880959

article-commentary2019
VAWXXX10.1177/1077801219880959Violence Against WomenReed et al.

Research Note
Violence Against Women
2020, Vol. 26(12-13) 1727­–1740
Cyber Sexual Harassment: © The Author(s) 2019
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DOI: 10.1177/1077801219880959
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Measures and Implications for journals.sagepub.com/home/vaw

Future Research

Elizabeth Reed1,2,3, Alice Wong1, and Anita Raj2

Abstract
Researchers have described cyber sexual harassment (CSH) as a range of sexually
aggressive or harassing images or texts delivered through the use of digital mediums.
CSH occurs in high proportions particularly among young populations, but the
prevalence varies substantially across studies, largely due to variation in measures
used and types of behaviors assessed. We describe the prevalence of CSH by types
of CSH assessed, identify the measures used in previous research, and provide
recommendations for future assessment. Future research is needed to ensure
consistent and comprehensive measures that accurately capture CSH to assess
prevalence and consequences.

Keywords
cyber sexual harassment, adolescents, sexual harassment

Sexual harassment has social implications as a form of gender discrimination and

sexual aggression; however, it also poses a serious public health concern for adoles-
cent girls in the United States and worldwide, particularly affecting girls’ mental
health and health behaviors such as substance use (Bucchianeri, Eisenberg, Wall,
Piran, & Neumark-Sztainer, 2014; Fairchild & Rudman, 2008; Gruber & Fineran,
2008; Madan & Nalla, 2016). Electronic communication technology, such as social

1San Diego State University, San Diego, CA, USA

2Center on Gender Equity and Health, University of California, San Diego, La Jolla, CA, USA
3Institute for Behavioral and Community Health, San Diego State University Research Foundation, San

Diego, CA, USA

Corresponding Author:
Elizabeth Reed, School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego,
CA 92182, USA.
Email: ereed@sdsu.edu
1728 Violence Against Women 26(12-13)

networking sites (e.g., Facebook, Instagram, Snapchat) and text messaging, is

increasingly a new mechanism through which sexual harassment and coercion is
experienced among girls (Henry & Powell, 2015). Technology, including social
media and smart phones, has been changing the communication landscape for young
people, particularly individuals between the ages of 14 and 34 years (Henry &
Powell, 2015). In the United States, about 95% of 12- to 17-year olds use the Internet
and 74% have mobile devices (Livingstone & Smith, 2014). These types of cyber
technologies facilitate social connections, but also present new ways in which girls
experience sexual harassment. Researchers have described cyber sexual harassment
(CSH) as a range of sexually aggressive or harassing images or texts delivered
through the use of digital mediums (Henry & Powell, 2018; Madigan, Ly, Rash, Van
Ouytsel, & Temple, 2018). CSH is unique compared to in-person experiences of
sexual harassment in that offenders can more easily target victims across geographic
barriers, are able to reach multiple victims at once, can be more difficult to regulate,
and can potentially retain their anonymity (Henry & Powell, 2015). Studies indicate
that adolescents are at high risk for CSH, with girls and LGBTQ youth being at even
greater risk (Henry & Powell, 2018).
Less is clear how pervasive CSH is among adolescent populations. There is sub-
stantial variation in prevalence of CSH across studies, from 1-59%, likely due to
differences in populations sampled but also due to variation in the range of CSH
behaviors being assessed through current measures (see Table 1). More comprehen-
sive measures of ever experiencing CSH conducted with older samples, such as
those seen in online polls, have yielded larger estimates, whereas measures assess-
ing past-year CSH and those conducted with younger adolescents and males have
reported smaller prevalence estimates. Further complicating the study of CSH, there
are various terms used to describe CSH. The use of consistent and comprehensive
terminology and measures will be key to assessing the prevalence and consequences
of this relatively new public health threat.
Thus, the objective of this research note is to summarize the CSH literature to date
to better understand what types of CSH are being measured and reported. Specifically,
we will describe the prevalence of CSH by types of CSH assessed, identify the mea-
sures used in previous research, and provide recommendations for future assessment.

Measures Used for Each Type of CSH and Implications

for Future Research
In Table 1, we outline the types of CSH that are most commonly identified in studies,
examples of measures used, as well as the prevalence reported, with the goal of sup-
porting clarity on how best to measure CSH in future research. The types of CSH most
commonly reported in studies have included the following:

1. Unwanted sexual solicitation

2. Receiving unwanted sexual messages/images
3. Having sexual texts/images shared without permission
 Table 1.  Types of Cyber Sexual Harassment: Examples of Items Used to Assess CSH Types and Prevalence Reported.
Studies using CSH items
(in this column, we
provide examples of
studies that have used
Types of CSH CSH items used across studies each of these CSH items) Sample Prevalence of CSH using items listeda

General items about In the past 12 months, how often have you been sexually Ybarra, Mitchell, Palmer, N = 5,542 5.4% total
sexual harassment harassed (via online interaction) and Reisner (2015) Adolescents 13-18 years old from Teen
experienced online Health and Technology Study in the
United States
Which, if any, of the following have happened to you, personally, Pew Research Center N = 2,849 6% total,
online? Been sexually harassed (ever) (2014) A nationally representative panel of 4% among males
randomly selected U.S. adults (18 years 7% among females
of age or older) living in households. 13% among males ages 18-24,
Analyses were restricted to respondents 25% among females ages 18-24
who self-identify as Internet users who
participate in the panel via monthly self-
administered Web surveys.
Pew Research Center N = 4,248; A nationally representative panel 6% total,
(2017) of randomly selected U.S. adults (18 years 4% among males
of age or older) recruited from landline 8% among females
and cellphone RDD surveys. Panelists 6% among males ages 18-24 years
participate via monthly self-administered 20% among females ages 18-24 years
web surveys. Panelists who do not have
Internet access are provided with a tablet
and wireless Internet connection.
Unwanted sexual Did anyone on the Internet ever ask you sexual questions about Marret and Choo (2017) N = 1,364 Reported unwanted requests to talk online
solicitation yourself or try to get you to talk online about sex when you Adolescents 15-16 years old from public about sex, unwanted requests for sexual
Major categories include: did not want to talk about those things? secondary schools in Negeri Sembilan, information, or unwanted requests to do
- Unwanted requests In the past year, did anyone on the Internet ever try to get you Malaysia something sexual (past 12 months):
to talk online about to talk about sex when you did not want to? 19.1% total,
sex or for personal In the past year, did anyone on the Internet ask you for sexual 17.2% male,
sexual information information about yourself when you did not want to answer 20.8% female
(some measures such questions? I mean very personal questions, like what your
include pressuring to body looks like or sexual things you have done.
do these things) In the past year, did anyone on the Internet ask you to do
- Unwanted requests for something sexual that you did not want to?
sexual photos or to
perform sexually over
a webcam
- Unwanted requests to
have sex in-person

1729
(continued)
 Table 1. (continued)

1730
Studies using CSH items
(in this column, we
provide examples of
studies that have used
Types of CSH CSH items used across studies each of these CSH items) Sample Prevalence of CSH using items listeda

Chang et al. (2016) N = 2,315 Reported unwanted requests to talk online

High school 10th and 11th-grade students about sex or requests to do something sexual
from Taiwan online that respondent did not want to do:
Of the students who reported no unwanted
online sexual solicitation victimization
experience in the 10th grade,
13.0% had experienced unwanted online sexual
solicitation victimization by the 11th grade
(incident rate for past 12 months)
15.9% for males
10.2% for females
Mitchell, Jones, N = 1,501 in 2000, 1,500 in 2005, and Reported unwanted requests to talk online
Finkelhor, and Wolak 1,560 in 2010 about sex (past year)
(2013) Data are from the Youth Internet Safety 6% (2000),
Surveys (YISS); three cross-sectional, 3% (2005),
nationally representative telephone 1% (2010)
surveys of 3,561 youth Internet users in Reported unwanted requests for sexual
the United States, ages 10-17 years information (past year):
9% (2000),
6% (2005),
4% (2010)
Reported unwanted requests to do something
sexual (past year)
5% (2000),
4% (2005),
4% (2010)
Mitchell, Finkelhor, N = 2,051 Reported unwanted requests to talk online
Wolak, Ybarra, and Adolescents 10-17 years old from the about sex
Turner (2011) National Survey of Children’s Exposure 3% past year
to Violence in the United States 5% ever
Ybarra, Mitchell, and N = 1,588 (2006), N = 1,206 (2007), N = Reported unwanted requests to talk online
Korchmaros (2011) 1,159 (2008) about sex, unwanted requests for sexual
Adolescents 10-15 years old from information, or unwanted requests to do
Growing Up with Media Survey in the something sexual (past year):
United States 14.5% (2006)
15.1% (2007)
17.6% (2008)

(continued)
 Table 1. (continued)
Studies using CSH items
(in this column, we
provide examples of
studies that have used
Types of CSH CSH items used across studies each of these CSH items) Sample Prevalence of CSH using items listeda

Mitchell, Wolak, and N = 1,500 Adolescents 10-17 years old Proportions of CSH were reported by whether
Finkelhor (2008) from U.S. Youth Internet Safety Surveys participants blogged or reported interacting
in the United States with others online (CSH in past year):
6% (no blogging/no online interaction)
11% (blogging/no online interaction)
25% (no blogging/online interaction)
33% (blogging/online interaction)
Ybarra and Mitchell N = 1,588 Reported unwanted requests to talk online
(2008) Adolescents 10-15 years old from about sex (past year)
Growing Up with Media Survey in the 11.2%
United States Reported unwanted requests for sexual
information (past year):
7.2%
Reported unwanted requests to do something
sexual (past year)
11.4%
Someone has pressured me repeatedly to talk online about sex Montiel, Carbonell, and N = 3,897 (1,836 males and 2,049 females) Past year:
(past year) Pereda (2016) Adolescents 12-17 years old recruited 12.2% total,
from 39 secondary schools in eastern 9.6% male,
Spain 14.6% female
Repeated and/or unwanted sexual requests online or via email Powell and Henry (2016) N = 2,956 21.3%
or text message Adults 18-54 years old from Australia
recruited through an online panel
provider, Research Now
Thinking about your peers, how often have the following things Sanchez, Munoz- N = 601 23% total (past year)
happened to you since the school year started via social Fernandez, and Vega- Adolescents 12-16 years old from
networks or via mobile phone without you wanting it to Gea (2017) secondary schools in Seville and
happen? Answer by thinking about those things that have Cordoba
happened to you.
Hinted or asked that you send photos of a naked part
of your body
Youth who reported experiencing unwanted online sexual Mitchell, Finkelhor, and N = 1,500 4% total (past year)
solicitation in the past year were asked the following: Did this Wolak (2007) Adolescents 10-17 years old from
person ever ask you to send them a sexual picture of yourself? Youth Internet Safety Survey (2005)
“Unwanted sexual solicitations” were defined as requests to engage in in the United States, a nationally
sexual activities or sexual talk or to give personal sexual information representative telephone survey
that was unwanted or, whether wanted or not, made by an adult.”

1731
(continued)
 Table 1. (continued)

1732
Studies using CSH items
(in this column, we
provide examples of
studies that have used
Types of CSH CSH items used across studies each of these CSH items) Sample Prevalence of CSH using items listeda

Someone has threatened me to pose for sexy pictures in front Montiel et al. (2016) N = 3,897 Past year:
of the webcam Adolescents 12-17 years old from 354 6.7% total
randomly selected secondary schools in 6.3% male
eastern Spain 7% female
Sexually solicited by an unknown person (online) Helweg-Larsen, Schütt, N = 3,707 Past year:
and Larsen (2012) Adolescents 14-17 years old from Danish 5.4% boys
public and continuation schools 16.2% girls
Unwanted solicitations for sex Olumide, Adams, and N = 653 6.8% total
Amodu (2015) Students from secondary schools who
owned a cell phone and/or had
access to the Internet for at least 6
months prior to the study, which was
conducted in rural and urban areas in
Oyo state by multi-stage sampling.
Receiving unwanted Made sexual comments, jokes, or gestures toward you on your Sanchez et al. (2017) N = 601 33.1% total
sexual messages/ social networking profile or via WhatsApp Adolescents 12-16 years old from (no stratification by sex was provided)
photos secondary schools in Seville and
Cordoba
Your partner has sent you sexual photos or naked photos of Sanchez et al. (2017) N = 601 Past 6 months:
himself/herself knowing that you didn’t want this. Shown, given Adolescents 12-16 years old from 14% total (no stratification by sex was
or left you sexual pictures, photographs or remarks secondary schools in Seville and provided)
Cordoba
Someone sending you explicit images that you did not ask for? Pew Research Center N = 4,165 35% total (ever)
(2017) U.S. adults above the age of 18 years
recruited from landline and cellphone
RDD surveys
Has anyone sent you a naked picture without you asking? Choi, Van Ouytsel, and N = 450 females 13.4% (past year, all females)
Temple (2016) Adolescents with an average age of 19.02
from public high schools in southeast
Texas
Someone has sent me, without me requesting them, images or Montiel et al. (2016) N = 3,897 Past year:
videos of people showing their private parts (ever) Adolescents 12- 17 years old from 354 24.4% total,
randomly selected secondary schools in 24.4% male,
eastern Spain 23.4% female

(continued)
 Table 1. (continued)
Studies using CSH items
(in this column, we
provide examples of
studies that have used
Types of CSH CSH items used across studies each of these CSH items) Sample Prevalence of CSH using items listeda

Unwanted sexually explicit images, comments, emails, or text Powell and Henry (2016) N = 2,956 29% (ever)
messages Adults 18-54 years old from Australia
recruited through an online panel
provider, Research Now
In the past year, did you ever open a message or a link in a Jones, Mitchell, and N = 1,500 Past year:
message that showed you actual pictures of naked people or Finkelhor (2011) Adolescents 10-17 years old from Youth 25% (2000),
of people having sex that you did not want? Internet Safety Surveys in the United 34% (2005),
States 23% (2010)
Getting unwanted pornographic messages or pictures (ever) Finn (2004) N = 339 58.7% of the sample reported to have received
Undergraduate students from University a message via email
of New Hampshire 18% of the sample received a message over IM
Having sexual messages/ Someone taking and/or sharing sexual pictures or videos of you Stop Street Harassment N = 2,000 Ever:
images shared without your permission (2018) Adults above the age of 18 years 5% male
without permission 10% female
Someone sharing explicit images of you without your consent Pew Research Center N = 4,165 7% total (ever)
(2017) U.S. adults above the age of 18 years old
recruited from landline and cellphone
RDD surveys
Publicly posted online an offensive sexual comment about you Powell and Henry (2016) N = 2,956 13.6% (ever)
Adults 18-54 years old from Australia
recruited through an online panel
provider, Research Now
Nude or semi-nude image posted online/sent onto others Powell and Henry (2016) N = 2,956 9.3% (ever)
without permission Adults 18-54 years old from Australia
recruited through an online panel
provider, Research Now
Image/video of an unwanted sexual experience posted online/ Powell and Henry (2016) N = 2,956 8.6% (ever)
sent onto others Adults 18-54 years old from Australia
recruited through an online panel
provider, Research Now
In the past 12 months, found that others disseminated sexual Priebe and Svedin (2012) N = 3,432 Past 12 months:
pictures/films of them electronically High school adolescents from Sweden 1.7%
Inappropriate picture(s) placed on the Internet against your will Helweg-Larsen et al. N = 3,707 Past year:
(2012) Adolescents 14-17 years old from public 0.8% boys
and continuation schools in Denmark 2.3% girls

Note. CSH = cyber sexual harassment; IM = instant messaging; RDD = random-digit-dial.

1733
aSome prevalence estimates combine several items of CSH, as indicated in the table.
1734 Violence Against Women 26(12-13)

Unwanted Sexual Solicitation

Sexual solicitation involves requests to engage in sexual behaviors that are unwanted
by the recipient (e.g., Helweg-Larsen, Schütt, & Larsen, 2012; Marret & Choo, 2017;
Mitchell, Wolak, & Finkelhor, 2008). Items pertaining to CSH include unwanted solic-
itation to exchange sexual messages/images, to have sex in-person, and to perform
sexually over a webcam (Table 1). Unwanted requests to talk about sex and unwanted
requests for sexual information/images were measured in most studies (e.g., Chang
et al., 2016; Mitchell, Jones, Finkelhor, & Wolak, 2013; Ybarra, Espelage, & Mitchell,
2007). Researchers used questions such as “In the past year, did anyone on the Internet
ever try to get you to talk about sex when you did not want to?” and “In the past year,
did anyone on the Internet ask you for sexual information about yourself when you did
not want to answer such questions? I mean very personal questions, like what your
body looks like or sexual things you have done?” Furthermore, questions to measure
unwanted solicitation to have sex in-person, send sexual photos, or pose sexually via
a webcam included “In the past year, did anyone on the Internet ask you to do some-
thing sexual that you did not want to?,” “[unwanted] hinting or asking you to send
photos of a naked part of your body,” and if “someone has threatened you to pose for
sexy pictures in front of the webcam.” However, the most commonly used measures
asked about unwanted requests to talk online about sex, unwanted requests for sexual
information, and unwanted requests to do something sexual. Prevalence estimates
have varied given that some studies reported a combined prevalence (usually 20% or
less) of these and a few reported the prevalence of each of these separately over the
past year. (See Table 1 for examples of sexual solicitation and prevalence estimates.)
Studies that assessed unwanted requests to send naked/sexual photos had especially
high proportions (more than 20%) reporting these incidents; however, it is difficult to
compare across different contexts and age groups.
While insightful, the most frequently used questions (unwanted requests to talk
online about sex, unwanted requests for sexual information, and unwanted requests to
do something sexual) may not adequately capture unwanted requests for or being
pressured to send sexual messages or images, yet such scenarios have been reported
in high proportions (Choi, Van Ouytsel, & Temple, 2016; Lippman & Campbell,
2014; Montiel, Carbonell, & Pereda, 2016). Nonconsensual sexting, which can
include being pressured to send sexual images as well as to have sexual images shared
without consent, has been identified in several studies on sexting (Drouin, Ross, &
Tobin, 2015; Madigan et al., 2018; Reed et al., 2019; Walrave, Heirman, & Hallam,
2014). Based on these existing studies, CSH measures also need to specifically cap-
ture the prevalence of experiencing pressure or coercion to send sexual messages and/
or images, as well as how often sexting occurs as a result of being pressured or
coerced. While multiple studies have reported poor health outcomes related to sex-
ting, particularly among adolescent girls, these consequences may be largely a result
of high proportions reporting being pressured into sexting (Choi et al., 2016; Reed et
al., 2019; Van Ouytsel, Walrave, Ponnet, & Heirman, 2015; Ybarra & Mitchell,
2014). Additional aspects that should be further explored to inform future measures
Reed et al. 1735

include the perpetrator type and the contexts of sexual solicitations, such as on which
digital platforms these occurrences are happening most often (e.g., texting, online
messaging, video chat) and the ways in which images/videos may be shared and cre-
ate vulnerability. In summary, most studies used items to assess unwanted requests to
talk online about sex, unwanted requests for sexual information, and unwanted
requests to do something sexual; however, items are also needed to specifically assess
pressure or coercion to send sexual messages and/or images (Table 2).

Receiving Unwanted Sexual Texts or Images (“Unwanted Sexts”)

Another examined area of CSH involves assessing the receipt of unwanted sexts (e.g.,
Finn, 2004; Jones, Mitchell, & Finkelhor, 2011; Ybarra, Mitchell, & Korchmaros,
2011; Table 1). This measure encompasses events such as getting unwanted sexually
explicit pictures, emails, text messages, or comments. An example of questions asked
include “Has anyone sent you a naked picture without you asking?” As with sexual
solicitation, the prevalence ranges substantially based on how this question is asked
and especially whether the question implied that the message was sent privately versus
a group email as well as whether it was a sexual photo taken of the sender or some
other pornographic material, for example (see Table 1).
Again, given the high prevalence of all of these scenarios reported, this area war-
rants attention. In developing improved measures for the future, items need to be
explicit in terms of whether the sexual image/message was sent as part of a mass email
versus a personal message, as well as whether the sexual images were of the sender
(versus something found online), as these may differ in terms of the sender’s intent and
impact on the respondent. In addition, items also need to be better operationally
defined to focus on communication that is unwanted to clarify the coercive nature of
these behaviors. To summarize, future measures are needed to better assess context
(private versus group message), content (e.g., whether or not sender is sharing a per-
sonal sexual photo), and consent, as sharing personal images with mutual consent may
be a normal part of a sexual relationship (Table 2). These distinctions will allow
researchers to better identify the scenarios that have a negative impact on recipients.
In addition, like all CSH measures, the types of relationships between the recipient and
sender (e.g., intimate or dating partner, friend, someone met online) as well as the
varied digital platforms used will also be important to assess.

Sexual Texts/Images Shared Without Sender’s Permission (Also Known

as Nonconsensual Sexting and “Revenge Porn”)
Another type of CSH involves disseminating sexual comments or pictures to the pub-
lic or to other people without the sender’s approval (e.g., Helweg-Larsen et al., 2012;
Jones et al., 2011; Priebe & Svedin, 2012; Table 1). An example of a question to mea-
sure this includes having a “nude or semi-nude image posted online/sent to others
without permission.” Another examples is “Someone sharing explicit images of you
without your consent.” Technology makes this behavior have a high potential for
1736 Violence Against Women 26(12-13)

Table 2.  Brief Summary of Recommendations for Measuring Cyber Sexual Harassment in
Future Research.

Types of CSH Summary/needs for future measurement

Unwanted sexual solicitation:
- unwanted requests or
pressure/coercion to send
sexual messages/images
- unwanted requests to talk about
sex or for sexual information
- unwanted requests to do
something sexual online or
in-person
Receiving unwanted sexual
messages/images
Having sexual messages/images
shared without permission
Most studies used items to assess unwanted
requests to talk online about sex, unwanted
requests for sexual information, and unwanted
requests to do something sexual.
Items are also needed to specifically assess
pressure or coercion to send sexual messages
and/or images, including experiencing pressure/
coercion to sext as well as whether sexting
occurred as a result of being pressured/coerce.
Items need to assess and clarify the following:
- context (private versus group message)
- whether or not sender is sharing a personal
sexual photo (e.g., “dick pic”);
- consent (whether recipient consented to
receive sexual messages/images) and/or whether
receipt of the sexual message was unwanted.
Future research should assess incidents when
sexual messages/images are shared by others
and specify whether this was without permission.

Note. CSH = cyber sexual harassment.

negative impact. Lifetime prevalence was usually assessed (versus past year) and most
estimates were just below 10%.
Notably, few CSH studies have assessed this, and among those that did, some
lacked specific assessment regarding whether the photos were shared without permis-
sion/consent. For example, questions that ask about whether sexual photos were
shared by others need to detail whether this was done without the sender’s approval.
In most online platforms, there is an expectation that anything posted publicly can be
shared by others and usually remains under control (e.g., can be deleted) by the person
who posted the content initially. As electronic communications evolve, the distinction
between “public” and “private” communications requires careful delineation.
Inaccurate assessment could conflate and confuse sharing of sexual images from CSH,
impeding recognition of the coercive and abusive nature of CSH. Thus, in summary,
future research should use measures to assess incidents when sexual messages/images
are shared by others without permission/consent (Table 2).

Summary and Next Steps

Table 1 illustrates the wide range of CSH prevalence estimates, indicating that CSH is
occurring in high proportions, but also warranting the need for consistent and compre-
hensive measures. While many studies included two to three of the above CSH types,
Reed et al. 1737

only a minority of studies captured incidents of receiving unwanted sexual messages/

images or when sexual messages/images are shared without permission, despite that
these types of scenarios were prevalent (e.g., Chang et al., 2016; Lwin, Li, & Ang,
2012; Montiel et al., 2016). Furthermore, while multiple measures captured unwanted
requests to talk about sex or for sexual information, more work is needed that specifi-
cally asks about incidents of being pressured or coerced to send sexual messages/
images as well as to assess the proportion of sexual messages/images that are sent as a
result of feeling pressured or coerced. Future research may also be needed to assess
specific scenarios of cyber sexual solicitation, including requests for sexual webcam
interactions and in-person sexual engagement, which was measured less frequently.
Important to note for future research and measurement development is that some of
these forms of cyber sexual solicitation may have implications for girls’ risk of sexual
victimization off-line. Furthermore, the perpetrator type and platforms (e.g., video
chat, texting, online messaging) in which the various types of CSH incidents are expe-
rienced across the population is largely unknown, but will be important in designing
intervention approaches.
While decades of research has measured in-person experiences of sexual harass-
ment, CSH is a new and emerging threat, often involving different scenarios and per-
petrators. This relatively new research on CSH may not only highlight similarities
between in-person and CSH but also identify unique aspects of each of these.
In summary, we identified the need for CSH items to include (a) receiving
unwanted sexual messages/images, (b) having sexual messages/images shared
without permission, and (c) unwanted sexual solicitation, which includes unwanted
requests or pressure/coercion to send sexual messages/images, unwanted requests
to talk about sex or for sexual information, and unwanted requests to do something
sexual online or in-person. As part of studying CSH types and prevalence, it will
be important for future research on sexting to distinguish scenarios that involve
coercive or abusive sexting, including sharing sext messages without permission
of the sender as well as the use of coercion to solicit sexual messages/images from
others. Given the high proportion of these scenarios occurring, previous findings
highlighting the relation between sexting and poor health outcomes may be due, in
part, to the high proportion of sexting that is nonconsensual. The use of clear,
operationally defined scenarios and behaviors are imperative to ensure the indi-
vidual understands the question being asked and all the CSH behaviors it entails.
Like other forms of sexual harassment and violence, CSH measures need to be
sensitive to norms that promote sexual exploitation disproportionately among cer-
tain subgroups (e.g., as a result of gender or sexuality) and consider how stigma
may influence CSH reporting. Finally, future work is needed to assess the preva-
lence of CSH perpetration and victimization, as well as the identification of perpe-
trators most commonly involved by CSH type.

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.
1738 Violence Against Women 26(12-13)

Funding
The author(s) disclosed receipt of the following financial support for the research, authorship,
and/or publication of this article: The preparation of this manuscript was funded by a grant from
the Bill & Melinda Gates Foundation (PI: Raj, Anita).

ORCID iD
Anita Raj https://orcid.org/0000-0002-8127-5123

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Author Biographies
Elizabeth Reed, ScD, is associate professor at San Diego State University School of Public
Health and affiliated with the Center on Gender Equity and Health at the University of California,
San Diego. Her research focuses on social and economic determinants of gender-based violence
and its effects on sexual/reproductive health among women and girls.
Alice Wong is a graduate student at San Diego State University School of Public Health.
Anita Raj, PhD, is a Tata Chancellor professor of Medicine and the Director of UC San Diego’s
Center on Gender Equity and Health in the Department of Medicine. She is also a Professor of
Education Studies in the Division of Social Sciences. Trained as a developmental psychologist,
Dr. Raj’s research includes epidemiologic and qualitative assessment of gendered, social, and
cultural vulnerabilities for reproductive, maternal, neonatal, child, and adolescent health
(RMNCH+A) concerns across national settings.