The risk of child sexual abuse - real or imaginary?

Children are paramount and that must be our focus.

Sandy Relph SRN, Ward manager, Department of Genito-urinary Medicine, Middlesbrough General Hospital, Middlesbrough. England

The risk of child abuse is very real and the perpetrator is more than likely to be known to the family hence the difficulty for the child. Exploitation by adults who are in a position of trust is skilfully manipulated and the child can be into a working situation through believing that the adult loves him/her more than any other member of the family. People are more aware of child abuse and are beginning to realise that the abuser is now always stereotyped, (i.e. black coat, long dirty hair). The media must police itself and understand that the majority of children can read and use the Internet.
The 9 o'clock watershed is a farce as often programmes are on TV before this time with sex and violence. Also people who are high profile e.g. pop stars, actors should also be aware of how much they influence youth. In England today the age of consent to sex between boy and girl, gay or straight is 16 years old. Throughout the world the age of consent differ (www.Avert.org. worldwide age of consent).
We are aware that travel and holidays encourage child abuse in countries where the age limit is low and prostitution is accepted. For example, Thailand has about 7.5million tourists a year but 5 million are unattached males. We also know that sometimes children who are abused may go on to abuse themselves when they reach adulthood.

Ethnicity and effect of age?
Ethnic minorities do tend to live in similar areas and also family groups live together. As with a lot of religions, underage sex or sex before marriage is not tolerated or advocated and the sexes do not mix without chaperones. To begin to discuss child sexual abuse is very difficult when any form or pre-marital sex is not only accepted but believed not to exist.
Child sexual abuse knows no age culture or boundaries. Between the age of 0-4 years, children are unable to make decisions as to their daily lives. They rely completely on the adults who care for them. This relates to diet and recreation and it is at this time that future patterns are put into place. When children enter the scene of education they may still be not aware that the mode of life differs from their friends at school. Puberty and some sex education lessons at late primary school are often the time of realisation that not all families are the same.
On entering senior school when children tend to share experiences the children becomes aware that all is not right. The path that the child may now take is unpredictable and may lead to self-harm, child prostitution and multiple partners and due to low self esteem often a teenage pregnancy.

Which gender is at greater risk?
All young children are at risk of abuse in many forms. This could be physical/mental or both. It also implies to a child who observes physical/mental abuse, which is subjected not to them but to another member of the family. This is often carried onto their own relationships in adult life. Boys as well as girls are at risk and although this may continue into teens often the boy may break away first as he matures and has physical strength. This may be more difficult for the females.

Child sexual abuse and future psychological health:
Child abuse is an old problem and has not always been acknowledged. Society in the past has always turned a blind eye.
Young children often pre Junior or Senior school level were never aware that they were being abused until realising that this was not the 'norm' in other families.
Children are taught to listen to adults, not to answer back and to do as they are told. It is difficult for a child to talk to an adult about another adult. They often share the situation with other siblings or friends and these friends can become mentally amused due to carrying this secret for their sibling, often for a long time.
In abusive or violent situations the child may often accept the abuse as a form of affection but on the part of the adult this is just control. Children who have been abused lose a lot of self-esteem and turn to adults in teen years for affection and cannot differentiate between manipulation and coercion. Often the promise of "easy " money may lead the young person into prostitution, which becomes a vicious circle and, without help it becomes very difficult to break from the situation.

Child Protection Policy - Is it working?
We don't know, but we hope it is. There are lots of areas to know. We would hope that the policy is working but everything we use can always be improved. Also we don't know if it works until we have to use it.
Wherever you work you should know the policy for your area and who to contact if advice is needed or you have cause for concern.

For whose benefit - child parents, teachers, others
The child must always be the main priority in all to do for any cause for concern or worry. In all forms of medicine the child protection act supersedes all other Acts of Parliament. Children may be in care for many reasons not necessarily that they have been abused and all things necessary must be ensured to keep those children safe, i.e. Police clearance. The family also needs protection as any false claims may affect the family unit in the future.
Whose responsibility?
Every person should be responsible for the well being of children. Often an abuser is not exposed until they die and then the family has no one to ask so they will not believe and the family is split. Denial is a big part in child abuse and often an event in a child's life brings back all memories. This could be a death of a family member or the birth of a child as this can give a worry as to whether the cycle will continue.
What should society do with paedophiles? Castration!
To talk about castration is always an emotive subject as this a knee jerk reaction. Chemical castration is with medication and who would supervise this? Surgical castration may be an answer but people do not need a penis to abuse a child (women have no penis?). People need to be aware of where their children are, believe the child and don’t stereotype.
What are the roles of professionals - teachers, nurses, doctors, social workers, priests: Education of professionals is very important and to be aware of the child protection policy and know whom to talk to if information should come your way.
You should give the child the confidence to show that you have listened and that they can come back to you at any time. They need to understand that adults can be trusted and not all will let them down. For a long time the children would have felt very vulnerable and we need to give them a sense of safety in a non-judgemental environment.

(This was part of the workshop on Child sexual abuse which S. Relph acted as the facilitator during the 4th Teesside Sexual Health Conference on 15th March 2003.)

 


©2001 Sexual Health Matters. Published Quarterly by Express Print Works, Middlesbrough, UK
ISSN 1469-7556
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