Child sexual abuse
[40] Sexual assault among teenagers has been shown to lead to an increase in mental health problems, social exclusion and worse school performance.
[10][26][55] Kendler et al. (2000) found that most of the relationship between severe forms of child sexual abuse and adult psychopathology in their sample could not be explained by family discord, because the effect size of this association decreased only slightly after they controlled for possible confounding variables.
[55][non-primary source needed] A 1998 meta-analysis by Bruce Rind et al. generated controversy by suggesting that child sexual abuse does not always cause pervasive harm, that girls were more likely to be psychologically harmed than boys, that some college students reported such encounters as positive experiences and that the extent of psychological damage depends on whether or not the child described the encounter as "consensual".
Recommendations for healthcare workers, such as primary care providers and nurses, who are often suited to encounter suspected abuse are advised to firstly determine the child's immediate need for safety.
Children often present for treatment in one of several circumstances, including criminal investigations, custody battles, problematic behaviors, and referrals from child welfare agencies.
[129] Major factors that affect both the pathology and response to treatment include the type and severity of the sexual act, its frequency, the age at which it occurred, and the child's family of origin.
He suggested that children who are victims of sexual abuse display a range of symptoms that include secrecy, helplessness, entrapment, accommodation, delayed and conflicted disclosure and recantation.
Its content varies widely between therapists, but a typical program might involve training in self-control, social competence and empathy, and use cognitive restructuring to change views on sex with children.
The most common form of this therapy is relapse prevention, where the patient is taught to identify and respond to potentially risky situations based on principles used for treating addictions.
[146][147] While progress has been made in raising awareness and implementing preventive measures, challenges persist in identifying and prosecuting perpetrators, supporting victims, and addressing systemic factors contributing to abuse.
[148] Despite advancements in understanding and addressing CSA, a more comprehensive and coordinated approach is needed to effectively combat this deeply concerning issue and ensure the safety and well-being of all children.
Its content varies widely between therapists, but a typical program might involve training in self-control, social competence and empathy, and use cognitive restructuring to change views on sex with children.
The most common form of this therapy is relapse prevention, where the patient is taught to identify and respond to potentially risky situations based on principles used for treating addictions.
[166]: 177–181 Gonadotropin-releasing hormone analogs such as leuprorelin (Lupron), which last longer and have fewer side-effects, are also used to reduce libido,[176] as are selective serotonin reuptake inhibitors.
[166]: 181–182, 192 The Association for the Treatment of Sexual Abusers opposes surgical castration[178] and the Council of Europe works to bring the practice to an end in Eastern European countries where it is still applied through the courts.
The definition includes any sexual activity between children that occurs without consent, without equality, or due to coercion,[197] whether the offender uses physical force, threats, trickery or emotional manipulation to compel cooperation.
[203] In Mozambique, a study by the Ministry of Education found that 70 percent of female respondents reported knowing teachers who use sexual intercourse as a necessary condition to advance students to the next grade.
"[212] A number of high-profile baby rapes appeared since 2001 (including the fact that they required extensive reconstructive surgery to rebuild urinary, genital, abdominal, or tracheal systems).
[234] In Uzbekistan, the UK Ambassador Craig Murray wrote that the government, under president Islam Karimov, used child rape to force false confessions from prisoners.
[252] According to Emily M. Douglas and David Finkelhor, "Several national studies have found that black and white children experienced near-equal levels of sexual abuse.
[264] This underreporting has been attributed to cultural denial of female-perpetrated child sex abuse,[265] because "males have been socialized to believe they should be flattered or appreciative of sexual interest from a female.
[270][271] Child sexual abuse is outlawed nearly everywhere in the world, generally with severe criminal penalties, including in some jurisdictions, life imprisonment or capital punishment.
[280] There are several cases where law enforcement agencies lack the manpower and resources to efficiently resolve CSA crimes, which leads to reduced rates of prosecution and conviction.
[citation needed] Second wave feminism brought greater awareness of child sexual abuse and violence against women, and made them public, political issues.
The institutionalization of child maltreatment interventions in federally funded centers, national and international societies, and a host of research studies (in which the United States continues to lead the world) offers grounds for cautious optimism.
'[293] Media reporting plays a crucial role in tackling the world-wide problem of child sexual abuse because it puts the issue on the public and political agenda.
[298] Several checklists and guidelines for journalist have been published by violence prevention and journalism organizations to help improve the quality of news reporting on child sexual abuse.
[299][300] In the United States, growing awareness of child sexual abuse has sparked an increasing number of civil lawsuits for monetary damages stemming from such incidents.
Some states have enacted specific laws lengthening the applicable statutes of limitations so as to allow victims of child sexual abuse to file suit sometimes years after they have reached the age of majority.
At the same time, a wider range of actions is also needed, including changes to teacher training and recruitment and reforms of curricula, so as to transform gender relations in schools.
