Child sexual abuse: a national epidemic that nobody talks about 

Sunil (name changed), an unmarried young servant in the house of a wealthy businessman entices young girls between the ages of 4 and 12 into the empty house when his master is away, with candy or knick-knacks. Once he has lulled them into a sense of false safety he takes their dupattas and strangles them until they pass out. He then tries to have sex with them but fails. Frustrated, he tries to masturbate on the supine and still body but fails again. As his lust turns to anger, he picks kills the child and carries her body upstairs into a toilet. He runs down, gets knives and proceeds to chop up the body, putting them into empty plastic bags and dumps them into large open drains around his house. He then remains in a state of heightened sexual arousal, masturbating repeatedly until his lust calms down, whereupon he contemplates the next catch. Bharat (not his real name), a high-flying non-resident Indian banker flies to UK and over 100 miles from London to Birmingham and checks into a hotel room to meet a 14-year-old girl.

He ‘groomed’ this girl through Whatsapp chats and convinced her to have sex with him at a hotel room, even warning her that having sex for the first time would be painful. When trapped by a cybercrime group that traps child sexual abusers, the man who is married and a father initially denies any sexual motive, claims that he thought the girl was 18 and even blames her for asking him to come to the hotel room. But when confronted with explicit text messages that he sent her, breaks down and pleads that he should be let off as he is an Indian national.

Bill and John (names changed), two British charity workers, set up a shelter for homeless boys in Mumbai. The pair were charged with sexual assault after five boys complained to the police about sadistic sexual and physical abuse that involved violent beatings and degrading sexual acts. Mumbai High Court acquitted them for lack of evidence but India’s Supreme Court overturned that decision and upheld guilty verdicts. The case raised questions about India’s lax laws and highlighted the need for special legislation for child sexual offences in the country.

These are just three of thousands of cases of child sexual abuse that are registered with Indian police on a daily basis. According to a 2007 study conducted by India’s Ministry of Women and Child Development, 53% of all children surveyed said they had been subjected to some form of sexual abuse: 1 in 2 Indian children has been sexually abused. Thus, while the society’s recent outrage against child abuse is welcome, the truth is that the educated Indian is slowly waking up to a reality that the economically poorer sections of the society have experienced for a very long time.

All molesters are not paedophiles

The child molester is called a paedophile by the Indian society by and large. That is a gross mistake.

Paedophilia is a Greek word which means ‘child lover’. This in itself is a misnomer since these offenders do things to children that demonstrate anything but love. Paedophilic disorder is a psychiatric diagnosis which is given to a person who gets recurrent, intense sexually arousing fantasies, urges or engages in behaviours involving sexual activity with children generally aged 13 years or younger. The person either acts on his desires or these urges and fantasies cause him marked distress or relationship problems. The diagnosis is generally not made for those below 16 years of age and when the perpetrator is a juvenile he must be at least 5 years older than the victim. Evidently the diagnosis is based upon a very narrow, specific and restrictive description and most child molesters do not fit the bill, as the case studies above show. In my long experience of working with sex offenders, the majority of child molesters come into contact with the police and forensic psychiatrists only after they have committed an offence, hardly ever before. We should therefore stop calling such offenders paedophiles and simply refer to them as child molesters.

Giving a medical diagnosis simply medicalises a crime and is misused by lawyers to get a lenient sentence for their clients, rather than prison sentences. Only the most innocuous of offences should be dealt with in the community.

How is a child molester ‘created’?

There is no one ‘cause’ for child molestation or paedophilia. It would be nice if were so, then one could work on changing or switching off that cause. I have said already that molesters are not paedophiles. Studies show that the vast majority do not suffer from any other mental disorder although up to 5% of molesters may have a psychotic illness. There is a link between antisocial personality and child molestation as such men are more likely to act out. A very small minority suffer from intellectual and learning disabilities and touch children as they do not have the social and communication skills to engage in age-appropriate sexual activities with others of their age. So, what leads to child molestation? There are many factors which contribute in ‘creating’ a child molester. Clinicians and researchers call them ‘risk factors’ based upon theoretical research. One of the biggest risk factors for becoming a child molester is a history of being abused himself as a child. Up to 2/3 of child molesters were sexually victimized themselves according to studies. This is ‘Cycle of Abuse’ hypothesis. However, not all abused children grow up to be molester themselves, disproving the hypothesis. But those who do molest get sexually aroused by children, without which abuse will not occur – the sexual preference hypothesis. In fact, incest abusers have lower sexual arousal to their victims than do non-familial abusers. What is surprising is that up to 20% of ‘normal’ men, those who have never molested anyone, show sexual arousal to children’s images when total confidentiality is provided to them in research. This suggests that 1 in 5 men can be a potential molester, except that the vast majority of them are able to control their urges. It’s those that don’t, who become molesters and only some of them are arrested. Child molestation is a hidden problem since children don’t report it often, and the abusers don’t come forward or do it openly either. Other major factors associated with molesters are coming from families that have poor attachment and do not show care and affection to their children. Such children suffer abuse and emotional neglect themselves and grow up lonely and unable to show affection or love to others.

They are vulnerable and are targeted by child abusers themselves. Even though its abuse, many of them find some meaning and love through these deviant connections. Such disordered attachment bonds serve as unfortunate templates for future relationships. Accordingly, the young male will develop distrust of age-appropriate romantic relationships and this will encourage him to seek out children who are non-threatening and can be readily controlled. This person grows up to become abusive to those who he can readily dominate and will have little empathy for. As most social skills are gained, particularly in relation with intimate relationships, are acquired through affectional and effective relations with parents, when such relationships are poor, the child (the future molester) will become mistrustful of adults, lack self-confidence and struggle to form adult relationships. Such a man may turn to children not only to serve his sexual needs but also for intimacy and a desire to dominate and thus feel loved, wanted and powerful; things he did not experience as a child.

Their strategies to lure the young

The typical child sex offender is everywhere and can be anyone. Such men, and invariably they are men, can be bankers, teachers, judges, doctors: white collar professionals and not the seemingly obvious criminals who look and act like criminals. They could be your neighbour, work colleague or indeed friend or relative. In fact, campaigners believe most of the abusers are not strangers but people well known to the victims - parents, siblings, relatives and schoolteachers. Such individuals use strategies that experts call “grooming”. It is the psychological process of befriending and establishing an emotional connection with a child (and sometimes the family when it’s a stranger) to disarm a child’s natural inhibition and fear of strangers. Most child sex offenders offer young children those things that kids generally yearn for from adults: attention, fun laughter and gifts of the things they love.

In fact, such men often find a convenient vocation to be close to children: volunteer teacher, sports coach in school, school bus driver, child-minder. After ‘grooming’ the child to trust the abuser, he would engage in a game of ‘secrets’ to ensure the child does not reveal to others what is going on. After touching a child sexually, an abuser may tell him/her ‘This is our secret, don’t tell anyone. If you do, no one will believe you or you will get into a lot of trouble’. After touching her he may say ‘Did you enjoy that? Anything enjoyable can’t be bad, can it?’ They will often identify broken families where the child is lonely or a vulnerable child being bullied at school, or indeed a very small child unable to protect or protest. He may tell the child that s/he is special and worthy of ‘special attention’ by the uncle who says ‘I care for you. I’ll always be here for you’ when her parents don’t. They will allow the child to control the relationship to an extent, giving her sexual power over him, and buying her gifts in order to get sexual favours. This is the ultimate tonic for the child: control over an adult. If the child objects or obstructs the advances, the abuser can turn nasty and threaten to tell everyone, or threaten to harm her family by displaying a knife or a weapon. They may even say that ‘this is the last time, it won’t happen again’ as a way to gain compliance. Of course it is not. The final strategies, for those not so psychologically sophisticated or feeling that their secret could be outed, might be to overpower the child physically, by coercion, violence or to trap the child in a situation of no return, like Sunil used to do in the example above.

Effects on the victim

Children are often too young to know what sexual abuse is or too ashamed to tell anyone else. The effects of child sexual abuse can however be devastating. They display many psychological symptoms, feel powerless, ashamed, and distrustful of others. They often experience other sexual assaults in the future. In the short-term (up to two years), victims may exhibit regressive behaviours (e.g., thumb-sucking and bed-wetting in younger children), sleep disturbances, eating problems, behaviour and/or performance problems at school, and unwillingness to participate in school or social activities.

The latter is often seen in children where abuse has taken place on way to or in school. Longer-term effects include anxiety and depression, self-destructive behaviours such as alcoholism or drug abuse, shyness and insomnia. Victims may show fear and anxiety in response to people who appear like the abuser, a feature due to post-traumatic stress disorder Survivors may feel anger at the abuser, at adults who failed to protect them, and at themselves for not having been able to stop the abuse and many experience difficulties in adult relationships and adult sexual functioning. Abusers may cause victims to feel stigmatized (i.e., ashamed, bad, deviant) and responsible for the molestation. Victims may feel betrayed and distrustful of others if someone they depended on, usually a family member, has caused them great harm or failed to protect them. Studies have consistently revealed that nearly 60% of women who were abused by a family member also reported a rape or attempted rape after the age of 14. Children who experienced rape or attempted rape in their adolescent years were 14 times more likely to experience rape or attempted rape in their first year of college

How to protect your child

Sexual awareness in children and indeed their parents in India are very poor. Parents let their small children go and play with strangers, allow family members to kiss and cuddle them, often inappropriately, and allow even unknown strangers to place the child in their laps. A number of such adults may well experience sexual arousal and have an erection when they do so. Don’t put your child’s photo on Facebook and certainly don’t put one that is without his/her clothes or showing the genital regions. Do object when those known to you put up such images. Listed below are a few principles of child safe-guarding that should be exercised by all, but particularly by parents and adults in caretaking roles with children. Parents must be aware of what others can do, however close the relationship might be. No relationship is taboo, and I have seen many fathers abuse their daughters in the worst possible way. Become aware of those adults in your family and amongst friends and visitors that women find a little lecherous and inappropriate. Identify those adults who appear to prefer the company of the child rather than the adults when he is with your family. Those men who have a alcohol and drug disorder and indeed those with severe learning disability and mental illness should be observed too when they are with your child. It does not harm to be vigilant, and you do not have to tell anyone what you are doing, but your vigilance can save your child from untold miseries in their life, even if it makes you a little paranoid along the way. Make your child learn and name body parts. No age is too young to begin. Don’t just stop at ears, eyes, head, arms and nose. Go on to tell them about legs, thighs, mouth and genital areas. You may choose an euphemism – a funny name usually - for the genital areas for your boy or girl. While doctors suggest using proper words – penis and vagina – so as not to associate such words with shame and embarrassment, parents generally use in western countries the word ‘pee pee’ or ‘privates’ is used for penis and for girls its ‘twinkie’ or ‘minnie’. I know of Indian parents who use the word ‘tutu’ for penis and ‘nunu’ for vagina when they are teaching their kids about body parts. The children should next be made aware of what is ‘good’ and what is ‘bad’ touching. ‘Bad’ touching is when an adult touches the child in the private areas and mouth or when an adult puts his hand underneath the child’s clothes. Teach your children to say ‘No’ and tell you when an adult engages in inappropriate behaviours. Teach him/her also to disclose secrets to you, and that will only happen if the child loves and trusts you. Abusive adults make children think that what’s going on is ‘our private secret’. Children need to learn that keeping secrets from trusted adults is not a good idea. They should feel that they can tell the trusted adults ANYTHING without getting into trouble. Another specific distinction the child needs to learn is the difference between secret gift and the surprise gift. A surprise gift is something that you may give your child for her birthday, without her prior knowledge and you do so in the presence of others. The surprise gift is a secret for a very short time and it ends with laughter. Secret gifts are those that an adult gives a child and tells her not to tell anyone else. That gift is a bribe to ensure the child does things with that adult behind closed doors or away from the gaze of others. The secret gift can never be enjoyed because it has to be consumed when nobody is watching. So the secret gift feels like trouble and ends in tears.

Parents can support children to develop the skills and confidence to identify abusive and controlling relationships and to speak out by using the mnemonic PANTS.

P – Privates are private: no one should touch you there

A – Always remember your body belongs to you and

N – No means no

T – Talk about secrets that upset you

S – Speak up, someone can help.

What can society and the government do

Children must be kept safe everywhere, not just at home. Place-based approach ensures keeping children safe in every place that they go to. So a school, a playground, a sports club, or an event; all must have policies and procedures that explicitly and specifically addresses child safe-guarding. Government should ensure that all such places are given licenses to work with children only if they have such policies in place. Parents must ensure they only allow suitable people to work with children. At home this could mean ensuring the babysitter has trusted references. At school this may mean that they ask to see safeguarding rules and insist that schools and other organisations follow safer recruitment practices and ensure that everyone working or volunteering with children has regular child protection training so they know the signs of sexual abuse. In the final reckoning, the only secret worth discovering is how our happy children pack innocence and wisdom together. In the meantime, let us safeguard our children from the common tricks played by paedophiles.

(The author is Consultant Forensic Psychiatrist, Specialist in managing sex offenders)