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Children, sexual abuse and its effects
A cultural understanding of child sexual abuse
The death of Maria Colwell in East Sussex in 1973 at the hands of her stepfather threw a glaring light on the physical abuse of children, which has yet to be dimmed (Department of Health and Social Security 1974). It gave renewed impetus to discussions, agitation, research, practice development, media coverage (sensationalist and otherwise), policy initiatives, and the restructuring of services which continues today. Long before some other professional groups became the subject of media and public scrutiny, social work was propelled into an arena to which it was not accustomed, a situation which still obtains all these years later.
Maria Colwellâs death came three years after the creation of social services departments, which had seemed to signal a new dawn for social work. Nearly 30 years earlier, in 1945, the death of 13-year-old Denis OâNeill, beaten and starved by his foster father, had led to the Curtis report and the decision to create childrenâs departments, that were later to be subsumed by those very the social services departments (Douglas and Philpot 1998). More than 50 years later the murder of Victoria Climbe by her great aunt and her auntâs lover in 2000 provoked the inquiry by Lord Laming which, in time, led indirectly to the abolition of the social services departments and the creation of local authority childrenâs services departments separate from those for adults (Department of Health and the Home Office 2003).
Few children suffer only one form of abuse. The deaths of Denis OâNeill and Maria Colwell drew wide attention to physical abuse and neglect, as that of Victoria Climbe was to do. This was not wholly surprising in that the care of children had been so much shaped by those who had been determined to tackle these very social ills. The great childrenâs charities, like Barnardoâs (Rose 1987), NCH (Philpot 1994), the Church of England Central Home for Waifs and Strays Society (now the Childrenâs Society) and the NSPCC, had been founded in the latter part of the 19th century to tackle the great evils of child neglect, physical abuse and abandonment.
In the last 20 years or so sexual abuse has come to the forefront in terms of professional concern and media and public interest. Indeed, it is arguable that this emphasis has now tended to overshadow issues of physical abuse and neglect. The definition of sexual abuse is something which changes from culture to culture, from period to period. Sanderson (2004) cites deMause (1976, 1991, 1992, 1993, 1998, 2002) as having found historical evidence of sexual abuse which has not been recognised as such because of the prevailing attitudes toward children at different times.
But we do not need to look at the past to understand how cultural norms affect how the treatment of children is viewed. In Chile and Mexico today, for example, the age of sexual consent is 12, which is two years below the age fixed by our Victorian ancestors in England. In other modern societies as diverse as Spain, North Korea and South Korea the age of consent is 13, while young people in Denmark, Sweden and France are able to consent to sexual intercourse when they become 15. In the United States the age of consent differs from state to state so that, for example, in New York it is 17 and in California it is 18. In Northern Ireland, a part of the UK, it is 17. Bolivia holds to 17, while Vietnam and Egypt have legislated for 18 and Tunisia for 20 years of age (The Guardian 2005).
Some sexual practices are acceptable in some places but abominated in others. Some African and Middle Eastern countries allow female genital circumcision, which is illegal in the USA and the UK, although there is evidence that operations still occur there. Sanderson (2004) quotes the World Health Organisation as estimating that between 130 and 140 million children in the world today have been subjected to this operation. In many countries marriage between children, and often marriage of a child to an adult, continues and in Egypt marriage between brothers and sisters is permitted. Elsewhere, temple maidens still exist: young girls provide sexual services to worshippers. The masturbation of boys to make them âmanlyâ is accepted in some parts of India, while it is done to girls to make them âsleep wellâ (deMause 1976, 1991, 1993, 1998, 2002 quoted by Sanderson 2004). In some African countries, sex with a female child or young girl who is a virgin is believed to cure sexually transmitted diseases, an idea reaching back to ancient notions of the purity of children. In the age of AIDS/HIV this supposed antidote or preventative has taken on what is, literally, a deadly topicality. Again, older ideas of child sacrifice can be seen revived in the idea of ritual abuse, which has gained some attention in the UK, although there must remain some doubt as to how âgenuineâ such rituals are as opposed to being used to frighten children into submission.
Increasing attention, in Europe at least, is now being given to child prostitution with its often attendant evil of child trafficking. However, children do not have to be taken across borders or âtraffickedâ for them to be ensnared in the trade: it is believed that there are 300,000 child prostitutes in the United States and 200,000 in Thailand, the country with which it is most commonly associated. Sanderson (2004) claims that 14 per cent of Asian countriesâ GNP can be attributed to child prostitution through the sex tourism trade. In Britain there are thought to be 5,000 children in the sex trade and in France 8,000 (Sanderson 2004).
The sex trade can cross over with child pornography: children working as prostitutes will often be used in the making of pornographic movies. Internet and mobile phone technology has facilitated the spread and availability of pornography in a way which makes it now very difficult to detect and check effectively. By contrast, not many years ago pornography could only be obtained by visiting certain addresses or by having it sent from abroad or importing it oneself, which allowed its detection by customs officials. Pornographic images of children can now be had at the touch of a button in the privacy of oneâs own home.
The definition of abuse through pornography has been slower to develop than the technology which makes it so readily and easily available. It has been said (and not only self-servingly by those who make use of it) that viewing pornography in this way is âsafeâ and âvictim freeâ, but it is obvious that anyone making use of these sites is colluding in the abuse perpetrated against the children who are being shown. Buying, selling or otherwise disseminating and obtaining pornographic videos, photographs, DVDs and films in which children, sometimes no more than babies, feature are no less actual forms of abusive activities than other forms of abuse. These are real children and this is not acting. These are not victimless crimes, and sentencing policies in the UK have now begun to reflect that fact, as has the public disapproval of those who take part in such activities.
What is child sexual abuse?
As we can see, there are inconsistencies in definitions of sexual abuse associated with social and cultural constructions. However, while the age of consent differs in many, often seemingly similar societies, key criteria concerning the imbalance of power between victim and perpetrator, lack of consent and the inability to give consent must remain central. This book follows the definitions current in the UK:
Definitions of child sexual abuse should acknowledge the abuse of power and trust; that it is carried out by an adult for his [sic] own sexual gratification; and that children cannot give free and informed consent to sexual acts with adults.
(Reid 1989: 1)
The widely used definition by Kempe and Kempe meets Reidâsdefinitional purposes:
Sexual abuse is defined as the involvement of dependent, developmentally immature children and adolescents in sexual activities that they do not fully comprehend, to which they are unable to give informed consent, or that violate the social taboos of family roles.
(Kempe and Kempe 1978: 60)
A quarter of a century after this definition was formulated the Department of Health and the Home Office offered another, which focuses on the nature of activities undertaken:
Forcing or enticing a child or young person to take part in sexual activities whether or not the child is aware of what is happening. The activities may involve physical contact, including penetrative (eg, rape or buggery) and non-penetrative acts. They may include non-contact activities such as involving children in looking at, or in the production of pornographic material, or watching sexual activities, or encouraging children to behave in sexually inappropriate ways.
(Department of Health and Home Office 2003)
While babies can be abused as can 15-year-olds, the age group most at risk is those aged 5 to 12 years (Sanderson 2004). Sanderson also has a list of 18 ânon-contact behavioursâ and 20 âcontact behavioursâ involved in sexual abuse and adds others like grooming, voyeurism, fondling and exhibitionism. Perpetrators may include family members, professionals whom children are likely to have contact with (for example, teachers and youth club workers) and others who have contact with children (for example, baby sitters), as well as people who may know the child, like shopkeepers (Sanderson 2004: 46).
All this serves to demonstrate that what we call sexual abuse can take many forms, happen in many places and include a wide range of activities, and that offenders are extraordinarily varied.
In middle-class families child sexual abuse can be often covered up, not talked about, and hidden in different ways. Indeed, the ârespectabilityâ of such homes can instil the belief that such things âdo not happenâ in such families. These families, too, are far less likely to be known to the authorities â like the police and social workers â and so there is less opportunity for such outsiders to suspect that something may be afoot. But, there is no evidence that sexual abuse is confined to any one social class: it occurs within a wider context of family dysfunction. However, abuse is more likely to occur in families where there is privation and deprivation, and much takes place in families that are chaotic. This is where children experience a frequently revolving pageant of adults who come into and go from their lives: when a parent changes partners, new sets of relatives, formal or informal, appear. A partner who lives in or who enters the family home may themself have other children who are then step- or half-brothers and sisters. Such complexity would be bewildering to an adult, let alone a child who is not only emotionally underdeveloped but is also not the agent of such change. What is happening to her is being caused by others. Indeed, she may have only the haziest understanding of who these others are, even if they are formally related.1
The extent of abuse
It is difficult to arrive at firm figures about how extensive sexual abuse is because, like rape, much of it goes unreported or is only reported many years later, when the victims are adults and when the possibility of conviction (never high) is considerably less likely. Cawson et al. (2000), in perhaps the most exhaustive, reliable and widely accepted study, found that 1 per cent of children aged under 16 had experienced sexual abuse by a parent or carer and another 3 per cent by another relative during childhood. To this must be added the 5 per cent said to be abused as children by an adult stranger or someone whom they have just met.2 However, the most common perpetrators of oral or penetrative sexual abuse within the family are brothers or stepbrothers (38 per cent), fathers (28 per cent), uncles (14 per cent), stepfathers (13 per cent), cousins (8 per cent), grandfathers (6 per cent) and mothers (4 per cent) (Cawson et al. 2000).
A much smaller scale study by Hooper (1992) of mothers whose children had been abused offers an insight into who are perpetrators. Her 15 mothers all had children who had been sexually abused by members of the household or ânon-resident kinâ (not all of whom were adults). The abusers were a son (1); husband (4); ex-husband (3); ex-cohabitee (2); relative of ex-cohabitee (2); motherâs father (1); and ex-husband and stepfather to child (2).
According to ChildLine (2003) both boys and girls are sexually abused but girls are more commonly abused by a ratio of nearly 1:4.3 Cawson et al.âs (2000) gender breakdown suggests that 11 per cent of boys under 16 and 21 per cent of girls aged under 16 have been sexually abused. Another study (Grubin 1998) found that 60â70 per cent of sex offenders against children targeted only girls, 20â33 per cent only boys, and about 10 per cent targeted either sex. According to Grubin, âabout 80 per cent of offences take place in the home of either the offender or the victimâ.
Available figures on convictions for sexual abuse against children are further complicated by the high percentage of perpetrators who are other children and young (mainly adolescent) people. Lovell (2002) says that there is âa broad consensusâ that they make up between 25 to 35 per cent of perpetrators.
Between 1985 and 2001, recorded offences of gross indecency with children more than doubled but the percentage of convictions fell from 42 per cent to 19 per cent. Stuart and Baines (2004) suggest that fewer than 1 in 50 sex offenders receive a criminal conviction. Although some of these unconvicted and unreported offences will have been committed by perpetrators who have been convicted for other offences, that still means that a very large majority of offences against children are not reported. If they are reported, the perpetrator may never get to court. If he does, there is a good chance that he will escape conviction.
Public discussion about child sex abuse is made more difficult because of traditional fear of strangers. It distorts public understanding of who actually abuses children. This may be accounted for, to a degree, by cultural notions of the safe family against the threatening outside world and the kind of external threats exemplified in fairy stories like âLittle Red Riding Hoodâ. Even if such fears are vestigial, they are exacerbated by popular media headlines about the âpaedoâ, âsex abuse monsterâ, âpervertâ, and such like which tend to highlight strangers who have committed acts against children. It is not difficult to understand the viewpoint of some journalists: stories of children who are abducted by severely disturbed and sometimes repeat offenders and are found to be the victims of sexual murder make more interesting âcopyâ than the horrors which the majority of child sex abuse victims suffer within the four walls of their own homes at the hands of their parents, other relatives and family friends. Media coverage of sexual offences against children can, therefore, grossly mislead and militate against proper public understanding of the issue.
The truth is prosaic: the facts show indisputably that a child is in much more danger in her own home, in the âcareâ of those whom she knows, than she ever is from a stranger in the street. The abuse could be carried out by a family member or family friend, and this includes, of course, children and young people who abuse other children.
Abuse is also often systematic and continuing. It may last for months or even years. Some children are abused into young adulthood and the abuse only ends when they leave the family home, although even that is sometimes not the case.
How children react to sexual abuse
Each child will react differently to sexual abuse and the most we can say, in general terms, is that its effect will very often (but not always) be profoundly damaging. How damaging and in what ways will depend on many things: the age at which abuse took place; the extent and nature of the abuse; how long it lasted; how isolated the child was within her family (for example, whether other children were abused and whether this was known to her); who the abuser was and her relationship with him; the prevailing family dynamic (that is, the relationship of the abuser, who may or may not have been the childâs father, and his partner, and the relationship of the child and her mother); and, importantly, how her disclosing what happened was dealt with and the help which she received. Whatever the effects, it is probably true, as one victim said, that âit creeps into every part of your lifeâ (quoted in Mudaly and Goddard 2006).
Whom do children tell? Many children never tell anyone, and this is the case even when they grow to adulthood. One in four children is thought to disclose what happened to them at the time when it occurred, and another quarter later, but just under a third (31 per cent) never tell. Of those who do disclose, more than half (55 per cent) tell a friend, 29 per cent their mother or stepmother, and 11 per cent their father. Brothers and sisters are told by 13 per cent, and social workers by 2 per cent. Seven per cent let the police know, 5 per cent inform a teacher and 1 per cent phone a helpline (Featherstone and Evans 2004).
The NSPCCâs National Commission of Inquiry into the Prevention of Child Abuse, which advertised for people to testify, found from the 1,121 responses it received that 32 per cent had told someone and 31 per cent of these had told an adult. For 13 per cent of those who had contacted the inquiry or an agony aunt (the inquiry used âagony auntâ columns as one way of reaching people), it was the first time that they had disclosed what had happened to them (Wattam and Woodward 1996).
An analysis of the 32 per cent who told the inquiry that they had told someone, revealed that 34 per cent told their mothers when they were children but 13 per cent did not do so until they were adults. Sixteen per cent told a friend or boyfriend when a child; 5 per cent did so in adulthood. Twenty-four per cent told partners and spouses, while 10 per cent told other relatives when they were children, and 8 per cent did so when they were adults. Three per cent told counsellors when they were children and 15 per cent did so when they were adults. Two per cent told a doctor when they were children and 6 per cent did so when they were adults. Seven per cent told the police in childhood and 4 per cent when adults. Seven per cent told teachers, while 5 per cent were children when they told social workers and 1 per cent were adults. Two per cent told their fathers when they were children; none did when they were grown up. Of the 2 per cent who told âothersâ, all did so as adults. It was not clear to whom 10 per cent had disclosed as children, and 20 per cent as adults (Wattam and Woodward 1996).
Female friends of the victim and her sisters were more likely to be told of assaults than were mothers. (Agencies learned of even fewer cases than did mothers.) However, it was more likely that a mother would be told when a girl was abused by an adult. When the abuser was under the age of 18, females of the same age as the victim were more likely to know (Kelly et al. 1991).
Sexual abuse presents a child with desperate dilemmas which place her in a terrible double bind when it comes to disclosure. When she tells what has happened to her, the abuse will end but its effects remain. But disclosure itself will have consequences. For example, how will a child defend herself from the wounding accusations which she may face from those affected by her allegation? She will naturally feel responsible for some results which may flow from her actions: the offender, whom she may love, may go to prison. What she has revealed may cause a rift in the family; a prison sentence may split it asunder. It is not only the perpetrator, his partner (usually her mother) and the child who are affected, but also other family members: any brothers and sisters, grandparents, uncles and aunts and cousins. Some may think she did right to disclose, some may not believe her, some may think she is exaggerating and ask why did she not leave well alone.
Disclosure may pro...