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FACTS ABOUT CHILDHOOD SEXUAL ABUSE
Marci A. Hamilton
Paul R. Verkuil Chair in Public Law
Benjamin N. Cardozo School of Law
Yeshiva University
Hamilton02@aol.com
(215) 353-8984
Childhood sexual abuse victims constitute a class of victims who share a number
of common characteristics. One of the primary characteristics is the extreme difficulty
they face making a connection between their typically serious problems in adulthood and
the sexual abuse when a child. See generally, Guy R. Holmes, See No Evil, Hear No Evil,
Speak No Evil: Why Do Relatively Few Male Victims of Childhood Sexual Abuse
Receive Help for Abuse-Related Issues in Adulthood?,17(1) Clinical Psychol. Rev. 69,
69-88 (1997); see also State v. Schnabel, 196 N.J. 116, 133 (2008) (observing that Child
Sexual Abuse Accommodation Syndrome involves five behavior patterns that may be
exhibited by a sexually abused child: secrecy, helplessness, entrapment and
accommodation, delayed reporting, and recantation). The unexpected fallout from
childhood sexual abuse for the typical victim is compounded by the fact that there are
many different problems that can flow from sexual abuse.
The injuries a particular child sex abuse victim will suffer cover a wide swath of
possibilities. Researchers in various studies have found -- specifically in men who were
sexually abused as children that long-term adaptation will often include sexual
problems, dysfunctions or compulsions, confusion and struggles over gender and sexual
identity, homophobia and confusion about sexual orientation, problems with intimacy,
shame, guilty and self-blame, low self-esteem and negative self images and increased
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anger.1 There is also an increased rate of substance abuse, a tendency to deny and delegitimize
the traumatic experience, symptoms of Post Traumatic Stress Disorder, and
increased probability of fear and depression.2
Hundreds of research studies have conclusively shown that sexual abuse can alter
a childs physical, emotional, cognitive and social development and impact their physical
and mental health throughout his or her lifetime. A 2002 study by Elliot Nelson, M.D.,
et. al. reaffirmed that childhood sexual abuse has a profound negative impact throughout
the victims life. Elliot Nelson et. al., Association Between Self-reported Childhood
Sexual Abuse and Adverse Psychosocial Outcomes: Results From a Twin Study, 59(2)
Archives of General Psychiatry, 139,139-45, available at
http://genepi.qimr.edu.au/staff/nick_pdf/CV321.pdf (last visited February 21, 2009).
This study examined both members of nearly two thousand same-sex twins (1159 female
and 832 male). Id. at 139. Twins were used to separate the effects of childhood sexual
abuse from possible negative effects of family background, such as parental alcohol
related problems, fighting and conflict, physical abuse, and neglect. Id. at 143-44. The
study looked at same sex twin pairs where one of the twins was sexually abused as a
child and one was not. Id. at 139. The study found that a person with a history of
childhood sexual abuse had an increased risk for subsequently occurring adverse
outcomes of:
1 David Lisak, The Psychological Impact of Sexual Abuse: Content Analysis of Interviews with Male
Survivors, 7(4) J. of Traumatic Stress 525, 525-526, 544 (1994). Unlike the victim of a toxic tort, there is
no medical necessity that the abuse will lead to a scientifically dispositive injury. For example, asbestos
exposure leads to asbestosis, a lung disease. Child sex abuse is more like the tort in Mancuso v. Mancuso,
209 N.J. Super. 51 (App. Div. 1986), where accrual was delayed because the victim was harmed in a
relatively minor car accident that would not have led victim to suspect that Parkinsons could result. Child
sex abuse victims simply do not apprehend that the abuse, which they may not even experience as abuse,
could lead to devastating effects in adulthood.
2 Id.
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Major depression,
Suicide attempt,
Conduct disorder,
Alcohol and/or nicotine dependence,
Social anxiety,
Rape after the age of 18 years old, and
Divorce.
Id. at 142.
Men were close to twice as likely to suffer from major depression if they were
sexually abused as children, compared with those who were not abused. Ibid. Women
and men who were sexually abused as children were roughly five times more likely to
attempt suicide, compared to those people that were not abused. Ibid. These adverse
outcomes alone make it very difficult for victims of childhood sexual abuse to discover
that the sexual acts were abuse and to discover the cause of their injuries because many
simply struggle to survive the onset of drug or alcohol abuse, major depression, and
suicide attempts.
Often it is not until years after the sexual abuse that victims experience these
negative outcomes. Clinician Mic Hunter observed that:
Some of the effects of sexual abuse do not become apparent until the
victim is an adult and a major life event, such as marriage or birth of a
child, takes place. Therefore, a child who seemed unharmed by
childhood abuse can develop crippling symptoms years later and can
have a difficult time connecting his adulthood problems with his past.
Mic Hunter, Abused Boys, 59 (1991) (emphasis added).
At the time the child is sexually abused he or she is often too young to appreciate
the harmful nature of the acts. Years later when the child does experience the injuries
arising from the childhood sexual abuse, the victim is disabled from relating the harm to
the abuse in a temporal sense the way that one would expect if the harmful event was
closer in time to the realization of the injury.
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In addition to delayed onset of injury, there are many other reasons that childhood
sexual abuse victims may not know they were abused or injured, or able to identify the
cause of their injuries until adulthood. The following reasons are by no means exclusive
but often affect a child who is sexually abused:
Most sexual abusers are someone that the child knows and trusts. In fact
only 4% of child sex abusers are strangers. Wisconsin Coalition Against
Sexual Assault, Child Sex Abuse, available at
http://www.wcasa.org/info/factsheets/childsa.htm(last visited February 22,
2009) (citations omitted).
Often abusers manipulate the child victim into thinking that the
relationship is built on mutual love. See Maxine Hancock & Karen
Burton Mains, Child Sexual Abuse: Hope For Healing 33 (1987) (citations
omitted).
Children may be told by the abuser to keep the abuse a secret. See Dale
Robert Reinert, Sexual Abuse and Incest 34-35 (1997).
Victims sometimes feel shame and embarrassment about the abuse,
making the victim feel they are to blame for the abuse. Mary L. Paine &
David J. Hansen, Factors Influencing Children to Self-Disclose Sexual
Abuse, 22 Clinical Psychol. Rev. 271, 271-75 (2002).
Many Children lack the cognitive ability to recognize that these acts were
abuse and harmful. See Margaret O. Hyde & Elizabeth H. Forsyth, The
Sexual Abuse of Children and Adolescents 10 (1997).
Some children are very confused by the physical sensations that
accompany physical acts. The body releases chemicals which tell it that
the sexual acts are a good thing, something pleasurable.
For most victims, the sexual abuse is their first sexual experience and they
have nothing to compare it with.
Because the victim could face any one or more of these experiences before,
during, or after the time of the abuse, it is often difficult for the victim to realize that the
sexual acts themselves are even abuse. See Louise D. Sas & Alison H. Cunningham,
Submissions of London Fam. Ct. Clinic Inco. To Fam. Violence Prevention Div. Health
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Can., Tipping the Balance to Tell the Secret: Public Discovery of Child Sexual Abuse 1,
91-92 (1995). These experiences compound the difficulty that is created by the delayed
onset of the emotional problems, all of which makes it difficult if not impossible for the
victim to realize that his or her problems are the result of the sexual abuse. See Mic
Hunter, Abused Boys at 31, 59.