Childhood sexual abuse: Lifting the veil of denial

Abstract

The reality and enormity of child and adolescent sexual abuse, especially in the Asian subcontinent had been until recently shrouded by collective denial and a conspiracy of silence. Child sexual abuse (CSA) in its various forms is alarmingly common. In a 2007 large-scale study undertaken by the Government of India, as many as 53 % of children reported being subjected to one or more forms of sexual abuse, several fold higher than that reflected in legal statistics. In a large number of these cases, the perpetrator is someone in the family or someone responsible for the child’s care like a school teacher. Risk factors involved in occurrence of CSA include lower socio-economic status, single parenthood, parental substance use amongst others. The response of the family and community is often that of disbelief, blaming the child and holding her/him responsible, and fear of and actual stigma and ostracism. Such a response coupled with insensitivity towards, anticipated harassment and inadequate protection of victims by concerned agencies and authorities increases the woes of the child. This also often results in under-reporting and ‘out of court settlements’. Unfortunately, the psychological impact of sexual abuse on children though unequivocally clear and well documented in the literature, is completely neglected in the aftermath. This is partly due to efforts of the family in protecting itself from social ostracism at the cost of protection and psychological health of the child-hushing rather than discussing. Partly, it is due to lack of defined governmental policies and guidelines or its implementation and of trained mental health professionals working in this area. Thus, occurrence of CSA and its consequences are enmeshed in a complex web of many aspects of the child’s life and circumstances, societal attitudes, attitude of the government and its agencies, and attitude and commitment of professionals.In this chapter, epidemiological, clinical and policy-related matters shall be discussed to understand this complex web, particularly in Asian context.