Sexual abuse is physical or psychological abuse that involves sexual behavior. Most forms of sexual abuse are crimes in most countries.
Forms of sexual abuse include rape and indecent assault.
Women and children are the most frequent victims of sexual abuse, but men can also suffer from it. Most sexual abusers are male, but there is a significant minority of female sexual abusers.
Sexual abuse is non-consensual, and should be distinguished from consensual sex, or activities such as BDSM. Many activities which are acceptable between consenting partners would constitute sexual abuse if forced on a non-consenting person. It should be noted that in some jurisdictions, people under a prescribed age of consent are presumed by law to be unable to give consent to some or any sexual activities. Often it also refers to activities that are morally condemned in society. These are ambiguous definitions, because moral norms, socially accepted behaviour and laws vary greatly both nationally and internationally and because the definition is too wide to be useful.
see spousal abuse for more
Student and Patient Sexual Exploitation
High school and college age students are sometimes victims of sexual exploitation by teachers and professors, see Academic abuse. Even if the sexual contact is initially consented to by the student, it may be considered a form of abuse as the teacher or professor is presumed to be exploiting his or her position of authority in a subtle form of psychological coercion. Whether this is a sound presumption in all cases may be disputed.
For a famous example of a teacher-student relationship, see Mary Kay Letourneau.
Patients of psychotherapists are another common category of sexual exploitation, see Psychotherapist abuse .
Child sexual abuse
Child sexual abuse [CSA] denotes sexual abuse of or sexual activity with children. The term has both moral and legal connotations. There is variation in criteria and specificity of the definition of "child sexual abuse", as with "sexual abuse", even in scientific literature.
Child sexual abuse is a criminal offense everywhere, although the range of activities that are prosecuted varies between countries. Child sexual abuse is more difficult to define than sexual abuse in general, because of debates over who is capable of giving consent. In addition to activities which would be considered sexual abuse between adults, this often includes
According to United States law, for instance, children can only give simple but not informed consent to sexual activity. An adult who performs sexual acts with a minor is guilty of statutory rape (or sex without consent when the child is very young). According to some state laws in the U.S., a minor, similarly, cannot give informed consent to another minor; two minors engaging in sexual activity may both be, somewhat paradoxically, classified as victims of sexual abuse. Cases in which both participants are minors have historically not been prosecuted, although a shift in the direction of prosecuting minors for consensual sex with other minors seems to have occurred in the last several decades. (See Ethical Treatment for All Youth for examples.)
Criticism of the definition
Some researchers such as Rind contend that this grouping of all sexual activity with minors with other forms of abuse makes it difficult to study the effects of abuse on children. Others claim that a distinction should be made between severe sexual abuse that is often associated with suicidal tendencies, sexual aggression, and self-mutilation (Kisiel and Lyons, 2001) and other types of CSA that do not necessarily have these severe negative effects.
Critics of outlawing sex with children, including some sociologists, psychologists, and educators as well as pedophile emancipation groups, disagree with labelling all child sexual activity as abuse and object to the use of terms victim and perpetrator when describing consensual acts. Many doubt that there is scientific evidence that consensual sexual activity causes harm to minors and argue that child sexual abuse is considered a crime solely because of sexual morality. Rind et al. (1998) stated that "CSA does not cause intense harm on a pervasive basis". Some further argue that denying a child the right to give informed consent ignores his/her right to sexual self-determination.
Effects of sexual abuse on children
A wide range of psychological, emotional, physical, and social effects has been attributed to child sexual abuse, including "anxiety, depression, obsession, compulsion, grief, post-traumatic reactions, poor self perception, sexual dysfunction, social dysfunction, dysfunction of relationships, poor education and employment records, and a range of physical symptoms" (Smith et al., 1995). There is a debate about how best to determine the causal dependency for some of these effects. A controversial study of child sexual abuse, Rind et al. (1998), found the confounding variable of poor family environment as a plausible cause for the majority of negative effects. Children with such a background are more likely to become victims of abusers.
The effect of Sexual Abuse on children in some cases leads to sexual behavior, physically and verbally in social. This behavior in social enviroments such as school and even the home is is usually frowned upon by other children, and authority figures including parents. This can in some cases cause child to develop a very low self-esteem, and self-hate from the alienation from their peers. This can lead children to develop shyness, anti-social behavior, and high attention seeking behavior. This effect on a child's behavior when combined with the sexual initiation can lead to far more complex issues. This shows that even in consensual cases of sexual initiation on a child that alienation is possible in societies that do not accept this behavior.
The percentage of adults suffering from long-term effects is unknown. Smith quotes a British study that showed that 13% of adults sexually abused as children suffered from long-term consequences.
Wakefield and Underwager (1991) note the difference between CSA experiences of boys and girls, where more boys than girls report the experience as neutral or positive, saying that "It may be that women perceive such experiences as sexual violation, while men perceive them as sexual initiation."
Forty to 71 percent of Borderline Personality Disorder patients report having been sexually abused.
Child sex offenders
Most offenders are situational offenders (pseudopedophiles) rather than people sexually fixated on children (pedophiles). They are rarely strangers, but instead relatives or acquaintances like trainers or playmates. Most offenders are male, the number of female perpetrators is usually reported to be between 10% and 20%, however in some studies it was found to be as high as 70%.
There are two main categories of offenders. These categories are known as the "regressed" offender and the "fixated" offender.
The regressed offender has a primary sexual orientation toward adults, but can be aroused by children. In most cases he is heterosexual. The sexual interest in children typically manifests itself in adulthood in this sort of offender. "Due to an inability to maintain adult relationships the offender substitutes a child for an adult sexual partner". The initial offense is often not planned and often alcohol related. The regressed pedophile is typically capable of a traditional life-style and often married. Social skills of the regressed offender are basically normal but with under developed peer relationships. The regressed offender typically has no problem making acquaintances or socializing with others, but is not capable of handling the responsibility of long-term relationships. This behavior is a maladaptive attempt to cope with specific life stresses.
The fixated offender has a primary sexual orientation toward children, i. e. he is a pedophile. The sexual interest in children manifests itself in adolescence for this offender. The offenses are typically planned out ahead of time and are not alcohol or drug related. The fixated pedophile has behavior that is characterized as a lack of maturity and this offender has difficulty with adult sexual and social relationships. "This offender identifies with children, in other words considers him or herself to be like a child and thus seeks sexual relationships with what the offender perceives to be other children". The fixated offender is often interested in the same activities and interests as the young children who are the offender's victims. Such offenders often collect articles related to small children (clothing, children's books), even if they do not have children. This behavior has been interpreted as a maladaptive resolution to issues with adult maturity. Most fixated offenders prefer members of the same sex, although there are some who abuse both sexes, and others who abuse only members of the opposite sex.
The great majority of offenders are regressed. Only 2-10 percent of all offenders are fixated. The third and very rare type of offender is sadistic. They primarily use sexuality for suppression not for sexual satisfaction.
Exhibitionists are commonly classified as a phenomenon of their own, and excluded from this typology of sex offenders.
"Children who molest"
Some therapists noticed that many adult sex offenders showed what they considered deviant sexual behavior in their childhood already. So they promoted early treatment of deviant minors as a preventive measure. However there is still little known about normal as opposed to deviant child sexuality. It is also unknown whether so called deviant minors have a higher risk of becoming an adult sex offender than anybody else.
The US started to focus on "juvenile sex offenders" or even children for therapy or detention perhaps in the early 1990s. The label "juvenile sex offender" is controversial because it is not only used to describe acts of violence, but also consensual acts that violate statutory rape laws; critics of this trend view many such children as simply engaging in sexual experimentation. They also criticize the law for forcing arbitrary classification of such pairs of offenders into victim and perpetrator.
Therapies used on children have included controversial methods historically used in the "treatment" of homosexuals such as aversion therapy, where children are, for example, forced to smell ammonia while looking at nude pictures or to listen to audio tapes describing sexual situations. In order to measure sexual response, devices like penile plethysmographs and vaginal photoplethysmographs are sometimes used on these children.
Variation in cultural norms
Though few doubt that child sexual abuse has negative effects on the children involved, there is controversy over what constitutes abuse. Critics often focus on rituals practised in cultures geographically or temporally removed from their own. In many cases, rituals or ceremonies of cultural or religious significance involve activities that some would describe as child sexual abuse. These include castration, circumcision (of males), female circumcision, spanking of children, infibulation, and cutting and bleeding of the genitals.
The various "remedies" against masturbation which were proposed and used from the late 19th to the mid-20th century, ranging from physical restraints to castration, have been called sexual abuse.
In ancient Greece and feudal Japan, pederasty (sexual relationships between adolescent boys and adult men) was an important part of life, sanctioned by the state and sanctified by religion.
Variations across studies
Some researchers note that the lack of a generally accepted definition leads to incompatible study findings and wrong generalisations, when different phenomena are often lumped together as if they had similar causes and results. Rind et al. has criticised the term "child sexual abuse" as being "of questionable scientific validity", arguing that scientists should not deal with such vaguely defined fields, but instead concentrate on specific phenomena that can be observed empirically and clearly defined. Okami (1990) criticises current research on adult-child sexual behavior and notes that "much of the current victimology-based research employs polemical devices and research methods that blur the line between social science and social criticism".
For decades there has been debate on the prevalence of child sexual abuse. The research has suffered from lack of common methodology, unclear definitions, use of questionable techniques for retrospective studies, such as memory recovery (see false memories), bias, unjustified presumptions and other factors. Goldman (2000) notes that "the absolute number of children being sexually abused each year has been almost impossible to ascertain" and that "there does not seem to be agreement on the rate of children being sexually abused". A meta-analytic study by Rind, Tromovitch, and Bauserman (1998) found that reported prevalence of abuse for males ranged from 3% to 37%, and for females from 8% to 71% with mean rates of 17% and 28% respectively. A study by Fromuth and Burkhart (1987) found that depending upon the definition of CSA used, prevalence among men varied from 4% to 24%.
Semantics and society
Child sexual abuse is regarded as particularly reprehensible in many modern societies. The attitudes towards various sexual activities also vary between countries. For example, in many countries children and adults going to saunas or public baths together is acceptable. In Japan activities such as groping schoolgirls in trains are tolerated to some degree. Child prostitution is tolerated in some societies as a way for children to support their families.
- Committee on Child Abuse and Neglect "American Academy of Pediatrics: Guidelines for the Evaluation of Sexual Abuse of Children: Subject Review" Pediatrics 103 (1) January 1999, pp. 186-191
- Smith D, Pearce L, Pringle M, Caplan R. "Adults with a history of child sexual abuse: evaluation of a pilot therapy service" BMJ 1995;310:1175-1178
- Kisiel CL, Lyons JS. "Dissociation as a Mediator of Psychopathology Among Sexually Abused Children and Adolescents" Am J Psychiatry 158:1034-1039, July 2001
- Ralph Underwager, Hollida Wakefield "Antisexuality and Child Sexual Abuse" IPT Volume 5 - 1993
- Eric Vern L. Bullough and Bonnie Bullough, "Problems of Research into Adult/Child Sexual Interaction" IPT Volume 8 - 1996
- Pedophilia: Biosocial Dimensions (). Edited by Feierman JR. New York, Springer-Verlag, 1990
- Some Methodological Problems in Estimating Incidence and Prevalence in Child Sexual Abuse Research. Journal of Sex Research, Nov, 2000 by Juliette D. G. Goldman, Usha K. Padayachi 
- Fromuth ME, Burkhart BR: Childhood sexual victimization among college men: definitional and methodological issues. Violence and Victims 1987; 2:241-253