Victims of rape, sexual slavery and forced marriage at the hands of Islamic State militants in Iraq have described a “horrific” pattern of abuse, according to a new Human Rights Watch report.

The harrowing accounts came from 20 Yazidi women and girls who escaped from ISIS in northern Iraq between September 2014 and January of this year.

Half of the victims, including two 12-year-old girls, told Human Rights Watch investigators that they were raped, some of them repeatedly and by multiple men. 

Nearly all the victims said they had been forced into marriages, sold or given to ISIS fighters as “gifts.”

Human Rights Watch said those accounts were corroborated by community leaders, as well as local and international medical workers and service providers.

Yazidis are a religious minority in northern Iraq and they have been viciously persecuted by ISIS. Stories of Yazidi women and girls being snatched from their families and abused by militants have been well-documented.

Earlier this month, ISIS released more than 200 Yazidi captives, including children and the elderly, after holding them for eight months. Other captured Yazidis continue to escape and make their way back to their communities, but they face huge challenges upon return. 

Dr. Samantha Nutt, the founder and executive director of War Child Canada, said community reintegration is especially difficult for Yazidi girls, who are stigmatized and sometimes shunned because they were raped.

“These are young women who will have enormous medical needs in the short term, for which they will need to be treated,” Nutt told CTV’s Canada AM Friday.

But it’s the long-term psychological and social support that will be more difficult to obtain, with local resources stretched to the limit.

In its report, Human Rights Watch said not all victims of ISIS have immediate access to medical treatment, emergency contraception and psychological support.

The systematic rapes and sexual slavery will have a “generational impact” on Yazidis and other victims of ISIS, especially those who end up pregnant, Nutt said.

“Unfortunately, rape in war is pervasive,” she said.

Human Rights Watch said all of the women and girls it interviewed “exhibited signs of acute emotional distress.

“Several said they had attempted suicide during their captivity or witnessed suicide attempts to avoid rape, forced marriage, or forced religious conversion.”

Human Rights Watch is calling on ISIS commanders to release all captured civilians and end sexual violence. It’s also calling on international agencies to step up their humanitarian efforts in the region.