Sam's loss of agency was a recurring theme through the series. The sexual assaults that he endured from various parties were just one aspect of that. We had his repeated possessions, where his body wasn't his to control (Meg and Gadreel). We had the numerous times when decisions were made for Sam that he was opposed to but forced to endure (having his damaged soul restored for example). We had the fact that nearly every facet of his life growing up was all part of a grand plan to shape him into being Lucifer's ideal vessel. And then we had all of the smaller abuses. The way his sacrifices were mocked or diminished in order to elevate other characters (Dean primarily, but Castiel as well). We had him abused and insulted for things that were entirely out of his control. We saw his genuine faith mocked and belittled by the beings that were supposed to respect it.
And we never saw his accomplishments given the same respect by the show writers as Dean's were. How many times did it make literary sense for Sam to get the big kill, but it was given to Dean. All of the adversaries that tormented Sam, like Azazel and Lucifer, were ultimately killed by Dean. But there was always plenty of blame to be assigned to Sam. Dean broke the first seal and went on to torture others in hell, but that was treated as a grand tragedy worthy of angelic rescue. Sam killed Lilith after being manipulated and lied to by both the angels and demons around him, but he then had to shoulder the blame for releasing Lucifer from his cage (and returning him became his sole responsibility). The violation of repeated possessions and the strength it took to overcome them was often handwaved away, but then we spent multiple episodes with woobie Dean having to deal with Michael (who he willingly became the vessel of).
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