Violence against women and mental illness are two of the most pressing issues in higher education. Despite decades of research, it is not entirely clear how subjective perceptions of victimization events shape distress. The current study integrates trauma perspectives and a symbolic interactionist approach to demonstrate how identity disruption and the violation of cultural meanings for identities leads to posttraumatic stress. In an online survey of female and non-cisgender college students at a southeastern public university, the identity disruption produced by sexual assault is positively associated with posttraumatic stress; this relationship is partially explained by re-identifying oneself as a “victim,” an identity that is considered deviant and powerless in U.S. society. The current study illuminates the relationships between sexual assault, stigmatized identities, and mental health while addressing sociological questions about the cultural meanings and disruption of identities through traumatic interactions.