Sexual Abuse

Recently Answered

• QWhat are the symptoms of sexual abuse of a child?

  2 Answers

  A

  

  A Dr. Michele Borba , Psychology, answered

  Sexual abuse can be a single incident or many acts over a long period of time. There usually are subtle signs along the way that can be overlooked. Here are a few possible warnings of sexual abuse. Look for a change in your child’s normal behavior that last or become more intense. Of course, there could be another explanation but any of these signs should be addressed. If you have any suspicions or a feeling something is wrong, seek the help of a mental health professional.
  

  • Physical signs: Bloody, torn or stained underclothes; pain, bleeding, burning or itching in genital area; difficulty walking or sitting; frequent urinary or yeast infections; STD or pregnancy
  • Psychosomatic signs: Stomachaches, headaches or marked mood swings; nightmares or trouble sleeping; sudden changes in appetite
  • Sexual behavior signs: Uses adult-like sexual knowledge, language or behavior; writes, draws or plays out sexual-type images; frequent use of masturbation
  • Emotional signs: Resorts to aggressive behaviors: thumb-sucking, bed-wetting; sudden clinginess; depressed
  • Behavioral signs: Shrinks away or seems threatened by physical contact; excessive bathing, poor hygiene; or talks about self as dirty or bad; trouble focusing; seems distracted or distant at odd times; overly protective and concerned for siblings, assumes a caretaker role; talks about a new, older friend; jumpy if the phone rings, a text or e-mail comes in; suddenly has unaccountable money, gifts, toys or mail; runs to mailbox

  If there was something your child said or did that made you concerned, ask. Do know that a child may not admit or deny the abuse usually due to fear, humiliation, guilt or shame, but studies show that if asked, kids generally will tell a trusted adult of their abuse.

  See All 2 Answers
• QWhat is sexual abuse of children?

  5 Answers

  A

  

  A Boston Women's Health Book Collective , Administration, answered

  One common form of violence against children is incest, which is defined as sexual contact between family members. Incest can be perpetrated by adult male or female relatives against male or female children. Sexual abuse can be perpetrated by friends, coaches, teachers, babysitters, or the clergy. Unfortunately, people in such positions can use the child's trust and dependence to initiate sexual contact and often to ensure that the relationship continues and remains secret.

  The extent of incest and childhood sexual abuse is hard to measure because of lack of reporting and uniform definitions and the limitations of memory. Incest and sexual abuse of children take many forms and may include sexually suggestive language; prolonged kissing, looking, and petting; vaginal and/or anal intercourse; and oral sex. Because sexual contact is often achieved without overt physical force, there may be no obvious signs of physical harm.

  See All 5 Answers
• QHow does sexual abuse affect the child?

  1 Answer

  A

  

  A Dr. Bonnie Lynn Wright, PhD , Geriatrics Nursing, answered on behalf of Sigma Nursing

  Sexual abuse is an Adverse Childhood Experience (ACE). ACEs stunt the growth and pruning of the brain 'trees' or neural architecture. This can lead to poor school performance, depression, suicide, inability to form and develop nurturing relationships, chronic diseases, obesity and addiction.
  
  In addition, people react from their past history to circumstances in the present. A person who was sexually abused as a child will exhibit responses to sexual stimuli in the present tainted with that abuse experience. For example, a woman who is uncooperative during a pelvic exam at the doctor's office may be reacting to abuse in her past.
• QWhat are the effects of sexual abuse on pregnancy?

  2 Answers

  A

  

  A Boston Women's Health Book Collective , Administration, answered

  Some of us have experienced sexual abuse in childhood or as adults. The aftereffects of abuse vary in severity, but they can last a long time. Abuse issues are sometimes triggered unexpectedly during pregnancy, labor, and birth, in the form of conscious memories or flash backs to the abuse, or unconscious body memories (tension, anger, sick feelings, or other discomfort) when a woman is reminded of the abuse in some way.

  Common triggers for those of us who are survivors include vaginal exams or other invasive procedures, and pain during or after childbirth, especially in the vagina, but also in the abdomen, back, breasts, and perineum. Our interactions with our care providers - authority figures who may expect compliance and trust - may remind us of our perpetrator or perpetrators, with whom we may have felt helpless, unequal, submissive, or overpowered. Control over our bodies, our contractions, or the emergence of the baby - and being controlled by the baby, whose needs come before our own, can be major issues for us. We may associate a lack of control with being abused. We may have learned that remaining in control is essential to safety and being out of control is threatening.

  Reminders during pregnancy or labor to "relax and it won't hurt," to "yield" or "surrender" to the contractions, to "trust your body" or "do what your body tells you to do" may have an effect opposite to the one intended, if we have learned to guard against giving up control in abusive situations. Abuse experiences may also leave us feeling that our bodies are damaged and untrustworthy.

  See All 2 Answers
• QWhat to do if I face past sexual abuse feelings during childbearing?

  1 Answer

  A

  

  A Boston Women's Health Book Collective , Administration, answered

  Recognize and accept that some fears and concerns make sense. Sexual abuse (or any other abuse) rarely leaves the victim free from aftereffects. Give yourself permission to be afraid or concerned.

  Try to separate your present pregnancy and upcoming birth and parenthood from your past abuse. Now you are older and more able to bring your wisdom and self-knowledge to these new challenges. Consider working with a trauma therapist or counselor who is knowledgeable about childbearing or reading books for survivors that contain suggestions for dealing with triggers and reducing your concerns.

  Decide whether or not to disclose your abuse history, along with issues it has brought up for you, to your care provider. Some caregivers are interested in emotional issues and are both willing and able to respond to your needs, while others may not have the skills needed to help you. If you are comfortable disclosing your history to your midwife or doctor, you can work together to plan your care so that it will be sensitive to your history. If you are uncomfortable with your provider, you may want to change to another person with whom you can establish a trusting relationship.

  If possible, have a doula (birth assistant) at your birth, one whom you trust. Share your fears or concerns with her, so that she can help you deal with them. She does not need to know about your abuse history in order to provide emotional support and help.

  Write a birth plan that is friendly and flexible yet clearly explains your preferences and fears.

  If you have a partner or other support person, enlist his or her support in dealing with this. You may want to tell your support person about specific settings or examinations that make you uncomfortable and work with her or him ahead of time on some ways to help you in these situations.

  With good communication, self-help tools, and caring support from your loved ones, doula, and health care providers, your chances of having a rewarding pregnancy, birth, and postpartum experience are greatly increased.

• QWhat are the medical considerations if I have been raped?

  1 Answer

  A

  

  A Boston Women's Health Book Collective , Administration, answered

  If you have been raped, it is critical for your physical and emotional health to receive medical attention as soon as possible, even if you have no obvious injuries. Your first reaction might be to take a shower and try to forget what happened. That is understandable, but you may wash away evidence that is crucial if you want to prosecute the rapist. Even if you do not want to press charges right now, you could change your mind in a few months or years. If you have evidence collected, you can always use it later. Collecting evidence involves going to a hospital and asking for a rape kit, which is designed specifically for collecting evidence of sexual assault, including semen and blood.If you go to the hospital:

  • Try to have a friend, relative, or rape crisis counselor go with you as an advocate.
  • Be aware that most states have passed legislation to ensure that rape exams are free of charge.
  • Bring a list of medications you are taking; a change of clothing if you are still in the same clothes; or the clothing that you were wearing during the assault, if you have changed your clothes. Ideally, when you go to the hospital, an advocate from your local rape crisis center should meet you there. You should also ask to see a trained sexual assault nurse examiner in the emergency room. Some hospitals have specialized programs staffed by nurses or doctors who have received extensive training in the medical, legal, and emotional issues associated with sexual assault. The programs are designed to provide sensitive medical exams and the best evidence possible for prosecution.
• QWhat are the effects of rape on the victim?

  1 Answer

  A

  

  A Boston Women's Health Book Collective , Administration, answered

  Rape can cause physical injuries to any part of the body. Therefore, you should request for a thorough examination that includes and/or results in the following:

  • A verbal history of the sexual assault and related medical concerns. You will be asked to give a detailed description of the assault, which will be written down. Although it may be difficult to talk about these details, they are important so that the medical provider knows where to check for injuries and what evidence to document, such as bruises, scrapes, and other injuries.
  • A pelvic exam. In collecting evidence, the practitioner will look for the presence of semen if you were raped by a man. However, semen may not be present after a vaginal or anal rape. The practitioner will also comb your pubic hair for the possible presence of the perpetrator's pubic hair. This medical evidence will be made available to police or others only with your written permission.
  • Examination and treatment of any external injuries. The practitioner will examine you for any external injuries and may photograph bruises or other marks to document the assault. If bruises emerge after the exam, take pictures of them and call the examiner so that the information can be added to your record.
  • Treatment for prevention of sexually transmitted infections (STIs). The practitioner will recommend giving you two shots of an antibiotic in your buttocks.
  • Treatment for prevention of pregnancy. If it is possible that you will become pregnant as a result of the rape, the doctor or nurse may offer you emergency contraception, sometimes called "the morning-after pill".
  • Information about AIDS/HIV. It is possible to be infected by HIV through a sexual assault. To treat potential HIV infection, you need medication immediately. Although not available everywhere, there are promising new treatments that help prevent HIV infection if taken right away. However, these drugs are controversial and you should take them only after they have been fully explained to you.
  • A follow-up exam. Although you may feel physically recovered shortly after the rape, ensure there is a follow-up visit that includes tests, treatment for STIs, and a pregnancy test.
• QHow can I protect myself and others from rape?

  1 Answer

  A

  

  A Boston Women's Health Book Collective , Administration, answered

  Most sexual assaults are committed by someone you know rather than a stranger. In either case, you can take steps to protect ourselves.

  • Safety in social situations. Pay attention to how you feel. If you want to end a date or leave a party, say so, even if you are afraid or embarrassed. If you drink alcohol, keep an eye on your drink. Drugs are available that can be slipped into drinks to tranquilize a person and induce a blackout.
  • Safety in intimate relationships. Learn to recognize potentially abusive relationships. An abusive or unhealthy relationship involves disrespect, fear, jealousy, possessiveness, and controlling behavior.
  • Safety at home. Make sure entrances are well-lit and windows and doors are securely locked. Use only your last name on your mailbox. Find out who is at your door before opening it for anyone.
  • Safety in your neighborhood. Arrange to walk home with people you trust. Get to know the people who live in your apartment building or on your street.
  • Safety on the street. Be aware of what is going on around you. Walk at a steady pace, and look as if you know where you are going. Dress so you can move and run easily. If possible, walk in the middle of the street, avoiding dark places and groups of men. Carry a whistle around your wrist. Always check the backseat of your car before getting in, and keep the car doors locked while driving. Avoid groups of men on public transportation. Avoid hitchhiking.
• QWhat are the lifelong consequences of sexual abuse in childhood?

  3 Answers

  A

  

  A Boston Women's Health Book Collective , Administration, answered

  Whether or not the signs of abuse are physical and obvious, sexual abuse in childhood can have lifelong consequences. Women often blame themselves long after the abuse has ended—for not saying no, not fighting back, telling or not telling, having been seductive, or having trusted the abuser. As victims of incest and abuse, you may have lots of sex with many partners in order to feel accepted, or to erase or overpower the memories of abusive sex. You may run away from home to escape the abuse, experience depression, and use drugs and alcohol to dull the pain.

  To heal from the trauma of incest or early sexual abuse, you need to tell your stories to people who can understand and empathize. Talking with others in counseling or support groups may break the silence, help you gain perspective, and end the isolation. Some women find it necessary to confront the family member who perpetrated the abuse. This is a frightening task, but it can also be rewarding.

  See All 3 Answers
• QWhat is sexual harassment?

  2 Answers

  A

  

  A Boston Women's Health Book Collective , Administration, answered

  Sexual harassment is unwanted sexual attention. It includes leering, pinching, patting, repeated comments, subtle suggestions of a sexual nature, pornography in the workplace, and pressure for dates. Sexual harassment is not limited to the workplace or school. It occurs in doctors with patients, welfare workers with clients, and police officers with the public. Sexual harassment involves the abuse of power. In addition to men harassing women, women can harass other women, and men can be harassed by other men or by women. Because sexual harassment can escalate, people who are sexually harassed are at risk of being physically abused or raped.

  In the workplace, women may experience a direct or implied threat; such as "Have sex with me or you will be fired"(called quid pro quo). A hostile work environment can interfere with your ability to do your job, whether the harasser is an employer, a supervisor, a coworker, a client, or a customer.

  Socializing at work often includes flirting or joking about sex. Although it may be a pleasant relief from routine or a way to communicate with someone you are interested in, this banter can turn insulting or demeaning. It becomes sexual harassment when it creates a hostile, intimidating, or uncomfortable working environment. Refusal to comply with the harasser's demands may lead to reprisals, which can include escalation of harassment; poor work assignments; sabotaging of projects; denial of raises, benefits, or promotion; and the loss of the job with only a poor reference. Harassment can drive women out of a job or the workplace altogether. Poor women, immigrant women, older women, and teenagers are especially vulnerable to sexual harassment because of difficulty in finding other employment.

  See All 2 Answers