Child sexual abuse

The term child sexual abuse (CSA) is commonly defined in contemporary western culture as any sexual acts engaged in by prepubescent minors and adults. A perpetrator of child sexual abuse is known as a child sex offender. Most child sex offenders are male; the number of female offenders is usually reported to be between 10% and 20%, although in some studies it was found to be as high as 70%. Most states force offenders to register with a national database, and releases the information to the public.

It has a special status among forms of abuse, because it includes not only


 * a) what is considered sexual abuse between adults, but also
 * b) all forms of sexual activity involving children and adults as partners, even if a child gives simple consent (see Definition based on Informed Consent).

The term has both moral and legal implications. As with the definition of sexual abuse in general, the definition of this term in legal, moral, and scientific literature varies in both criteria and specificity. The term includes also the commercial sexual exploitation of children (CSEC), defined by the International Labour Organization in the text of the Worst Forms of Child Labour Convention.

List of activities considered CSA
In countries and jurisdictions where child/adult sexual behavior is illegal, it is a criminal offense, although the list (range) of activities that are prosecuted varies between countries. Activities which are often defined as abuse only when children are involved include the following:
 * penetrative intercourse (oral, anal or vaginal) between a child below a predefined age of consent (generally between 12 and 18 years) and an adult (or a much older child),
 * asking a child to give consent to any kind of penetrative intercourse,
 * fondling a child's genitals,
 * asking, forcing, or inducing a child to fondle genitals (either his or her own, an adult's, or another child's),
 * acting as a pimp for child prostitution (including a parent acting as a pimp),
 * inducing a child to behave sexually in a performance, or to appear in child pornography,
 * asking, forcing, or inducing a child to watch any kind of sexual behavior (including masturbation),
 * asking, forcing, or inducing a child to look at adult genitals (in many countries if a child is not intentionally directed to look at adult genitals in public baths or nudistic settings, the mere presence of them is not considered CSA),
 * lewd action towards children, including disseminating pornography to a minor,
 * asking, forcing, or inducing a child to undress for any reason other than to help a child who is too young or otherwise unable to wash, dress exclusively to keep hygiene for himself or herself,
 * observing a child's genitals for any reason other than for examining existing health problems.
 * any sexual interaction of a child with an adult or other child where coercion or a power differential is present
 * purposefully undressing in front of or being seen nude around one's children after they have reached the age of awareness (often estimated as early as four or five and as late as ten years of age)
 * bathing a child who is old enough and capable enough to bathe himself/herself

Effects of sexual abuse on children
The majority of experts believe that CSA is innately harmful to 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 stress disorder symptoms such as flashbacks, emotional numbing, pseudo-maturity symptoms, and other more general dysfunctions such as sexual dysfunction, social dysfunction, dysfunction of relationships, poor education and employment records, eating disorders, self-mutilation, and a range of physical symptoms common to some other forms of PTSD, such as sensual numbness, loss of appetite (see Smith et al., 1995). Additionally, young girls who are victims of abuse may encounter additional trauma by pregnancy and birth complications. See Pregnancy after childhood sexual abuse.

Some studies have reached other conclusions about CSA. For example, a 1982 meta-analysis by Mary DeYoung reported that 20% of her "victims" appeared to be "virtually indifferent to their molestation" and instead tended to be traumatized by the reaction of adults to its discovery. Most notably, a controversial meta-analytic study of other various studies of CSA, Rind et al. (1998), found only a weak correlation between sex abuse in childhood and the later stability of the child's adult psyche, noted that a not insignificant percentage reported their reactions to sex abuse as positive in the short term, and found the confounding variable of poor family environment as a plausible cause for the majority of negative effects. Although the study stated in its conclusion that "the findings of the current review do not imply that moral or legal definitions of or views on behaviors currently classified as CSA should be abandoned or even altered," (Rind et al., 1998, p. 47), it on one hand drew widespread outrage from conservative activists, and on the other hand was often cited as supporting evidence by pedophile advocates. The authors' defense of it can be found here.

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." Much of this has been challenged, the effects of sexual abuse on men being seen by some researchers as similar to the effects on women, "initiation" being considered part of the myth of male socialisation that men are the initiators of sex and cannot be abused (Draucker 1992). However, even accepting that the notion that males cannot be abused is a myth does not prove that there is no difference between early sexual initiation and sexual abuse for males (or for females for that matter.)

Forty to 71 percent of Borderline Personality Disorder patients report having been sexually abused.

More recent studies conducted in the new mellenium indicate that sexual abuse in children can lead to the overexitation of an undeveloped limbic system; causing damage. This could explain the problems sexual abuse victims have with regulation of mood and other limbic functions. Other studies also indicate sexual abuse can lead to temporal lobe epilepsy, damage to the cerebellar vermis, along with reduced size of the corpus callosum

Offenders
Most offenders are situational offenders (pseudopedophiles) rather than pedophiles. They are rarely strangers, but 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%.

Typology
There are three categorizations of child sex offenders studied in the field of criminal psychology. The first two are major while the third is minor.

Regressed offenders
Regressed offenders are primarily attracted to their own age group but are passively aroused by minors (pseudo-pedophiles).


 * The sexual attraction in children is not manifested until adulthood.
 * Their sexual conduct until adulthood is aligned with that of their own age group.
 * Their interest in children is either not cognitively realized until well into adulthood or it was recognized early on and simply suppressed due to social taboo.

Other scenarios may include:


 * Not associating their attractions as pedosexual in nature due to cultural differences.
 * Age of consent laws were raised in their jurisdiction but mainstream views toward sex with that age group remained the same, were acted upon, then they were charged with a crime.
 * The person's passive interest in children is manifested temporarily upon the consumption of alcohol and acted upon while inhibitions were low.

Some view regressed offenders as people who are unable to maintain adult sexual relationships and so the offender substitutes an adult with a child. This appears to be a flawed concept since it would suggest the offender was primarily pedosexual and they would thus fit into the fixated category.

Fixated offenders
Fixated offenders are most often adult pedophiles who are maladaptive to accepted social norms. They develop compatibility and self-esteem issues, stunting their social growth. This is commonly characterized amongst psychologists as a "lack of maturity".

"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".

Such offenders often resort to collecting personal articles related to minors (clothing, children's books) as an outlet for their repressed desires. Most fixated offenders prefer members of the same sex. There is a difference of opinion as to whether this may be classified as homosexuality due to the nature of the individual's attractions. The sexual acts are typically preconceived and are not alcohol or drug related.

Sadistic offenders
Sadistic offenders are very rare and inherently violent criminals. They primarily use sexuality as a tool of sadistic suppression and not for sexual satisfaction. For this reason they do not fit within the classification of pedophilia.

Categorization
The great majority of offenders fit into the regressed category. Only between 2-10% percent of all offenders are fixated.

These categories, (primarily the first two), are based on the assumption that the offender suffers from an irreversible mental illness. A few have noted that the primary division between "regressed" or "fixated" offenders seems to rest on two criteria: the offending person's ability to successfully live a socially acceptable lifestyle before committing the crime and the person's primary sexual preference. These categorizations also assume the act is a crime in the jurisdiction they reside in.

These terms generally do not encompass the full range of possible scenarios and merely attempt to label easily identifiable situations. A growing number of pedosexuals feel that the two main classifications are a direct result from the lack of understanding and/or bias in the mainstream regarding pedosexuality in western society and thus are categorically flawed.

"Children who molest"
Some therapists noticed that many adult sex offenders already showed what they considered deviant sexual behavior during childhood. 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 offenders 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 practices, norms and research findings
Between cultural relativists and cultural universalists there is no consensus whether and which among different past or present cultural practices in Western or non-Western societies can be defined as abusing either general universalistic human rights or special universalistic rights of children due to which there is no generally accepted definition which of them can be listed as CSA.

In different cultures the practices sanctioned by cultural norms involve for example cutting and bleeding of the genitals, female circumcision, circumcision (of males), castration, infibulation, sexual relationships between adolescent boys and adult men sanctioned by the state and sanctified by religion in ancient Greece and feudal Japan, child prostitution tolerated in some societies as a way for children to support their families, groping of schoolgirls in Japanese trains, in the Western societies now abolished remedies against masturbation (once named 'self-abuse'), and nudity in public baths and nudistic settings etc.

In some South Pacific island cultures, such as the Sambia of Papua New Guinea, one of the primary rituals of initiation for boys involves having them ingest semen, which they consider to be the literal essence of manhood. The boys obtain semen by fellating older boys who have already passed through the initiation. Upon initiation into higher stages, the roles are reversed, making the fellator the fellated. Ritual fellatio is somewhat common throughout southeastern Papua New Guinea but has been studied the most in the Sambia (Herdt 1982). 

Because of the lack of the universal definition the research on CSA is open both to personal biases of the researchers and of their critics.

Epidemiology
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%.

Sexual abuse, consent, minors, age gap and culture
The simple definition of child sexual abuse is when an adult forces or coerces sex on a prepubescent minor. There is an ongoing controversy surrounding this definition. The controversy lies within the argument as to whether children can or cannot give cognitive consent. The mainstream opinion in countries such as the U.S. and U.K. is that any minor under the legal age of consent is deemed mentally incapable of consenting to sexual activity with people older than they are, thus any and all contact is automatically considered abuse.

Also, in cases of multi-generational relationships where both parties are legal adults, such relationships are still often widely considered immoral and taboo, even though legal. Such relationships often result in humorous anecdotes or parodies, and in some more severe cases, social abolishment.

In most cases involving minors, the combination of these two elements results in the passing of laws which prohibit minors from giving legal informed consent, even if they are indeed a willing partner to the best of their own knowledge. Thus, if such acts are discovered, the adult may be charged with a criminal offense.

Definition based on moral objection; relativity
The mainstream view is that any and all contact between minors and adults is immoral and automatically abuse in all cases. In more severe opinions it is considered inherently evil, and in their own words, "the perpetrators must be held liable to the utmost extent of the law."

Innocence of children
On one hand, moral opponents also strive to maintain preservation of the perceived innocence in children.

On the other hand, proponents claim this argument based on innocence is inherently flawed in that it is ignorance, not innocence, which is wrought by not allowing children to be exposed to sex at an earlier age.

This debate is a separate one in and of itself, and lends to ideals which both sides of the argument deem worthy enough for strong objection. Both sides routinely refer to the "preponderance" of psychological, sociological, and historical evidence to back their claims.

Both sides agree that genuine cases of force and coercion are indeed true abuse.

Objection to homosexuality
In cases of same-sex relations between adults and minors in western civilisation, there is also the stigma based on the homosexual nature of the actions. There are other societies, however, in which adult/adult homosexuality is considered criminally and morally offensive behavior, but child/adult heterosexual relations are viewed as acceptable.

Criticism of the definitions
Views on sexual relations between adults and prepubescent minors in western society remains a deep controversy.

Critics disagree with labeling all child sexual activity involving adults as partners or observers as abuse based on the concept of informed consent, arguing that simple consent should suffice to exclude consensual acts from the definition of child sexual abuse (CSA). Those critics, including some sociologists, psychologists, educators, and some pedophilia advocates, also object to the use of the 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 some sexual activity of or with minors is considered a crime solely because of sexual morality. Some researchers contend that categorizing all sexual activity with minors as abuse makes it difficult to study the effects of abuse on children. Others claim that a distinction should be made between, on the one hand, severe sexual abuse that is often associated with severe symptoms such as suicidal tendencies, sexual aggression, and self-mutilation (Kisiel and Lyons, 2001), and on the other hand, milder types of CSA that do not necessarily cause harm. Rind et al. (1998) argued that "CSA does not cause intense harm on a pervasive basis," although anecdotal evidence documents harmful effects of early sexual activity (see Bass, Ellen et al, The Courage to Heal, 3rd edition, 1994)

Some further argue that denying a child the right to give informed consent ignores his or her right to sexual self-determination.

However, due to conservative views on the nature of child sexuality in western society, these criticisms are highly controversial. The mainstream definition of child sexual abuse is predicated on whether children are developmentally able to give informed consent, not just consent based on their feelings and expectations. Informed consent requires full cognitive understanding of one's own mind and the mind of the other person. The scientific evidence from psychological experiments, such as the Sally-Anne test, clearly show that full understanding does not develop until the end of puberty.

Critics of the mainstream definition counter that the focus on informed consent is a red herring. They believe the issue should be whether sexual relations involving simple consent are harmful. They believe they are not. They point to a long tradition of older men marrying young girls that is common across time and cultures, and also to pederasty (man-boy sexual relations), which was deemed acceptable in Ancient Greece, New Guinea, and feudal Japan. It is not clear whether the absence of informed consent is a predictor of harm.

On the other hand, on the Isle of Alor, it was discovered that parents were masturbating their children and referring to it as a natural way of relieving their children's tensions. The Alorese exhibit a number of psychological symptoms many connect to the sexual abuse.