Sexual abuse affects at least one of every 10 families in the United States. In Missouri, more than 2,100 cases of sexual abuse are reported each year, but it is estimated that nine in 10 cases are never reported. Any sexual contact between an adult and an unconsenting person is considered abuse and any sexual contact between an adult and a minor, regardless of consent, is abuse. Sexual abuse also can include indecent exposure, pornography, obscene phone calls, or exposure to sexual acts. Like rape, sexual abuse is a form of violence. Its effects span generations with many victims of childhood sexual abuse experiencing emotional problems years later as adults.

The offense 
Sexual abuse knows no demographic boundaries, but more than 80% of victims are female, while the overwhelming majority of perpetrators is male. The typical victim is a pre-teen girl abused over a long period of time by a middle-aged male family member who may have experienced sexual abuse himself. Sexual abuse is not driven by love or sexual gratification; rather, it typically is an act of control over a weaker victim to bolster an offender’s feelings of low self-worth, to gain attention, and/or to feel cared for by someone. Typically, the offender is someone unable to have a healthy, intimate relationship with other people. The offender often takes advantage of the natural trust among family members and then uses the same trust to hide the offense, threatening further harm or the loss of another family member’s trust and affection if revealed. A complex bond may develop between an offender and victim.

The effects 
Some of the physical effects of sexual abuse are immediately apparent and can include bruises, cuts, burns, injury to genitals, damage to reproductive and other internal organs, pregnancy, and sexually transmitted diseases. The psychological effects of sexual abuse may appear immediately, but often are delayed. Sexual abuse can destroy trust and warp the victim’s perception of a normal, loving relationship. Victims frequently feel they are at fault for the abuse and have low self-esteem. These feelings can lead to depression, eating and sleeping disorders, and suicide attempts. Victims may fall into a pattern of searching out marital and sexual partners who abuse them. They may find it difficult to form meaningful and lasting relationships with members of the opposite sex or to have normal sexual relations. They may use sex to gain attention or affection and may see themselves worthy only as sex objects. Victims also resort to defense mechanisms to blot the incidents from their mind. These repressed feelings of anger and guilt may lead to physical and psychological problems. Physically, repressed feelings may cause ulcers, colitis, and migraine headaches. Psychologically, repressed memories of abuse may resurface as symptoms of other mental illnesses. Unless a history of abuse is revealed, a victim may be treated for a mental illness while the real cause of the symptoms goes untreated.

Treatment 
The physical trauma of sexual abuse usually heals without long-lasting effect. The psychological trauma also can be treated successfully. Through support groups and individual and group therapy, a victim can overcome the barriers that the memories and pain of abuse place in the way of a normal, happy, and productive life. Recovery may take years of intensive therapy and years of follow-up and support.  To learn more about therapy for survivors of sexual abuse, call 314-516-5711 to schedule an appointment with UMSL Counseling Services.  Other local resources include The Center for Trauma Recovery Clinic, the YWCA St. Louis Regional Sexual Assault Center, and Safe Connections.

What can be done? 
Good communication within a family may be the best defense against sexual abuse. Parents should make it clear to their children what types of attention and touching are permissible and what parts of the body are private and not to be touched by another person. Parents should respect their children's boundaries at all times and teach them that their 'no's regarding access to their bodies will be respected; do not force a child to give or receive affection from another person, tolerate being tickled or touched, or receive physical punishment.  Adults may be unwilling or may find it hard to believe a child’s complaint of abuse, but children rarely lie about sexual abuse. Parents should assure children that they will be believed and loved no matter what they have to tell. Warning signs include changes in a child’s personality, a sudden aversion to another person, and unusual secretiveness. Parents should be alert to sexual acting out and unexplained bruises, tenderness, and rashes, especially on or about the genitalia and mouth. They should question unwarranted gifts or money and talk with children about close relationships they form with adults. Sexual abuse makes up three-fourths of all crimes against children. To report suspected or known abuse, call toll-free, 1-800-392-3738. The call is confidential. If you, or someone you know, is a victim of sexual abuse and in need of counseling, call 314-516-5711 to schedule an appointment with UMSL Counseling Services.  Other local resources include The Center for Trauma Recovery Clinic, the YWCA St. Louis Regional Sexual Assault Center, and Safe Connections.  You can also call the Missouri Division of Family Services at 314-751-3221 for more information.

Adapted from information from the Missouri Advisory Council for Comprehensive Psychiatric Services.