The Epstein Files, the Abuse of Women, and Psychiatry
Key Takeaways
- The Epstein case reveals the psychiatric impact of sexual abuse, with victims facing trauma and societal disbelief, leading to severe psychological consequences.
- Low conviction rates for sexual abuse cases hinder victims' psychological healing, perpetuating their trauma and suffering.
Women are experiencing ongoing trauma and sexual abuse, highlighting the need for psychiatric support and societal change.
PSYCHIATRIC VIEWS ON THE DAILY NEWS
“No, but I sit with a patient once a month who was one of them and has suffered for decades but is too terrified to speak out, or let me, given how many end up dead.” - Personal email from a psychiatrist colleague
I received this response almost immediately after I recently asked colleagues whether there was any psychiatric organizational response to the Epstein files. The current news about them is that President Trump has supported their release.
Why now was I interested in doing a column on the story? After all, this ongoing topic surely fit our weekday daily column series in Psychiatric Times on “Psychiatric Views on the Daily News.” And aspects of this case started to erupt 20 years ago in 2005. The psychiatric ramifications are multiple and distressing in many ways.
First in distress are the women, like this patient of the opening quote, that have suffered the ongoing trauma of sexual abuse at young, often legally underage, ages. Such women have double major jeopardy: the trauma itself and the suffering aftermath. Common has been the discounting of their credibility and experiences.1 The end result can be death, as in the recent suicide and related memoir that was only published after the author’s death.2
Speaking of suicide, there is also the unexplained suicide of Jeffrey Epstein himself while incarcerated. His woman partner in his sexual operation is in prison.
The abusers of the young women may not be bereft of psychiatrists. A famous one was indicted.3 On the other harmful hand, women psychiatrists also get raped.4
Legally, some aspects of this case can fall into child sex trafficking, a classic case at that.5 But in only 14% of all child sexual abuse cases are the perpetrators convicted or plead guilty. For adult rape charges, only 1% end in connection or a guilty plea. How can those rates help psychological resolution of the shame and suffering?
All these aspects fit into the long history of various kinds of abuse of women by powerful men, abuse which controls women’s bodies, whether for sex, power, or prevention of desired abortion. No wonder, then, that research on the prevalence of mental disorders in the United States consistently shows higher rates in women than men.6 Other than from being involved in war, women have particularly higher rated of posttraumatic stress disorders than men.7
Though not an official DSM diagnosis, there is survival guilt reported by some who have been too traumatized to go public when they see it happening to other women, as reported in the current public testimony by many women who were involved in the Epstein operation.
The political fallout is major and escalating for now. The possible release of the files to the public has become the rare item of bipartisan agreement, yet the female representative, Marjorie Taylor Greene, has called for the release, but is resigning from Congress anyways. Some pundits are wondering what the involvement of the President has been.8 Even so, there is a risk that the political goal is a diversion from the prior, current, and future suffering of women, let alone the multiple major other political challenges.9 As one prominent writer, Rebecca Solnit, has written, the imbalance of power is a threat to democracy.10
There is also a risk that the public discussions have an aspect of being triggers for the trauma of the women traumatized. Perhaps that is a good excuse for my delay of addressing this issue.
Besides my own wondering about my delay, why now this unified political response? Collective guilt? Potential for scapegoating? Voyeurism? A time for reckoning? Silence allows a concern to continue. The #MeToo movement cries out.
As far as I can tell, the American Psychiatric Association (APA) has not put out a statement about this issue. Nor has any of the medical and psychiatric organizations that are protesting the new administrative politics of the government.
The APA, though, did put out a 2019 guide for psychiatrists treating intimate partner violence (IPV) survivors.11 Is that enough for now? It is limited to close intimate partners. What about prevention? Can men be guided away and redirected from such behavior which must have bio-psycho-social underpinnings, and can girls and women protect themselves better? Though the Epstein case, like many others, involves rich white men and vulnerable women, others involve men and women of other socioeconomic and cultural backgrounds. The scapegoating and control of women also falls under the rubric of sexism, one of what I call the social psychopathologies.
The Epstein files case is thereby another opportunity for some redemption, including psychiatric redemption.12
Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.
References
1. Epstein D, Goodman L.
2. Giuffre VR. Nobody’s Girl: A Memoir of Surviving Abuse and Fighting for Justice. Knopf; 2025.
3. Safer K. Epstein accuser files lawsuit alleging famed psychiatrist Henry Jarecki facilitated sexual abuse. Wall Street Journal. June 3, 2024. Accessed November 25, 2025.
4. Weiss R. Politicians and Masks. New York Times. July 26, 2020. Accessed November 25, 2025.
5. Price K. ‘Jeffrey Epstein is not unique’: what his case reveals about the realities of child sex trafficking. The Conversation. November 20, 2025. Accessed November 25, 2025.
6. Chen LP, Murad MH, Paras ML, et al.
7. Novotney A. Women who experience trauma are twice as likely as men to develop PTSD. Here’s why. American Psychological Association. July 8, 2024. Accessed November 25, 2025.
8. Douthat R. The outstanding question about Epstein and Trump. New York Times. November 15, 2025. Accessed November 25, 2025.
9. Weiner J. Endless gossipy chatter about Epstein. one glaring omission. New York Times. November 19, 2025. Accessed November 25, 2025.
10. Solnit R. The Jeffrey Epstein cover-up is an affront to US democracy. The Guardian. September 6, 2025. Accessed November 25, 2025.
11. Treating women who have experienced intimate partner violence. American Psychiatric Association. 2019. Accessed November 25, 2025.
12. Moffic HS. Redemption in psychiatry. Psychiatric Times. June 6, 2025.
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