The health impact of (sexual) torture amongst Afghan, Iranian and Kurdish refugees: A literature review

  • Roghieh Dehghan Institute for Global Heath, University College London
Keywords: Sexual torture, health, Muslims, refugees


Background: Amongst Muslim majority countries, torture is reported most in Afghanistan and Iran. In addition, despite the significant impact of sexual violence on individuals and public health, the issue has been poorly researched amongst victims of torture. Objectives: The original intention of this paper was to review the health impact of sexual torture amongst Iranian and Afghan refugees in high-income countries; however, a comprehensive search of relevant databases did not produce any results. The aim of this review was then altered to examine those health-related studies that explored the impact of torture in this population. Special attention was given to the discussion of gender and sexual violence in those studies. Methodology: Web of Science, PILOTS, Medline, PsycINFO, Scopus, Popline and the online catalogue at DIGNITY were searched for health studies that examined the health impact or predictors of adverse health outcomes in Afghan, Iranian and Kurdish refugee survivors of torture. Outcome: Seven papers were identified and examined in this review. The results were limited by the diverse methodologies, by the use of psychiatric tools that had not been validated in this population, and by small sample sizes. Since there is a high prevalence of sexual torture in Iranian and Kurdish refugees, the issue merits greater attention in this population. Studies are most limited amongst the Afghan population. Moreover, there is a great need for further culture-andgender- specific health research in torture survivors from Muslim backgrounds.


Agger, I. (1989). Sexual torture of political prisoners: An overview. Journal of Traumatic Stress, 2(3), 305-318. doi:10.1007/bf00976234

Ba, I., & Bhopal, R. (2017). Physical, mental and social consequences in civilians who have experienced war-related sexual violence: A systematic review (1981–2014). Public Health, 142, 121-135. doi:10.1016/j.puhe.2016.07.019

Basoglu, M. & Paker, M. (1995). Severity of trauma as predictor of long term psychological status in survivors of torture. Journal of Anxiety Disorders, 9, 339-350.

Berry, J.W., Poortinga, Y.P., Breugelmans, S.M., Chasiotis, A., Sam, D.L. (1992). Cross-cultural

Psychiatry - Research and Application. Third edition. Cambridge University Press.

Bogic, M., Njoku, A., & Priebe, S. (2015). Long-term mental health of war-refugees: A systematic literature review. BMC International Health and Human Rights, 15(1). doi:10.1186/s12914-015-0064-9

Bracken, P. J. (2001). Post-modernity and post-traumatic stress disorder. Social Science & Medicine, 53(6), 733-743. doi:10.1016/s0277-9536(00)00385-3

Bradley, L., Tawfiq, N. (2006). The physical and psychological effects of torture in Kurds seeking asylum in the United Kingdom. Torture, 16(1), 41-47.

Burt, M. R. (1980). Cultural myths and supports for rape. Journal of Personality and Social

Psychology, 38(2), 217-230. doi:10.1037//0022-3514.38.2.217

Busch, J., Hansen, S.H., Hougen, H.P. (2015). Geographical distribution of torture: An

epidemiological study of torture reported by asylum applicants examined at the Department of Forensic Medicine, University of Copenhagen. Torture, 25 (2).

Canning, V. (2015). Unsilencing Sexual Torture: Responses to refugees and asylum seekers in Denmark. British Journal of Criminology, 56(3), 438-455. doi:10.1093/bjc/azv079

Carlsson, J., Olsen, D., Mortensen, E., Kastrup, M. (2006). Mental health and health-related quality of life. The Journal of Nervous and Mental Disease, 194(10), 725-731.

Crenshaw, K. (1991). Mapping the margins: Intersectionality, identity politics, and violence

against women of color. Stanford Law Review, 43(6), p.1241.

Dadfar, A. (1994). The Afghans: Bearing the Scars of a Forgotten War. In A.J. Marsella, T. Bornemann, S. Ekblad, & J. Orley (Eds.). Amidst Peril and Pain: The Mental Health and Well-being of the World’s Refugees. 125-139. doi:10.1037/10147-006

Duffy, R. M., O’Sullivan, S., Straton, G., Singleton, B., & Kelly, B. D. (2017). Demographic characteristics of survivors of torture presenting for treatment to a national centre for survivors of torture in Ireland (2001–2012). Irish Journal of Psychological Medicine, 34(2), 111-116.

Freedom From Torture (FFT), (2013). We Will Make You Regret Everything: Torture in Iran Since the 2009 Election. Freedom from Torture Country Reporting.

Ghazinour, M., Richter, J., & Eisemann, M. (2003). Personality related to coping and social support among Iranian refugees in Sweden. The Journal of Nervous and Mental Disease, 191(9), 595-603. doi:10.1097/01.nmd.0000087186.03513.38

Hollander, A., Bruce, D., Burström, B., & Ekblad, S. (2011). Gender-related mental health differences between refugees and non-refugee immigrants: A cross-sectional register-based study. BMC Public Health, 11(1). doi:10.1186/1471-2458-11-180

Hooberman, J. B., Rosenfeld, B., Lhewa, D., Rasmussen, A., & Keller, A. (2007). Classifying the torture experiences of refugees living in the United States. Journal of Interpersonal Violence, 22(1), 108-123. doi:10.1177/0886260506294999

Isakson, B. L., & Jurkovic, G. J. (2013). Healing After Torture. Qualitative Health Research, 23(6), 749-761. doi:10.1177/1049732313482048

Jefferson, A. M. (2016). Situated perspectives on the global fight against torture. Reflexivity and Criminal Justice, 335-356. doi:10.1057/978-1-137-54642-5_15

Jobson, L. & Okearney, R. (2008). Cultural differences in personal identity in post-traumatic stress

disorder. British Journal of Clinical Psychology, 47(1), 95–109. doi:10.1348/014466507X235953

Johnson, H., & Thompson, A. (2008). The development and maintenance of post-traumatic stress disorder (PTSD) in civilian adult survivors of war trauma and torture: A review. Clinical Psychology Review, 28(1), 36-47. doi:10.1016/j.cpr.2007.01.017

Kalt, A., Hossain, M., Kiss, L., & Zimmerman, C. (2013). Asylum seekers, violence and health: A systematic review of research in high-income host countries. American Journal of Public Health, 103(3), e30-e42. doi:10.2105/ajph.2012.301136

Kastrup, M., Arcel, L. (2004). Gender Specific Treatment. In: Wilson., J., Drozdek, B (Eds.), Broken Spirits: The Treatment of Traumatized Asylum Seekers, Refugees, War and Torture Victims. New York: Brunner Routledge, 547–571.

Kira, I. A., Smith, I., Lewandowski, L., & Templin, T. (2010). The effects of gender discrimination on refugee torture survivors: A cross-cultural traumatology perspective. Journal of the American Psychiatric Nurses Association, 16(5), 299-306. doi:10.1177/1078390310384401

Kira, I. A., & Tummala-Narra, P. (2014). Psychotherapy with refugees: Emerging paradigm. Journal of Loss and Trauma, 20(5), 449-467. doi:10.1080/15325024.2014.949145

Leaman, S., Gee, C., & Cogar, M. (2009). Risk factors for psychological distress and uses of religious coping among African torture survivors. PsycEXTRA Dataset. doi:10.1037/e517292011-464

Leatherman, J. (2011). Sexual Violence and Armed Conflict. Cambridge: Polity Press.

Lerner, E., Bonanno, G. A., Keatley, E., Joscelyne, A., & Keller, A. S. (2016). Predictors of suicidal ideation in treatment-seeking survivors of torture. Psychological Trauma: Theory, Research, Practice, and Policy, 8(1), 17-24. doi:10.1037/tra0000040

Lunde, I., & Ortmann, J. (1990). Prevalence and sequelae of sexual torture. The Lancet, 336(8710), 289-291. doi:10.1016/0140-6736(90)91814-q

Matsuo, H., Poljarevic, A. (2011). Life satisfaction of Bosnian refugees in St louis, Missouri. International Journal of Humanities and Social Science, 1 (19), 30-38.

Morville, A., Amris, K., Eklund, M., Danneskiold-Samsøe, B., & Erlandsson, L. (2014). Activity of daily living performance amongst Danish asylum seekers: a cross-sectional study. Torture. 24(1), 49-64.

Morville, A., Amris, K., Eklund, M., Danneskiold-Samsøe, B., & Erlandsson, L. (2015). A longitudinal study of changes in asylum seekers ability regarding activities of daily living during their stay in the asylum center. Journal of Immigrant and Minority Health, 17(3), 852-859. doi:10.1007/s10903-014-0004-0

Oosterhoff, P., Zwanikken, P., & Ketting, E. (2004). Sexual torture of men in Croatia and other conflict situations: An open secret. Reproductive Health Matters, 12(23), 68-77. doi:10.1016/s0968-8080(04)23115-9

Patel, N., Mahtani, A. (2004). Psychological Approaches to Working with Political Rape. In: M. Peel (Ed.), Rape as a Method of Torture. London: Medical Foundation for the Care of Victims of Torture.

Peel, M. (2004). Men as Perpetrators and Victims. In: M. Peel (Ed.), Rape as a Method of Torture. London: Medical Foundation for the Care of Victims of Torture.

Priebe, S., Ismaili, S. (1997). Long-term mental sequelae of torture in Iran-who seeks treatment? The Journal of Nervous & Mental Disease, 185(2), 74-77. doi:10.1097/00005053-199702000-00002

Sansani, I. (2004). Responses by health care providers in Ireland to the experiences of women refugees who have survived gender- and ethnic-based torture. Women's Studies International Forum, 27(4), 351-367. doi:10.1016/j.wsif.2004.10.005

Song, S. J., Kaplan, C., Tol, W. A., Subica, A., & Jong, J. D. (2014). Psychological distress in torture survivors: Pre- and post-migration risk factors in a U.S. sample. Social Psychiatry and Psychiatric Epidemiology, 50(4), 549-560. doi:10.1007/s00127-014-0982-1

Steel, Z., Chey, T., Silove, D., Marnane, C., Bryant, R. A., & Van Ommeren, M. (2009). Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement. JAMA, 302(5), 537. doi:10.1001/jama.2009.1132

Suarez, E., & Gadalla, T. M. (2010). sSop blaming the victim: A meta-analysis on rape myths. Journal of Interpersonal Violence, 25(11), 2010-2035. doi:10.1177/0886260509354503

Summerfield, D. (1999). A critique of seven assumptions behind psychological trauma

programmes in war-affected areas. Social Science & Medicine, 48(10),1449–1462. doi:10.1016/S0277-9536(98)00450-X

Weishut, D. J. (2015). Sexual torture of Palestinian men by Israeli authorities. Reproductive Health Matters, 23(46), 71-84. doi:10.1016/j.rhm.2015.11.019

Young, M. Y., Chan, K. J. (2015). The Psychological Experience of Refugees: A Gender and Cultural Analysis. In: S. Safdar & N. Kosakowska-Berezecka (Eds.), Psychology Of Gender Through The Lens Of Culture: Theories And Applications (pp. 17-36). Cham, Switzerland: Springer International Publishing.

How to Cite
Dehghan, R. (2018). The health impact of (sexual) torture amongst Afghan, Iranian and Kurdish refugees: A literature review. Torture Journal, 28(3), 77-91.