10 COMMON MYTHS

ABOUT SEXUAL ABUSE

Bernadette J. Madrid, MD
Child Protection Unit
University of the Philippines
Philippine General Hospital
MYTH 1:

¨  Normal appearing, well-educated,

middle–class men do not sexually abuse
children
The truth is:
¨  Anybody can be a sexual abuser
¨  A double life is prevalent among child sex

offenders*

*Salter (2003). Predators:

Pedophiles, Rapists and other sex
offenders: Who are they, how they
operate… New York: Basic Books
MYTH 2:

Sexual abusers will abuse any

¨ 
child.
The truth is:

¨  Sex offenders carefully select and

groom their victims.*

*Elliot, M,. et al (1995). Child Sexual

Abuse Prevention: What Offenders tell us.
Child Abuse & Neglect. 19, 579-94.
MYTH 3:

¨  Children who are being abused

immediately tell their parents.
The truth is:

¨  Estimates suggest that only 3% of all

cases of CSA* and only 12% of rape*
are ever reported to the police.

*Finkelhor et al (1994). Children as Victims of

Violence. Pediatrics, 94(4, :413-420) and Hanson
et al (1999). Factors related to the reporting of
childhood rape. CAN, 23, 559-69
The truth is:
¨  Among Filipino sexually abused children aged 4 – 17 years who
underwent medico-legal evaluation, initial disclosures were more
commonly elicited (47.1%) than voluntary (34.9%).

¨  Disclosures within 72 hours of the first/only incident were less

frequent (37.2%).

¨  The odds of delayed disclosure was increased 4 times with an

intrafamilial perpetrator (p=0.001, CI 1.69-9.00).

¨  Delayed disclosures were also 3 times more likely with an

intrafamilial confidant (p=0.046, CI 2.46-17.72), and 6.6 times more
likely for children who were threatened verbally (p<0.001, CI
1.02-8.93) (9).
Hernandez SS, Madrid BJ, Castillo MS, 2012
 MYTH 4:

¨  Children who are being sexually abused

will have physical findings to show
evidence of abuse.
The truth is:
¨  Even with a history of severe abuse such as
vaginal or anal penetration, the rate of abnormal
medical findings are only 5.5%.*

*Heger, et al (2002). Children referred

For possible sexual abuse: medical
Findings in 2384 children. Child Abuse
& Neglect, 26, 645-59.
The truth is:
¨  In a case review of 36 pregnant teens who were
sexually abused, only 2 of the 36 (5.5%) showed
definitive evidence of penetration.*

*Kellog, et al. (2004). Genital Anatomy

in pregnant adolescents: Normal
does not mean nothing happened. .
Pediatrics, 113 (1 pt 1), 67-9.
The truth is:
¨  In the Philippines, a review of 153 cases of sexually
abused pregnant adolescents seen in a child
protection unit of a tertiary hospital from
2005-2010 showed that hymen was normal in half
(52.3%) of cases of pregnant adolescents.

Makalinaw, SR, 2011

However, Child Sexual Abuse is harmful:

q  CSA is associated with posttraumatic stress disorder,

delinquency, academic difficulties,
conduct disorders, substance abuse, depression,
anxiety, suicidal ideation, personality disorders.
¨  Physical health problems such as HIV, pain

syndromes, gynecologic conditions, neurobiological

disorders, and gastrointestinal
problems

Berkowitz, 1998; Johnson, 2004; Putnam; Ullman &

Brecklin, 2003, Dallam et al, 2001
 MTYH 5:

Sexual abuse of boys are not

¨ 
common
The truth is:
¨  Sexual abuse of boys are common,
underreported, under-recognized, and
undertreated.
¨  Prevalence estimates range from 4% to 76%

Holmes et al (1998). Sexual Abuse of Boys:Definition,

Prevalence, Correlates, Sequelae and Management.
JAMA, Dec. 2, 1998;Vol 280, no. 21

Tang S. Freyd J, Wang M, 2007

J of Psych Trauma, 6(4): 1-25.
The truth is:
There may be more boys who are sexually abused than girls!

Baseline Surveys for the National Objectives for Health, DOH, 2000
Reasons why boys do not report sexual abuse:

¨  They are unaware that ¨  They blame themselves;

it was sexual abuse accept responsibility for
especially if the abuser what happened
is female ¨  Peer pressure

¨  Stigmatization ¨  Lack of societal

¨  Homophobia encouragement to
¨  Beliefs about report e.g. rape laws
masculinity define rape as being
committed only on a
female.
 MYTH 6:

¨  When the sexual abuse victim is a male,

male homosexuals are the sex
offenders.
 The truth is:

¨  Heterosexual men, who do not find sex with other

men satisfactory, perpetrate most child sexual
abuse. Many male abusers have relationships
with adult women.

McGee H, O Higgins M, Garavan R, Conroy R, 2011

Rape & Child Sexual Abuse: What Beliefs Persists
About Motives, Perpetrators, and Survivors?
J of Interpersonal Violence 26(17): 3580-3593
 Sexual Abuse of Boys: Relationship of Perpetrator to Victim
(PGH CPU Study)

95% of the alleged offenders were male

¨  Neighbor 31.68%
¨  Acquaintance 19.80%
¨  Stranger 13.86%
¨  Nuclear Family 8.91%
¨  Authority Figure 7.92%
¨  Member of Household 5.94%
¨  Unknown 6.93%
Herrin and Castillo, 2007
 MYTH 7:

¨  When a boy and a woman take part in sexual

behavior and it is the boy s idea, he is not being
abused.
 The truth is:

¨  Child abuse is an act of power by which an adult

uses a child. Abuse is abuse; a woman engaging
in sexual behavior with a male child is still
sexually abusive, even if she thinks he initiated
the contact.

Brown, J. 2012
American Journal of Men s Health 6(4): 331-343
Boys are harmed by sexual abuse

¨  Negative health, social, and psychological effects of

CSA are similar for males and females (Dube et al.,
2005; Kendall-Tackett, 2000; Putnam, 2003)
MYTH 8:

¨  People are too quick to believe an

abuser is guilty, even if there is no
supporting evidence.
The truth is:
¨  Most people are too quick to believe that the
accused is innocent even if there is plenty of
evidence if he does not fit their stereotype picture
of a rapist !

*Salter (2003). Predators: Pedophiles,

Rapists and other sex offenders: Who are
they, how they operate… New York: Basic
Books
MYTH 9:

¨  Child Sexual Abuse, especially incest, is

mainly a problem of poor people.
or
Child sexual abuse takes
place mainly in poor, disorganized,
unstable families
The truth is:
¨  While poverty is a risk factor, Child Sexual Abuse
happens in all socio-economic classes.

Olafson E, 2011
Sexual Abuse: Demography, Impact, and Intervention
J of Child & Adolescent Trauma, 4:1, 8-21
MYTH 10:
¨  Sexual abuse of a child is usually an isolated,
one-time incident when the offender was drunk
and could not control himself.
FACT:
¨  Child sexual abuse and incest occurrences
develop gradually, over time; repeat occurrences
are generally the rule rather than the exception.

Cromer LD, Goldsmith RE, 2010

Child Sexual Abuse Myths: Attitudes, Beliefs and
Individual Differences
Journal of Child Sexual Abuse, 19:6, 618-647
Have you seen these behaviors in children?

¨  Expressed unwillingness or fear to be left in the care of a

particular person or to play with a particular child;
¨  Reluctance or fear of certain places, such as showers and
washrooms;
¨  Change in the child's behavior when a particular person is
present, e.g. a usually outgoing child becomes quiet or
withdrawn or an easygoing child becomes agitated and
unruly;
¨  The use of new words to describe genitalia or sexual
behavior
Have you seen these behaviors in children?

¨  Sudden self-consciousness about genitals; 

¨  Sexual behavior that is inappropriate for the age of the
child, such as a young child "french kissing".   
¨  Involving other children in sexual behaviors or using toys
or dolls to act out sexual scenarios;
¨  Having money, new clothes, CDs or other personal items
and you are unaware how the child or teen received these
and from whom;
¨  Discomfort or reluctance in giving details about time spent
with another adult or child
Have you seen these behaviors in children?

¨  Clinging, anxious, irritable behavior

¨  Regression to babyish habits, such as thumb-sucking;

¨  Fearful behavior towards examination of the mouth

¨  Nightmares, bedwetting, fear of the dark, difficulty

falling asleep, new fear

Have you seen these behavioral signs in adults who
interact with your children?

¨  Doesn t appear to have a regular number of adult

friends and prefers to spend free time interacting with
children and teenagers who are not his own;
¨  Finds ways to be alone with a child or teen when adults
are not likely to interrupt, e.g. taking the child for a car
ride, arranging a special trip, frequently offering to
baby sit, etc.;
¨  Ignores a child s verbal or physical cues that he or she
does not want to be hugged, kissed, tickled, etc.;
Have you seen these behavioral signs in adults who
interact with your children?

¨  Seems to have a different special child or teen friend

of a particular age or appearance from year to year;

¨  Doesn t respect a child s or teen s privacy in the

bathroom or bedroom;
Have you seen these behavioral signs in adults who
interact with your children?

¨  Gives a child or teen money or gifts for no particular

occasion;
¨  Discusses or asks a child or teen to discuss sexual
experiences or feelings;
¨  Views child pornography through tapes, photographs,
magazines or the Internet. (In addition to being an
important behavioral sign, possessing, viewing and/or
selling child pornography is a criminal offense and
should be reported.)