A dark image of a young child riding a bicycle.
For people who experience sexual abuse as children, the impact on their mental health may continue through their adult lives. Photo courtesy: Unsplash


Child Sexual Abuse: Where Does the Mental Impact End?

Trauma can change you, sometimes even to a genetic level.

In an episode from the second season of the popular Netflix show, “Sex Education,” a group of teenaged girls were given an assignment to outline a common lived experience that everyone could relate to. After hours of discussion, they realized that they had all been sexually assaulted to varying degrees during the course of their young lives and that served as their only common denominator. It reminded me of a sleepover that I had as a 13-year-old when my friends and I learned that four out of six of us in that room had experienced child sexual abuse (CSA). The fact remains that one in ten children will be sexually abused before their 18th birthday. But, from short-term changes in behaviour to long-term effects on development, does the impact of CSA ever end?

A blue card with statistics about child abuse.

After experiencing sexual abuse, children may display behavioural changes including becoming more withdrawn and anxious. Illustration by (c) Reset Fest Inc, Canada.

The Indelible Mental Scars of Sexual Abuse

32-year-old Mumbai-based doctor, Ratika (name changed to protect privacy), told Re:Set that at the age of seven, she was repeatedly molested by her family’s driver. Her initial reaction was that of shock, “I think I went into a shell for a bit.” She observed small, but noticeable, changes in her behaviour, “[I was] lying, stealing money from home, [and I experienced] temper issues.” Her parents attributed her behavioural issues to just being a difficult child, but never tried to talk to her about it, Ratika said. Moreover, their strict attitude prevented her from revealing what she went through. She blamed them for a long time, leading to a rift in their relationship. During adolescence, Ratika realized the magnitude of what had happened to her, which took a toll on her academic performance. 

“I became acutely aware of what touch could do to me and how safe I had to feel to trust someone.”

As an adult, she believes that she is emotionally distant and this affects her relationships detrimentally. She believes that being completely transparent and speaking out about her emotions is difficult for her. “I became acutely aware of what touch could do to me and how safe I had to feel to trust someone,” Ratika told Re:Set. She feels like the incident made her more practical and less emotional, which has sometimes led to her losing out on many relationships.

Dr. Anthony Murphy, senior lecturer in psychology and head of The Centre for Applied Research, at Middlesex University Dubai, noted that experiences of CSA may be associated with secretive behaviours and an increase in sexualized behaviours. According to Murphy, other notable behavioural changes that can be observed in sexually abused children are:

  • Unwillingness or fear of being left in the care of a particular person,
  • Reluctance to be in a particular setting such as a shower or washroom,
  • Changes in behaviour when certain persons are present, such as becoming quiet, withdrawn, or agitated,
  • The use of new words to describe particular acts or the genitals,
  • Sudden self-consciousness or indeed fascination about their own or others’ genitals,
  • Involving other children in sexual behaviours during play (such as with dolls),
  • Clingy, anxious or irritable behaviour,
  • Nightmares, bedwetting, fear of dark or difficulty falling asleep.

The long-term implications of CSA can range from heightened impulsivity to increased incidence of diagnosable psychiatric conditions like post-traumatic stress disorder and major depressive disorder. According to Murphy, prolonged periods of child sexual abuse and neglect are significantly more likely to impact long-term development. According to Murphy, parts of the brain demonstrate changes when exposed to CSA. This further affects functions such as forward planning, social interaction and decision-making. The distress has the potential to affect individuals at a genetic and epigenetic level. He observed that the trauma itself may be more exacerbated by the undermining of trust, as well as the physical nature of the abuse, particularly among younger survivors. 

“As a child, I just couldn’t get myself to trust my mother again,” remarked Neeti (name changed to protect privacy), a 22-year-old marketing associate based in Mumbai. When she was 11, her uncle tried to force himself on her by touching her without consent, coercing her to take her clothes off till she broke free. She later confided in her mother who did not do much except tell her to keep it a secret. She was left shaken after the incident, admitting that to date, she violently recoils anytime a man tries to touch her without warning. 

A person with shoulder length hair stands in a forest during sunset.

The trauma of experiencing child sexual abuse has the potential to affect individuals at a genetic and epigenetic level. Photo courtesy: Unsplash

42-year-old Maryam (name changed to protect privacy) was sexually assaulted multiple times by a stranger between the ages of eight and nine. This has resulted in her being overprotective of her young son, so much so that she almost never lets him out of her sight. The Denver-based writer told Re:Set that though the incident happened decades ago, it still haunts her and even scents can sometimes trigger a flashback. “Looking back…I just feel shame, numbness and anger,” she reflected, adding that when she told her parents, their initial reaction was to beat her and call her a liar. As a result, she felt very ashamed and stopped talking about it. Since then, Maryam has experienced bouts of depression and admits that it has taken many years of therapy to deal with it and accept that the episodes were not her fault. Teaching her son lessons about consent and boundaries is something she has prioritized as a parent, hoping to break through the stigma. 

For parents, Murphy stressed the importance of acknowledging your child if they bring any such complaints to your notice. “Provide a safe space for the child to disclose their experience to the extent that they are comfortable doing so…being supportive is vital.” The next steps may include notifying authorities, ensuring appropriate testing is done and timely retrieval of any forensic evidence available. He emphasized that communicating the concepts of safe touch and consent from when the child is a toddler is crucial. Giving children the right vocabulary to identify body parts may also help reduce embarrassment and stigma. 

Blue card with words: survivors of child sexual abuse are 4 times more likely to develop symptoms of drug abuse and experience PTSD as adults.

According to Murphy, prolonged periods of child sexual abuse and neglect are significantly more likely to impact long-term development. Illustration by (c) Reset Fest Inc, Canada.

Whenever sexual assault is discussed, it often has gendered undertones to it, causing mainstream discourse to leave abused boys out of the purview of discussion. Murphy pointed out that in the U.K., male victims of familial sexual abuse outnumber female victims in the below-14 age group. 

Between the ages of 13 and 14, Rohit (name changed to protect privacy) was an avid cricket player, being trained by a professional cricket coach. Soon after, this man began touching him inappropriately. “He would mostly try to guilt-trip me [by finding] faults with my performance and asking me to come and sit on his lap.” The 32-year-old Bengaluru-based product manager told Re:Set that he didn’t tell his friends or family because he felt ashamed that he did not resist and disclosing this would make him come off as “less of a man.” He remarked that the anger and confusion related to the time caused him to repress this memory. He has since stopped following the sport completely. 

There is potential to heal but, just as each person’s experience differs, the tools used on their journey to overcome these challenges could also vary.

Lived experiences and experts have established that prolonged periods of child sexual abuse are significantly more likely to impact long-term development and add to factors influencing mental health challenges. There is potential to heal but, just as each person’s experience differs, the tools used on their journey to overcome these challenges could also vary, ranging from structured psychological intervention to psychotherapy and counseling. Murphy emphasized that there is hope for victims with the presence of supportive, trusting relationships and good evidence-based intervention such as cognitive behavioural therapy.

Relief was one way to describe how I felt when I told my friends at the sleepover about my own experience of being sexually abused as a child. I was able to let go of something I’d been holding onto for years because I finally realized that I wasn’t alone. It is good to remind ourselves that the crime perpetrated against us might have changed us, but it does not define us. Healing is a complex journey and it becomes easier when we realize that we are not alone.    

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Child Sexual Abuse: Where Does the Mental Impact End?