantly linked with higher severity of violence (Study II). Interviews revealed that "rough sex" was often embedded within dominant-submissive gender scripts. Some participants viewed these practices as exciting, while others found them uncomfortable or unacceptable. These practices were shaped by pornography, social media, and peer influences. Participants also reported risks of harm and instances of non-consent during these practices (Study III). Consent was viewed as mutual and ongoing; however, barriers included relational dynamics, discomfort, fear of rejection, and gendered expectations (Study IV).</p><p dir="ltr"><b>Conclusions and Implications:</b> Sexual violence among young women attending post-assault care has become more severe, and men's experiences warrant greater attention. While some participants described rough sex as pleasurable and consensual, others perceived it as possibly harmful. Additionally, gendered sexual scripts and communication barriers create consent ambiguities. The findings highlight the need for clinical protocols addressing non-fatal strangulation during sexual assaults. The findings also underscore the importance of comprehensive consent education in schools and public campaigns, emphasizing skill-based communication, boundaries, and power dynamics, alongside open, non-judgmental discussions with young people about the risks associated with certain sexual practices.</p><h3 dir="ltr">List of scientific papers</h3><p dir="ltr">I. <b>Larsson, F.</b> M., Nielsen, A., Zeebari, Z., Salazar, M., Ekström, A. M., & Möller, A. (2025). Changes in physical violence and injury during sexual assaults over time among females 16-29 years. Acta Obstetricia et Gynecologica Scandinavica, 104(9), 1627-1639.<a href="https://doi.org/10.1111/aogs.70012" target="_blank">https://doi.org/10.1111/aogs.70012</a></p><p dir="ltr">II. <b>Larsson, F.</b> M., Nielsen, A., Zeebari, Z., Salazar, M., Ekström, A. M., & Möller, A. (2025). Sexual Violence Against Men: A Retrospective Study on Victim Characteristics, Violence Severity, and Occurrence of Injuries Among Male Victims Attending a Sexual Assault Center Between 2015 and 2022 in Stockholm, Sweden. Journal of Interpersonal Violence, 8862605251361127. <a href="https://doi.org/10.1177/08862605251361127" target="_blank">https://doi.org/10.1177/0886260525136112</a></p><p dir="ltr">III. <b>Larsson, F.</b> M., Salazar, M., Möller, A., Ekström, A. M., & Nielsen, A. Between desire and harm: A qualitative exploration of rough sex among young men and women aged 16-24 years in Sweden [Manuscript]</p><p dir="ltr">IV. <b>Larsson, F.</b> M., Salazar, M., Möller, A., Ekström, A. M., & Nielsen, A. Barriers to expressing and interpreting sexual consent: a qualitative study among men and women aged 16-24 in Sweden [Manuscript]</p>

Predicting injury risk with “New Car Assessment Program” crashworthiness ratings

Reviewed by: Rape and Resistance by Linda Martín Alcoff Ellie Anderson (bio) Linda Martín Alcoff, Rape and Resistance Medford, MA: Polity Press, 2018; 269 pp. Concerns about sexual harms have burst into public view in recent years, culminating in the #MeToo movement. This movement is part of a resurgence of feminism that some are calling the fourth wave. Yet discourse about rape and other sexual violations within this movement has generally accepted existing theoretical frameworks inherited from liberalism, which emphasize verbal consent and individual freedom. In Rape and Resistance, Linda Martín Alcoff argues that it is high time to reconsider these frameworks. Being legalistic in nature, verbal consent fails to do justice to the complexity of sexual encounters and sexual violations. And, given that feminist theory has for decades taken issue with the abstract ideal of individual freedom, we also need to reframe talk of violation in a way that takes a bigger picture of the formation of our individual selves within our cultures and histories. In the face of these insufficient conceptual resources, we need nothing short of a new account of sexual normativity. Rape and Resistance is a must-read that cuts to the core of contemporary feminist theory and public discourse. Feminists and anti-feminists alike have worried in light of recent events that liberalism is not up to the task of accounting for the complexity of sexual encounters, yet it has not been clear what kinds of alternative norms might take the place of liberal ones. Part of the challenge is that feminist and queer theory have for decades deflected the very idea of norms, beginning with the sexual libertarianism theorized by Gayle Rubin in the wake of the sexual revolution. Rubin, inspired by [End Page 275] Foucault’s worries about the ways that sexual norms serve disciplinary functions to normalize “deviant” individuals, advocates a tolerant approach to sexual diversity (Rubin 1984). Alcoff argues that this approach, according to which all norms around sex and oppressive and should be removed, renders sexual accountability unintelligible: accountability is unthinkable outside of norms. An absence of norms makes it impossible to register sexual violation as a harm, since the notion of harm is normative. Alcoff compellingly argues in Rape and Resistance that the current dominant discourse around sexual violation is still libertarian in its logic. For Alcoff, in contrast, sex is a normative issue, and must be considered as such in order to do justice to survivors of sexual violation. While worries about the normalizing tendencies of sexual morality are well grounded given the violent history of excluding non-normative sexualities, Alcoff points out that normativity is different from normalization (77). The conflation of the two in much recent feminist and queer theory following Rubin has led to a wholesale rejection of norms that is performatively contradictory, given that suggesting that “norms are bad” is a normative statement. Alcoff reminds us that “In reality the practice of norming, theoretical and otherwise, is simply the ubiquitous and unavoidable practice of judging” (77). Following Foucault’s late work on self-making and normativity, Alcoff offers a thin ethical account centered on the notion of self-making in relation to others. She seeks to offer “guide-ropes but without scripts” (121). For her, agents are responsible for the development of their sexual selves, but responsibility is complex and intersubjective. Additionally, rather than being an issue of power rather than sex (paceSusan Brownmiller), sexual violation for Alcoff is about sex, and sex concerns our subjectivity and will (12). Alcoff combines feminist theory with Foucauldian, hermeneutic, and phenomenological frameworks in order to challenge additional assumptions at the heart of the zeitgeist. For one, she worries that the proliferation of survivor-discourse is a form of the “confessional” speech that Foucault describes in The History of Sexuality as serving to entrench power rather than resisting it. For another, she argues that feminist theory’s critiques of experience and first-person authority should not amount to wholesale rejections of these concepts, for this would render it impossible to take sexual violation as a violation. In this respect, Alcoff’s view picks up on the spirit of Ann J. Cahill’s 2001 book...

Travel speed and the risk of serious injury in vehicle crashes

To evaluate the relationship between number of falls and risk of injury after a specific fall. Prospective cohort study. Greater New Haven, Connecticut. Probability sample of 1,103 community-living persons aged 72 and older. Falls and fall-related injuries were ascertained monthly for 3 years using a fall calendar and follow-up telephone interviews. Of 606 participants with a fall, 164 (27.0%) had at least 1 fall with a serious injury, and 455 (75.1%) had at least 1 fall with any injury; mean number of falls was 2.6±2.3 (range 1-18), of falls with serious injury was 0.3±0.6 (range 0-4), and of falls with any injury was 1.4±1.4 (range 0-9). On a per-participant basis, risk of serious injury and any injury increased progressively as the number of falls increased (P < .001). On a per-fall basis, risk of serious injury and any injury increased from 1 to 2 falls but then decreased from 2 to 3 or 4 falls and from 3 or 4 to 5 or more falls, although these differences were not statistically significant. The results were consistent for women and men and for analyses that evaluated the proportion of falls with injuries. In community-living older persons, risk of injury from a specific fall did not differ as the number of falls increased. Falls appear to operate independently in terms of conferring risk of injury in the setting of multiple falls. J Am Geriatr Soc 67:119-123, 2019.

Neighborhood-level built environment and social characteristics associated with serious childhood motor vehicle occupant injuries

Aim: Safety air cushions play a key role in the Polish rescue system. The basic principles of operation of the jump cushion are based on controlled absorption of the kinetic energy of the human body falling from a great height. Thanks to the use of air layers and flexible energy-absorbing materials, the jump cushion is able to reduce the overload affecting the human body during contact with the shock-absorbing surface. The mechanism of impact overload during a fall involves a sudden deceleration and the accumulation of forces acting on the body, which creates a risk of injuries such as fractures, damage to internal organs or concussion. In order to ensure an optimal level of safety while minimising the risk of serious injuries to both rescuers and rescued people, it is important to understand the excessive deceleration mechanisms during a fall from a significant height. Safety air cushions are designed to slow the body down in a controlled manner by spreading kinetic energy over a larger surface area and for a longer period of time, which reduces the risk of serious injury. Typical g-forces on a well-designed air cushion are in the range of 5-10 g and exceeding them significantly increases the risk of injury. Methodology: series of experiments was conducted, where drop test manikins weighting 40 kg to 90 kg and equipped with accelerometers were thrown from height of 16 metres onto jump cushion targets. During these experiments, various jump cushions from different manufacturers with air-filled frames fed via air tanks were used. The data gathered together with video recordings of those tests were then thoroughly analysed. Conclusions: The research results established acceptable levels of g-force overload for the human body in specific boundary conditions. The data were confirmed consistent with the results accessible in the available literature and enabled the development of technical and operational requirements for safety cushions. The research emphasises the importance of refining the technical parameters of safety air cushions in order to ensure safety and minimise the risk of injuries during rescue operations. In the future, it may be necessary to conduct tests with a manikin of greater mass, which is dictated by the social tendency to gain weight, and to not limit falls to other places on the upper surface of the jump cushion, which may be significant for the magnitude of the overload occurring. Keywords: air cushion, jump cushion, biomechanical overload, air-filled frame, air cushions, impact (shock) absorption technologies

Objective This study determined the type of striking vehicle or object associated with serious injury to at least 1 occupant in the vehicle struck in the rear. Method The 1990–2015 NASS-CDS was analyzed for light vehicles involved in rear crashes. The type of vehicle struck in the rear resulting in serious injury to at least 1 occupant was determined. Rear impacts were identified with GAD1 = B without rollover (rollover ≤ 0). Vehicles with serious to maximum injury were identified as VAIS 3 to 6 (VAIS 3+). The type of striking vehicle or object was determined for the rear impacts causing serious injury. The risk and relative risk for serious injury were determined. Review of electronic cases was conducted for light vehicles with serious injury (VAIS 3+) in impacts by tractor-trailers or large trucks. Results The highest risk for serious injury to an occupant in the struck vehicle was from a tractor-trailer or large truck (2.71%), followed by a fixed object (1.49%) and van (1.00%). The average risk was 0.33%. The relative risk was 8.2 times for impact with a tractor-trailer or large truck and 4.5 times for impact with a fixed object. The highest risk impacts with a fixed object were rear impacts into a tree/bush (3.57%) and pole (2.90%). Tractor-trailers and large trucks accounted for 16.2% of serious injury in struck vehicles, followed by fixed objects at 12.9%; the 2 accounted for 29.1% of serious injury to occupants of struck vehicles. The case review identified 22 tractor-trailer and 1 large truck crashes involving 31 seriously injured occupants in the struck vehicle. There were 2 general crash scenarios associated with serious injury. One involved intrusion deforming the occupant compartment. The other involved vehicle accelerations sufficient to seriously injure an occupant in the struck vehicle without significant deformation to the occupant compartment. Conclusion This study provides insight into the striking vehicle or object associated with serious injury to light vehicle occupants in rear impacts. Tractor-trailer impacts into the rear of a vehicle involved a high risk for serious injury in the struck vehicle. The use of collision mitigation technologies, such as forward collision warning or automatic emergency braking, on the tractor-trailer may support better speed control and lead to lower closing velocities of rear impacts to light vehicles.

Consent is often positioned as the linchpin of sexual ethics and justice, framed within binary paradigms such as ‘yes means yes’ and ‘no means no’. However, this fails to account for the complexities of power dynamics, ambiguous desires, and the interplay of verbal and non-verbal communication in sexual encounters. This paper critically interrogates how consent is constructed and mobilised in legal cases involving ‘sex games gone wrong’, where claims of consensual rough sex are often used to mitigate or exonerate acts of violence in which women are killed or injured by men. It provides an innovative intervention into these debates framed around the potentialities of queer approaches to consent and sexual encounters. Through in-depth analyses of Crown Court case transcripts, the paper reveals how heteronormative romantic relationship scripts and rape myths underpin consent narratives, often privileging male perspectives while erasing or discrediting those of women. Significantly, the paper draws on queer and BDSM scholarship to propose a ‘queerying’ of consent: a deconstructive approach that unsettles traditional assumptions and embraces the ambiguity, imperfection, and intersubjectivity of consent. By challenging the legalistic and cultural orthodoxy of consent, this paper offers a more nuanced, ethics-driven framework that fosters sexual justice in both legal and socio-cultural contexts.

As the number of children receiving care in out-of-home settings increases in the United States, the risk of injury in such settings has become the subject of intense research. OBJECTIVES:...

To investigate the impact of the type of the intraocular lenses (IOLs) in first-eye cataract surgery in elderly people on the risk of hospitalisation due to falls and injuries. A retrospective cohort study was conducted using the Australian Government Department Veterans' Affairs claims data. All people aged 65years and above who had first cataract surgery between January 2007 and July 2017 were identified. Two cohorts were established depending on the type of IOL-monofocal and multifocal. The risk of injuries and falls requiring hospitalisation in the first 3months post the surgery was assessed using Cox proportional hazard models with age at entry as primary time scale and adjusting for gender, comorbidities and prior history of falls. There were 45728 people across the two cohorts with the majority receiving monofocal lenses (97%), followed by multifocal lenses (3%) at the time of first cataract surgery. The risk of injury and falls was lower (but not significant) in the multifocal cohort compared to monofocal cohort (adjusted hazard ratio (aHR) 0.56, 95% CI 0.26-1.17). The risk was also lower (but not significant) when stratifying by age group at the time of the surgery. Regardless of age, multifocal lenses did not appear to be associated with the higher risk of serious injuries and falls after first-eye cataract surgery compared to monofocal lenses.

Passenger and heavy vehicle collisions with pedestrians: Assessment of injury mechanisms and risk

This paper examines the effectiveness of seat belts in reducing injury among passenger car drivers and right front passengers. The analysis is based on more than 1.5 million occupants involved in North Carolina crashes during the years 1973-1981. Initial results show that seat belts reduce the risk of serious injury to the driver by 58% and fatal injury by 73%. For right front passengers, the comparable figures are 53% and 66%. When a measure of vehicle deformity reflecting the severity of the crash is introduced as a control variable, these effectiveness values decline somewhat. Depending on the specific approach taken, seat belts are shown to reduce the risk of serious injury to passenger car drivers by 51-52%, and the risk of fatal injury by 63-67%. For right front passengers, the effectiveness ranges are 43-44% for serious injury and 53-55% for fatal injury. While these adjusted estimates of belt effectiveness are lower than those based on the raw data, they nevertheless represent considerable benefit to car occupants using seat belts.

From crime scene to courtroom: A review of the current bioanalytical evidence workflows used in rape and sexual assault investigations in the United Kingdom

Objectives Vehicle and occupant responses in 35 mph NCAP tests were determined for small-midsize passenger cars grouped around model year (MY) 1980, 1990, 2000, 2010 and 2020. A baseline was established with 1980 vehicles not designed for NCAP. The results of four decades of vehicles designed for NCAP were compared to the baseline. The study also determined the risk for serious injury (MAIS 3 + F) by vehicle model year (MY) using 1989–2015 NASS and 2017–2020 CISS. It explored safety trends in frontal crashes over 50 MYs of vehicles. Methods The 1980 baseline group was established with 10 1979–1983 MY passenger cars weighing <1,500 kg. Four decades of vehicle crash tests from five manufacturers established trends in vehicle dynamics and dummy responses over four decades of vehicles designed for NCAP. Triaxial acceleration of the head and chest were reanalyzed for each test to have a consistent set of responses over five decades. The risk for serious injury (MAIS 3 + F) to the driver and front passenger was determined by vehicle MY using 1989–2015 NASS and 2017–2020 CISS with belted and unbelted drivers and right-front passengers. The data was sorted in four MY groups 1961–1989 MY, 1990–1999 MY, 2000–2009 MY and 2010 MY-2021 MY. The risk for MAIS 3 + F injury was determined with standard errors using weighted data. Results The 1980 NCAP tests brought about changes in vehicle structures and occupant restraints by 1990; however, HIC15 and 3 ms chest acceleration have not changed much the past 20 years since the use of advanced airbags and seatbelts with pretensioner and load-limiters. For the driver, HIC15 dropped 40 ± 19% from the 1980 to 1990 NCAP tests and dropped further to 76 ± 32% in 2020. The percentage drops after 1990 were not statistically significant. The driver 3 ms chest acceleration dropped 18 ± 5% from 1980 to 1990 and plateaued with 22 ± 6% in 2020. For the front passenger, HIC15 dropped 68 ± 52% from the 1980 to 1990 NCAP tests and plateaued at 71 ± 49% in 2020. The passenger 3 ms chest acceleration dropped 13 ± 5% from 1980 to 1990 and has fluctuated with minimal change. Injury risks based on responses show the same initial drop in 1990 and have remained essentially constant. Nothing meaningful has changed in dummy responses in the past 20 years of NCAP testing. The field data found the belted driver MAIS 3 + F risk was 1.66 ± 0.37% in 1961–1989 MY vehicles and 1.39 ± 0.33% in 2010–2021 MY vehicles. For belted right-front passengers, the risk was 1.52 ± 0.39% in 1961–1989 MY vehicles and 1.42 ± 0.46% in 2010–2021 MY vehicles. The field data shows no meaningful change in injury risk in 50 MYs of vehicles. NCAP involves 35–40 mph delta-V, which represents a small fraction, 0.33%, of belted occupant exposure and only 8.6% of severe injury based on 1994–2015 NASS. Conclusions The NCAP test lacks field relevance. Manufacturers are merely “tuning” the restraint systems for star ratings without meaningful changes in field injury risks the past 20 years. There are disbenefits of “tuning” safety for a single, high-severity crash when most of the severe injury occurs in lower severity crashes. NHTSA should reevaluate plans to change the dummy to Thor and add BrIC injury criteria to assess NCAP responses. These changes would cause manufacturers to further “tune” structures, restraints and interiors without meaningful effects in real-world crashes.