Intended for healthcare professionals


Sexual violence as a weapon of war in Ukraine

BMJ 2022; 377 doi: (Published 10 May 2022) Cite this as: BMJ 2022;377:o1172
  1. Jelke Boesten, professor of gender and development
  1. Department of International Development, King’s College London

The atrocities unfolding in Ukraine are shocking to watch. After the destruction of cities and the flight of Ukrainians turned refugees, we saw the images of murdered civilians in Bucha and received the first reports of Russian soldiers raping women in the international press. The actual scale of these atrocities is still unclear, but the reports indicate that sexual violence is being perpetrated in different war theatres across Ukraine. Given the likelihood that these atrocities are only the tip of the iceberg, the difficulty of reporting such incidents, and the enormity of the overall violence being deployed, it seems likely that the Russian army is using indiscriminate killing and rape to terrorise the population into submission.

Research and debate on sexual violence as a weapon of war surged after the wars in the former Yugoslavia and the genocide in Rwanda in the 1990s.12 These conflicts made clear that the military leadership in both countries encouraged and participated in patterns of sexual violence against enemy populations with genocidal intent. Rape was used to fragment and subjugate the “enemy” population by raping “its” women, drawing on patriarchal constructs of women as the holders of honour and biological and cultural reproduction.

In such contexts, torture practices against men and boys may also be highly sexualised and focus on harming genitals.3 But men and boys are also raped, sometimes in the context of a public performance that aims to terrorise and subdue; instances of this happening in Ukraine have been reported.4 The use of rape as a weapon of war is not, therefore, as straightforward as a heteronormative patriarchal narrative suggests, although one can argue that it is always intended to engender total submission by humiliating the community as well as the individual.

Recent research has uncovered practices of rape in wars and internal armed conflicts in Sierra Leone, Uganda, the Democratic Republic of the Congo (DRC), Colombia, Guatemala, and Peru that are similar to those prosecuted by the tribunals on the war crimes, crimes against humanity, and genocide in Bosnia-Herzegovina and Rwanda.56 More recently, the kidnapping and sexual slavery experienced by Yazidi women and girls at the hands of ISIS in the mid-2010s is, according to reports, not over yet.78 And a UN report from March 2022 described the “hellish existence” that women and girls face amid the conflict in South Sudan, with systemic rape and violence widespread.9 Clearly, our decades long knowledge of the existence of sexual violence as a weapon of war has not yet had a preventative effect. Dealing with conflict related violence may require a more contextual approach that considers peacetime violence as well.

Rape is one of the multiple harms being inflicted on the people and infrastructure of Ukraine, many of which will have long term effects. However, the intimate and potentially reproductive consequences of rape often means it has a far reaching, generational impact on the fabric of society and its identity. Survivors of wartime rape have reported long term physical injuries, as starkly shown by the work of 2018 Nobel Peace prize winner Denis Mukwege, who treated women’s internal injuries in the DRC.10 Survivors also face long term mental health consequences,11 children born of rape, and often continuous family conflict and domestic violence.5

To mitigate these long term harms, survivors of rape need access to emergency contraception, mental health support, and medical care for physical injuries. International aid organisations on the ground will need to take these needs of survivors into account.

Survivors also need recognition of the harm done to them to counter the shame and stigma that often go hand in hand with sexual violence. The international press is already focusing on what future justice can be meted out through the International Criminal Court, but convictions for sexual violence are difficult and thus rare. While not impossible,1213 first the war needs to end and, even then, drawn out and difficult judicial processes are unlikely to provide comfort to many of the survivors. For them, perhaps most important will be societal recognition that explicitly overcomes the stigma associated with sexual violence, and which will help to heal the deep rooted trauma of rape as an attack on the individual and community. This also means working towards a global society that condemns all forms of sexual violence and which places shame and stigma upon the perpetrators rather than the survivors.


  • Competing interests: None declared.

  • Provenance and peer review: Commissioned; not peer reviewed