More than one-third of South African young people report having been exposed to some form of sexual abuse. That is the equivalent to filling up Johannesburg’s Soccer City Stadium eight times over and the Cape Town Stadium fourteen times over. With a prevalence rate this high, it is important to understand Child Sexual Abuse and how it impacts survivors later in life.
Child sexual abuse (CSA) is any sexual act, or attempt to commit a sexual act, with a child, with or without the child’s consent. Children under the age of 12 are viewed as incapable of consenting to sexually related activities.
According to the Children's Act 38 of 2005, sexual abuse of a child includes:
o “Sexually molesting or assaulting a child or allowing a child to be sexually molested or assaulted;
o Encouraging, inducing or forcing a child to be used for the sexual gratification of another person;
o Using a child in or deliberately exposing a child to sexual activities or pornography; or
o Procuring or allowing a child to be procured for commercial sexual exploitation or in any way participating or assisting in the commercial sexual exploitation of a child.”
A child does not only suffer physical wounds and noticeable traumas. Their cognitive, social, psychological and emotional development is also impacted by the effects of child sexual abuse.
We need to remember that there is diversity in child sexual abuse regarding both offenders and victims. Children are not only abused by men and women, but children also offend against each other as well.
According to the 2016 Optimus Study, 60% of South African children are abused by someone in their social circle and a black South African girl has a greater chance of being raped than learning to read.
Adult functioning can be impacted by numerous childhood experiences such as: Parenting styles, schooling, peers, home environment, and family characteristics. Research has shown that one of the most vital areas to impact adult functioning is abuse, specifically sexual abuse. Therefore, mental health in adulthood of CSA survivors is not only dependant on one factor but rather:
o Age when the abuse occurred;
o The familiarity between victim and perpetrator;
o The severity of abuse;
o Frequency and duration of abuse including the number of perpetrators committing the abuse either at one time or during the victim’s life.
Within the South African context, these factors need to be considered with other variables such as:
o The Socio-economic status of the victim;
o The co-occurrence of poverty;
o High unemployment rates; and
o Quality of education.
Erik Erikson’s (1959) eight stages of human development can be related to the effects of CSA. With these stages of development, each stage has both an opportunity for a healthy and unhealthy manifestation of growth. Of particular import, is Erikson’s third stage of development – “Initiative vs Guilt”, defined around children 3-5 years old. Although evidence in South Africa suggests girls usually experience CSA around fourteen while boys are usually aged fifteen, it can be as young as four. If a child is sexually abused in this stage of development expressions of guilt can dominate their world views. These expressions may involve: Becoming depressed easily, putting the self-down, poor eye contact and low energy levels. “The negative aspect of guilt may consume a tremendous amount of psychic energy that paralyses progress towards recovery.” If this unhealthy manifestation of growth continues into their adolescence (12 to 18 years), they are likely to take on expressions of role confusion instead of expressions of identity. This can have huge effects on the individual. Expressions of role confusion include doubts about sex role, lack of confidence and a weak sense of self. If this continues into young adulthood (19 to 40 years), the individual would possibly take on expressions of isolation instead of the healthy expressions of intimacy. These unhealthy expressions include feelings of failure, loneliness and isolation.
In addition, sexual abuse by familiar individuals is more severe than sexual abuse by strangers or acquaintances. If the offender is a stranger, the victim does not generally see them again however, with a more familiar offender, the child is often exposed to them in everyday routines. This can be traumatic for the child and often leads to a negative self-image or distorted thinking patterns. Consequently, more negative mental health effects are experienced in later life.
Posttraumatic Stress Disorder (PTSD) symptoms experienced in adulthood are extremely prevalent in all CSA victims. Victims who disclosed abuse, abused by relatives, and more severe forms of abuse (such as penetration) often results in more PTSD symptoms later in life. An important phenomenon to understand here is why disclosure results in higher PTSD symptoms? This contradicts what one would expect. As researchers point out, a disclosure that is encountered with feelings of indifference, uncertainty, non-supportive, hostile or a non-protective response can be distressing in itself and result in confusion and fear. In this way, the nature of the response to disclosure has been cited as a key factor in adult functioning. In addition, one needs to consider the courage it takes an individual to disclosure to someone and the betrayal the victim feels when this individual tells someone else without their permission. This could be necessary, such as an 8-year-old child telling their teacher about their friend. However, for this child, it could also be a sign of betrayal and a loss of protection. This is where anonymous reporting systems are becoming popular. They give the victim control in speaking out without fear of rejection and embarrassment.
Another finding in the research is that adults in their 30’s to 40’s have shown more mental health symptoms, due to CSA, than adults in their 20’s. This is very useful to know because it could mean that younger adults have benefited from community awareness, prevention programmes and improved professional responses. Still, it may be probable that younger adults are more inclined to deny, repress and minimize their abuse experiences.
Everyone experiences events and situations differently and thus utilises different coping skills, coupled with diverse cultural values. Using Bronfenbrenner’s bioecological model to understand the effects of CSA would be useful. That being said, every adult has their own microsystem fitting in with the larger chronosystem at play. Understanding and using that as both a prevention and treatment base would be useful in the South African context.