Sexual abuse is seen as one of the gravest crimes a person could commit after murder or killing. A victim is physically and sexually tortured or abused by the suspect, either by forced intercourse or similar acts, which often leads to traumatizing effects for the victim. Some would often find victims mentally unstable after the assault, traumatized to see people with the same gender as their attacker or even be with people. Others would become haunted by nightmares, leading them to taking their lives or succumb to insanity. A few may only attempt to recreate the act and become the suspect themselves for other victims under abuse. However, these general effects vary when it comes to the background and age of the victim. In the case of children, sexual abuse can thwart physical, mental and social development, and also transform a child’s personality for the worst if they are not properly treated.
According to Johnson (2006), sexual abuse can be defined as any activity involving minor or forced victims for the sexual gratification of the suspect, which may either be an adult or an older child. The activities counted as a form of sexual abuse are oral-genital, genital-genital, object-genital, object-rectal, hand-genital, hand-rectal, or hand-breast contact; forced exposure of sexual anatomy, forcing children to view pornography and child pornography. Sexual abuse also denotes that the victim can either be forced to do the act, or willingly do the act on the suspect. Sexual play is also included when counting sexual abuse instances, the acts included in sexual play are viewing or touching sexual anatomy of victims under 4 years old. A sexual abuse case can also be influenced by the difference in physical, and social standpoint between the perpetrator and the victim. Parents or guardians can also be filed with a sexual abuse case if they are unable to provide children with safe environments that would shield them away from exposure to sexual acts or sexual information. It would be seen as a failure on the part of the parents if they cannot provide a safe environment .
Child sexual abuse is often hard to notice considering the nature of the act and the fact that victims are often threatened or coerced to silence. According to the Victorian Government Department of Human Services (2009) children easily succumb to fear and keep the abuse a secret as they are afraid of the consequences if they do reveal the abuse. Another reason secrecy is also placed in sexual matters is due to the fact that adults, whether they may be parents or guardians, are reluctant to discuss the issue openly in fear that children might commit sexual acts early or become curious as to why many are enticed to do the act. This secrecy and common norm that sexual activities, and or abuse, should not be discussed directly makes confession hard for children to admit to sexual abuse directly. Indicators as to identifying if a child is sexually abuse can be done in checking the physical and behavioural changes of the child. Physically, child victims of sexual abuse have injuries in their genital or anal areas, have irregular urination or discharge, exhibit symptoms of sexually transmitted infections, and finally have semen in their genital or anal areas. Victims can also exhibit irregular walking or sitting, urinary tract infections, and several pains in their genital areas. It is often that parents or guardians would only question children if they sexually abused when the child showcases symptoms of pregnancy. In terms of behaviour, child victims would often exhibit familiarity to sexual matters, displaying interest to the sexual anatomy of the other sex. They would also exhibit mood swings, and withdrawal .
The indicators in identifying sexual abuse in children also have their underlying effect on children which may influence their overall development. Leserman (2005) noted that physical indications of sexual abuse on children would cause functional disability, more severe physical symptoms, and chances of increased surgeries especially if the child is traumatized severely by the ordeal. It has been noted by the study done by medical experts in the US that forced or threatened sexual intercourse can cause risk either for the perpetrator or victim high tendencies of health risks such as hypertension, high cholesterol and even obesity. Leserman cited several physical effects of sexual abuse in children which causes deterred development in the part of the victim. Studies have indicated that sexual abuse victims, especially children, exhibit abdominal pain, diarrhea and other gastrointestinal disorders as a long-term effect of sexual abuse to their bodies. Young female victims of sexual abuse in Los Angeles have noted that they exhibit gastrointestinal problems such as vomiting, nausea, diarrhea and bloating. For male victims, they acquire heartburn, irritable bowel movement, and dyspepsia. Others even complain that they feel stomach ache, nausea, and even pelvic pain. Sexual abuse can also cause problems in the pelvic area and the genital area for victims, especially children considering that they have yet to develop these parts. Studies have noted that sexual abuse victims report pelvic pain, painful intercourse or dyspareunia, genital infections, and sexually transmitted diseases despite their young age .
Anatomy is also affected by sexual abuse in children, which do not only constitute pain, infection and diseases in the genital area. According to Johnson (2004), young victims to sexual abuse were found to have abnormal physical anatomy such as dents and bumps in the genital area. However, there are victims who are seen with deep lacerations such as Neisseria gonorrhoea. Scientists and experts often note that lacerations are caused on how the penetration was done, visible in the hymenal clefts of the victim. Anal lacerations are often visible to victims who have been penetrated by blunt objects larger than the victim’s sphincter. However, this is still debated by experts as anal lacerations can also happen due to large and hard stools, which are excreted. Nonetheless, experts believe that if sexual abuse was done to the victim, he or she is likely to have constipation that had led to the anal laceration and fissures . In some instances, child sexual abuse can also present victims with cardiopulmonary symptoms. According to Irish, Kobayashi and Delahanty (2010), victims of child sexual abuse tend to report chest pains, shortness of breath, irregular heartbeat, and even ischemic heart diseases. Studies note that child victims of sexual abuse receive these problems as their bodies are still developing prior to the abuse, leaving their bodies unable to cope with the forced maltreatment. Overall cardiopulmonary health is also affected when it comes to victims of child sexual abuse as compare to those without history of abuse of any form.
Instances of pregnancy can also be an effect of sexual abuse should the child be exposed to forced intercourse without protection or abused numerous times. Tyler (2002) cited that there have been studies that indicated that there is a relationship between child abuse and teenage pregnancy. The study done by Herrenkohl, Herrenkohl, Egolf, and Russo (1998) showed that 49% of teenage parents have been sexually abused in the past. An indicator to teenage pregnancy was noted to be self-esteem, which is doubted once abuse has been done. In another study noted by Tyler, sexual abuse is a risk factor that increases chances of teenage pregnancy. Reports note that sexually abused children, who then begin to have sex a year earlier than the usual age for intercourse, are less likely to use contraception and are likely to have intercourse under the influence of substances or drugs. Abused children, especially females, tend to be physically victimized by their partners. In a 1992 study, it has been revealed that victimization is often seen with Whites as compared to Hispanics or Blacks. In addition to this, a 1997 study showcased that sexually abused females in grades 8 to 12 are three times more likely to engage in premarital sex despite their early experience. Some would even forgo the use of birth control or contraceptives.
There have been studies as to how many mental effects are contracted by victims if they are sexually abused. In the study done by Spataro, Mullen, Burgess, Wells and Moss (2004), mental incapacities tend to develop in child victims of sexual abuse. Female victims exhibit emotional and behavioural problems, which includes depression, anxiety, somatic disorders, and even withdrawal. Self-concept and perception to the people around them and their position in society are also questioned once victims try to recover from sexual abuse. Studies have also noted that child victims of sexual abuse are likely to show conduct disorders, especially in females. When it comes to adulthood, child sexual abuse can produce mental disorders in the future such as the development of schizophrenia. While this matter is yet to be analyzed for future studies, it is seen as a possibility as children who experience abuse, may it be sexual, mental, and physical abuse, tend to develop these types of mental disorders after experiencing the ordeal and can pass on till they reach adulthood. The study had also noted that most of the risks of mental disorders in adulthood tend to be plausible to young female sexual abuse victims rather than male victims. Female victims of child sexual abuse also tend to exhibit anxiety disorders and acute stress reactions easily, as females are normally emotional and can easily show how much it hurts their body and soul. While male victims of child sexual abuse also exhibit these mental incapacities in their adulthood, females are often of high risk since they are usually the victims of such abuse. Anxiety and stress disorders both male and female child sexual abuse victims range also include post-traumatic stress disorders which ultimately influence withdrawal and behaviour changes for victims throughout their adult years .
Depression is also a significant mental effect of sexual abuse in children, which can be carried up to adulthood. According to Putnam (2003), childhood sexual abuse can generate serious depression, which leads to the high prevalence rates and mortality in victims. According to several studies, major depression and dysthymia or neurotic depression are strongly associated with sexual abuse in children. For young women, depression is highly plausible if she has a history of sexual abuse and it are a common effect to them by the abuse. Major depression is also presented differently depending on the person’s history and the abuse he or she had undergone. Some studies noted that victims of sexual and physical abuse often show signs of reversed neurovegetative signs of depression such as an increased appetite, weight gain and hypersomnia, or the extended sleepiness as compared to those without history to abuse. Depression is also different in strength per victim as it is dependent on how severe the sexual abuse was done. The gender of child victims also influences depression after being abused by the perpetrators and is likely to continue to adulthood . Lev-Wiesel (2008) adds that child sexual abuse victims also tend to develop Attention-deficit hyperactivity disorders or ADHD, which is also misdiagnosed in several instances, causing treatment to be incompatible with the patient. Misdiagnose of ADHD in sexually abused children tends to present emotional and behavioural dysregulation.
Dissociation is also a common effect in children sexually abused, which pertains to the lack of connection in thoughts, memories, and even the sense of self. Children with dissociation tend to utilize mechanisms for them to escape the memory and the suffering that was dealt to them by their abusers. Victims tend to create automatic behaviors that would respond once they feel vulnerable or they are in the verge of relieving the event. This is often seen as a way for denial as dissociation would often cause child victims to treat the event was nothing more than a dream. Dissociation may seem to protect the child against any similar experience; however, it fragments one’s mind and prevents children to talk about what they have experienced. This may go negatively if the perpetrator is caught as courts would require the entire testimonies of victims before a suspect is deemed guilty. Dissociation also prevents children from processing the experience, leading them into utilizing coping strategies that promote aggression and passivity. Sexually abused children who also utilize dissociation tend to feel helpless and betrayed by the people that they trust, causing them to develop detachment. Dissociation also tends to cause five main symptoms that can ultimately affect the child’s mental behaviour: amnesia, depersonalization or detachment to one’s self, derealisation or detachment to the environment, identity confusion and identity change. Depending on the abuse experienced and the age of the victim upon the abuse would determine the severity of these five symptoms. Some even develop Dissociative Identity Disorder, which somehow creates two or more identities that take control over the victim in occasions. Emotions also tend to go awry once a child tries to recover from the abuse. They can easily exhibit guilt, aggression, hostility, shame, and also lack of self-worth as they feel tainted by being abused sexually by people they should be able to trust .
Behavioural effects are also presented to child victims of sexual abuse, which can become harmful to the child if it is not treated or remedied immediately. According to Kendall-Tackett (2002), child victims often find themselves drawn to substance abuse once they survive until adulthood. Studies have shown that adult survivors of childhood sexual abuse are likely to consider taking alcohol and drugs to forget their past. This is also similar to males and homosexuals, who are likely to succumb to the influence of psychoactive drugs to remain sane or sexually active. Female survivors of sexual abuse are also likely to have histories of drug addiction and alcohol abuse, as compare to those who have only taken substances in their adulthood. Eating behaviour is also an effect of sexual abuse as several studies have indicated that HMO patients have a history of incest, and became overweight after their ordeal. Some patients have also been noted to be 100 pounds overweight and have a history of sexual abuse in their childhood. In females, sexual abuse and eating disorders are seen in several cases of bulimia. According to the study done by Miller, McClusky-Fawcett and Irving (1993) bulimia patients also noted that they were sexually abused after turning 12. Experts even cited that sexual abuse can also be connected to the development of bulimia in rare cases . Records have also indicated that, despite the steeper rate of body mass growth for abuse girls, the body mass index of abuse girls have increased. Irish, Kobayashi, and Delahanty noted that victims of penetrative child sexual abuse have increased BMI, especially for women. Male victims of sexual abuse often retain their body mass, depending on the abuse they have received .
Sexual behaviour is also noted as a major effect of child sexual abuse to its victims, especially if they survive until adulthood. Children who had been sexually abused at a young age tend to engage in more sexual activity, especially in men as compared to normal children and adolescents. Some reports have indicated that male child victims of sexual abuse tend to engage into intercourse every day as compared to their female counterparts. These males also tend to forgo the use of contraception. In some cases, child sexual abuse victims tend to have a high risk in acquiring HIV and other sexually transmitted diseases once they begin to exhibit an almost active sexual activity early. Sexual revictimization is also plausible for sexual abuse victims as they can easily be identified through their action. Another study presented that some sexual abuse victims tend to exhibit sexual anxiety and sexual abuse fears, leading them to have complicated relationships and varying perceptions of the opposite sex. This adds to the problem of trust issues that sexual abuse victims acquire .
For child victims with disabilities, sexual abuse can present several dangers and risks as disabled children could not fight against the abuse due to their disabilities. Brown (2010) noted that children with disabilities are most likely to be removed from the care of their families, and be placed with caregivers to take care of their “difference”, opening them to perpetrators. This opens them to a possibility that caregivers can abuse them physically without alerting the family or guardians. It is also hard to undermine the vulnerability, and the risks disabled children are placed into as current laws and policies only allows childcare agencies to identify and resolve cases of sexual abuse for normal children. There can also be the possibility that agencies caring for disabled children themselves would accidentally allow perpetrators to access their next victims. Disabilities mark children as vulnerable victims as they are often isolated and considered different from the others. Some would even utilize this vulnerability since disabled children cannot communicate efficiently with adults. The effects of sexual abuse for disabled children are similar to the effects it brings to normal children. However, due to the different norms and standards applied for children with disabilities, the effects of sexual abuse can be severe. Mental instability is one of the major effects of sexual abuse to disabled children, as they would lose trust entirely to people they can normally trust like caregivers or their love ones. Some would also develop post-traumatic stress disorder, borderline personality disorder, and identity disorders as disabled victims would find themselves incapable of accepting that the abuse happened to them, questioning if they should be treated in such manner. Fear would also become a substantial effect for disabled children, making them withdrawn to others, causing their self-esteem to drop and create problems in their communication with others; and also have tendencies to lean towards substance abuse to forget their ordeal .
Many consider children as the next face of the future, the reason the world continues to evolve and the reason families become closer. The idea that children are being targeted by people who wish to gratify themselves sexually through these young ones is appalling, considering that children must be protected and not abused in such manner. It is necessary for parents, guardians or for adults to understand child victims of sexual abuse and help them recuperate from the ordeal by listening to them and treating them without prejudice. While it might be hard to recover from such ordeal altogether, showing child victims of sexual abuse love, understanding, and comfort can allow them to move forward. It is highly probable that young victims to sexual abuse would remove themselves to society, and even commit the same crime done to them if they are not given the same attention and treatment before the abuse occurred. It is essential to develop stricter laws, child care policies, and effective intervention and therapy strategies to help child victims of sexual abuse to recover from the ordeal.
References
Brown, H. (2010). Sexual abuse of children with disabilities. Retrieved September 23, 2012, from Committee of the Parties to the Council of Europe Convention on the protection of children against sexual exploitation and sexual abuse: http://www.coe.int/t/dg3/children/1in5/Source/PublicationSexualViolence/Brown.pdf
Irish, L., Kobayashi, I., & Delahanty, D. (2010). Long-term Physical Health Consequences of Childhood Sexual Abuse: A Meta-Analytic Review. Journal of Pediatric Psychology, 35(5), 450-461.
Johnson, C. (2006). Sexual Abuse in Children. Pediatrics in Review, 27(1), 17-27.
Johnson, C. F. (2004). Child sexual abuse. Lancet, 364, 462-470.
Kendall-Tackett, K. (2002). The Health Effects of Childhood Abuse: Four Pathways by which Abuse Can Influence Health. Child Abuse and Neglect, 6(7), 715-730.
Leserman, J. (2005). Sexual Abuse History: Prevalence, Health Effects, Mediators, and Psychological Treatment. Psychosomatic Medicine, 67, 1-10.
Lev-Wiesel, R. (2008). Child sexual abuse: A critical review of intervention and treatment modalities. Children and Youth Services Review, 30, 665-673.
Putnam, F. (2003). Ten-Year Research Update Review: Child Sexual Abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 42(3), 269-278.
Spataro, J., Mullen, P., Burgess, P., Wells, D., & Moss, S. (2004). Impact of child sexual abuse on mental health. British Journal of Psychiatry, 184, 416-421.
Tyler, K. (2002). Social and emotional outcomes of childhood sexual abuse. Aggression and Violent Behavior, 7(6), 567-589.
Victorian Government Department of Human Services. (2009, May). Child Sexual Abuse. Retrieved September 23, 2012, from Victorian Government of Department of Human Services: http://www.dhs.vic.gov.au/__data/assets/pdf_file/0019/574210/child-sexual-abuse-understanding.pdf
