Child sexual abuse refers to the inappropriate exposure of children to adult content. It also refers to acts of physically assaulting children for sexual pleasure. This includes, but not limited to child pornography, sexual fondling, and oral, anal or vagina sex (SexInfo Online, 2017; Higgins & Swain, 2009; Hirakata, 2009; Kendler et al., 2000; Lev-wiesel, 2000). This vice is common across different races, cultures, and communities all over the world. For instance, in the United States (U.S), statistics show that a child is abused sexually every eight minutes. Further, research has established that in 93% of these cases, the perpetrators of this heinous act are close family members or friends to these children. It is estimated that 12-40% of the U.S population has experienced sexual abuse in the course of their childhood (SexInfo Online, 2017a). Child sexual abuse has over the years been a predisposing factor in many health, behavioral, psychological and mental disorders amongst the older generation. However, research on this area is limited despite increased public outcry on the rise of child sexual abuse cases. This paper explores the effect of childhood sexual abuse on adult women. In this pursuit, the paper will explore the physical, psychological, sexual and interpersonal effects exhibited by female child sexual abuse survivors. It will also highlight some of the predisposing factors that make female children vulnerable to sexual abuse or exploitation. Lastly, the paper will discuss the effects of childhood sexual abuse on the child’s future prospects for intimacy, sexuality, and trust.
Childhood Sexual Abuse: A Background
Child sexual abuse or sexual exploitation refers to sexual intercourse with a minor. Most of the reported cases involve forced intercourse or exploitation, where the dominant older adult demands sexual favors in exchange for food or other valuables that are attractive to the minor. Most countries consider a minor as anyone below the age of 18 years. Most childhood sexual abuse cases are not reported. This is because most of the abused children do not know where to report. They also fear the repercussions of reporting since the abuser may be a close member of the family. The abuse may take place take place when the child is too young to comprehend. In most case, the perpetrators threaten the children physically and psychologically. Subsequently, the victims are not able to disclose the abuse. Due to these inhibiting factors, many of the abuse cases go unnoticed (Hall, 2003). The children live in tribulations and trauma of these inhuman experiences to their old age ( Dube et al., 2005) . However, on reaching maturity, these child sexual abuse victims open up and share these daunting experiences in an effort to find solace, come to terms with the past and move on by making peace with their past. This is exemplified by the fact that a significant number of research or scholarly findings are based on personal testimonials from young adult women. In this case the victims have openly discussed their experiences and how these experiences have or continue to affect their day-to-day lives. Research has found that one in three girls faces sexual abuse in North America within the course of their childhood (Hirakata, 2009).
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In Australia, between the years 2009 – 2010, residents reported 287,437 cases of child sexual abuse. This accounted for 12.7% of the child abuse cases in the country. Another study targeting England elementary and high school students from the age of 9-16 years established that cases of child sexual abuse were rampant. In the study, 19% of the respondents were reported to have either been sexually assaulted, attempted to be assaulted or were held captive away from their home by molesters at a point in their childhood (SexInfo Online, n.d.). The study showed a higher prevalence rate of abuse amongst girls compared to boys where 10.4% girls reported sexual assaults versus a prevalence of 4.2% for the boys. In trying to demystify the gender of the molesters further, the study reported that most of them were male, who constituted 88.2% of the molesters. The report further confirmed the fact that most of the cases go unreported. For instance, the study established that 79.9% of the victims disclosed details of their ordeal to caregivers, but only 33.3% of the cases were reported to law enforcement officers. In another study conducted by the United Nations in the year 2002, it was discovered that about 150 million girls undergo sexual molestation before their 18th birthday (SexInfo Online, n.d.).
Risk Factors
Child abuse does not occur randomly in the society. More often, the vice takes place amongst the less fortunate in the society or within broken families. Research has also shown that young girls living with disability are at higher risk of sexual abuse. In this regard, children living with disabilities are three times more susceptible to sexual abuse, with the likelihood being even higher for those with intellectual disability (Higgins & Swain, 2010). Child sexual abuse is also prevalent in families where parents have either divorced or separated. The perpetrators take advantage of the vulnerability of the children in these families and molest the young girls. Child sexual abuse cases are also common in families that are characterized by domestic violence. This is because domestic violence leaves the children vulnerable as their parents are consumed in unending disputes ( Herrenkohl et al., 2008 ). Sexual abuse amongst young women has also been perpetrated by their step parents. When parents divorce, separate or one passes away, the remaining partner may get married again. This introduces a stranger to the growing young girls. For instance, the foster father may develop a poor parent-child attachment that may lead to increased likelihood of sexual abuse. However, little research has been done on the magnitude of the risk young girls face under foster care. Although the majority of the sexual abuse cases are not carried out by members of the immediate family, it’s highly likely that poor detachment with the children creates an environment characterized by inadequate supervision, care, and parenting. This leaves the young girls susceptible to molesters ( Herrenkohl et al., 2008 ).
A direct correlation exists between violence and physical assault, emotional distress and sexual abuse. Children from families in which disagreements and disputes are common are more prone to sexual abuse. Children who have been victims of emotional and physical abuse are also at high risk. In their study, Mullen et al. (1994) found that women who were sexually abused when they were young had five times more probability of being victims of physical abuse. Likewise, they were three times more vulnerable to emotional torture. This could be explained by the fact that an environment characterized by physical and emotional torture is also conducive for sexual abuse and exploitation (Mullen et al., 1994). The other factors that put young girls at risk of abuse include physical maturity, physical attractiveness, and temperament. For instance, child molesters target girls who are beautiful and physically attractive as well as those who are gullible. In this case, a girl’s maturity may be directly associated with vulnerability of attack and abuse (Patzer, 2006). The girls who are isolated from their age mates also have double risk of abuse and exploitation.
Effects of Childhood Sexual Abuse on Adult Women
Physical and Mental Effects
Globally, most campaigns against sexual abuse against young girls are focused on the future implications of the act rather than its immediate effects on the child. These campaigns have also been inclined to the psychological impacts since women mostly open up to their psychologists about their ordeal when they are mature. While this is important, it is only a corrective rather than a preventive measure that only serves to make peace with one’s past. For this reason, most accounts of the subject are written by psychiatrists hence focus more on the psychological effects of the vice (SexInfo Online, n.d.). Child sexual assault may lead to many physical and mental complications which, depending on intensity, may threaten the life of the child. The power to cope differs from one individual to another, with women being more prone to trauma than men. The intensity of the trauma also varies. For instance, sexual assault involving penetration is more traumatizing than any other form of abuse.
Sexual abuse in teenage girls presents more than psychological effects as physical concerns about diseases, and early pregnancies are also at play. These pose a challenge to the children since they are torn between seeking support from friends, relatives or parents while risking the wrath of the perpetrator who may have given the victim a stern warning against disclosing the ordeal. In many countries, the avenues and channels via which children can report and seek support are few. This is unfortunate because the children may be uncomfortable sharing this humiliating information with a relative or friend. It is further made worse if the perpetrator is a relative or family friend. Lack of these institutions leaves the abused women more prone to depression, low self-esteem and many more life predicaments (SexInfo Online, n.d.). Research has found that young girls who are victims of sexual abuse may suffer from trauma or emotional distress that limits their active participation in academics, leading to poor performance. Thus, the experience may negatively influence their prospects of attaining good grades. This makes them disgruntled, leaving them vulnerable to peer pressure and bad company when in school. All these aspects may impair their ability to be disciplined in school and gain the necessary skills (Rates, 2007).
In another study, it was established that women who were victims of sexual abuse had the tendency of getting married to spouses of lower social classes. This observation suggests that childhood sexual abuse disorients a woman’s self-esteem to the point of compromising her ambitions or potential. This decline in the respective partner’s social class was more remarkable in women who had undergone horrific experiences characterized with violence and penetration. The decline in potential was also evident in the workplace where women with a history of sexual abuse were noticeably found in the lowest salary grades. However, this could not be linked to their performance in school, reduced participation in the workforce nor their preference for lesser duties or part-time jobs. The phenomenon can be explained by the fact that the women’s past sexual abuse experience lowers their self-esteem, which in turn lowers their bargaining power since they do not believe in themselves. This could also explain why they find it hard to transition from schooling to the real world. The act of selecting a partner whose social status is lower is an indication of the effect of childhood sexual abuse on the victim’s self-esteem. Moreover, Lev-wiesel (2000) cites that these women also find it hard to maintain their positions.
Emotional Effects
The environment in which a child grows affects his or her brain development. Thus, a child who is exposed to sexual abuse may develop emotional distress which could be characterized by feelings of anger, guilt, low self-esteem and grief. These factors are likely to affect their day to day life. The assault deprives the children of their innocence while introducing them to sexual acts that are associated with adulthood. In this regard, the children’s brains are incapable of handling the acts to which they are exposed. This may impair a child’s sense of security. Also, the child may find it difficult to trust again (Hall, 2003). Most victims of sexual abuse have reported having felt guilty of the assault over their lifetime. They also blame themselves for their predicament, with some believing that they deserved to be assaulted. Due to threats from their abusers, the victims of sexual abuse suffer in silence. Further, in a bid to find solace, they end up blaming themselves. These efforts, in turn, lower the women’s self-esteem. Likewise, they tarnish the women’s perception of the world as a safe place. These attributes may lead to dissociation of these women from the society making them more susceptible to psychological disorders (Hall, 2003).
Psychological Effects
Research has established that about 80% of children with a history of sexual abuse during their childhood exhibit psychotic condition by their 21st birthday. Each individual experiences a unique ordeal. Thus, based on their coping strategies, the victims present unique disorders. The most common symptoms include post-traumatic stress disorder (PTSD), anxiety, depression and eating disorders ( McLean & Gallop, 2003) . When children are sexually abused, and the perpetrators threaten them if they disclose their ordeal, the chances of developing depression in their adulthood increase. In concealing their worries, they hold the trauma for long, dissociate with people and often suffer in silence leading to depression (Igelman et al., 2014). However, sharing the ordeal with a friend, psychiatrist, parent or a confidant helps to relieve depression and anxiety. For instance, in a past study, increased cases of depression were noted amongst a group of individuals who concealed details of their molestation. Victims of childhood sexual abuse may exhibit eating disorders which can manifest in two different ways ( Sanci et al., 2008) .
The first type of eating disorder is referred to as anorexia nervosa. Women suffering from this disorder often have an illusion that they have excess weight in their body. To counter this, these women tend to avoid eating, undertake massive body exercises as well as hide themselves when eating. In the U.S, approximately 1% of the adult women are living with this condition. The second type of eating disorder is bulimia nervosa. This disorder is characterized by moments of overeating followed by corrective behaviors such as induced vomiting. It’s estimated that in the U.S, bulimia nervosa affects 4% of the women in their early adulthood. Bulimia nervosa is characterized by binge eating disorder which involves overfeeding within a limited timeframe. This leads to excessive weight gain. To counter this disorder, it’s advisable for the victims of childhood sexual abuse to share their ordeal with friends, parents or confidants. This may aid in eradicating these eating disorders.
Sexual Effects
Many women who were molested at an early age describe their ordeals as painful. Due to this, they tend to abstain or become hypersexual. On the other hand, women with a history of sexual abuse also testify to having been addicted to sex and having many partners. The latter makes them susceptible to sexually transmitted infections and early pregnancies. Psychologists explain this condition as a fixation in the victim’s childhood that makes them communicate through sedation and sexuality. In some cases, the victims avoid sex for an extended period due to the physical and emotional suffering they undergo when they try to get intimate. This is complicated by the fact that survivors have low self-esteem particularly with regard to their sexuality. As a result, these individuals struggle to convince themselves that they are good for their partners. To address this problem, these individuals are advised to seek professional assistance from sex therapists or psychologists (Igelman et al., 2014). The victims also tend to have mental flashes of their ordeal when they intimately engage their spouses. They may also get violent or emotional. This is because the memories of the ordeal torment them and they feel like they are being used or abused. Therefore, victims of childhood sexual abuse find it hard to maintain an intimate relationship and this often leads to separation or divorce (Igelman et al., 2014).
Sexuality
Past research efforts on sexuality have sought to explore the sex lives of women who were victims of childhood sexual abuse. The scope of these studies has included the plight, feelings and the extent to which these ladies enjoy their sex life in adulthood. The existing literature on these issues points towards two common features. Firstly, there is a consensus that reduced sex drive is common amongst women who were molested sexually when they were young. These women embraced dating life with caution because they found it hard to trust. This is especially true in women who underwent physical abuse and penetration ( Johnson , 2004). A conflicting school of thought that has been backed by research is that there is no direct link between sexual abuse and sexual esteem among women with a history of sexual abuse. For instance, a previous study reported that women who had been sexually abused in their adulthood underwent a broad range of sexual escapades of discovery which were greater than those of their counterparts who had a normal and ideal upbringing sexually. Thus, victims of sexual abuse are believed to be more sexually active compared to women who had a normal sexual childhood. Another study failed to create a link between sexual satisfaction in adulthood and sexual abuse in childhood. This is after failing to identify significant dysfunction or dissatisfaction in adults with reported cases of childhood sexual abuse.
A rapid study involving 2,250 respondents was carried out in New Zealand and focused on the prevalence of sexual activity in children and whether most of these intercourses were consensual or could be classified as abuse. Majority of the respondents confirmed that they engaged in consensual intercourse before their sixteenth birthday. However, when the study focused on those who reported sexual abuse, they were also more likely to report consensual sexual intercourse with their peers before their 16th birthday. These results showed that teens voluntarily engaged in sexual activities and that there was no considerable deviation between controls on those who did it voluntarily and those were abused (Mullen et al., 1994). Also, most of those who were sexually assaulted were sexually active months before the survey and were twice more likely to report dissatisfaction and sexual disorders compared to those who had no history of abuse. About forty percent of women with a history of sexual abuse did not have a regular pattern in their sexual encounters, and their lack of control in terms of frequency was a bother to them. In contrast, only twenty-seven percent of those with no history of abuse held similar sentiments (Mullen et al., 1994).
An analysis of the perception and general feelings regarding their sexual lives depicted a significant difference between those with histories of abuse. Women with a history of abuse reckoned that their attitude and perception about sexual intercourse affected their relations and consequently prevented them from having fulfilling sexual lives. Sexual abuse that involved penetration affected the victims' sexuality, and they were more likely to report uneasiness when discussing their sexuality. Further, this group was more likely to develop negative attitudes against their partners thus further complicating their sex life. Another study in Australia mapped early sexual abuse with penetration as a significant precursor to complications in adult sex life. This was even after consideration of the victims’ social and family backgrounds (Hall & Lloyd, 1993). Another study sought to examine the link between sexual abuse, cohabitation, and early pregnancy. This study established that girls who had an abusive childhood were more likely to cohabit with their peers early in their lives leading to earlier pregnancies. This was as compared to their counterparts with a normal sexual childhood. The early sexual engagements and commitments to start a family were attributed to the victims’ clamor for affection and love away from the childhood environments that exposed them to the vices of abuse. Unfortunately, the study also found that for those who had a history of repeated sexual abuse with penetration, their intentions to strike long-lasting family engagements were more likely to fail (Hall & Lloyd, 1993).
Evidence has also depicted that children who underwent sexual abuse were more likely to suffer sexually transmitted infections, early pregnancies, have more sexual partners and be at a higher risk of being victimized again. A past study delving into this established that sexual abuse in young girls involving penetration made them susceptible to rape and consequent cases of domestic violence in marriages. These findings support the fact that early cases of child sexual abuse have enormous effects on the abused women’s adult sex life. One common argument is that the more extreme the childhood sexual abuse is, the more extreme the expected disruption on adult sexuality ( Lev-Wiesel , 2000; Mullen et al., 1994; Hall & Lloyd, 1993). There is no much literature exploring the relationship between the ages of the girl at the time of abuse to the impact of the abuse on their sexuality. It’s however expected that sexual abuse that occurs before puberty is more likely to lead to trauma than the sexual abuses that occur after puberty. Clinical observations have shown that girls who have been sexually abused during the early stages of their childhood portrayed heightened anxiety in physical contact. This anxiety is characterized by avoidance of relationships due to an internal feeling of inadequacy and low sexuality (Hall & Lloyd, 1993).
Women who have had a history of sexual abuse are often more likely to classify any sexual advancements by men towards them as promiscuous. This is because these women tend to have a high subjective evaluation of sexual advances based on their prior experiences. They are therefore more cautious of being hurt than their counterparts with no history of sexual abuse. These differences portray a change of attitude towards their sexuality. There is, however, a body of research that shows that women who were exposed to sexual exploitation leading to penetration done for a longer period, and frequently by a person close to them developed a tendency of heightened sexual activity in their early childhood. This made them more vulnerable to early pregnancies and sexually transmitted infections (Hall & Lloyd, 1993). These findings were confirmed by a survey aimed at understanding the problems women encounter that could be traced to early sexual abuse. Three percent of the test sample responded to having a promiscuous adulthood and blamed their heightened sexual activity to their childhood sexual abuse. In the sample, 50% of the respondents confirmed that their sexual abuse had affected their adult sexual life. Another 5% of the respondents linked their childhood sexual abuse to the emotional and mental challenges that they faced in their adulthood exploitation (Mullen et al., 1994). Another study carried out in Australia established that 17% of the women who reported childhood sexual abuse believed that the incidents had severely damaged their sexual life ( Fleming et al., 1999) . This observation is heightened when the focus is shifted from sexuality to the pressing concern of the psychological effects the childhood encounters inflict in the victims and how this affects their adulthood sexual developments. These research efforts confirm that early sexual abuse in girls immensely effect how they view their sexuality when they become adults. This is because the experiences create a visual construction of intimacy mulled by coercion and exploitation.
Relations and Intimacy
The effects of childhood sexual abuse that may affect the children’s future relationships and perceptions on intimacy are mostly trauma-related. The girls who are assaulted at a younger age tend to develop a distorted image of the world around them. In this regard, they tend to find it hard to trust others while developing a negative attitude towards their sense of sexual identity. Insecurities and disorganization in adult life have been attributed to sexual abuse in childhood. The victims of childhood sexual abuse are more prone to breakups in their adult life compared to their counterparts who have an ideal life in their childhood (Hall & Lloyd, 1993). For instance, women who have been victims’ of childhood sexual abuse have difficulties communicating with their partners. Secondly, more than half don't feel confident to share their problems with their partners. Further, they are likely to perceive their husbands as controlling and this increases the likelihood of divorce. A significant number of childhood sexual abuse victims report that they have received negative remarks from their partners in response to their past predicaments. However, more than a quarter report having healthy communication with their partners (Mullen et al., 1994).
Another study showed that women with a history of sexual abuse tend to have a depressing marriage life and are more likely to rate their spouses negatively. They often view their spouses as non-considerate and over-controlling. This further increases the likelihood of separation or divorce. A significant number of these women report that their spouses are not supportive nor are they caring. This makes them uncomfortable in their marriages. The childhood sexual encounter also makes the women limit their capability to maintain an intimate relationship, thus impairing their sexuality and the ability to trust others completely. Interestingly, the same women did not find challenges in reaching out to friends and seeking emotional support. This may support the conclusion that the sexual abuse of a girl at a tender age tends to alter the development of trust and limit the emotional ability to form and maintain intimate relationships. This may be manifested in the assertion that their partners are not caring and that they are over controlling. Consequently, childhood sexual abuse may lead to an emotional disorder triggering unrealistic expectations that their partners cannot fulfill. Further, these women’s rudeness may be a survivor tactic aimed at taming their partners. Due to their trauma and low self-esteem, these women also tend to have selected partners without any emotional attachment.
Self-esteem
This refers to the general feeling of worth in oneself. Self-esteem is also associated with one's achievements and a perception on how others view the concerned person. This feeling gives a person contentment and self-acceptance in the society. Over the years, a number of research efforts have directly linked childhood sexual abuse to low self-esteem. One of the earliest studies outlined the correlation between low self-esteem in adults to their sexual abuse in their childhood. This linkage has been a benchmark of much research in this domain. Those with intensified low self-esteem have reported complex sexual abuse involving penetration in their childhood. Further, these women find it hard to deal with external criticism. They also get irritated when they cannot manage to sway external events in their lives. Interestingly, some of them are very good at creating a positive aura around their friends, seek support and are determined to achieve their goals in life.
Mental Health
This is one of the key areas of interest in the field of psychology. Research has found that children who have had traumatic childhoods are at a higher risk of developing dissociative disorder when they become adults ( McLean & Gallop, 2003) . These traumas may be caused by negligence, physical abuse, emotional abuse or sexual abuse. In this regard, incidences of rape, forced sex or sexual exploitation may disorient the mind of the young girls. This disorientation is visible in adult women who exhibit signs of chronic stress, trauma or depression ( Roberts et al. , 2004). In coping with this trauma, the victim may disassociate with the society. One of the strategies that some people use is the subconscious development of an alternative character, in the process exhibiting different thoughts, mannerisms, and memories. This new personality is referred to as an ‘alter’ and serves to shield the primary alter against the concerned person’s traumatic experiences ( Roberts et al. , 2004). This disorder is commonly associated with memory lapses and the existence of two or more personalities in one person. The switch from one alter to another is associated with a memory gap, and the new personality exhibits a different identity, behaviors, preferences and a different thought system. Research has also shown that women with a history of sexual abuse are at a higher risk developing this disorder. This condition is referred to as dissociative identity disorder (DID) and entailing the replacing the traditional multi-personality disorder. Victims of sexual abuse not only suffer from DID but have also reported cases of depression, suicidal tendencies, and stress ( Roberts et al. , 2004; McLean & Gallop, 2003 ).
Alcohol Abuse
A previous study has analyzed women undergoing alcohol abuse treatment in an effort to establish whether their addiction was in any way related to a history of sexual abuse. The study found that most of the women abusing drugs had a history of childhood sexual abuse. Recent research has widened the scope to cover community samples with a better understanding of drug and sexual abuse (Cook et al., 2017). Most women highlighted their ordeal and how traumatizing it had been to forget all over their life. They felt that the thoughts of the assault have made them develop a cold hurt on intimacy and engage in alcohol to brace reality and forget the past and frustrations it has caused in their lives.
It’s indubitable that there is a wide range of life situations that arise in adulthood that can be linked to childhood sexual abuse. Similarly, the severity of abuse and the perception varies between one victim and another. It’s therefore prudent to view childhood sexual abuse as a predisposing factor to many adult problems and disorders. When focusing on adulthood challenges or conditions, it’s imperative to consider that most of the victim’s memories fade away with age. The memories may, however, be fresh for those left with a physical scar or a traumatizing ordeal that is so vivid that it cannot fade away from their minds. Childhood sexual abuse occurs at a time when complex and essential developments are at play in a child’s life. These complex changes transform the social, psychological and physical well-being of the child. As a result, sexual abuse and exploitation may leave the young girl susceptible to severe complications leading to retardation, delay or inhibition of critical developmental features. However, the physical impact of abuse may be withered away as the body develops. The psychological and social implications of the abuse may take a while to fade away depending on the victim’s degree of resilience. Other factors in the family may influence the recovery. For instance, a child born in a family with constant domestic violence may find it hard recovering from a sexual abuse trauma. Conversely, a victim from a privileged background is at a better position to recover from the social and psychological traumas associated with sexual abuse. Due to the supportive care system by the family, the child is also unlikely to develop serious long-term effects or disorders.
Further, if the victim had a high self-esteem before the abuse, a successful life story and a supportive team of friends and family members, the long-term effects are gradually reduced. Therefore, sexual abuse coupled with the child's background may interact to disrupt a child's self-mastery and self-esteem. This means that their perspective on a safe environment changes, and so does the feeling of self-importance. If the child doesn’t gain a positive support system after the abuse, she may experience intensified psychological and emotional distress later in her adult life. In childhood sexual abuse involving penetration, the risk of sexual, psychological and interpersonal complications is high. Moreover, women who in their adulthood fail to find confiding and intimate relationships are prone to depression. This depression may be associated with low self-esteem coupled with feelings of hopelessness. This condition is brought about by the realization that one cannot influence his or her life. Low self-esteem, being a common side effect of sexual abuse may thus lay a foundation for depressive mental disorders among women with a history of sexual abuse. Overall, childhood sexual abuse has serious adverse effects on adult women.
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