CONTENTS
- The World Takes Notice
- Intimate Partner Abuse
- Sexual Coercion
- Impact on Reproductive Health
- Threats to Health and Development
- Health Providers Play a Key Role
- An Agenda for Change
HIGHLIGHTS
- What lies behind violence?
- Culture: a double-edged sword
- Child sexual abuse is widespread
- Violence harms women in many different ways
- *Pullout guide: What Health Providers Can Do
- Responding to violence: Lessons learned
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The Center for Health and Gender Equity (CHANGE) is a research and advocacy organization that seeks to integrate concern for gender equity and social justice into international health policy and practice. CHANGE staff can be reached by e-mail at change@genderhealth.org or at http://www.genderhealth.org.
December, 1999
Series L, Number 11
Issues in World Health
Sexual Abuse in Childhood
Because of the taboo nature of the topic, it is difficult to collect reliable statistics on the prevalence of sexual abuse in childhood. The few representative sample surveys that exist report that such abuse is widespread (see Table 6). The studies are not directly comparable because of differences in samples and in definitions of abuse. Most distinguish between abuse that involves physical contact and abuse that does not, such as exhibitionism. They also report on different types of sexual contact—for example, genital touching versus intercourse.
Although both girls and boys can be victims of sexual abuse, most studies report that the prevalence of abuse among girls is at least 1.5 to 3 times that among boys, and sometimes much more (75, 153). In Barbados, for example, 30% of women and 2% of men reported behavior constituting sexual abuse in childhood or adolescence (199). Abuse among boys may be underreported compared with abuse among girls, however.
Women tend to report being more profoundly affected by sexual abuse than do men, although some men and boys undoubtedly suffer greatly (336, 373). The experience of being penetrated appears to be especially traumatic for both boys and girls (42, 81, 247, 336).
Studies consistently show that, regardless of the sex of the victim, the vast majority of perpetrators are male and are known to the victim (217, 336, 396, 414). Many perpetrators were themselves sexually abused in childhood, although most boys who are sexually abused do not grow up to abuse others (462).
 Hesperian Foundation (54) | Sexual abuse in childhood and adolescence seems widespread virtually everywhere. Most perpetrators are known to the victim. |
Sexual abuse can lead to a wide variety of unhealthy consequences, including behavioral and psychological problems, sexual dysfunction, relationship problems, low self-esteem, depression, thoughts of suicide, alcohol and substance abuse, and sexual risk-taking (25, 53, 81, 276, 399). Women who are sexually abused in childhood also are at greater risk of being physically or sexually abused as adults (26, 37, 149).
Although for some children the effects of sexual abuse are severe and long-term, not all will experience consequences that persist into later life (247, 314). Sexual abuse is most likely to cause long-term harm when it extends over a long period, is by a father or father figure, involves penetration, or involves force or violence (26, 247, 373).
A child's resilience and the response a child receives when disclosing the abuse also affect the long-term consequences (85, 247, 396). When children who disclose abuse are believed and supported, the consequences are often less severe than when disclosure is met with disbelief, blame, or rejection (396).
