Any sexual activity involving a child under 18 years is considered child sexual abuse. However, it is not limited to sexual activity but any sexually exploitative use of children. Instead of physical force, perpetrators often use strategies to manipulate the child and hide the abuse, causing it to go unnoticed and continue for weeks or years.
Long-term abuse and its consequences can be prevented through parental awareness of the emotional, behavioral, and physical signs of child sexual abuse; and by teaching children body boundaries and how to speak out about their problems. Suspected child sexual abuse or exploitation cases must be reported to the police, child helplines, or other relevant organizations.
Read this post to learn about the signs, risk factors, and prevention of child sexual abuse.
What Is Child Sexual Abuse?
According to the World Health Organization (WHO) 1999 consultation on child abuse prevention, child sexual abuse is defined as the involvement of a child in a sexual activity, they do not fully comprehend or cannot give informed consent to since they are not developmentally fit for it (1).
Any sexual activity with a child accomplished by force, threat, or tactics, regardless of the age of the abuser and whether the child understands the sexual nature of the activity, is considered child sexual abuse.
Although the legal definitions of child sexual abuse may vary across countries, it usually includes sexual penetration, sexual touching, fondling, and non-contact sexual acts, such as voyeurism, exposure, masturbation, and obscene phone calls or texts. Child sexual abuse can be committed by an adult or another child regardless of their relationship with or authority over the child (2).
In addition, the use of a child in prostitution, sex trafficking, pornography, and other unlawful sexual practices are included in child sexual abuse. Producing, sharing, or owning child pornographic movies and images are also considered child sexual abuse.
How Often Does Child Sexual Abuse Take Place?
According to the US anti-sexual assault organization, RAINN (Rape, Abuse, and Incest National Network), child protective services finds evidence for or substantiate a child sexual abuse claim every nine minutes (3). However, it must be noted that many cases go unreported.
RAINN also provides the following statistics on child sexual abuse based on data from the National Crime Victimization Survey (NCVS), an annual study by the Justice Department (3):
- Based on the information from child protective services agencies, 57,329 children were victims of sexual abuse in 2016.
- Two of three victims (66%) were between ages 12 and 17, while about 34% were under age 12.
- One in nine girls (82%) and one in 53 boys under 18 years experienced sexual abuse or assault from an adult.
- Girls between ages 16 and 19 were four times more likely to be victims of child sexual assault, rape, or attempted rape than the general population.
- 34% of all child sexual abuse is incest (sexual activity by close relatives).
According to the WHO, the lifetime prevalence of child sexual abuse is 18% for female children and 7.6% for male children (4). These statistics indicate that child sexual abuse is a widespread problem, and measures are needed to prevent it.
How Can Child Sexual Abuse Be Prevented?
According to RAINN, sexual abuse can be prevented or identified early when parents are actively involved in the child’s life by talking to them about their daily activities, identifying the warning signs, choosing caregivers carefully, and encouraging them to speak up (5).
Some parents do not discuss body safety at a young age fearing their child would be frightened. To avoid this and teach body safety appropriately to your child, the Child Mind Institute recommends the following steps (6):
- Talk about body parts from an early age. Teach the proper names of the body parts, including the private parts, so that they are more comfortable opening up to you and can explain clearly if something inappropriate happens to them.
- Teach them that some body parts are private and not for everyone to see. Explain that no one should see them naked when their mom or dad is not present.
- Teach them body boundaries. For example, no one should touch their private parts or ask them to touch someone else’s private parts. The latter is equally important since many cases of abuse begin with the perpetrator asking the child to touch their or someone else’s genitals.
- Tell them that secrets are not okay. Many abusers ask or threaten children to keep the abuse a secret. Abusers may also trick the child into thinking they are playing a secret game. Children who know not to keep secrets from parents may disclose or give hints about abuse from the beginning.
- Tell them that no one should photograph them naked or their private parts. Many abusers take children’s photographs and trade them online.
- Explain how they can get out of uncomfortable or scary situation Teach your child a phrase they can use to get out of an uncomfortable situation with an adult, including elders or relatives. For example, they could tell them they need to leave to go potty.
- Share a code word with your child if they are old enough. They can use it to inform you when they feel unsafe around guests at home or a friend’s or relative’s house.
- Tell them that they will never be in trouble for sharing their body secrets. Explain that you can help them get out of the problem, and keeping secrets will only worsen it. Assure them that you will be there for them and protect them in all circumstances.
- Tell them that personal body touches are never good. Although some books talk about good and bad touches, children can be confused by this since, sometimes, touches from abusers may not hurt or feel bad.
- Explain that these rules apply to strangers and familiar people, including another child. Explain that it’s only okay for mom, dad, or a caregiver to touch private parts while cleaning or applying creams. Tell them that no one else, including family members, coaches, or teachers, should not touch them even though they are in charge or like them.
One discussion may not be enough to convey this knowledge to children. Talk to them often, especially at bath time or when they are naked. Although this knowledge may not completely prevent child sexual abuse, it may help prevent children from being targeted due to their innocence or lack of awareness.
What Are The Risk Factors For Child Sexual Abuse?
According to the WHO, the following are the risk factors for sexual abuse in children (1):
- Male sex in developing countries
- Mentally or physically disabled children
- Children of single parents or broken homes (divorced parents)
- Residing in war zones or armed conflict areas
- Social isolation with lack of emotional support
- Parent or caregiver with mental illnesses or drug or alcohol dependency
In most cases, children may not disclose the abuse immediately, fearing the perpetrator or threats to harm the child or the family members. As a result, a child may feel helpless and trapped, often resulting in sexual exploitation for a longer time.
What Are The Signs Of Sexual Abuse In Children?
Though most children may not disclose that they have been sexually abused, certain behavioral, emotional, and physical signs can point toward it. Children’s response to sexual abuse may vary depending on their age, who the abuser is, the kind of abuse, and how severe and frequent it is. Some may show subtle signs, while a few may not show any signs of abuse.
The following signs may indicate sexual abuse in children up to 11 years (7):
1. Emotional changes
Caregivers or parents may notice the following emotional changes in younger children who have been sexually abused:
- Becoming silent or distant
- Showing aggression or anger without reason
- Bedwetting (enuresis) or clothes soiling (encopresis) in toilet trained children
- Becoming more clingy than usual
- Asking questions such as “Is it okay to keep secrets?”
Always pay attention to your child’s questions and concerns since they may ask questions when unsure of what to do.
2. Behavioral changes
The following behavioral issues may arise in younger victims of child sexual abuse:
- Lack of interest in playing
- Poor academic performance
- Avoids particular people or places
- Problematic sexual behaviors
Sexual abuse is a major cause of problematic sexual behaviors in children. Preschoolers and school-going children may show signs of abuse through problematic sexual behaviors such as touching their genitals or playing with toys, dolls, or pets sexually (8).
3. Physical signs
Children may also develop certain physical signs of sexual abuse that they may hide from their parents. The common physical signs of sexual abuse in children include
- Red and swollen genital area
- Troubles while walking and sitting
- Bruises on the thigh, buttocks, and other soft parts of the body
- Pain during bowel movement or urination
- Sexually transmitted infections (STIs) causing penile or vaginal discharge
The signs of sexual abuse can be different in teenagers. Certain changes may be due to puberty or social influences, so you must assess them carefully. The signs of sexual abuse in teens may include (7)
4. Emotional changes
Teenagers may exhibit the following emotional changes after being sexually abused:
- Aggression or anger without reason
- Stomach aches or headaches without physical cause
- Becomes angry or upset when a particular place or person is mentioned
- Trouble making and maintaining relationships
- Cries without apparent reasons
- Confusions in sexual identity
5. Behavioral changes
The following behavioral changes are often seen in teenagers who face sexual abuse:
- Self-harming behaviors such as cutting or injuring hands or other parts of the body
- Poor appetite or overeating
- Spends a lot of time online and is secretive about virtual communications
- Obtains new accessories or clothes from unknown sources
- Problematic sexual behaviors, including using sexually explicit language; accessing adult movies, games, or websites with sexual content; touching their genitals or that of others; or engaging in risky sexual activities (8).
- Avoids friends’ houses, sports groups, or certain people
- Avoids activities or sports they previously enjoyed
- Poor academic performance
Teens who experience sexual abuse may have issues in school and their social life. Keeping in touch with their teachers and peers may help you identify these changes.
The physical signs of sexual abuse can be similar in younger children and teens. Some teen girls may miss periods in case of unprotected sexual intercourse. Consult a gynecologist for an exact diagnosis since many teens have amenorrhea (missed period) during the initial years of menstruation.
All the emotional, behavioral, and physical changes mentioned above can be seen in children for reasons other than sexual abuse. If you are uncertain, contact the right sources to seek necessary help.
What Are The Consequences Of Child Sexual Abuse?
Sexual abuse can cause short-term and long-term physical and emotional harm to children of any age. The physical health consequences of sexual abuse on children may include (1) (9) :
- Gastrointestinal disorders, such as chronic abdominal pain, non-ulcer dyspepsia (indigestion), and irritable bowel syndrome
- Gynecological disorders, such as dysmenorrhea (painful menstruation), irregular menstruation, and chronic pelvic pain
- Somatization, which causes their psychological stress to manifest into physical Somatization may also be the body’s way of communicating psychological stress.
Child sexual abuse can also result in the following behavioral and psychological effects:
- Post-traumatic stress disorder(PTSD), causing avoidance, numbing, or re-experience of the event
- Eating disorders, such as anorexia nervosa or bulimia nervosa
- Hyperarousal, such as increased sexual behaviors
- Issues in social competence
In addition to physical and psychological health problems, children who have been abused may also have an increased risk for sexual exploitation. Hence, early detection is essential.
What Do Perpetrators Of Child Sexual Abuse Look Like?
According to RAINN, 93% of children under 18 have experienced sexual abuse from a known person. The perpetrator does not have to be an adult or a person with sexual disorientation to harm a child. They can be a parent, stepparent, older sibling, playmate, grandparent, family member, caregiver, coach or instructor, teacher, or parent of peers or relatives. Children may not understand or disclose abuse from known persons unless they know their body boundaries (10).
Strangers can also take advantage of unaccompanied children. One in six cases of child sexual abuse involves the abuser taking advantage of the child’s vulnerability regardless of their sexual orientation. Since abusers may use tactics and threats to keep the sexual exploitation a secret, child abuse is not only a physical violation but a violation of authority and trust.
How Can Child Sexual Abuse Be Reported?
Never delay reporting if you suspect child sexual abuse though there is no time limit for it. Instead, directly contact the police or local children’s social services center to report a case or contact them via phone or email. You could also consult healthcare professionals who can report suspected child sexual abuse cases to law enforcement. The police and many national commissions keep the informer anonymous if you wish to remain so.
Children and teens could reach out to the police or several child helplines, such as the National Domestic Violence Hotline, Child help, and RAINN (11).
Children cannot comprehend consent for sexual activities, so any sexual activity with a child is considered child sexual abuse. Establishing good communication with your child and teaching them body boundaries from an early age can help prevent many child abuse cases. Never delay or hesitate to report suspected cases of child sexual abuse to the legal authorities or help centers in your area.
References:
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Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has 3+ years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education made… more
