Horrifying details about what the hostages experienced

Handcuffed and dazed, she tries to climb out of the trunk of the Jeep. She is barefoot and limping. She is bleeding from her temple. Her ankle is cut.

Her gray sweatpants are covered in blood. She is dragged into the vehicle at gunpoint by her long brown hair. A crowd of people watches. The car speeds away.

This is the last time 19-year-old Naama Levy was seen alive, as seen in a video taken on October 7. She is one of 17 female hostages between the ages of 18 and 26 still being held by Hamas somewhere in Gaza.

Their families fear the worst.

“Naama is running out of time,” said Levy’s mother, Ayelet Levy Shachar. “Time is running out for defenseless young women who are being held hostage by those who torture and abuse them.”

Shachar was referring to growing evidence of rape, sexual violence and mutilation of women and men during Hamas attacks in southern Israel on October 7.

But the sexual assaults do not appear to have been limited to Oct. 7. Two Israeli doctors who treated released hostages and an Israeli military official familiar with the matter confirmed to USA TODAY that some released hostages have said they were victims of brutal sexual assaults while in captivity.

All three spoke on condition of anonymity.

One of the doctors estimated that “many” of the released Israeli female hostages aged between 12 and 48 – about 30 people – were sexually abused during their captivity in Gaza.

Out of concern for the survivors, the doctor declined to elaborate on the exact nature of the assaults. He said the death rate for people who have been sexually abused is typically four times higher than for people who have not been sexually abused.

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The second doctor said many of the freed hostages showed signs of post-traumatic stress disorder and “came to us as patients with the trauma of those who have witnessed serious sexual assault.”

The first doctor said all released hostages of childbearing age had been given pregnancy tests and screened for sexually transmitted diseases.

The Hostages and Missing Persons Families Forum, a group representing the families of those held captive by Hamas, recently published a selection of anonymous quotes purporting to come from a meeting between some of the released hostages and their families with the Israeli war cabinet.

“First of all, they touch our girls,” said one of the released hostages at the meeting.

“My mother almost fainted here (during the cabinet meeting) because she knows what is going on there. She saw what was done to the men,” said the daughter of another released hostage.

The Israeli military official said authorities knew that many women were sexually assaulted in their homes during the Supernova music festival and on October 7, and that they “were also raped while in Hamas captivity.”

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The official said that “we know” the remaining female hostages are being held in “very poor psychological and physical conditions.” He said the hostages are being beaten, lack access to adequate food, water and medicine, and are being held in southern Gaza, where they are being moved from house to house, sometimes on the ground and sometimes through tunnels to avoid detection.

The official said some of the information came from statements made by the released hostages and other parts from the Israeli intelligence network. The official declined to comment.

President Joe Biden, who has sought to balance support for Israel’s retaliation against Hamas with concern for Palestinian civilians, has strongly condemned reports of Hamas sexual violence against Israeli women and girls, calling them “appalling and unforgivable.”

“We must all condemn such brutality without reservation and without exception,” Biden said this month at a Hanukkah reception at the White House.

In mid-December, 33 US senators wrote a letter to UN Secretary-General António Guterres calling on the international body to immediately launch an independent investigation into Hamas’s sexual assault on October 7. Volker Turk, the UN High Commissioner for Human Rights, claimed that Israel had blocked his team’s investigators.

Five volunteers and first responders who collected and helped identify the bodies of those killed on Oct. 7 said they observed several signs of obvious and undeniable sexual violence, including women naked from the waist down, with their legs spread or their underwear torn. USA TODAY was shown photos and videos that appeared to confirm those claims, which were confirmed by medical examiners.

“We went from house to house and never knew what we would find,” said Nachman Dickstein, a volunteer with ZAKA, a search and rescue group that works closely with the Israeli military and government.

Israeli medical and morgue officials said many of the women who died on October 7 had broken legs and pelvic bones. They said the mutilations were so severe that it was not always possible to distinguish female from male victims. At least one survivor of the attack, who was at the Supernova music festival, has told Israeli police she witnessed a gang rape.

Despite the evidence, Hamas has denied allegations that it used sexual violence on October 7. It claims the allegations are part of an attempt by Israel to distract from the mass killings of civilians in Gaza. International human rights groups waited two months before finally condemning the sexual violence.

The evidence of the sexual violence on October 7 is “overwhelming and irrefutable,” said Carly Pildis, director of community engagement at the Anti-Defamation League, an advocacy group that campaigns against anti-Semitism and extremism.

“The voices of so many of these women and girls were stolen by Hamas, but their bodies tell the story,” Pildis said. “Broken pelvises. Mutilated genitals. Abused bodies. Then eyewitnesses come forward with stories of gang rape, torture and murder.”

Anti-Jewish prejudices make it easier for some people not to believe these reports, says Pildis.

“We live in an era where all women are believed, and that philosophy has somehow disappeared very quickly when it comes to Israeli women,” she said. “It’s really hard not to see that as deep-rooted anti-Semitism, as deep-rooted bias that leads people to not want to believe those voices.”

However, one of the doctors who treated the freed hostages said that determining whether sexual assault was involved is not an easy task. First of all, physical evidence in the form of bodily fluids, cuts and bruises can disappear quickly, and oral statements from victims can take months, years or even decades to arrive.

“In the first few days after the hostages were released, they talked mostly about not having enough to eat. Then they started talking about how children were separated and left alone in isolated rooms. Then they talked about Hamas’ aggressiveness and how some sick and elderly people were denied their medicine. Finally, physical violence occurred. It happened step by step, as testimony of sexual violence usually does.”

The doctor said it took decades in Israel for soldiers who were kidnapped and sexually abused during the 1973 Yom Kippur War between Israel and a coalition of Arab countries led by Egypt and Syria to begin speaking out about their experiences.

It is not uncommon for victims of sexual violence to not remember what happened for long periods of time and to recall details later, says Jim Hopper, a US clinical psychologist and nationally recognized expert on psychological trauma.

Sexual assault is so horrific that some victims virtually shut down while it is happening, he said. Some feel like they are floating on the ceiling or like they are dreaming or in a movie and therefore may not be aware of what is actually happening to them, Hopper said.

Later, they may come across something – a particular place, person or event, for example – that acts as a trigger and allows them to remember specific information stored in their brain about the assault, Hopper said.

Defense attorneys often point to a victim’s delayed recall or inconsistencies in their memories to cast doubt on the victim’s credibility, but research suggests that only 5% of sexual assault reports are false, Hopper said.

Chen Goldstein-Almog, a released hostage held by Hamas in the Gaza Strip, told Israeli broadcaster Kan that three women held hostage with her had told her stories of sexual abuse by their captors.

Goldstein-Almog, 48, did not say whether she herself had been sexually abused.

One of the doctors who treated the released hostages said one of the clearest examples of how Hamas might treat hostages still in captivity was Levy, the bloodied 19-year-old woman caught on video being dragged into the back of a jeep at gunpoint.

Her mother, Shachar, said she could barely watch the video of her daughter. She describes her as a “cheerful”, good-natured young woman who likes to dance with her friends, enjoys athletics and dreams of a career as a diplomat.

Every moment is the most indescribable pain Shachar has ever felt. Her heart is broken. Her nights are haunted by absence.

Contributors: Michael Collins and Maureen Groppe. Illustrations by Veronica Bravo.

If you are a victim of sexual assault, RAINN offers support through the National Sexual Assault Hotline (800.656.HOPE & online.rainn.org).

This article originally appeared on USA TODAY: Sexual violence: New details about the lives of hostages in Hamas captivity