For one in every 16 women in the U.S., their first sexual encounter was rape, according to a new study that attempted to understand the reproductive, gynecological and physical health effects of forced initiation into sex for girls and women. That translates to a whopping 3.35 million rape survivors — let that sink in.

Those who experienced assault or coercion into sexually activity for the first time reported higher rates of abortions, unwanted pregnancies and a host of physical and mental health problems, according to the study published in the Journal of the American Medical Association.

U.S. researchers surveyed government data, from 2011 to 2017, of 13,310 women between the ages of 18 and 44 and found 6.5% of them were raped the first time they had intercourse. The average age when these women — nay, minor girls — were raped was 15.6 years, compared to 17.4 years for women who reported a consensual first sexual experience.

“We’re talking about girls here,” Dr. Laura Hawks, lead author of the study and a researcher at Cambridge Health Alliance and Harvard Medical School said, in an email to Reuters. “We need a dramatic cultural shift to make sure young girls of all races are safe in their homes and schools, that we have an environment where they can seek help when it’s needed, and that we have resources readily available to provide treatment when violence occurs.”

The trauma of rape as a first sexual experience also leaves a legacy of negative health outcomes for the survivor, found the study.

Rape survivors were twice as likely to have an unwanted pregnancy over the course of their lives, and 50% more likely to have an abortion, than those who had a voluntary first sexual experience. Rape survivors were also 60% more likely to develop endometriosis, 80% more likely to have menstrual problems and twice as likely to contract pelvic inflammatory disease. Gynecological effects aside, rape survivors were also three times more likely to use illegal drugs, twice as likely to have poor health and more than twice as likely to face difficulties in completing tasks due to the aforementioned poor physical and mental health.

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“Obviously a forced sexual experience can result in physical trauma to the genital areas of the body, transmission of HIV or another sexually transmitted disease, or unwanted pregnancy,” Dr. Alison Huang, author of an editorial accompanying the study and a professor of medicine at the University of California, said to Reuters. “But for many women, it’s likely that the most severe or enduring consequences of this event are not directly related to one of any of the above. Instead, they may arise from the emotional trauma that women experience from being forced or coerced into sex at an early and vulnerable time in their lives.”

According to the U.S. Centers for Disease Control and Prevention’s 2010 National Intimate Partner and Sexual Violence Survey, one out of five women and one out of 71 men will be raped in their lifetime. Closer to home, 106 women were raped every day in India in 2016 — the most recent year for which official statistics are available — with the rapist knowing the victim/survivor in nearly 95% of the cases, reports The Times of India. But that number — 106 women — is only an average taken from the 0.9% of rapes that actually get reported in the first place. We don’t even know about 99.1% of the cases of sexual violence that take place but go unreported, according to a National Family Health Survey released last year, as reported by LiveMint.

How much more mind-boggling data will it take for law and policymakers and adjudicators across the world to sit up and notice that sexual violence against women and girls is not just an interpersonal offense? It is and has always been a pandemic-level public health emergency, the kind for which you pull out all the political, legislative, educational, judicial and financial stops; anything less than that will simply not work.