Child sexual abuse is defined by the ACE study as “an adult or person at least 5 years older than you touching or fondling you or having you touch their body in a sexual way, or trying to or actually having oral, anal, or vaginal sex with you”. There is no single, perfect definition of child sexual abuse but this is pretty close.
Child sexual abuse is among the most common ACEs, and it is the only one frequently perpetuated by someone outside the child’s family. Child sexual abuse is almost always committed by someone the child has a relationship with, and because of that children can experience very complex and confusing traumas; they may become intensely afraid of the perpetrator, or they may care about the perpetrator very deeply and see the abuse as something worth enduring in order to maintain that relationship. The abusive acts themselves may be painful or may not be, which can cause massive confusion and shame in the child. Sexually abused children may become deeply fearful of anything that reminds them of sexual contact or they may become sexually precocious, possibly to the point they are sexually offending against other children (some estimate that 40% of sexual abuse is committed by minors). And this wide spectrum of painful behaviors and consequences is further masked by a deep stigma and ignorance, often willful.
Physical evidence of child sexual abuse is rare, and because of the complexity of the trauma and relationship with the abuser, victims seldom disclose the abuse until adulthood.
What causes someone to sexually abuse a child? There is no one, simple answer, and there is also some disagreement among experts. We do know that one significant contributing factor is sexual attraction to children. The word “pedophile” is a medical term that refers to a consistent, significant sexual attraction to prepubescent children. The term is often misused to refer to someone who has sexually abused children. The percentage of pedophiles who will go on to sexually abuse children is unknown. Besides the arousal at the sight of children, other factors that contribute to someone’s willingness to sexually abuse them are attraction to the power imbalance inherent to a relationship with a child and the innocence and adoration that children bring into relationships. With minors who sexually offend there is a very strong connection to their own sexual abuse; with adults this link is more disputed.
All children are at some risk of being sexually abused, regardless of what zip code or tax bracket they live in, but some factors appear to make children at higher risk. Children who are disabled, particularly in ways that impair their ability to communicate, appear to be at higher risk of sexual abuse, as do children living in rural and inner-city areas. The causes of these correlations are unclear; it is likely that disabled children are more appealing victims, and they are also likely to have more trusted adults around them in the form of aides, therapists, etc. The correlations between children in urban and rural areas could be related to limited options for child care, a greater cultural tendency to rely on extended family and peers, rather than vetted institutions, to watch children, it could be related to parental trauma that limits the parents’ ability to move from economically depressed areas, or it could be something else entirely.
With as many gaps in our knowledge of child sexual abuse as there are, it seems logical that there are also gaps in our knowledge of how to prevent it. Child sexual abuse is illegal; but prosecution is tricky. Children don’t always present in court the way a judge or jury expects them to and there is rarely medical evidence. Since most victims don’t disclose while they are still children, statutes of limitation on the crime can be a significant barrier to prosecution, and these two factors combined help create the startling statistic that 85% of the people who sexually abuse children will never see a day behind bars. Educating adults about child sexual abuse appears to increase their knowledge about it and increase the odds that they will talk about it with people in their community. Maternal home visitation programs decrease the rates child sexual abuse as documented by CPS, but since that is a very small percentage of child sexual abuse to begin with we don’t really know how well the programs work at preventing sexual abuse. It appears that offenders who are convicted, incarcerated and go through specific, intensive, long-term therapy and intensive post-release monitoring are unlikely to reoffend, but none of the evidence takes into account how long it typically takes survivors to disclose their abuse. Similar programs exist for minors who have sexually offended but who aren’t arrested. There are some resources to connect people who are aware of and unhappy about their sexual attraction to children with the specific types of therapy that will teach them to manage that attraction, but there is no research as to how well that works.
Despite all our knowledge gaps, there are still a few things experts agree on that will help parents protect their kids.
- Avoid one-child, one-adult situations behind closed doors as much as possible. Most parents will find it impossible to completely avoid them, but at the very least they should insist that schools, daycares, youth sports, etc all have policies forbidding these situations.
- Forbid secrets. Sex offenders will often “test” prospective victims on their ability to keep secrets by asking them keep inconsequential ones, then escalate to more consequential ones. Don’t get in the habit of asking your children to keep secrets, and tell them to tell you if someone asks them to.
- Know the warning signs. Demographically, the people who want to sexually abuse children look like the rest of us. It’s their behavior that sets them apart. If someone is more interested in spending time with kids than with adults, if someone refers to a child as their “special friend”, if someone is showering a child with gifts, money, or outings, this can be a red flag. If there is someone in your neighborhood who always comes out of the woodwork to babysit at a moment’s notice, don’t let them babysit. And if someone seems more fond of your child than you are, you need to be concerned.
- Teach anatomy. Teach children the correct names for their genitals. This teaches them that sexuality is something that they can talk about with you. Some sex offenders say that prefer abusing children with no knowledge of sexuality. If a child does know the correct names for sexual body parts and acts they will also be able to describe sexually inappropriate acts they witness or any abuse that is committed against them.
Two varieties of child sexual abuse that warrant a brief explanation are child pornography and child sex trafficking. Child pornography is images of a child being sexually abused. It is usually produced by the person sexually abusing the child as a sort of “memento” of their exploits, and there are many sites where uploading original images of child pornography allow them to download other images. These images can also be sold. Child sex trafficking refers to one person providing sexual access to a child for money. In the United States, most trafficked children are teenagers, who often were in foster care or have run away from home or been kicked out. Trafficking will have the same emotional dynamic as child sexual abuse; the victim forms a very strong relationship with them, they often provide the victim with shelter and gifts. Teenagers are also trafficked by their family and guardians. The biggest risk factor for a child being sexually trafficked is an ACE score of 6 or more with sexual abuse being one of the ACEs. A very small percentage of sexually trafficked children are pre-pubescent; an annual FBI raid documented a two-year-old. These children are almost always trafficked