Continuum of Sexual and Gender-Based Violence Risks among Syrian Refugee Women and Girls in Lebanon

Abstract

Background: A myriad of factors including socio-economic hardships impact refugees, with females being additionally exposed to various forms of sexual and gender-based violence (SGBV). The aim of this qualitative analysis was to understand and to provide new insight into the experiences of SGBV among Syrian refugee women and girls in Lebanon.
Methods: The data are gained from a larger mixed-methods study, investigating the experiences of Syrian refugee girls in Lebanon, using an iPad and the data collection tool, SenseMaker®. The SenseMaker survey intentionally did not ask direct questions about experiences of SGBV but instead enabled stories about SGBV to become apparent from a wide range of experiences in the daily lives of Syrian girls. For this analysis, all first-person stories by female respondents about experiences of SGBV were included in a thematic analysis as well as a random selection of male respondents who provided stories about the experiences of Syrian girls in Lebanon.
Results: In total, 70 of the 327 first person stories from female respondents and 42 of the 159 stories shared by male respondents included dialogue on SGBV. While experiences of sexual harassment were mainly reported by women and girls, male respondents were much more likely to talk explicitly about sexual exploitation. Due to different forms of SGBV risks in public, unmarried girls were at high risk of child marriage, whereas married girls more often experienced some form of IPV and/or DV. In abusive relationships, some girls and women continued to face violence as they sought divorces and attempted to flee unhealthy situations.
Conclusions: This study contributes to existing literature by examining SGBV risks and experiences for refugees integrated into their host community, and also by incorporating the perceptions of men. Our findings shed light on the importance of recognizing the impact of SGBV on the family as a whole, in addition to each of the individual members and supports considering the cycle of SGBV not only across the woman’s lifespan but also across generations. Gendered differences in how SGBV was discussed may have implications for the design of future research focused on SGBV.

Full text

Page 1/21
Continuum of Sexual and Gender-Based Violence Risks
among Syrian Refugee Women and Girls in Lebanon
Sophie Roupetz
Department of Medical Psychology and Medical Sociology, University of Leipzig, 04103 Leipzig, Germany
https://orcid.org/0000-0003-1183-7730
Stephanie Garbern
Department of Emergency Medicine, Alpert Medical School, Brown University
Saja Michael
ABAAD Resource Center for Gender Equality, Beirut, Lebanon
Harveen Bergquist
Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
Heide Glaesmer
Department of Medical Psychology and Medical Sociology, University of Leipzig, 04103 Leipzig, Gemany
Susan A. Bartels (  susanabartels@gmail.com )
https://orcid.org/0000-0003-2782-3480
Research article
Keywords: sexual and gender-based violence, women, girls, Lebanon, SenseMaker, refugee, Syria
DOI: https://doi.org/10.21203/rs.2.12094/v3
License:   This work is licensed under a Creative Commons Attribution 4.0 International License.  Read Full License

Page 2/21
Abstract
Background: A myriad of factors including socio-economic hardships impact refugees, with females being additionally
exposed to various forms of sexual and gender-based violence (SGBV). The aim of this qualitative analysis was to
understand and to provide new insight into the experiences of SGBV among Syrian refugee women and girls in Lebanon.
Methods: The data are gained from a larger mixed-methods study, investigating the experiences of Syrian refugee girls in
Lebanon, using an iPad and the data collection tool, SenseMaker®. The SenseMaker survey intentionally did not ask direct
questions about experiences of SGBV but instead enabled stories about SGBV to become apparent from a wide range of
experiences in the daily lives of Syrian girls. For this analysis, all rst-person stories by female respondents about
experiences of SGBV were included in a thematic analysis as well as a random selection of male respondents who provided
stories about the experiences of Syrian girls in Lebanon.
Results: In total, 70 of the 327 rst person stories from female respondents and 42 of the 159 stories shared by male
respondents included dialogue on SGBV. While experiences of sexual harassment were mainly reported by women and girls,
male respondents were much more likely to talk explicitly about sexual exploitation. Due to different forms of SGBV risks in
public, unmarried girls were at high risk of child marriage, whereas married girls more often experienced some form of IPV
and/or DV. In abusive relationships, some girls and women continued to face violence as they sought divorces and
attempted to ee unhealthy situations.
Conclusions: This study contributes to existing literature by examining SGBV risks and experiences for refugees integrated
into their host community, and also by incorporating the perceptions of men. Our ndings shed light on the importance of
recognizing the impact of SGBV on the family as a whole, in addition to each of the individual members and supports
considering the cycle of SGBV not only across the woman’s lifespan but also across generations.Gendered differences in
how SGBV was discussed may have implications for the design of future research focused on SGBV.
Background
Syrian crisis
Since the start of the conict in 2011, the situation in Syria has remained one of the worst humanitarian crises in the world
(1) with 5,5 million Syrians having ed the country as of June 2020, and another 6 million people internally displaced (2,3).
Lebanon hosts the largest number of Syrian refugees per capita with approximately one million displaced individuals, and
refugees now account for greater than a fth of the country’s population (2,4). Although not a signatory to the 1951 United
Nations (UN) Refugee Convention, Lebanon has a long history of hosting refugees including 200,000 Palestinian refugees in
addition to 18,500 refugees from Ethiopia, Iraq, Sudan and other countries (5). As a consequence of the Lebanese
government’s decision to not establish formal camps for displaced Syrians, refugees are dispersed across the country, living
in informal tented settlements (ITSs) or integrated within local communities, either living with family or in rental
accommodations, as opposed to being hosted in formal, supported refugee camps (6,7). The highest numbers of Syrian
refugees are located in the governorate of Bekaa (339,233) followed by North Lebanon (237,392) and Beirut (215,929) (5).
Nine years into the crisis, Syrian refugees in Lebanon are now more vulnerable than ever, with more than half of them
currently living in extreme poverty and over three quarters living below the poverty line (8,9). Daily economic challenges
signicantly affect parents’ ability to adequately care for their children. The increased stress of not earning adequate income
to cover the family's living expenses, can lead to negative mental/physical health consequences, while also contributing to
an ongoing cycle of poverty (10). Having itself experienced war and years of political instability, Lebanon’s precarious
infrastructure and resources are signicantly strained by hosting more than one million Syrian refugees. This in turn has
resulted in tensions within the host communities, which at times has been manifested as violence and discrimination
towards Syrian refugees (11). Displaced Syrian families in Lebanon are also confronted with burdensome governmental
policies and regulations. For example, those registered with UNHCR must pledge that they will not work in Lebanon, while

Page 3/21
other Syrians are only permitted to work in agriculture, construction and environment. Although the Lebanese Government
agreed in 2016 to ease work restrictions for Syrian refugees, discussions are still ongoing around implementation of these
procedural changes (12–14).
Sexual and Gender-Based Violence (SGBV) in humanitarian settings
Lebanon currently hosts about 500,000 Syrian children between the ages of 3 and 18 (9) and it is estimated that 54% of the
Syrian refugee population in Lebanon is under the age of 18. While many of these children face risks related to poverty, food
insecurity, lack of access to healthcare, and forced labor, girls are also vulnerable to additional gendered risks including child
marriage, domestic violence (DV) and intimate partner violence (IPV), sexual exploitation and assault, as well as intimidation
and fear of violence within their communities (15–17). In humanitarian crises women and girls are at risk of various forms
of sexual and gender-based violence (SGBV) (18). SGBV is dened as “any act that results in harm, suffering or humiliation
to women and girls and includes rape and sexual abuse, forced pregnancy, dowry-related abuses, female infanticide and
domestic violence” (19). Although a violation of human rights, SGBV has remained widespread with at least one in every
three women being beaten, coerced into sex, or otherwise abused in her lifetime (20,21). In conict settings, women are at an
even higher risk of SGBV (22,23) with different manifestations of it sometimes being used as a “weapon of war” to conduct
ethnic cleansing (24,25) and to terrorize people as a method of systematically destroying communities (26). Mass rape in
war has been documented in crises regions such as Bosnia, Somalia, Uganda, the Democratic Republic of Congo and
Myanmar (24,27,28). As of today, Rohingyan women in Myanmar and Yezidi women in Iraq face systematic campaigns of
sexual violence based on their ethnicity and religious aliations (24,29). At the time of displacement, refugees are also
recognized to be at particular risk of sexual victimization with many women being forced into “commercial sex work” or
subjected to sexual exploitation and/or torture to pay for their migration (30). In post-migration settings, women frequently
experience social and cultural isolation as well as dire economic need, making them again vulnerable to sexual abuse and
exploitation as well as commercial sex work (31). While SGBV against women and girls during the Syrian conict, mainly
perpetrated by armed actors, is well documented (32), data about SGBV in Syria before the crisis is lacking as it was rarely
discussed (33).
SGBV and Gender Norms in Pre-Conict Syria versus Post-Displacement
Prior to the war, Syria was very patriarchal and men dominated almost all aspects of society (34). According to the feminist
perspective, men dominated the public sphere whereas women were essentially relegated to the private sphere. This
public/private dichotomy served to entrench the patriarchal system and ensured the oppression of women. For instance,
women found it dicult to raise issues that impacted them and the political process was biased towards the public sphere
whilst largely ignoring the private realm. By marginalising the private sphere, men maintained their dominance of the
political process from one generation to the next (35,36). Earlier evidence has suggested that gender norms are changing
due to the Syrian crisis and its resultant displacement. For instance, Syrian women report feelings more empowered and
describe having increased responsibilities with regards to work outside the home and providing for their families (37). These
altered gender norms have been accompanied, however, by increasing reports of SGBV perpetrated by men who use violence
as a coping mechanism and to reassert hegemonic patriarchal roles (16). Under these circumstances, men’s low self-esteem
and feelings of disempowerment have contributed to violence against the family as some men have felt stripped of their
function in society (34).
Increased rates of child marriage within Syrian refugee populations have been identied (38–40) and studies in Lebanon
have highlighted that nancial hardships, lack of educational opportunities and safety concerns are the main drivers of early
marriage among Syrian refugee populations (38,39). Sexual exploitation, forced prostitution and, “survival sex” have also
been described as a negative coping strategies for some Syrian women and girls who have no other means to raise the
funds needed to cover living expenses in Lebanon (41,42). Economic vulnerability also puts many girls and women at risk of
sex tracking (42). In addition, Syrian women and girls in Lebanon are exposed to physical and verbal abuse, sexual

Page 4/21
harassment, robbery and fear of being kidnapped (16), often resulting in parents’ reluctance to permit their daughters to
leave the house unaccompanied (43).
While many SGBV risks have been well documented and are common across a variety of settings, less is known about the
SGBV threats faced by displaced women and girls who are largely integrated into their host communities rather than hosted
in formal refugee camps. It is also less common that research on SGBV includes the perspectives of men and boys in
addition to that of women and girls. Therefore, what the current study contributes is two-fold: i) an analysis of threats and
experiences of SGBV among Syrian refugee women and girls who are integrated into their host communities; and ii) a
perspective of SGBV that is broader and more nuanced because it also includes insights from male community members.
The ultimate goal of the research is to reduce SGBV risks and to improve assistance to those who have been affected.
Methods
Study Design and Participants
The study was conducted by Queen’s University in collaboration with the ABAAD Resource Center for Gender Equality. Data
was collected across three locations in Lebanon hosting a majority of Syrian refugees: Beirut, Beqaa and Tripoli. Twelve
interviewers were selected by the ABAAD Resource Center for Gender Equality and completed a four-day training seminar
immediately ahead of data collection. The team included six Syrian female interviewers to collect the perspectives of
women and girls, as well as three Syrian and three Lebanese male interviewers to collect the perspectives of Syrian and
Lebanese men respectively. To represent a broad spectrum of perspectives on the lives of Syrian girls in Lebanon, a
convenience sample within each of the following participant subgroups was recruited: married and unmarried Syrian girls,
Syrian, Lebanese or Palestinian men, Syrian parents, and community leaders. Within each location, research assistants
approached potential participants from their naturalistic community settings including: markets, post oces, commercial
settings, bus stops, etc. Only participants aged 13 years and older were eligible to participate in the study. Narratives were
audio recorded in Arabic and then transcribed and translated from Arabic into English by native Arabic speakers. Because
the story prompts were open-ended, participants could share narratives about any experience of Syrian girls in Lebanon and
thus, multiple themes arose from the data. The research presented here is a qualitative analysis of the subset of narratives
about experiences of SGBV among Syrian women and girls. All rst-person stories by female participants from married and
unmarried Syrian girls, Syrian mothers and female community leaders were screened and those about experiences of SGBV
were included for analysis (n=327). To ensure that male perspectives were also represented, every fth story out of 701
stories from male participants was also screened and those about experiences of SGBV were included for analysis.
Instrument
The dataset is derived from a larger mixed-methods study, investigating the experiences of Syrian refugee women and girls
in Lebanon (38). For our purposes, Syrian girls referred to Syrian females under the age of 18, and this was clearly dened
for all participants at the beginning of the survey. In the original 2016 study, data were collected using SenseMaker®, a
mixed-method data collection software tool that extracts meaning from a repertoire of stories shared about people’s
experiences. SenseMaker was developed by Cognitive Edge and has been used historically for understanding corporate
culture, corporate restructuring, etc. Using SenseMaker, participants selected one of three open-ended prompting questions
to share an anonymous story about the experiences of Syrian girls in Lebanon: 1. Tell a story about a situation that you
heard about or experienced that illustrates the best or worse thing about the life of a Syrian girl (under the age of 18) in
Lebanon, 2. Provide a story that illustrates the biggest difference between life for Syrian girls (under the age of 18) living in
Lebanon in comparison to life for Syrian girls in Syria, 3. Suppose a family is coming to Lebanon from Syria, and the family
has girls under the age of 18. Tell a story about a Syrian girl in Lebanon that the family can learn from. After telling a story,
participants interpret their shared narrative by responding to predened questions on handheld tablets, smartphones or
computers. SenseMaker then quanties each of the responses, providing statistical data backed up by the explanatory
narrative (44). The SenseMaker survey intentionally did not ask direct questions about experiences of SGBV but instead

Page 5/21
enabled stories about SGBV to become apparent from a wide range of Syrian girls’ lived experiences. In total, 1422 self-
interpreted stories from 1346 unique respondents were collected. More detailed information on the survey design and data
collection procedure has been previously published (45).
Analysis
Two researchers (SR, SG) independently screened all 327 rst person female narratives as well as the 159 systematically
selected male narratives to identify main themes and subcategories around SGBV. Please see below for the denition of
SGBV used for screening and coding purposes. Screening discrepancies between researchers were reviewed by a third
researcher (HB) and inclusion of the narrative was decided by consensus agreement between all three researchers. Thematic
analysis was considered appropriate as it allows rich and detailed meaning to be drawn from data through the emergence
of patterns (46,47). Analysis consisted of familiarization with the data by three researchers (SR, SG, HB) through reading all
narratives multiple times, followed by independent coding to create the set of initial codes. Initial codes were then grouped
into potential themes representative of the data by researchers SR and SG. Themes were reviewed by researchers SR and SG
and nal themes decided by consensus agreement after discussion between researchers SR, SG, HB and SB.
Denition of SGBV and its use within the study context
For the purpose of this study, stories that discussed any form of physical, sexual, psychological or verbal violence
perpetrated against women and girls and seen as a direct result of their gender were screened in and later coded as being
about SGBV. Additionally, harassment based on gender, domestic and intimate partner violence of a physical, sexual or
emotional nature as well as sexual assault, commercial sex work and exploitation were all included as forms of SGBV. While
men and boys are also affected by SGBV, because this study focused on the experiences of Syrian girls, SGBV perpetrated
against men and boys was not captured in the current dataset. While early, forced and child marriage is widely recognized
as a form of SGBV, these narratives were only included in the current analysis if they also described one of the above forms
of SGBV since a separate analysis of early, forced and child marriage from this data has been previously published (38).
Results
In total, 70 of the 327 (21,4 %) rst person narratives shared by females discussed some form of SGBV while 42 of the 159
(26,4%) male stories included dialogue on some form of SGBV. Demographics of study participants are presented in Table
1.
Table 1. Characteristics of participants who shared stories about SGBV

Page 6/21
Characteristics
Female󰁅
󰁅No (%)
Male 󰁅
No (%)
Gender 70 (21,4%) 42 (26,4%)
Subgroup
Married Syrian girls 30 (42,9) ------------------
Unmarried Syrian girls 31 (44,3) ------------------
Syrian mothers 9 (12,9) ------------------
Syrian fathers 󰁅 11 (26,2)
Married Syrian, 󰁅 󰁅
󰁅 󰁅 Palestinian and
󰁅 󰁅 Lebanese men ------------------ 12 (28,6)
Unmarried Syrian, 󰁅 󰁅 󰁅 󰁅 󰁅 󰁅󰁅
󰁅 󰁅 Palestinian and󰁅
󰁅 󰁅 Lebanese men ------------------ 16 (38,1)
Community leaders ------------------ 3 (7,1)
Age
󰁅 13-17 48 (68,6) ------------------
󰁅 18-24 15 (21,4) 9 (21,4)
󰁅 25-34 4 (5,7) 21 (50)
󰁅 35-44 3 (4,3) 6 (14,3)
󰁅 󰁅> 45 ----------------- 6 (14,3)
Marital status
Married 28 (40,0) 25 (59,5)
Single 30 (42,9) 17 (40,5)
Divorced/separated 11 (15,7) ------------------
󰁅 󰁅 Prefer not to say 1 (1,4) ------------------
Religion
Sunni 69 (98,6) 27 (64,3)
Shia ------------------ 3 (7,1)
Other 1 (1,4) 12 (28,6)
Home region
Lebanon ------------------ 21 (50,0)
Homs ------------------ 6 (14,3)
Damascus 11 (15,7) 6 (14,3)
Aleppo 13 (18,6) 1 (2,4)
Hama 10 (14,3) 1 (2,4)
Idlib 6 (8,6) 1 (2,4)
Other 30 (42,8) 6 (14,2)
Location in Lebanon
Beqaa 37 (52,9) 20 (47,6)
Greater Beirut area 22 (31,4) 17 (40,5)

Page 7/21
Tripoli 11 (15,7) 5 (11,9)
Time in Lebanon (years)
󰁅< 1 year 8 (11,4) 1 (2,4)
1–3 18 (25,7) 5 (12,0)
3–5 37 (52,9) 11 (26,1)
5–7 2 (2,9) 2 (4,7)
󰁅> 7 years󰁅 5 (7,1) 23 (54,8)
󰁅
n, number of shared stories.
Qualitative Data Analysis
Two main themes around SGBV among Syrian refugee women and girls in Lebanon were highlighted in this analysis: 1.
Continuum of SGBV risks in the public and private spheres; 2. Gendered differences and perspectives around SGBV.
Theme 1: Continuum of SGBV risks for Syrian women and girls in Lebanon
Different threats and experiences of SGBV in both the private and public spheres were evident for Syrian women and girls in
a continuum across the adolescent and early adult years. By private sphere, we refer to acts of violence that occur in the
home, typically behind closed doors and often perpetrated by either a family member, friend, or someone else known to the
woman or girl. By public sphere, we refer to those acts of SGBV that occur outside the home, in public areas such as
schools, streets, shopping areas, parks, etc., and more likely involving an unknown perpetrator. The continuum described in
our analysis refers to life stages from unmarried adolescent girls living in the family home, to child brides living with her
husband and/or parents-in-law, and in some cases to being divorced or separated after a marriage ends. From this
chronological perspective, early SGBV risks refer to those primarily affecting unmarried adolescent girls, while later SGBV
risks refer to those experienced more so after being married and leaving the family home.
As adolescents, girls are perceived to be at high risk of sexual harassment and sexual violence in their communities. In an
effort to protect them from these public sphere threats and to protect their honor, some parents choose to marry their
daughters earlier than they perhaps would have under different circumstances. Child marriage is itself a form of SGBV but
the risks are further compounded by the IPV that many girls experience after they are married. In addition to IPV within their
marriages, some girls also describe DV by their husbands’ relatives and in a few cases girls were subjected to abuse after
they ed violent relationships and returned to their parents’ home.
a. Public SGBV risks for women and girls: harassment and assault
Several forms of SGBV were reported by women and girls as part of their experiences in the public sphere. A majority of the
rst-person female narratives about SGBV referred to various forms of harassment directed towards women and girls in
public spaces, and street harassment was often mentioned as the reason why girls’ mobility was forcibly limited.
Harassment was most commonly reported by girls while travelling to and from school as well as in school, creating a sense
of unease and fear among some participants. Fear of harassment and heightened concerns around safety for girls led some
parents to engage in negative coping mechanisms in an attempt to protect them. For instance, an unmarried Syrian girl
based in Tripoli (age 18-24) reported that she was not allowed to attend school.
“… When our family moved to Lebanon, I lived in a very unsafe neighborhood, so I was not allowed to leave the house to
attend school, fearing that the Lebanese men would take sexual advantage of me or subject me to verbal violence and
threats. Moreover, my sister and I are not allowed to stay at home by ourselves because our parents fear that someone
might come in and harass us.”

Page 8/21
Some participants described being bullied and harassed not only by boys, but also by teachers and school ocials. An
unmarried Syrian girl living in Beirut (age 13-17) reported being harassed by her teacher.
“...One time in class the teacher would ask me to sit right in between two guys, and I would ask him whether he would be ok
with his wife sitting in between my father and uncle and he would say “no”. I told him that he has tomove me from between
the two boys or I would go home, and he would ask me to go home. The teacher kept going on with his hitting and making
me sit between guys and I told him that if my father was here he would have never treated me like that…”
Living in ITSs or integrated into the host community, many respondents felt unsafe due to experiences and / or perceived
threats of sexual harassment and sexual assault on the streets. One Syrian mother based in Beqaa (age 25-34) shared her
personal story about being sexually harassed by a male driver while she was walking with her daughter, and discussed
concerns for her daughter’s safety in Lebanon.
“My daughter and I were going to the pharmacy once, when a man in a car started following us and honking. My daughter
and I ignored him completely, so he stopped the car and opened the window, only to nd him naked in the car. I was very
scared for my daughter. He was a disgusting man and what he did was even more disgusting. If the man had done this
while she was alone, the man could have kidnapped her. I advise every girl to leave the house with an adult, someone who
can protect her.”
Some female respondents reported being followed and verbally harassed on the streets by passing drivers or while
commuting on public transportation. A 22-year old married Syrian girl from Beirut talked about her experiences of
harassment and commented that all women were at risk of harassment.
“When I go to Beirut, the taxi drivers would harass and catcall any women passing by. Regardless if the woman was with her
child, married, or pregnant. Some of them would say some very dirty words. When she is walking with a man, they wouldn’t
dare to say anything. But they will harass a woman walking alone a lot.”
One married 18-year-old Syrian girl, who had been in Beqaa for 5 years ago reported being sexually assaulted in the public
sphere and discussed misconception and the disrespect she faces as a refugee girl in Lebanon.
“… I worked in a chicken restaurant, they disrespected me and assaulted me. The owner was paralyzed and harassed me
sexually, he always tried to get close to me. He was old. They think that the Syrian girl has no dignity. I felt really offended
and we argued a lot. He gave me a wrong idea of the Lebanese men, they just want us sexually, they think that we sell our
dignity for cheap.”
An unmarried 13-year old Syrian girl living in Beqaa blamed herself for being sexually assaulted on the street and felt that
she could not tell her parents about the incident.
“After some time alone, the boy cornered me in a high place, and then he started holding my hand, touching me in places,
and getting his body close to mine. He then wanted to take me somewhere, but I refused, so I wanted to break free but he
wouldn’tlet me. He kept pulling me towards him, making our bodies collide and touch. After freeing myself from his grip, I
ran home and I have not been outside the house since. I know that it is my fault and I am responsible for such action. I
cannot tell my parents about this because they will make a big deal out of this. They will blame us and get away with it
because we are Syrians. I advise every girl to never play with boys and to never leave the house by herself or without an
adult.”
One married Syrian father living in Beqaa valley (age 25-34) shared a story about a Syrian refugee girl who had lost all her
family back in Syria and needed to work to nance herself in Lebanon where she has been sexually assaulted at her
workplace.
“… She had to work here to support herself so she started by selling owers. As the days

Page 9/21
passed she started staying out late for her job. One day, a group of men promised her money if she’d walk with them. They
assaulted and raped her.From that day on, the barrier that was once there in her mind was gone so she started working as a
prostitute. The girl is a minor, she is 16 years old.”
Moreover, given the dire nancial situation, some women and girls worked in order to support their family’s nances. The
employment market in Lebanon, however, often restricts women's labor opportunities to domestic house work, posing an
increased risk of SGBV due to the lack of accountability and reporting mechanisms. Some female respondents reported
unwanted sexual advances by their supervisors and in some cases, employers were beneting from the nancial
dependency of female employees. For instance, one married Syrian man living in Beqaa (age 25-34) described how an 18-
year old girl was harassed by her employers.
“I know a girl who came to Lebanon with her husband. While they were entering Lebanon, they took her husband on the
border. So, she had to work in houses here. Some people used to pay her and others didn’t. She has a little boywho she needs
to secure food for. Some people used to harass her while working. So, she never returned to these people’s houses. She is
only working for the sake of her son. And she doesn’t know what to do.”
b. Private SGBV risks: child, early and forced marriage
SGBV risks for Syrian refugee girls were described as one of the main drivers for parents to marry their daughters early, since
marriage and having a husband were perceived as protective against SGBV. One 16-year-old married Syrian girl in Beqaa
was married at the age of 14 as a protection measure due to safety concerns.
“… I got married because my parents feared for my safety. There were a lot of
kidnapping cases happening in our village. … I have marital problems as well. I advise parents to rejecttheidea of early
marriage. It is not right. The girl should be allowed to live through her whole childhood. I will not approve for any of my
daughters to get married at an early age; especially after this experience that I am going through.”
This Syrian girl in Beqaa chose to get married at the age of 14 and gave up education due to a fear of being harassed and
assaulted.
“When I was 14 years old, I chose to get married. This was due to my former school
principal; he used to harass the students and teachers. He constantly harassed them. After a while, he started to harass me.
Therefore, I hated school, and I accepted to get married to the rst man who proposed to marry me. I was relieved after I got
married. I was relieved from men’sharassment. I preferred to get married. Now, I am very comfortable. I hated being
harassed. I saw how the teachersharassed the girls at school. … More than one girl from my school decided to get married.
Even though I would have preferred to continue my education, I was compelled to marry in order to get rid of the
harassment.”
One Syrian girl who was displaced with her parents to Beirut at the age of 12 was forced into marriage to protect her from
further harassment after being targeted by a man in the community.
“…In Lebanon, I was sexually harassed from an old aged man. When my parents knew,
they forced me to get married. Now, I have a child, and I am pregnant. I am unhappy.”
Early, child and forced marriage is a form of SGBV because it forces girls to have sex before they are old enough to consent
and before their bodies are physically mature. In some cases, the outcomes are extreme as in this example shared by a
married Lebanese man in Beirut (age 45-54).

Page 10/21
“...My daughter is only 9 or 10 years old. The employer sees my daughter,and he asks to either marry her or to buy her. I
accept since I don’t have any other solution, but my wife starts shouting and crying. We got a clerk and married the employer
to our child, and he took her as his wife…Our daughter died the next day from an extensive hemorrhage that was the result of
brutal intercourse. He is a monster. Our child died. This is a true and very sad story. I hope, by documenting and sharing this
story, to spread awareness to the public.”
c. Additional private SGBV risks: intimate partner violence and domestic violence within marriages
In addition to experiencing early marriage as a form of SGBV, married Syrian girls were sometimes exposed to violence in
their homes after being married at a young age. In the private sphere, intimate partner violence (IPV) against women and
girls in their own homes was commonly reported. Other girls experienced domestic violence (DV) perpetrated by other family
members, while a few girls were sexually exploited by their parents, often under the guise of marriage. IPV was a prominent
form of SGBV discussed by respondents in this analysis. Much of the narratives around IPV were linked to a power
differential since the bride was a child/minor and/or was forced into a marriage. For instance, one 15-year old married
Syrian girl (age 13-17) in Beqaa reported on the abuse she experienced by her husband.
“…I got married to another man, and my husband abuses me. I have two daughters now. I wouldn’t have gotten married, if I
knew what I was going to go through. I am not happy…I am 15 years only. I lost my life. I advise girls not get married before
the age of 20.”
This Syrian girl located in Tripoli (age 18-24) reported being married at the age of 18 and described her experiences of
violence.
“My husband has anger issues, and he rarely works. I used to have a job, but he prohibited me from working. When he gets
mad, he starts swearing at me and beating me. I live with my parents-in-law. I like living with his parents because I don’t like
my husband.”
Overall, physical violence perpetrated by husbands was the most commonly reported form of IPV. A Syrian girl based in
Tripoli (age 13-17) reported physical abuse by her husband during their brief marriage.
“I was 15 years old when I got married. I didn’t get engaged, and I didn’t doa wedding. We were married in four days only.
Problems started immediately. I lived with him for 20 days only. He used to beat me, he wanted to send me to Turkey, he
wanted me to work as a dancer, and he wanted to take me away from my parents. One day, I ran away from him. People I
know helped me, to get from where he lived to my parent’s village. Then, my parents helped me to get a divorce.”
Another Syrian girl from Beqaa (age 18-24) was forced into marriage at the age of 16 and then experienced IPV from her
husband.
“At rst, I refused then my parents encouraged me. I didn’t love my husband. He prohibited me from visiting my parents, and
he beat me. At rst, we lived with his parents then his father kicked us out. We moved a lot. My parents didn’t stand by my
side. I suffered a lot. I tried to kill myself.”
This Syrian girl (age 13-17) in Tripoli chose to marry her husband; at rst the marriage was happy but then the girl
experienced IPV when she was beaten by her husband and DV when she was beaten by her brother- in-law.
“…My husband and my brother-in-law started to beat me. I started to yell, so our neighbor came to help me. But they kept on
beating me. My mom picked me up and took me to the doctor. We got a report, and we hired a lawyer to get my son back.
Now, my son is with me, and I returned to my parent’s house waiting to get divorced.”
Another married Syrian girl in Beqaa (age 13-17) was similarly exposed to both IPV and DV after being pressured into
marriage.

Page 11/21
“One of my father’srelatives wanted to marry me. At rst, I didn’t accept, but then they convinced me that he is a good man,
and I accepted. We fought constantly. Then I fought with his parents. My husband, his mother, and his uncle beat me. Even
their guests would beat me. I suffered a lot when I lived with them. I neither ate nor drank anything, and I always stayed
alone.”
d. SGBV risks after leaving unsafe marriages: domestic violence and sexual exploitation
Despite nding themselves in unsafe and unhealthy marriages, some Syrian girls continued to face violence and abuse even
as they sought divorces and attempted to ee abusive situations. Due to traditional values, social stigma and taboo
surrounding divorce, this violence was often
perpetrated by the husband’s and / or the girl’s family and there was a perception that the girls
were blamed for their unsuccessful marriages. For instance, one married Syrian girl in Beqaa (age 13-17) was maltreated by
her parents after eeing her abusive husband.
“They [husband and his family] would yell at me and insult me all the time. I stayed there for 20 days, and I couldn’t take it
anymore. I returned to my parents’ house, and they told me that everything will be okay after my husband and I reconcile.
When I told them I do not wish to reconcile things with my husband, they started to beat me as well. They took me to a clerk
(Sheikh) to check if I was possessed or something. I suffered at my parents’ house and at my parents-in-law’s house. I cried
all the time.”
As a result of the dire economic need, some girls were sexually exploited by their parents under the guise of marriages. For
instance, this Syrian father (age 25-34) from Beqaa shared a story about a Syrian family that was displaced to Lebanon
with their 12-year old daughter.
“The father marriedhis daughter to a Lebanese man. This man got married to her because he wanted to have fun. After a
while, he divorced her. Her parents married her to a Syrian man. Her father has married her seven times, and he would
increase her dowry every time; he is beneting from her dowry. This girl is younger than 18 years old, and she doesn’t know
what is going on. Her story is known all over the Syrian camps.”
As a result of being refused by relatives after a divorce due to shame and dishonor, some girls turned to commercial sex
work to support themselves. One Lebanese man in Beqaa (age 25-34) shared a story about a 17-year old Syrian girl who
tried to return to her parent’s home after being physically abused by her husband.
“They got her married to a Lebanese guy. After a while of their marriage, which lasted less than a month (25 days), the guy
and his family started hitting her, she ran away to her parents’ house, but they did not welcome her because she is a married
woman now. However, the neighbors pressured her parents to let her into the house, but after 3 days the girl disappeared. A
neighbor they know saw her in Beqaa, but she acted as if she didn’t know or see him. And he nds out that she is working in
prostitution; her parents are trying to get her back now.”
Theme 2: Gendered differences discussing SGBV risks
SGBV risks for female Syrian refugees were discussed differently by female and male respondents. For instance,
experiences and fears of sexual harassment were mainly reported by women and girls, with 48 of 70 female narratives
presenting sexual harassment as the primary form of SGBV in Lebanon. There were no accounts of sexual exploitation
shared by women or girls in this study.
This unmarried Syrian girl in Beqaa and her school friends were harassed while waiting for the bus (age 13-17).

Page 12/21
“… My friends and I, who are waiting for the bus, are all girls and there were children amongst us as well. During the walk, a
car with black tinted windows started following us; every now and then it would shine the front lights and honk. When we
reached our camp, the car drove off. My friends and I were terried.”
Another unmarried Syrian girl in Beqaa (age 13-17) reported how unsafe she felt as a girl in Lebanon due to harassment,
comparing her situation in Lebanon to that in Syria.
“…We are living in tents and I cannot go out and walk around. I can’t even smell the fresh air (the fresh air has been
prohibited for me). I am not even sad that I cannot go out in the city because there are young men that sit outside and I am
scared to go outside because they bother us and I am a girl, I do not want to go out.”
In contrast, only 8 of 42 male respondents discussed sexual harassment against Syrian girls. Instead men were much more
likely to talk explicitly about sexual assault (14 out of 42) and sexual exploitation (19 out of 42). For instance, this
unmarried Lebanese man from Beirut (age 18-24) reported a story on sexual abuse where one man wanted to marry a Syrian
girl, but her father refused.
“The guy started threatening to kill her father if she does not marry him. Every day, a different man would sexually abuse her
until the girl, 17 years old by that time, broke down mentally and she started talking to herself, prompting everyone to call her
crazy. Furthermore, this man and his group of friends surrounded the house, banning anyone from coming in or out. Her
father tried leaving the house once, but they would not let him. The girl contemplated suicide because of what she has
suffered.”
One Syrian man (age 25-34) in Beqaa shared a story about a 16-year old girl who was forced into commercial sex work to
nancially support her family.
“
I know a Syrian family that displaced to Lebanon. They have three daughters. When one of their daughters was 16 years
old, she was compelled to work in sinful routes due to the family’s circumstances. She got raped, and she worked in
prostitution. Now, she is a drug addict, and she is 18 years old.”
In some cases, the dire economic need led to coerced commercial sex work. For instance, a married Syrian man located in
Beqaa (age 25-34) shared a story about a 17-year old Syrian girl who was forced into commercial sex work in order to pay
for rent:
“They came here after the war. She lived with someone here in this area. He abused her age and bad situation and made her
work in prostitution. It started as a secret, but then we found out what was happening with this girl. He is abusing her in
return of a little amount of money, let’s say for rent maybe.”
Similarly, a Syrian father in Beqaa (age 25-34) shared a story about Syrian girls who were promised job opportunities but
ended up as commercial sex workers.
“I know three girls who came from Damascus. They are students at school; the youngest one is 18 years old to 16-17 years.
They are under the age of 20. They came to work at restaurants and cafes, but they used them and took them to prostitution
places, for the sake of money. Several girls came, not only one.”
Sexual exploitation in the form of short term, contractual marriages was also discussed as illustrated by this Syrian father
from Beqaa (age 35-44).
“… She is getting married for two weeks or a month, and then she’ll get divorced. I asked one of the girls how is she? She told
me that she resents herself. She is being exploited. They are continuously getting married, and they are still minors. Even in
her few weeks with one of her husbands, she’ll be abused. … I know a girl who has been married 6 times. This is wrong.”

Page 13/21
Discussion
In this analysis, SGBV was identied as an important issue by both women and men, even though the study design and
methodology did not include any prompting about the topic, neither in the study introduction nor in the questions. Given the
methodology, experiences and threats of SGBV arise naturally from a broad spectrum of lived experiences. Sexual
harassment in the public sphere was the most common form of SGBV identied in this study, followed by sexual abuse and
exploitation, which is consistent with previous research (16,17,48). Despite facing a range of SGBV threats, Syrian women
and girls also demonstrated their agency by making strategic decisions to protect themselves from SGBV threats (for
instance, leaving school and leaving abusive relationships). It is important to recognize their strength and resourcefulness
despite living with very constrained choices.
In Lebanon, Syrian refugees are largely integrated within their host communities, as opposed to living in formal refugee
camps, where SGBV risks have been better documented (6,7). Hosting Syrian refugees has strained Lebanon’s resources and
infrastructure, which has created tension, and at times hostility, within the host community towards displaced Syrian
families (12,49). What this analysis adds to the existing literature is a more nuanced understanding of SGBV risks faced by
refugees who are integrated into such a host environment. This is especially relevant since most of the perceived SGBV
threats for girls were derived from the host community itself (particularly from the perspective of women and girls). For
instance, since work permits are restricted in Lebanon (50,51), some Syrian women and girls are forced to work to meet their
families’ basic needs. Since this work is usually in the informal sector, it can increase their risk of sexual abuse and
exploitation (52). Furthermore, since some Syrian women and girls are not registered in Lebanon, they are understandably
hesitant to report sexual assault since reporting could lead to detention and deportation (15). Women and girls also faced
SGBV risks in their private lives with signicant threats reported from husbands, from the husband’s family, and from the
girl’s own family. IPV perpetrated by husbands was the most common form of violence in the private sphere, consistent with
other existing evidence (18,53). IPV is thought to be exacerbated among displaced Syrian families by the frustration that
some men experience when their lives are disrupted, when their pre-existing roles as breadwinners within the family are
altered, and when traditional gender norms are challenged (16,54). Girls who marry young and have a large age gap with
their spouses seem to be more at risk of IPV related to systems of power (39,55). Restricted educational opportunities and
insecurity increases girls’ dependency on men, thereby limiting their agency and perpetuating patriarchal gender norms
(39,56). While Syrian men may have lost some of their patriarchal power due to displacement, women and girls are often
challenged to take on more responsibilities, both inside and outside the home (37). These new gender roles, as well as an
unsafe environment and severe economic strain may increase stress levels and contribute to men perpetrating IPV.
Increased levels of IPV have been reported during other periods of armed conict in the region included during the second
Intifada in the West Bank and Gaza (29) as well as among Palestinian refugee communities in Lebanon (57).
Continuum of SGBV risks
Our analysis highlights that female Syrian refugees are at heightened risks of SGBV in their host communities. However, the
types of SGBV experienced appear to differ across the adolescent and early adult years. As earlier risks of SGBV, sexual
harassment and sexual assault were experienced in the public sphere limiting girls’ mobility as well as access to education
and work. It has been documented that if a girl experiences sexual abuse, her risk of subsequent sexual and physical
victimization is signicantly increased (58) and this phenomenon was evident in the current research. As a result of shame
and dishonor, these SGBV threats and experiences in the public sphere lead to other SGBV risks in the private sphere. For
instance, unmarried Syrian girls who are perceived to be at risk of sexual harassment and sexual assault in the community
are sometimes pressured or forced into child marriage as a means of “protecting” them. Child marriage is itself a form of
SGBV since girls are forced to have sex before they are able to give consent, and sometimes before their bodies are
physically mature. In essence, some families exchange the threat of sexual harassment or sexual assault in the community
for another form of SGBV, namely child marriage, as they believe that it will protect the honor of the girl as well as the honor
of the family (59). The cultural and gender norms that render girls unmarriable and their families dishonourable in the event

Page 14/21
of sexual harassment (60), sexual assault or pre-marital dating, directly contribute to girls experiencing the next type of
SGBV, i.e. child marriage. After their marriages, sometimes to older men with the age inequality further compounding the
gender inequality, many child brides face the additional threat of IPV in the form of physical and emotional abuse. Again,
this phenomenon has been well documented in previous research (34,61). Leaving violent relationships can be challenging
particularly for young brides as there is sometimes family and societal pressure to maintain the marriage despite violence. If
women attempt to leave their abusive relationships they may then be at risk of abuse by their own families including
physical and emotional abuse as well as sexual exploitation, as they are often blamed for their failed marriages (62).
Children born into this cycle of violence are more likely to witness IPV and to experience DV (63), with this exposure
increasing the risk that the children will personally experience and perpetrate violence later in life (64–66), thus continuing
an intergenerational cycle of violence.
Gendered differences discussing SGBV risks
Although SGBV was noted to be an important issue for both men and women there was a gendered difference in how SGBV
risks were discussed. Female respondents mainly described experiences and/or fears of sexual harassment in the public
sphere and talked about the resultant limitations in their daily movement and freedom. Among women and girls, the notable
lack of dialogue around IPV and DV aligns with previous portrayals of IPV and DV as private issues. Challenging the privacy
of SGBV and attempts to address/report it has sometimes been perceived as a betrayal of family and a violation of social
cohesion (67,68). In contrast, men more explicitly and openly discussed sexual assault and sexual exploitation. In some
cases, male respondents identied commercial sex work as a form of sexual exploitation, often related to the family’s dire
economic needs similar to other research (69). It is noteworthy that there were
no
cases of sexual exploitation mentioned by
women or girls despite interviewing men and women from the same communities. This may be secondary to the stereotypic
differences in gender socialization whereby women are raised to shy away from talking about sex, but boys are socialized
with less taboo around sex (70). If the analysis had only included narratives from female participants, the more overt forms
of SGBV such as sexual exploitation and abuse would not have been appreciated. It is also likely that SenseMaker
contributed to this nding since it asks broad, open-ended questions, thus allowing participants to decide what they would
like to share. This observation may be relevant and have implications for the design of other SGBV research. Since many
SGBV studies focus exclusively on women and girls, they may be missing important ndings and our experience in the
current work would suggest that researchers should consider additionally including men and boys, particularly if
stereotypical taboos around sex are anticipated to prohibit women from sharing their experiences / concerns openly.
Strategies to Address SGBV
The study’s ndings demonstrate a varying array of SGBV threats faced by Syrian women and girls in Lebanon, and these
threats require a multi-pronged prevention and protection strategy.
1. Consider protection strategies in the context of refugee integration into the host community
First, protection strategies must consider particular SGBV risks arising from the integration of Syrian refugees into host
communities, and how inherent tensions likely contribute to feelings of insecurity and perceived SGBV threats. In Lebanon’s
ITS, Syrian women and girls have limited access to essential SGBV programs due to lack of transportation, as well as cost
and gendered expectations around mobility and domestic responsibilities. Recognizing that Syrian women and girls are a
hard-to-reach population, a few organizations have piloted mobile service provision and an initial evaluation of one model
showed promising potential to increase refugee’s social networks, knowledge and self-condence (71). A replication of such
mobile services nationwide may therefore have the potential to reduce barriers to SGBV services. Additionally, these
programs should serve as one-stop shops for women and girls where they can access different services all in one place,
while also following the GBV Call to Action 2016-2020 in emergencies by providing a minimum package of legal services,
case management, and referral.

Page 15/21
2. Addressing patriarchal social norms
Second, addressing SGBV must challenge patriarchal social norms and the socialization of men towards the use of
violence, in addition to raising awareness about the negative effects of SGBV. Engaging men in SGBV prevention
programming is critical to challenging social norms, attitudes and practices that increase the risk of SGBV while also
harnessing positive male power to prevent violence and promote safety. Veale et al. (72) found that, through guided
discussion on masculinity and gender roles, Syrian men talked about their changed circumstances as refugee men and
fathers. In this work, a safe emotional space was created for men to collectively talk about their problems, to become more
attuned and reective about their relationships with their wives and children, and to engage in better emotional regulation.
Through dialogue, men started to distance themselves from earlier responses of anger and frustration and became more
empathic and reective on their own needs as well as those of their families (72). Several other initiatives have been piloted
in Lebanon targeting men and boys as a means to alleviate the burden of some forms of SGBV, and in 2014 the Men
Engage Lebanon Country Network was launched (73) to harmonize these efforts, while ensuring minimal duplication of
interventions. Little evidence-based curricula are currently available to guide front-line staff on how to engage with men and
boys and future efforts should prioritise this gap to produce context specic and culturally sensitive tools.
3. Addressing structural drivers of SGBV including legal reform
Lastly, in line with Heise’s ecological model, which conceptualizes SGBV as being perpetuated through multi-layered factors
including intra-individual level, microsystem, exosystem and the macrosystem, programming efforts should also address the
overarching structural problems that contribute to SGBV (53). In their adapted social ecological model for GBV against
Syrian women in Lebanon, Yasmine and Moughalian (74) argue that interventions designed to focus on the intrapersonal
level fall short from effectively inuencing a change. They recommended that programming should aim at challenging
existing power dynamics and urged organizations to look at structural determinants that contribute to SGBV during forced
displacement, such as lack of employment, dire economic situation, as well as security and protection concerns (74). For
instance, Lebanon adopted legislation in 2014 aimed at better protecting women from SGBV, but feminist and women’s right
organizations argue that the law falls short of addressing all forms of SGBV and more robust legislation is called for (48,75)
especially when it comes to the protection of Syrian and other refugee populations. Further legal reforms are also necessary
including laws against street harassment and work protection laws, as well as modifying the age requirement for marriage
to 18 years. Additionally, policy reform to facilitate legal registration and obtaining ocial documents is urgently needed in
Lebanon since women and girls are vulnerable to sexual exploitation and assault, yet currently have little mechanism for
recourse without risking detention and deportation.
Strengths and Limitations
This qualitative study has several limitations. First, the sample is not representative of the Syrian refugee population in
Lebanon and therefore the results are not generalizable. Girls less than age 13 were excluded and since this study is
qualitative in nature there is no consideration of the subgroups’ balance. Second, due to time and human resource
constraints we were not able to analyze all male narratives, and this may have also introduced a bias. However, a systematic
sampling method was utilized in an effort to be objective. Third, the SenseMaker narratives are often quite brief, and without
the follow up questions typically asked in qualitative interviewing, the shared stories sometimes lack the detail and richness
expected of in-depth qualitative interviews. Finally, it was sometimes not clear whether the SGBV experiences described were
perceived to result from being a Syrian refugee, from being a female or from a combination of the two. The study also has a
number of strengths worthy of mention. Since the SenseMaker survey did not ask directly about SBGV, participants shared
their stories more naturally as part of their broader experiences. Moreover, the current analysis offers a variety of
perspectives from women and girls of different ages as well as from men and it illustrates the various SGBV risks faced by
female refugees who are integrated into their host communities rather than housed in formal refugee camps.
Conclusions

Page 16/21
Our ndings shed light on the importance of recognizing the impact of SGBV on the family as a whole in addition to each of
the individual members, and to also consider the cycle of SGBV not only across the woman’s lifespan but also across
generations. Furthermore, this analysis contributes to our understanding about the SGBV risks faced by female refugees
integrated into the host community rather than hosted in formal refugee camps, highlighting how SGBV is intimately related
to other aspects of social welfare as well as being part of the everyday lives of Syrian girls. Syrian girls are exposed to early
SGBV risks in the public such as harassment and assault, which sometimes leads to child marriage as the next form of
SGBV experienced. Within early / forced marriages, some girls face additional SGBV risks in the private sphere in the form of
IPV and/or DV. In this analysis, female respondents were more likely to share stories about sexual harassment, while male
respondents were more likely to discuss explicit forms of SGBV such as sexual exploitation, and this may have implications
for the design of future research focused on SGBV prevention and response.
Declarations
Ethics approval and consent to participate: This study protocol was approved by the Queen’s University Health Sciences and
Aliated Teaching Hospitals Research Ethics Board (Protocol # 6014981). All narratives were collected anonymously and
were treated with strict condentiality. Each participant reviewed the informed consent in Arabic and indicated consent by
ticking a box on the handheld tablet. Everyone, including minors under the age of 16, provided verbal informed consent.
Additional consent was not obtained from parents/guardians as the girls were considered emancipated (given that many of
them were already married). This was deemed appropriate by the ethics review board at Queen’s University. Participation in
the study was voluntary and no compensation was offered. Local ethics approval was deemed unnecessary by the
Lebanese collaborating partner and is not required by national regulations. Referral to support services was offered to all
participants who shared a story about SGBV.
Consent for publication: not applicable
Availability of data and material: The datasets used and/or analysed during the current study are available from the
corresponding author on reasonable request.
Competing interests: The authors declare that they have no competing interests.
Funding: Sexual Violence Research Initiative and the World Bank Group’s Development Marketplace for innovation on GBV
prevention
(in Memory of Hannah Graham),
Principal investigator, S. Bartels
The funder had no role in the study design, data collection, analysis or interpretation of the data, writing of the manuscript,
or in the decision to submit this work for publication.
Authors’ contributions: S.A.B. and S.M. conceived study design. S.A.B. designed study survey with input from S.M.. S.A.B.,
S.M. conducted the pilot. S.M. directed eld implementation and oversaw recruitment of interviewers and team leads. S.A.B.
designed interviewer training with S.M., S.A.B. and S.G. leading the training. S.R. and H.B. assisted in quality control during
data collection. Analysis was done by S.R. with support of S.G. and H.B. and supervised by S.A.B.. H.G. contributed in edition
and revision of the manuscript. S.R. drafted initial manuscript with all
authors contributed to writing. All involved authors gave their consent to the nal manuscript. Acknowledgements: We are
thankful for the efforts of ABAAD Resource Center for Gender Equality team for their management, eld coordination and
technical support.
Abbreviations

Page 17/21
DV Domestic Violence
IPV Intimate Partner Violence
ITSs󰁅 Informal Tented Settlements󰁅
SGBV Sexual and Gender-Based Violence
UN United Nations
References
1. UNHCR. Syria conict at 5 years: the biggest refugee and displacement crisis of our time demands a huge surge in
solidarity [Internet]. 2016 [cited 2020 Jun 29]. Available from:
https://www.unhcr.org/afr/news/press/2016/3/56e6e3249/syria-conict-5-years-biggest-refugee-displacement-crisis-
time-demands.html
2. UNHCR. Situation Syria Regional Refugee Response [Internet]. 2020 [cited 2020 Jun 9]. Available from:
https://data2.unhcr.org/en/situations/syria/location/71
3. Watch HR. Syrian Country Summary [Internet]. 2017. Available from:
https://www.hrw.org/sites/default/les/syria_1.pdf
4. Kelley N. Responding to a Refugee Inux: Lessons from Lebanon [Internet]. Vol. 5, JMHS. 2017 [cited 2020 Jun 9].
Available from: http://www.
5. Situation Syria Regional Refugee Response [Internet]. [cited 2020 Jun 29]. Available from:
https://data2.unhcr.org/en/situations/syria/location/71
6. Benage M, Gregg Greenough P, Vinck P, Omeira N, Pham P. An assessment of antenatal care among Syrian refugees in
Lebanon. Con Health [Internet]. 2015 Feb 26 [cited 2020 Jun 29];9(1):8. Available from:
https://conictandhealth.biomedcentral.com/articles/10.1186/s13031-015-0035-8
7. Saadallah, S Baker D. Women and Girls in the Syria Crisis: UNFPA Response - Facts and Figures [Internet]. 2016.
Available from: https://www.unfpa.org/resources/women-and-girls-syria-crisis-unfpa-response-facts-and-gures
8. UNHCR. Survey nds Syrian refugees in Lebanon became poorer, more vulnerable in 2017 [Internet]. 2018 [cited 2020
Jun 29]. Available from: https://www.unhcr.org/news/brieng/2018/1/5a548d174/survey-nds-syrian-refugees-
lebanon-poorer-vulnerable-2017.html
9. Vulnerability Assessment of Syrian Refugees in Lebanon [Internet]. 2017. Available from:
https://reliefweb.int/sites/reliefweb.int/les/resources/VASyR 2017.compressed.pdf
10. Akesson B, Badawi D. “My Heart Feels Chained”: The Effects of Economic Precarity of Syrian Refugee Parents Living in
Lebanon.
11. Nader H. VIOLENCE AGAINST REFUGEE WOMEN AND MITIGATION PROGRAMS: Highlighting the perspectives of Syrian
refugees. 2018 Aug.
12. International A. Lebanon: Wave of hostility exposes hollowness of claims that Syrian refugee returns are voluntary
[Internet]. 2019 [cited 2020 Jun 29]. Available from: https://www.amnesty.org/en/latest/news/2019/06/lebanon-wave-
of-hostility-exposes-hollowness-of-claims-that-syrian-refugee-returns-are-voluntary/
13. Janmyr M. Precarity in Exile: The Legal Status of Syrian Refugees in Lebanon. Refug Surv Q. 2016 Dec 1;35(4):58–78.
14. Chalcraft J. The Invisible Cage: Syrian Migrant Workers in Lebanon [Internet]. 2009 [cited 2020 Jun 29]. Available from:
https://www.sup.org/books/title/?id=15882
15. Watch HR. Lebanon: Residceny Rules Put Syrians at Risk [Internet]. 2016. Available from:
https://www.hrw.org/news/2016/01/12/lebanon-residency-rules-put-syrians-risk.
16. El-Masri R, Harvey C, Garwood R, Oxfam GB, Oxfam, ABAAD Resource Center for Gender Equality. Shifting sands :
changing gender roles among refugees in Lebanon. Oxfam International; 2013. 42 p.

Page 18/21
17. Committee IR. Syrian Women & Girls: Fleeing death, facing ongoing threats and humiliation [Internet]. 2012. Available
from: https://data2.unhcr.org/en/documents/details/36572
18. Usta J, Farver JM, Hamieh CS. Effects of Socialization on Gender Discrimination and Violence Against Women in
Lebanon. Violence Against Women [Internet]. 2016 Mar 18 [cited 2020 Jun 29];22(4):415–31. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/26385360
19. Alsaba K, Kapilashrami A, Kapilashrami B A Phd A, Macmillan C. Reproductive Health Matters An international journal
on sexual and reproductive health and rights Understanding women’s experience of violence and the political economy
of gender in conict: the case of Syria Understanding women’s experience of violence . Reprod Health Matters [Internet].
2016 [cited 2020 Jun 29];24:5–17. Available from: https://www.tandfonline.com/action/journalInformation?
journalCode=zrhm21
20. Nations U. Resolution adopted by the General Assembly on 25 September 2015 [Internet]. 2015. Available from:
http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E
21. Committee I-AS. Guidelines for Integrating Gender-Based Violence Interventions in Humanitarian Action – Reducing risk,
promoting resilience and aiding recovery [Internet]. 2015 [cited 2020 Jun 29]. Available from:
https://gbvguidelines.org/en/
22. UNDP. Tenth Consolidated Annual Progress Report on Activities Implemented under the UN Action Against Sexual
Violence in Conict Fund Report of the Administrative Agent of the UN Action Against Sexual Violence in Conict Fund
for the period [Internet]. 2018 [cited 2020 Jun 29]. Available from: http://mptf.undp.org
23. Committee I-AS. Report of the task force on protection from sexual exploitation and abuse in humanitarian crises
[Internet]. 2002. Available from: https://www.unicef.org/emergencies/les/IASCTFReport.pdf
24. Beyrer C, Kamarulzaman A. Ethnic cleansing in Myanmar: the Rohingya crisis and human rights [Internet]. Vol. 390, The
Lancet. Lancet Publishing Group; 2017 [cited 2020 Jun 29]. p. 1570–3. Available from:
http://www.thelancet.com/article/S0140673617325199/fulltext
25. Hägerdal N. Ethnic Cleansing and the Politics of Restraint: Violence and Coexistence in the Lebanese Civil War. J
Conict Resolut [Internet]. 2019 Jan 3 [cited 2020 Jun 29];63(1):59–84. Available from:
http://journals.sagepub.com/doi/10.1177/0022002717721612
26. Gingerich, Tara Leaning J. The Use of Rape as a Weapon of War in Darfur, Sudan [Internet]. 2004 [cited 2020 Jun 29].
Available from: https://phr.org/our-work/resources/the-use-of-rape-as-a-weapon-of-war-in-darfur-sudan/
27. Clark JN. Untangling Rape Causation and the Importance of the Micro Level: Elucidating the Use of Mass Rape during
the Bosnian War. Ethnopolitics [Internet]. 2017 Aug 8 [cited 2020 Jun 29];16(4):388–410. Available from:
https://www.tandfonline.com/doi/abs/10.1080/17449057.2016.1165919
28. Peterman A, Palermo T, Bredenkamp C. Estimates and determinants of sexual violence against women in the
Democratic Republic of Congo. Am J Public Health [Internet]. 2011 Jun 1 [cited 2020 Jun 29];101(6):1060–7. Available
from: https://pubmed.ncbi.nlm.nih.gov/21566049/
29. Watch HR. Iraq: ISIS Escapees Describe Systematic Rape. Yezidi Survivors in Need of Urgent Care [Internet]. 2015.
Available from: https://www.hrw.org/news/2015/04/14/iraq-isis-escapees-describe-systematic-rape
30. Piscitelli V, Iadicicco A, De Angelis D, Porta D, Cattaneo C. Italy’s battle to identify dead migrants [Internet]. Vol. 4, The
Lancet Global Health. Elsevier Ltd; 2016 [cited 2020 Jun 29]. p. e512–3. Available from:
https://pubmed.ncbi.nlm.nih.gov/27443771/
31. Barbara G, Collini F, Cattaneo C, Marasciuolo L, Chiappa L, Fedele L, et al. Sexual violence and unwanted pregnancies in
migrant women [Internet]. Vol. 5, The Lancet Global Health. Elsevier Ltd; 2017 [cited 2020 Jun 29]. p. e396–7. Available
from: https://pubmed.ncbi.nlm.nih.gov/28288742/
32. Davis L. Syrian women refugees: out of the shadows. Publ Res [Internet]. 2015 Jan 1 [cited 2020 Jun 29]; Available
from: https://academicworks.cuny.edu/cl_pubs/54

Page 19/21
33. Maziak W, Asfar T. Physical abuse in low-Income women in Aleppo, Syria. Health Care Women Int [Internet]. 2003 [cited
2020 Jun 29];24(4):313–26. Available from: https://pubmed.ncbi.nlm.nih.gov/12746003/
34. Charles L, Denman K. Syrian and Palestinian Syrian Refugees in Lebanon: the Plight of Women and Children. J Int
Womens Stud [Internet]. 2013 Dec 23 [cited 2020 Jun 29];14(5). Available from:
https://vc.bridgew.edu/jiws/vol14/iss5/7
35. Held D. Political theory today. Stanford University Press; 1991.
36. Evans M. Introducing Contemporary Feminist Thought. 1991. 176 p.
37. International C. Syrian Refugee Women’s Roles. How the Conict has affected the role of women within their families
and communities (positively and negatively) within refugee hosting communities in Lebanon, Jordan, and Turkey. 2020.
38. Bartels SA, Michael S, Roupetz S, Garbern S, Kilzar L, Bergquist H, et al. Making sense of child, early and forced
marriage among Syrian refugee girls: A mixed methods study in Lebanon. BMJ Glob Heal. 2018;3(1):1–12.
39. Mourtada R, Schlecht J, Dejong J. A qualitative study exploring child marriage practices among Syrian conict-affected
populations in Lebanon. Con Health [Internet]. 2017 Nov 14 [cited 2020 Jun 29];11(S1):27. Available from:
https://conictandhealth.biomedcentral.com/articles/10.1186/s13031-017-0131-z
40. Al-Tuwaijri S. Gender-Based Violence and Child Protection among Syrian Refugees in Jordan with a Focus on Early
Marriage. 2013.
41. UNHCR. Syria Regional Refugee Response [Internet]. 2013. Available from:
http://data.unhcr.org/syrianrefugees/country.php?id=122
42. Watch HR. Lebanon: Syrian Women at Risk of Sex Tracking [Internet]. 2016. Available from:
https://www.hrw.org/news/2016/07/28/lebanon-syrian-women-risk-sex-tracking
43. Michael, Saja Roupetz, Sophie. Bartels SA. Caught in Contradiction: Making Sense of Child Marriage among Syrian
Refugees in Lebanon [Internet]. 2018 [cited 2020 Jun 29]. Available from: https://www.girlsnotbrides.org/resource-
centre/caught-in-contradiction-making-sense-of-child-marriage-among-syrian-refugees-in-lebanon/
44. SenseGuide. Sensemaker monitoring narratives on a large scale for social impact [Internet]. 2016 [cited 2020 Jun 9].
Available from: http://senseguide.nl/en/sensemaker-narrative-monitoring/
45. Bakhache N, Michael S, Roupetz S, Garbern S, Bergquist H, Davison C, et al. Implementation of a SenseMaker® research
project among Syrian refugees in Lebanon. Glob Health Action [Internet]. 2017;10(1). Available from:
https://doi.org/10.1080/16549716.2017.1362792
46. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.
47. Vaismoradi, Mojtaba Turunen, Hannele Bondas T. Content analysis and thematic analysis: Implications for conducting
a qualitative descriptive study. Nurs Health Sci. 2013;15(3):398–405.
48. Watch HR. Lebanon: Domestic Violence Law Good, but Incomplete [Internet]. 2014. Available from:
https://www.hrw.org/news/2014/04/03/lebanon-domestic-violence-law-good-incomplete
49. Refaat MM, Mohanna K. Syrian refugees in Lebanon: facts and solutions. 2013 [cited 2020 Jun 29]; Available from:
http://ees.elsevier.com/thelancet/www.thelancet.com
50. Armstrong M. Lebanon resists granting work permits to Syrian refugees | Middle East Eye [Internet]. 2016 [cited 2020
Jun 9]. Available from: https://www.middleeasteye.net/news/lebanon-resists-granting-work-permits-syrian-refugees
51. Rights U for J and H. Syrian Women Refugees in Lebanon: Houses without Walls Project Promoting and Supporting
Women Victims of Gender-based Violence in Refugee Camps outside Syria. 2018.
52. International A. Lebanon: Refugee women from Syria face heightened risk of exploitation and sexual harassment
[Internet]. 2016 [cited 2020 Jun 29]. Available from: https://www.amnesty.org/en/latest/news/2016/02/lebanon-
refugee-women-from-syria-face-heightened-risk-of-exploitation-and-sexual-harassment/
53. Heise L. Violence against women: an integrational, ecological framework. Violence Against Women. 1998;4(3):262–90.

Page 20/21
54. Promundo UW&. International Men and Gender Equality Survey [Internet]. 2017 [cited 2020 Jun 9]. Available from:
https://promundoglobal.org/programs/international-men-and-gender-equality-survey-images/#
55. Cherri Z, Cuesta JG, Rodriguez-Llanes JM, Guha-Sapir D. Early marriage and barriers to contraception among syrian
refugee women in lebanon: A qualitative study. Int J Environ Res Public Health [Internet]. 2017 Aug 1 [cited 2020 Jun
29];14(8). Available from: /pmc/articles/PMC5580540/?report=abstract
56. Bartels, Susan Andrea, Michael, Saja, Bunting A. Child Marriage Among Syrian Refugees in Lebanon: At the Gendered
Intersection of Poverty, Immigration, and Safety. Manuscr Submitt Publ.
57. Khawaja M, Tewtel-Salem M. Agreement between husband and wife reports of domestic violence: evidence from poor
refugee communities in Lebanon. © Int Epidemiol Assoc [Internet]. 2004 [cited 2020 Jun 29];33(3):526–33. Available
from: https://academic.oup.com/ije/article-abstract/33/3/526/716603
58. Noll JG, Horowitz LA, Bonanno GA, Trickett PK, Putnam FW. Revictimization and self-harm in females who experienced
childhood sexual abuse: results from a prospective study. J Interpers Violence [Internet]. 2003 Dec 2 [cited 2020 Jun
29];18(12):1452–71. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14678616
59. Ouis P. Honourable traditions? Honour violence, early marriage and sexual abuse of teenage girls in lebanon, the
occupied palestinian territories and yemen. Int J Child Rights. 2009;17(3):445–74.
60. Spencer D. To protect her honour: child marriage in emergencies–the fatal confusion between protecting girls and
sexual violence. Gender and protection in humanitarian contexts: critical issues series. 2015.
61. Usta J, Masterson AR, Farver JAM. Violence Against Displaced Syrian Women in Lebanon. J Interpers Violence
[Internet]. 2019 Sep 1 [cited 2020 Jun 29];34(18):3767–79. Available from:
https://pubmed.ncbi.nlm.nih.gov/29294605/
62. Ghanim D. Gender and Violence in the Middle East. Praeger; 2009.
63. Øverlien C. Children exposed to domestic violence: Conclusions from the literature and challenges ahead. J Soc Work.
2010 Jan;10(1):80–97.
64. Abramsky T, Watts CH, Garcia-Moreno C, Devries K, Kiss L, Ellsberg M, et al. What factors are associated with recent
intimate partner violence? ndings from the WHO Multi-country Study on women’s Health and Domestic Violence. BMC
Public Health [Internet]. 2011 Feb 16 [cited 2020 Jun 29];11(1):1–17. Available from:
https://link.springer.com/articles/10.1186/1471-2458-11-109
65. Dodge, KA, Bates, JE, Pettit G. Mechanisms in the cycle of violence. Science (80- ). 1990;250(4988):1678–83.
66. Noll JG. Does childhood sexual abuse set in motion a cycle of violence against women? What we know and what we
need to learn. J Interpers Violence [Internet]. 2005 Apr [cited 2020 Jun 29];20(4):455–62. Available from:
https://pubmed.ncbi.nlm.nih.gov/15722501/
67. Sharara. What do you say on Gender? Saqi Books: Lebanon; 2012.
68. Abadeer A. Norms and Gender Discrimination in the Arab World [Internet]. 2015 [cited 2020 Jun 29]. Available from:
https://books.google.co.uk/books?hl=de&lr=&id=vgreCgAAQBAJ&oi=fnd&pg=PP1&dq=Abadeer,+A.+S.+
(2015).+Norms+and+gender+discrimination+in+the+Arab+world.+Springer.&ots=hNSSUESnIG&sig=uZ4QqUd5ezg1G0f-
hPIqFKSfBEA&redir_esc=y#v=onepage&q&f=false
69. Samari G. The Re s pon se to Sy rian Re fu gee Wo men’s Health Nee ds in Le ba non, Tur key and Jordan [Internet]. 2014.
Available from: https://www.humanityinaction.org/knowledge_detail/the-response-to-syrian-refugee-womens-health-
needs-in-lebanon-turkey-and-jordan-and-recommendations-for-improved-practice/?lang=de
70. Ercevik Amado L. Sexual and Bodily Rights as Human Rights in the Middle East and North Africa. Reprod Health
Matters [Internet]. 2004 Jan 18 [cited 2020 Jun 29];12(23):125–8. Available from:
https://www.tandfonline.com/doi/full/10.1016/S0968-8080%2804%2923119-6
71. Lilleston P, Winograd L, Ahmed S, Salamé D, Al Alam D, Stoebenau K, et al. Evaluation of a mobile approach to gender-
based violence service delivery among Syrian refugees in Lebanon. [cited 2020 Jun 29]; Available from:

Page 21/21
https://academic.oup.com/heapol/article-abstract/33/7/767/5037237
72. Veale A, Hijazi A, Osman Z, Macken S. Engaging Men to Support the Resilience of Syrian Refugee Children and Youth in
Lebanon. In 2020. p. 25–42.
73. Bartelink B, Le Roux E, Levinga MW, Bartelink BE, Le Roux E, Levinga MW. ‘WORKING EFFECTIVELY WITH FAITH
LEADERS TO CHALLENGE HARMFUL TRADITIONAL PRACTICES.’ 2017.
74. Yasmine R, Moughalian C. Systemic violence against Syrian refugee women and the myth of effective intrapersonal
interventions. Reprod Health Matters. 2016 May 1;24(47):27–35.
75. Gender-Related Laws, Policies and Practices in Lebanon. 2018.