Is it Possible to End Child Sexual Abuse? What Would it Take?

 

Bloomberg School

What Would It Take to End Child Sexual Abuse?

Preventing CSA requires challenging our misconceptions, understanding where current approaches fall short, and investing in strategies that can work to keep kids safe.

An estimated 20% of all children in the U.S. will experience child sexual abuse (CSA) or attempted CSA, either online or offline, before they turn 18.

It’s a reality we have the tools to change, says Elizabeth Letourneau, PhD, a professor in Mental Health and the director of MOORE | Preventing Child Sexual Abuse. Letourneau is also the co-author of One in Five, which presents CSA as the biggest public health crisis of our time—as well as entirely preventable.

“There’s this misperception that child sexual abuse is uniquely unpreventable compared to other types of harm that can befall children, like child physical abuse, child neglect, or bullying,” Letourneau says.

In fact, evidence shows that it is possible to prevent CSA.

The Truth About CSA

What many people think about child sexual abuse has been framed in some part by news stories, TV shows, and movies centered around exposing and punishing adults who harm children. These incidents are rightfully criminalized, and adults who offend must be held accountable, Letourneau says. But the incidents that make headlines—the prosecutions of adult strangers with dozens of victims—represent a fraction of CSA offenses.

Decades of research have revealed important information about the people who sexually offend against children and the factors that put someone at greater risk of offense or victimization. Much of this evidence runs contrary to popular beliefs.

In the U.S.:

• Around 70% of in-person CSA is caused by another child. “It’s somebody they know, usually within a few years of age of the victim,” Letourneau says. In situations of children and adolescents engaging in harmful sexual behavior against other children, many simply didn’t know that what they were doing was inappropriate, Letourneau says.
• Less than 3% of children convicted or adjudicated for a sex crime will have a new charge or conviction in adulthood.
• The majority—about 60% of online and 90% of in-person CSA—of adult-perpetrated CSA is by someone known to the child or the child’s family.
• Half of adults who sexually offend against children are not predominately sexually attracted to children. People who work around children may become “situational offenders” out of proximity, opportunity, or impunity, Letourneau says.
• People with sexual attraction to children are not doomed to commit CSA. “Pedophilia is a risk factor for offending against children, but many people who have that attraction don’t want it, and they do not want to hurt children,” says Letourneau.
  But, many of them will watch CSAM, not realizing that they are contributing to creating a colossal market for kiddie-porn that results in staggering numbers of CSAs.
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Criminal Justice Is Essential, Yet Not Enough

The U.S.’s primary approach to CSA focuses on keeping people who have offended from reoffending—through incarceration, sex offense registries, and community notification. Fortunately, sexual reoffense rates are low, indicating that prosecution is a highly effective prevention strategy. In the U.S., only about 5% of sex crimes that become known to law enforcement are committed by people with a previous sex crime conviction. Current systems are not set up to prevent the other 95% of crimes committed by people without sex crime priors.

I have trouble with the 5% recidivism rate. Most studies show between 5 and 15% rates, but longer-term studies reveal rates much higher. According to Grok: Meta-analyses and reviews of adult sexual offenders overall report average sex recidivism around 13–14% over ~5–6 years, rising to roughly 20% at 10 years and 24% at 15 years. Rates for child molesters as a group are similar to rapists in some large samples, but subtypes differ. 

“We need prevention for all, healing for survivors, and justice to hold people who offend accountable.”

Moreover, post-prison interventions like registration and notification have not been shown to keep people safe—and these policies can cause significant and lasting harm, particularly for children. Researchers like Letourneau have been able to compare outcomes in states with different offense registration policies and have found that kids ages 12–17 who are placed on sex offense registries are at greatly increased risk of sexual assault victimization and have much higher rates of suicide attempts.

Every year, the U.S. spends $5.4 billion on incarcerating people convicted of CSA compared to about $3 million for CSA prevention research. “We focus on after-the-fact criminal justice solutions to CSA, which are essential, but they’re far from complete,” says Letourneau. “We need prevention for all, healing for survivors, and justice to hold people who offend accountable.”

Prevention Is Possible

Because CSA can happen at any point before age 18 and is caused by virtually anyone, it is a complex issue to prevent—but that doesn’t mean solutions don’t exist. “There’s never going to be a single intervention that can reduce most instances of child sexual abuse,” Letourneau explains. Rather, preventing CSA requires strategies at multiple levels that address a range of risk factors, environments, and populations. Many interventions are proven or promising and are worth scaling and adapting, she says.

In One in Five, Letourneau and co-author Luke Malone, MA, present evidence-based strategies that can help prevent child sexual abuse from happening in the first place, interrupt abuse and mitigate its harms, and keep it from reoccurring.

Educating Children

Most prevention efforts focus on teaching children to keep themselves safe—by recognizing, resisting, and reporting inappropriate behavior by adults—which is important, but places a lot of responsibility on children at risk of victimization, Letourneau says. These efforts also don’t address the realities of children at risk of causing harm—including against younger children or peers—or behavior during early dating.

Since the 1990s, several school-based prevention programs have reduced CSA among children and adolescents by providing age-appropriate education to middle schoolers. Programs like Safe Dates and Shifting Boundaries have taught students about healthy relationships, consent, the age of appropriate partners, what to do if they have concerns or experience sexual violence, and the legal consequences of perpetrating it. Responsible Behavior with Youth and Children (RBYC), developed by MOORE, extends this focus to include addressing the inappropriateness of sexual behavior with younger children.

• Safe Dates not only reduced sexual violence victimization and perpetration, but also empowered healthier, safer relationships as participants progressed into high school.
• A study in New York City middle schools found the Shifting Boundaries curriculum, combined with building interventions, reduced victimization by peers by 40%.
• RBYC teaches adolescents about similar concepts as Safe Dates and Shifting Boundaries, while also explicitly addressing why younger children cannot consent to sex. RBYC shows promise in preventing problem sexual behavior online and in person.

Training for Adults

“No one likes to think ‘this could happen here’,” Letourneau says. But evidence suggests that adults who spend a lot of time around children may be at increased risk of perpetrating CSA, even if they are not primarily sexually attracted to children. In addition to thoroughly vetting adults who will be in contact with kids through work or volunteering, training and regulations can help make people aware of this vulnerability while also enabling them to identify and address boundary-violating behaviors that often precede abuse and report CSA when it does happen.

In youth programs—schools, summer camps, sports and other extracurriculars—prevention can encompass a range of strategies:

• Background and reference checks for all adults.
• Detailed codes of conduct that enforce clear boundaries for interactions with youth participants.
• Training staff and volunteers to identify, intervene in, or report concerning behavior.
• Educating staff and volunteers about the potential for their own sexual thoughts to arise and how to seek help for them.
  
  Here, she avoids talking about gender types. I wonder what the odds are that men or teenage boys in roles of teacher, carers, babysitters, etc., are more likely to commit CSA than women. I am convinced the odds are staggering and that you should never leave your children in the care of males not closely related, or transgender people.

Parents can also play an important role in preventing CSA and reducing its harms by:

• Educating their children about sex, relationships, and appropriate behavior both on- and offline.
• Understanding the factors that can increase the risk of CSA at home—including the blending of unrelated adults into a home with kids.
• Knowing how to identify and interrupt boundary-violating behavior.
• Accessing support services for children who have experienced CSA.

Making Physical Spaces Safer

The Shifting Boundaries program showed how easy and effective it can be to adapt spaces within the school to prevent abuse between students. Students and teachers identified places where abuse or other bad behavior is likely to occur, and informed administrators where to implement interventions. Better lighting and faculty monitors can make hallways safer between classes, posters in bathrooms can remind kids what is appropriate and who to contact about concerning behavior, and trimming shrubs or removing unused outbuildings can remove visual barriers.

Building design can go a long way toward making interactions between adults and kids observable and interruptible—for example, by adding windows to doors and interior walls, and arranging furniture to maintain clear lines of sight. Rules prohibiting closed doors or one-on-one interactions can serve a similar purpose without modifying the structure.

“There are a lot of strategies to improve the built environment to make it safer for kids—and frankly, safer for adults too, who may not even think about abusing a kid unless it seems like it would be really easy to do,” says Letourneau.

Making Digital Spaces Safer

Letourneau and her colleagues have also seen evidence that CSA can be thwarted online. MOORE designed an online prevention program for people with sexual attraction to children called Help Wanted. Since its global launch in May 2020, this free, anonymous resource has been visited over 1.5 million times, and over 50,000 people have explored at least one of the self-help modules. “That’s how many people are trying to get help,” Letourneau says. “There are many people who seek that intervention … who want to figure out how to manage this attraction without acting on it.”

Warning and “get help” messages can help deter people from seeking out child sex abuse material (CSAM) online and increase help-seeking. In a study conducted on PornHub, users who searched the site for CSAM received a warning about the legal consequences of accessing it and a “get help” option. Of the users who got that message, 80% went back to searching for legal pornography, and a small percentage (0.6%) engaged with the provided chatbot to seek help.

Other strategies can include automated systems of detecting and removing CSAM once it’s been uploaded and shutting down websites where CSAM is hosted—and laws that hold tech companies, websites, and individuals accountable for it. New methods will be needed to tackle the current era of AI-facilitated CSAM.

Supporting Survivors

When abuse does happen, efforts need to shift to reduce recidivism and mitigate the effects of abuse. “You are not destined to a miserable life if you have survived child sexual abuse,” Letourneau emphasized on the Armchair Expert podcast, but “it’s a risk factor for almost every bad thing you can experience.”

Survivors of CSA are more likely to experience mental health issues like depression, PTSD, and addiction, and are at higher risk of future victimization of sexual violence. While most survivors will never go on to offend, victimization is also a risk factor for future perpetration, as children often model what they see or experience. Ensuring that everyone who experiences child sexual abuse has access to trauma-informed cognitive behavioral therapy and other evidence-based support over their life can reduce the likelihood and severity of such outcomes. Similarly well-researched therapies are also helpful for adolescents who have perpetrated against other kids and their families.

Increasing awareness of CSA can empower survivors to open up about their experiences and, in turn, seek support. Lawmakers can also support survivors through policies, like those that broaden or eliminate statutes of limitations—the amount of time a survivor has to come forward about a CSA incident or take legal action against their perpetrator—which some states have already done. Likewise, it is important to ensure that institutions that enabled or ignored CSA are held accountable, along with the individuals who offend.

Making CSA Prevention a National Priority

To end to CSA, Letourneau says, the U.S. needs a national strategy that identifies the public health issue of CSA and prioritizes prevention. She wants to see the establishment of a federal Office of Child Sexual Abuse Prevention, which as she and Malone envision it in their book, would have representation from all other major entities responsible for children: “Department of Justice, Department of Education, Department of Child Welfare—they [all] have to be at the table and also have some responsibility,” Letourneau says.

“It's going to need a whole-of-government approach to implementing and adapting existing evidence-based interventions, and developing more to address gaps,” she explains, pointing to other countries already doing this. The Australian government has invested billions into better understanding the issue and developing effective intervention strategies—and can already point to reductions among some types of CSA. The European Commission is placing a stronger focus on prevention strategies, including in the tech sector, in addition to strengthening criminal enforcement and providing support for survivors. A number of European Union member countries, like Ireland, are moving in that direction, Letourneau says.

A federal government actively engaged on the issue is ultimately what will drive real change, Letourneau says. “I think that’s what it’s going to take, and I think we can get there.”

These are all useful ideas and could go a long way toward reducing CSA and the consequences of it. But CSA will not come to an end before Jesus returns. There is a large element of rebellion against God in child sex abuse. He will bring it to an end when He returns, and I suspect it will be brutal.

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