Lessons And Thoughts From The 2017 Moore Center Symposium

My First Symposium... Via Youtube

In case you did not know, I watched the entire symposium via Youtube, and for my sake, I am glad I did. I was able to pause, go back, and rehear things that I found interesting and catch nuances that I missed the first time. Perhaps I have been missing from the academic world for too long, but I would almost certainly miss things if I had been sitting in the audience. Therefore, I am very grateful to the Moore Center for generously putting their symposium on Youtube.

Three Big Ideas

To me, there were three big ideas shared at the symposium:

• Current policies are failing, and failing hard if you take any kind of a close look at the research.
• We need to do a better job at outreaching to those that share the goal of prevention as well as the general public, so that sexual abuse can be prevented and handled effectively if it does happen. 
• Most sex offenders have some kind of trauma in their childhoods, so paying more attention to children from difficult backgrounds can aid prevention just as much as a formal intervention.

These three ideas were present throughout the symposium, and were illustrated in a variety of ways via a variety of new research presentations and discussions. 

Two Opportunities For The Average Person

There are two great opportunities that the average person can take (yes, you, random person that just stumbled onto my blog, and you, person that subscribed to my posts).

The first is seeing the documentary Untouchable, which does an even more fantastic job than I can at telling a story. I could tell you my story, but it will almost certainly be limited forever to the written word, and those stories have limits. Untouchable can tell a story that I cannot: The story of a father whose daughter was abused and what he did about it, the story of a daughter who was abused and what she did about it, and the stories of those whose lives were affected by what this father-daughter duo did. While Untouchable does weave boring facts and statistics into the stories it seeks to tell, I can promise that it will be the most thought-provoking 104 minutes you will spend watching a film.

The second is learning more about the subject of child sexual abuse, why you should learn more, and how you can help end child sexual abuse once and for all. Maybe you were sexually abused, and are working through the pain it caused you. Maybe someone you know was sexually abused, and you want to know how to help them through their pain. Maybe you know someone who was sexually abused, and you just do not yet know it. Regardless, sexual abuse has affected everyone. The trauma of abuse is not limited to just the one in four girls and one in six boys that experience it before they turn 18 years old, it also affects the friends, neighbors, and family members of those children. That trauma needs to be a thing of the past, and the only way we can make that happen is by learning about the issue, learning about what we are currently doing to solve it, and coming up with new ideas that are based in research.

One Thing Advocates Need To Do

Tell stories. You need to share your story (and yes, I realize I have not yet shared the full brunt of my own story, and for many reasons, that must wait a few months). People need a person, a face, a name that they can identify with. They need you to paint them a picture of how child sexual abuse has affected you, and they need to know what you think can help solve the epidemic. They need to see that the issue of sexual abuse does not need to be scary and that anyone can tackle it.

Zero People Are Unaffected By This Issue

I touched on this in one of the two opportunities: If you were not directly affected by sexual abuse, you know someone who was. Maybe they are your best friend. Maybe it was a spouse, a brother, a sister, a mother, or a father. Maybe it was an uncle, or that guy you play tennis with. Whether they have said anything or not does not matter, because most victims take years to talk about it, if they do at all. The fear and the stigma drives this issue under the rug, and that is where it thrives. By realizing that we all know someone who has faced this issue, we can help shine a light on this dark and scary subject.

Why Does The University of Minnesota Not Have A Sexual Abuse Prevention Division Of Some Kind?

Yes, I learned the other day by calling the University of Minnesota's School of Public Health that they do not have any division or organization that addresses child sexual abuse. They have a program in human sexuality, but that is not nearly the same thing. I think the University of Minnesota needs to step to the plate, and for the next few weeks, I will be determining what it might take to make that happen. Oh, of course that project is bigger than I am. Yes, I am idealistic in thinking they care about some guy with a weird pseudonym. Maybe you can help me succeed in convincing them why it is needed. Just try not to steal my idea before I get the chance to implement it!

Issues In Mandatory Reporting

Introduction

Mandatory reporting can be an immensely complex topic to cover. Given the pushes in the United Kingdom for mandatory reporting, I think it is necessary to address some of the failures that mandatory reporting can have, as well as some of the misconceptions of what mandatory reporting calls for. I think that in the United Kingdom, there are particular concerns about whistleblowers who may wish to report what they know to be an abusive situation, but fear that their job may be on the line. This is a separate issue from mandatory reporting. So, this post will aim to address the difference between mandatory reporting and whistleblower protection, and the pitfalls of mandatory reporting.

Issues In Mandatory Reporting

One of the biggest issues that comes to mind with mandatory reporting is the reality of who sexually abuses children, or for that matter, the reality of who abuses children in general. The public perception seems to continue to be that dirty strangers and sex offenders abuse children, or sexually abuse children. However, the reality is that over 90% of those who sexually abuse children are people known and trusted by both the child and the community around the child. With sexual assault as a whole, that statistic is still above 80%. In other words, in the majority of these cases the perpetrator is someone who is known, trusted, and well-liked in the community of the child.

When you love someone, the last thing you want for them are the legal hassles of being arrested, charged, or convicted of a crime. You can tell yourself until you are blue in the face that it does not matter who the person is, if they are sexually abusing your child, you will report them immediately. I really do not care what you tell yourself, but the reality is not at all that simple. Say you are married with children, and you find out that your husband or wife is sexually abusing one of the children. You want them and the child, first and foremost, to get mental health help to wade through the issue and ensure it does not happen again.

Another common public perception is that most of the time someone does sexually assault or abuse someone, they will inevitably reoffend. Please stop here. Go to the right-hand side of this blog, and at the top you will find, “Resources:Studies And Articles”. Click it. You can pick any number of studies and articles in this resource, but the facts and statistics firmly establish the fact that most people who sexually take advantage of someone else will not do so again. The facts also show that help is effective in dropping the number of people who re-offend. While recidivism rates are far from perfect, they are a great general indicator of how likely to re-offend a particular criminal population is.

So, let us visit a few scenarios:

1.      A single parent who discovers that a teenage son or daughter is sexually abusing a younger sibling.

2.      A married couple with children, and one of the couple discovers that the other is sexually abusing the children.

3.      A married couple without children, and one of the couple discovers that the other is volunteering with children, and takes individual children to private places for unknown reasons. They suspect something might be going on.

4.      Someone who has sexual attractions to children, and fears they might someday act upon their attractions.

5.      Someone who has sexually abused a child and wants to get help to stop and make sure it does not happen again.

In each of these scenarios, which are likely very common, you have people who, under mandatory reporting laws, would not be mandated to report the abuse. However, if any of these people see a therapist, that therapist would be required, under mandatory reporting, to tell law enforcement about that situation. All of these people are either very close to the abusive person (1-3), or they are the abusive person (4-5). If they are aware that seeing a therapist means the involvement of law enforcement, how likely are they to seek help?

That just covers five scenarios not involving mandatory reporters. Now, let us take a glance at some situations that could involve mandatory reporters, under mandatory reporting laws:

1.      A social worker, teacher, or church official that becomes aware of abuse within the child’s family.

2.      A social worker, teacher, or church official that becomes aware that a coworker is abusing a child.

3.      A police officer that becomes aware that their partner or boss is abusing a child.

4.      A doctor or nurse that becomes aware that their direct supervisor is abusing a child.

5.      Someone who works in any one profession that requires mandatory reporting, but knows someone in their personal life who is abusing a child.

Suddenly, mandatory reporting stops being straightforward. Does the person in the first scenario do their duty and rip apart the child’s family, which is also traumatic for a child? Does the person in situations 2-4 shatter their workplace with such a revelation? If their country does not have whistleblower protection laws, which shield someone in those situations from losing their job, will they be risking their job? How likely are any of these people to say anything in the absence of mandatory reporting laws? How likely is it that, under mandatory reporting laws, these people will be making a difficult situation even more traumatic, not only for the child, but all of the people around them?

Mandatory reporting may sound like the right thing to do at first, but these ten situations raise a number of questions that do not have solid answers. Countries that have mandatory reporting, like the United States and Canada, sometimes will have procedures in place for law enforcement to limit the trauma of involving the police. These procedures are not in place in every situation, and come places will have child protective services, family court, or a similar setup to ensure that fairness and justice are both in place. Child advocates, lawyers, judges, juries, therapists, social workers… the complications to each of these situations are not as simple as “make them report it to police”.

Whistleblower Laws

Some countries, like the United States, have what are called “whistleblower” laws to protect people who know of illegal activity within the company from facing retaliation for reporting the illegal activity to the police. These whistleblower laws do not mandate that people report such activity, but they do give them legal protections and courses of action to take if their employer retaliates against them if they choose to make such a report. These laws give added protection and are aimed at limiting the actions that employers can take in response to such a report being filed.

Pedophiles

I must stop a moment to address something that most people do not consider, and that is the reality that pedophiles do not always abuse children. A pedophile is someone with sexual attractions to young children, and there is academic evidence to suggest that not all pedophiles are even a danger to children. Observing that reality does not make me some kind of “sex offender advocate”, or mean that I am “taking the side of sex offenders”. It means I recognize a fact that is related to the issue of child sexual abuse. I have discussedthe estimates that can be made based on what we know about these issues, and these estimates show that using the most conservative estimate of the number of pedophiles, only 8% or less are known to sexually abuse children.

With that being said, and as you probably realize with me having to dedicate an entire paragraph to explain it, pedophilia is an extremely stigmatized condition. If you wish to know more about this stigma, please copy “stigma against pedophiles” into Google, as it is not the main focus here.

However, it should be pointed out that most mental health providers do not have specific experience with pedophilia or other sexual issues. There have also been many horror stories of pedophiles being reported to the police merely for talking with a therapist about their attractions in order to get help with them. Therefore, the common assumption among pedophiles is that if their country has mandatory reporting, it is not safe to talk with a therapist about the issues they are experiencing. Sexual abusers who are sexually attracted to children (“pedophilic”, in other words) make up about a third of sexual abusers. Imagine if even half of those people felt they were able to get professional help, before they had sexually abused a child.

Conclusion

Mandatory reporting is not an ideal solution to child sexual abuse. It can cause more issues than it solves by pushing people further away from mental health help, and it can have the added effect of stigmatizing mental health issues. Other solutions besides mandatory reporting, like whistleblower laws, should be considered in the UK instead, and a closer look must be paid to the child sexual abuse prevention program Don't Offend: Germany's Prevention Program. The United States has had a “Help Wanted” study this year to look at what pedophiles report that they needed in adolescence to help them with pedophilia. A great many organizations exist to reduce and eliminate the stigma around mental health issues. We must investigate other alternatives to mandatory reporting. 

Circumcision: Why I Mention It

Introduction

Circumcision has been in the news recently, although you probably skim over it. The Huffington Post recently did an article about it, and the New York Post did an article awhile back. Male circumcision has been claimed to have health benefits and is said to reduce the risk of STD's/STI's. However, the science and ethics of circumcision make it perfect fodder for this blog.

My Story

Circumcision has always been an odd topic for me. Growing up, I always peppered my mother with questions like why my penis had a ring around it, and I was always baffled by her answer: "Because you were circumcised as a baby." So, I asked what that was, only to get, "They removed your foreskin." And I asked what that was, and I never really understood what it meant. All I really understood was that people were healthier without it, that it is easier to clean without it.

Hindsight is always 20/20, they say, and they are right. Finally, when I was in middle school, I saw a picture of an "uncut" male, and I understood what was missing. The part that stood out to me was that the foreskin had veins and seemed to be very much a part of the rest of the penis. That is when I first started feeling loss, and that the choice was not mine. My thought at the time was that my parents had a part of my penis cut off because a doctor said it was better for me. It seemed odd.

Fast forward into high school, and I still felt that same loss, and it was the same in college. As I started getting into learning about child sexual abuse and the issues surrounding it, I was getting into ways of improving myself. I was figuring out that there were things about me that I always saw as permanent that could change. Some of them were psychological- that I could change how I thought about myself. Others were more educational- that I could learn another language, as I had always wanted to do. But one of the tie-ins was physical: That I could restore my foreskin.

Foreskin... restoration?

Yes, foreskin restoration. The process works on the same principle as those that put guages in their ears, or plates, or neck stretching: You put skin or some other body part under a mild amount of stretching/stress, and the body can be molded as desired. There are devices sold that can help accomplish this. I thought it was a great idea because it is a long process that becomes habitual over time.

Ethical Issues

I see circumcision and intactivism (the advocacy for an intact penis and against male genital mutilation, as circumcision is sometimes called) as a basic human rights issue just like child sexual abuse is. In a case of child sexual abuse, the child is subjected to behavior they are not ready to handle and do not have any control over. In a case of circumcision, the child is subjected to a surgical procedure that is usually medically unnecessary and does not have any control over. Both are human rights violations.

While the harm between the two varies, the ethical issues are very similar. Circumcision has risk of complications that in some cases cause permanent damage to the penis. The damage is physical and only partially reversible. The nerves, the mechanism that holds the foreskin to cover the glans/head of the penis, the frenulum and the function and role it has to the function of the foreskin are still lost. While the functions can be partially restored, the skin will not stay on the glans the same as if the penis had never been circumcised.

To take that away from a child without their ability to choose it is barbaric, just as it is barbaric to take a child's innocence by sexually abusing them. The idea that circumcision is done for health reasons is just a distorted justification because of the poor science that is used to support that justification (there are many other articles on the subject), similar to the reasoning that a child molester uses to justify their abuse is just a justification.

A Child Has a Right To Their Body

The bottom line with both issues is the right of the child: In circumcision, the child has a right to an intact body and to make informed decisions about their body. In the absence of medical necessity, the child is being physically altered for no reason. In child sexual abuse, the child has a right to live a trauma-free life that does not involve people crossing their boundaries. That is why prevention advocates often talk about children having the ability to set boundaries and make their own decisions. The right of the child takes priority in both issues, and the concern in both is for the child.

That is why I occasionally tweet about circumcision, and that is why I am an intactivist. I do not see how anyone could be against child sexual abuse because of the rights of the child, but be pro-circumcision and ignore the rights of the child. It does not make sense and is hypocritical to be against one form of human rights violations, but in favor of another violation. My advocacy, if nothing else, is aimed at being consistent.

Defining Child Sexual Abuse: A Therapeutic Approach

It is always helpful to define terms, particularly when terms can be as controversial as the subject matter is. Child sexual abuse is a controversial topic because it is a broad topic. Contained in that one subject are consent laws, mandatory reporting laws, civil laws aimed at improving public safety, SORNA, residency restrictions, sex offenders, law enforcement training, and a slew of other items. Many people love to debate controversial issues.

I used to be one of those people, but on this topic, I have a generally narrower focus. I specifically avoid the legal subjects involving age of consent and mandatory reporting because those issues are never-ending. I also avoid using a legal definition of child sexual abuse, because it is overly broad. It is possible for a legal act of child sexual abuse to occur, yet have the legal victim be an enthusiastic participant in the activity, particularly among older teenagers. It is also possible for teens to send explicit images of themselves to others, and have them be legally charged with child pornography, with themselves being both the legal victim and perpetrator.

That is why I avoid legal conversations. I avoid age of consent, because no matter what number is picked, there will always be someone below that number who is mature enough to consent, and someone above that number who is not mature enough to consent. I likewise try to avoid a legal definition of child sexual abuse: No matter how diligent or understanding the police are, there will always be someone arrested for something that was not harmful to the legal victim.

Therapeutic?

I try my best to be clear that when I talk about child sexual abuse, I use a therapeutic approach. In my treatment/support group, they considered a sexual offense as an act that crossed someone's sexual boundary in a way that harmed or traumatized them. For me, the definition of child sexual abuse is tied with harm done to the victim: If there was no harm, there was no victim, if there was no victim, it was not abuse. The act is tied to sexual exploitation and the aftermath of the act: If the act was done by someone several years older than the victim, and the act was sexually exploitative, coercive, and resulted in harm, it was abusive.

So... what is a child?

In talking about perpetrators of abuse of said children, there is typically an age difference of at least a few years. For example, an 11-year-old touching the private parts of a 7-year-old would be considered child sexual abuse if the 7-year-old was harmed. Developmentally, such behavior is not expected or considered the norm. If a 7-year-old is touching the private parts of another 7-year-old, that behavior is considered normal curiosity and exploration. The key is an age difference. Many groups push for considering anyone under 18 a child, but I do not think the reality is that simple unless a therapeutic definition is used for abuse.

Practically speaking...

That is great, but how does that look practically? An adult who photographs a child when they are nude is sexually abusive if that child is harmed in the process, or afterwards by knowing the photograph is on the internet. They are not if the child is unharmed during or afterwards (still illegal). Someone several years older who touches a child's private parts are sexually abusive if the child is uncomfortable with it, and are harmed by it. They are not abusive if the child is unharmed and okay with it (still illegal). Someone who, as a 19-year-old, has sex with their 15-year-old lover, is sexually abusive if the 15-year-old was harmed and did not consent to the act. They are not abusive if the teen was unharmed and consented (still illegal in the US). A lewd conversation between an adult and a child, if the child was harmed, it was abusive (legal unless solicitation was involved).

Those are just a few out of many possible situations. You might ask me, "How can you describe a situation where a child goes through that and isn't harmed? That's impossible." However, those situations are real and documented. There are a number of studies that show that there are some children who are either unharmed, or move past the event enough that it ended up not being traumatic. Running With Scissors is a book where one such situation is detailed by the author. The book is an autobiography. As I have pointed out before, those situations do not justify or make legal the acts that do not result in harm, it means a therapeutic definition is important.

Researchers prefer to view those situations as examples of people overcoming potentially traumatic events. I have the perspective that these children are well-adjusted because they were able to accurately examine how they felt about the events, and decided for themselves that they were not harmed. You could say that these children are very robust and emotionally healthy, because they were able to look at an event and decide for themselves how they felt about it. Here is one great example of an act that was consensual, that the teenager did not report harm, but was still illegal and still overreacted to by the adults in their life. Bear in mind that this would have still been illegal if the man was not on probation for a different sex crime. Also, that case is a great example for groups that discuss age of consent laws. They would point out that in most parts of the world, including Europe, that act would not have been illegal. It perfectly illustrates why legal discussions on this subject are never-ending: What if the girl was 15? 14? 12? What if she still consented then? How does she know what consent is?

Primary prevention tie-in?

The presence of these situations is critical to the primary prevention of child sexual abuse, and here is why. The presence of these situations means that there are children who knew their own boundaries and feelings well enough to know when something did or did not cross those boundaries. It is a win for primary prevention, because these select few children were able to express themselves clearly. It serves as a model for what happens when children are able to create, set, and maintain their own boundaries. If they are able to look at something potentially traumatic as a neutral event, they will likewise be better able to determine when something crosses boundaries and causes them harm.

It is also a reminder that when approaching a child who was impacted by sexually exploitive behavior, we must let the child tell their own story. It is a reminder that overreacting can make a neutral situation traumatic for the child, and to respect the child enough to tell their own story.

Why the emphasis on children?

When it comes to detecting when abuse is occurring, preventing it from happening, and holding perpetrators accountable, the first priority must be the child. While the surrounding community does have feelings about abusive events, the primary impact is to the child. No one should ever presume to tell a child how to feel, only help the child work through how they feel and what they think. It is extremely common for children who have been abused to care for and trust their abuser. The child has a right to feel that way, just as they have a right to hate their abuser. Without that sort of emphasis on children, it is possible to dictate how the child feels and make the impact and effects of the abuse worse than they initially were. Magnifying the effects of child sexual abuse is obviously not something to be striving for, and that is why an emphasis on children must take priority. Without it, primary prevention cannot happen.

Final thoughts...

I know there are some people out there who might twist my argument here to mean that sexual acts with children are acceptable if the child is not harmed, and I must be clear that just because there are children who are not harmed does not make the behavior on the part of the older youth or adult acceptable or moral. The high potential for harm makes the act immoral and unacceptable, every time. Just because even 15/100 cases do not result in harm does not make the behavior itself okay. Another issue is that child sexual abuse does not always result in readily apparent harm. Sometimes, it can take years for someone to realize they were in fact traumatized.

My own abuse was exactly like that: It affected how I saw myself and the world around me. It was not until I began talking about my past that I came to a more realistic understanding of what happened to me, where previously I saw it as normal. I felt shamed for the normal experiences because I did not believe I had the right to enjoy them. But I felt that the abusive experiences were normal for no other reason than that they happened to me. And how I felt about everything was a garbled mess because I had no idea how to properly feel or identify my emotions.

While it is possible that children involved in sexual acts with older youth or adults will not be traumatized or harmed does not make the behavior acceptable. Just because a handful of alcoholics are able to recover to the point of being able to drink socially with no problems does not mean that all alcoholics will get to that point.