Monday, September 3, 2012

Dissertation on shame. Chapther 2.2 The prevalence of sexual abuse

2.2 The prevalence of sexual abuse

How common is child sexual abuse? The United Nations Secretary-General’s Study on Violence against Children (United Nations 2006) was published in October 2006 and was based on reports from 133 different countries, research, and new studies that have been carried out by the UN and voluntary organizations from all over the world. The results of this study show that between 13 and 27 percent of all children in the world have suffered sexual abuse or exploitation, but how sexual abuse and exploitation is defined in this study is in my opinion not clarified because this will vary from one country to another. Sexual abuse still seems to be a worldwide problem which is usually silenced. When the silence is broken and the abuse is exposed, it seems not unusual that the child is blamed or convicted. Most of the abuse against children happens within the family, and is therefore kept hidden. The report concludes that only between two and three percent of all the children in the world have the same judicial protection as adults. Only 17 countries in the world have laws against the use of violence against children within the family. Disclosure of child abuse is therefore a difficult matter due to the silence connected to it and the fact that it often happens within the family; the responsibility for disclosure thus resides with parents or caregivers, who may themselves be perpetrators or dependent on perpetrators. 

Sexual abuse has emerged as one of the major forms of child abuse. It was in the late 1970’s that official reports started to grow, and the number of reports grew rapidly. Sexual abuse did not all of the sudden begin as a phenomenon at this time, but sexual abuse was now conceived differently than before. Focus was now turned towards close family members (particularly fathers and stepfathers) and not strangers or depraved individuals outside the family (Finkelhor 1979). It became apparent in these years that most victims never talk about the abuse they have suffered. The consequences of child sexual abuse was also focused on, especially the psychological problems as en negative self esteem and the inability to develop trust in intimate relationships (Herman 1981).

Estimates vary about how many have experienced child sexual abuse as children. Finkelhor (1984) has concluded that studies range from 9 to 52 percent of adult women and 3 to 9 percent of adult men report having been sexually abused as children, either by family members or strangers. Maltz and Holman (1987) argue that this variation has to do with the fact that different studies use different definitions of sexual abuse. The figures are much higher when the definition of sexual abuse is broadened to include experiences such as being forced or encouraged to watch sexual activity of being forced to stimulate oneself in front of another person. Gilman (1991) has collected and compared 15 studies about reported abuse carried out between 1956 and 1990. The results here vary from 11 to 62 percent of adult women and 3 to 30 percent for adult men. All of these studies, except one, involve both contact and non-contact abuse of the child. When non-contact abuse includes more common experiences such as receiving obscene phone calls, being called sexually offensive names, and being treated as a sexual object, it becomes evident in my opinion that almost all females and males have experienced some form for sexual abuse.

Levett (2003) argues that studies, mainly in North America and the UK, commonly suggest up to 54 percent of women have been subjected to child sexual abuse. She has in a previous study (Levett 1980) with South African university female students, that the reported 44 percent of the female students, who said they had been sexually abused as children, is an under-report. Levett argues that the two main reasons for the vast differences in reported prevalence of child sexual abuse, is related to the many definitions of sexual abuse and to the different methods used to collect data.

DeMause (1991) uses a broad definition of sexual abuse, including not only cases of rape or attempted sexual intercourse, but also genital fondling and other forms of unwanted and intrusive contact behavior. His conclusions show that at least 60 percent of girls and 45 percent of boys have been sexually abused in childhood. He argues further that 80 percent of all sexual abuse takes place before puberty and that 80 percent of all sexual abuse takes place within the family.

Spaccarelli (1994) has carried out a study of literature within the field of child sexual abuse, and concludes that it is difficult to carry out research in a field where there is little consensus regarding definitions of sexual abuse, conceptions of childhood and the significance of age difference between perpetrator and victim. Painter (1986) argues that method problems, sampling techniques, the use of volunteer informants and unsophisticated questionnaires, make it difficult to compare studies of prevalence and consequences of child sexual abuse. Levett (2003) argues that the most serious problem in studying the prevalence of child sexual abuse is the absence of understanding and acceptance of the active sex life of children and their interest in adults and in taboo behavior.

The first Norwegian study was to my knowledge carried out by Sætre, Holter and Jebsen (1986) in 1985, showing that 19 percent of women and 14 percent of men answer that they have at least once experienced sexual abuse before the age of 18. The study includes a number of different forms for both contact and non-contact abuse. A drawback with this study is that the percentage of answered questionnaires was relatively low (48 percent). Other Norwegian studies are Schei, Muus and Bendixen (1994) who conclude that 19 percent of women and 4 percent of men have been sexually abuse as children; Tambs (1994) who concludes that 13 percent of women and 7 percent of men have been sexually abused; Pedersen and Aas (1995) who conclude that 17 percent of women and 1 percent of men have been sexually abused.

The latest Norwegian study I have found concerning the prevalence of sexual abuse has been conducted by Mossige and Stefansen (2007) for Norwegian Social Research (NOVA). 7033 students from secondary school (from 67 schools all over Norway) took part in the study. 22 percent of all girls and 8 percent of all boys reported having experienced less severe forms for sexual abuse, while 15 percent of all girls and 7 percent of all boys reported having experience severe sexual abuse. 9 percent of all girls report having experience attempted rape or have been raped. Less severe forms for sexual abuse consist of indecent exposure and non-contact abuse; while severe sexual abuse consist of contact abuse such as sexual intercourse. This study does not define sexual abuse as in the same way previous studies have done, but uses the description of sexual abuse given the Norwegian Criminal Law concerning sexual crimes (chapter 19). This study investigates the amount of unwanted sexual incident which the informant has experienced. The different incidents are then categorized according to the Norwegian sexual crime law, which differs between the severe form for sexual intercourse and the less severe forms of sexual acts and sexual violations.

Sexual abuse is a widespread social problem in our culture and seems to be committed mainly by adult men (Sætre, Holter and Jebsen 1986; Finkelhor 1984). This is also confirmed by the Incest Centre in Vestfold where information has been collected about  sexual perpetrators since 1991 to the users of the centre in the period 1991-2006. The statistical data from their Annual 2006 (Årsrapport 2006) is based on information given by victims of sexual abuse about 8051 perpetrators (for the period between 1991 and 2006). The statistics show that the overall majority of sexual abuse is committed by male offenders; 91 percent (6621) were reported as male. Female sexual offenders are reported in 9 percent (1430) of all sexual abuse stories. Their statistics also show that 41 percent of the sexual abuses reported to the centre are committed by a biological parent (incest); 41 percent of the incest perpetrators were biological fathers while 12 percent were committed by biological mothers. Sexual abuse is also something that happens more often in the home of the child than outside the home; 63 percent of all child sexual abuse happened within the family home, while 37 percent happened outside the home. It must be noted that the statistics from the Incest Centre in Vestfold show only one perpetrator per victim. They have only registered the perpetrator standing closest to the victim. The statistics mentioned here focus primarily on abuse in the home. Their statistics show that only 20 percent of the perpetrators do not belong to the family. Statistics about victims with several abusers are not registered and therefore the picture shown her is not entirely correct. But it does give a picture of sexual abuse committed by person’s standing close to the victim. The statistics are also grounded on the victims own personal view of sexual abuse. If the victim considers the act they have experienced as sexual abuse, then it is registered as sexual abuse. This opens for the possibility for a very wide understanding of sexual abuse. How victims describe their sexual abuse is not given in these statistics.

The official sexual crime statistics from Statistics Norway (Statistisk sentralbyrå) for 2007 shows a different view of the prevalence of sexual abuse. The number of offenders convicted in Norwegian courtrooms in 2007 for sexual abuse was 720. The total number of persons that were reported (anmeldt) to the police for sexual abuse was 3802 the same year; showing that approximately 80 percent of reported offences are not convicted, either because these cases are acquitted or dismissed on the lack of evidence. While incest is registered in 42 percent of the cases at the Incest Centre in Vestfold, only 0.2 percent of all convicted cases in 2007 were incest in Norwegian courtrooms. This has been stable for the last decade; only between 1 and 4 persons are convicted for incest yearly in Norway.  It is my experience that sexual abuse cases often lack the evidence necessary in a courtroom. Witnesses of the abuse are often not there; physical evidence of sexual activity may suggest that abuse has taken place but may not be enough to convict a given suspect; a child’s statement may be faulty, insufficient, inaccurate, hard to believe, and in clash with the account from the suspected adult; the investigation may be poorly carried out; or the time limit for conviction may have expired. I believe that these statistics show the difficulty in investigating sexual abuse cases by the police and the need for withstanding evidence in the court system for convicting a person for sexual abuse. Svedin (1999) argues, from his study of conditions in the USA, that only 6-12 percent of all sexual abuse cases that are uncovered are reported to the police. In 2007, the police in Norway received a total of 3802 reported cases of sexual abuse. If Svedins estimate is correct and assumed appropriate to use in the Norwegian culture, this means that the correct number of sexual abuse cases should be between 22 800 and 45 600 for 2007. This is a very insecure estimate because many of the cases that are reported each year are not new, but concern abuse that have taken place several years in the past. Another factor to be taken in to consideration is that Svedin’s study is from the USA and that conditions in the Nordic countries may be different. But it seems feasible in my opinion to conclude that the numbers of cases reported to the authorities in Norway are under-reported.

It is also possible to find statistics of the prevalence of sexual abuse by looking at the statistics from the child care (Barnevern) system in Norway which is registered by Statistics Norway. The child care system has a central responsibility for the welfare of children and a special duty towards children who have experienced physical or sexual abuse. The Child Care Law (Lov om Barnevernstjenester) states in paragraph 1 that the prime objective for child care authorities is to make sure that children which live under circumstances which injure their health and development, receive necessary help and care when they need it. The child care services has a special responsibility to take necessary precautions and considered the need for cooperation with other authorities, where there is  a suspicion of physical or sexual abuse, or where parents are not able to protect their children sufficiently. Statistics for child care in Statistics Norway give an indication of registered new children who receive help from child care in Norway because of sexual abuse. The total number of children who received help from child care in 1993 was 9937. Of these only 199 children (2.0 percent) received help because of sexual abuse. The number of children who received help from child care in 2007 was 11 731. Of these only 51 children (0.4 percent) received help because of sexual abuse. This seems to indicate that the number of children who received help because of sexual has declined from 199 children in 1993 to 51 children in 2007. Statistics from Statistics Norway show that few cases within the child care system in Norway are primarily related to sexual abuse. It seems probable that sexual abuse might be concealed behind others factors that are more common grounds for giving help to children and their families, such as; uncontrolled behavior, intoxication, criminal activity, self-harm, running away from home, and so forth. Dahle and Hennum (2008) argue that the number of cases that the child welfare workers engage themselves into are low most probably because social workers fear the subject of sexual abuse. They argue that even though child sexual abuse is clearly defined in Norwegian Criminal Law, social workers tend to protect themselves against the pain inducing knowledge these cases hold within them. Social workers must also take a stand to the question of trustworthiness to children’s statements of abuse. Can one always trust that children tell the truth? Or is it possible that they can lie, talk wildly, or exaggerate. Bakketeig (2001) argues that the silence that dominates in this field of work shuts the door for mutual reflections, resulting in the absence of a professional perspective needed in order to be able to disclose sexual abuse; and professional knowledge and competence remains underdeveloped.

The disparity between the aim given child care in the Child Care Law paragraph 1 (Lov om Barneverntjenester) and the reality within child care shown in Statistics Norway (Statistics Sentralbyrå), gives reason to ask several questions: Why is there such a disparity? How does the child care system understand its role in handling these cases? These are questions also raised by Brottveit (2006) in a study of how child care workers understand child sexual abuse. She argues that child care workers are dominated by the control system they work within: the judicial framework; institutional casework procedures that are given through regulations; conditions that govern criminal law such as the need for evidence. The framework conditions which child care workers must use in child sexual abuse cases demand that cases be put forth in a special way and meet certain judicial criteria. The room for using personal judgement and practical wisdom they might have attained through years of experience, becomes limited. 

One must be careful in my opinion in comparing registered sexual abuse case in the child care system, the number of sexual crime cases that are reported to the police, the number that are convicted for sexual abuse and incest, and the results from the many surveys that have been carried out on various parts of the population in different parts of the world. These statistics are not directly comparable with each other, but they offer a starting point for further exploration. At first glance, it seems likely to close from the statistics concerning convicted sexual offences in Norwegian court rooms and the number of children who receive help from help from the Norwegian child care system because of sexual abuse, that the problem of sexual abuse and incest is relatively small. But it seems necessary to reflect over the possible causes for why only 20 percent of all reported sexual abuse cases to the police lead to sanctions, and only 0.4 percent of all new children reported to the child care system receive help because of sexual abuse, and if these numbers reflects the true-life situation of sexual abuse or if there are other possible explanations. Sexual abuse is a complex field of work which demands a great deal from the victim, the perpetrators, their families, and the various systems that are involved. Is there a lack of knowledge about sexual abuse and incest? Is there a lack of practical competence in interviewing adults and children about sexual abuse? May it be possible that such “moral institutions” as the judicial system and the child care system induce more shame and guilt to the victim so that information about sexual abuse concealed and the victims remain silent lack knowledge concerning sexual abuse? These questions are neither explored nor answered in this study, but it is my hope that this exploration will be a contribution to the discussion of such question and the need for further research within these areas.

It seems that almost all of the studies I have explored use different definitions of sexual abuse, and use different samples. They are therefore not directly comparable. I do not conclude that any of these studies are fault. I have not investigated them closely enough to make such a conclusion. But they all find answers to the specific questions they have asked on the background of different definition of sexual abuse, and used different samples of the population. This is sufficient to conclude that one should be very careful in comparing these studies, and the results should be read on the background of all the different definitions that have been used.

Child sexual abuse has received much public attention since the 1970’s, not only because the true prevalence has increased but because the Women’s Movement and Children’s Protection Movement in the United States had success in promoting sexual abuse as a social problem to be taken seriously by both the public and policymakers (Finkelhor 1984). These two movements focused on different aspects of sexual abuse. While the child protectors considered it as a form of so-called “child abuse and neglect” (Avery-Clark, O’Neil & Laws 1981), feminist tended to focus on sexual abuse as rape rather than child abuse (Brownmiller 1975). The child abuse movement argued for whole-family treatment programs (Giaretto 1981, 1982), while the feminists adopted a more “victim advocacy” approach based on rape crisis counselling and victim witness programs (Nelson 1982).

Is the increasing number of sexual abuse cases since the 1970’s evidence for an actual increase in sexual abuse in our society? Or is the picture more complex?  It seems evident that sexual abuse has existed for centuries. In Greek, Roman, and medieval times, children were used as prostitutes and favoured sexual companions. This has continued also in later periods. In London around 1870, it is estimated that there were 20 000 children prostitutes and 70% of these had syphilis before they reached the age of 21 (Rush 1980; Schultz 1982). Finkelhor (1984) suggests that there are plausible arguments that sexual abuse is actually declining and not increasing.

It seems plausible that many of the historical changes that have benefited children – laws against child labour and harsh physical punishment, age-of-consent laws, educational reforms, child welfare agencies, as well as greater scientific knowledge about child development – have resulted in a decline of both physical and sexual child abuse. But it is hard to be certain. (Finkelhor 1984: 6-7)                                                                                                                                                                                           

Child sexual abuse can not only be considered as a social problem, but also as a moral problem. People usually agree in public discussions that sex between adults and children are wrong. Sex is not limited to intercourse but refers to “activities, involving the gentiles, who are engaged in for the gratification of at least one person” (Finkelhor 1984: 14).

Adult’s refer to persons 18 years of age or more, and children refer to pre-pubertal children. This picture is complicated by the fact that different countries have different age limits for sexual practice. In Turkey the age limit is 18 (the highest in Europe), in Norway the age 16, Sweden and Denmark 15, Island 14 years, and in Spain the age is 13 (the lowest in Europe). This having the consequence that an adult having sex with a 13 year old in Norway, Sweden or Denmark will be considered as illegal, while the same relation will be considered as legal in the Spain. In the Netherlands the age limit is as in Norway 16 years, but the “absolute age limit” is 12. This gives young people in the Netherlands between the age of 12 and 16 the possibility to have sexual experiences.
 Kaare T. Pettersen

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