More than half of female survivors of sexual violence in Greater Manchester did not receive enough support, according to researchers.
Their experiences have been published in a report compiled by Manchester Metropolitan University (MMU) and three different charities.
Researchers spoke to nearly 400 women who had suffered sexual violence.
There needs to be "urgent action" to address the "shocking lack of adequate provision", said researcher Kate Cook.
Dr Cook, head of MMU's Sylvia Pankhurst Gender Research Centre, said: "Hundreds of women who are survivors of abuse in Greater Manchester lack support, right now.
"Women have experienced some poor service from a wide range of agencies."
Many women told researchers how they felt judged and silenced, and that they did not know where to go for help.
In particular, those who live away from Manchester city centre struggled to find specialist support.
The report was written by Voices of Survivors: Hearing Women for Change - a research project by MASH (Manchester Action on Street Health), Manchester Rape Crisis, Trafford Rape Crisis and MMU.
- 56% said they had not been able to access the support they needed
- 173 women said they had been raped
- 153 women said they had been victims of child sexual abuse
- 84 women said they had experienced sexual abuse in the home
- For four women, completing the questionnaire was the first time they had disclosed what had happened to them
- One woman said: "I have never told anyone about it for fear of being judged."