Two-third of child sexual abuse survivors bear no physical injuries: Experts

The rape of a 11-year-old girl in Chennai over a span of seven months has raised several questions including why her parents did not notice physical injuries.
Two-third of child sexual abuse survivors bear no physical injuries: Experts
Two-third of child sexual abuse survivors bear no physical injuries: Experts
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There has been an alarming rise in the number of child sexual abuse cases in India. The recent rape of a 11-year-old girl by multiple men over a span of seven months in an apartment in Chennai forces us to ask – just how safe are our children? She was allegedly drugged with injections, forced to consume spiked soft drinks and other substances by her assaulters, who also allegedly blackmailed her into not telling her parents. The survivor’s horror came to light only when the girl confided in her sister that she had stomach pain.

The horrific assault has raised several pertinent questions. How do parents know if a child has been sexually assaulted? How did the child’s mother not notice physical injuries? Does a child always bear physical marks or injuries on his/her body? What activities constitute child sexual abuse? 

What is CSA?

According to Medline Plus, a service of the US National Library of Science, “Child sexual abuse is the deliberate exposure of minor children to sexual activity. This means a child is forced or talked into sex or sexual activities by another person. Such abuse includes: Oral sex, pornography, sexual intercourse, touching (fondling).”

Speaking to TNM, forensic medicine professor in Vydehi Medical College, Bengaluru, Dr Jagdish Reddy said that in cases of child sexual abuse (CSA), two-thirds of penetrative acts bear no physical signs of injury or trauma.  Also depending on how the assaulter misleads or coerces the child before or after abusing, at times children may not even know that they were sexually abused. In cases of incest, it has been reported that the relative often makes the child believe it is a game or a gift.

Like in the case of the Chennai survivor, Dr Jagadish said it is possible that the child complains of a stomach ache because of some infection. 

Infections, which may even include sexually transmitted diseases, can be seen in several cases after some days or weeks, depending on the type of infection.  “Physical injuries also depend on what perpetrators use during the act. At times, abusers use lubricants and protection due to which there may be an absence of physical injury. Sometimes they may also clean up the children,” he stated. 

He further explained that in cases of child sexual abuse (CSA), it is difficult to immediately collect evidence. This usually means that proving a case of a sexual assault becomes all the more difficult.  However, recent changes to laws have made it possible for accused to be convicted even when there is no medical proof of violence. 

And while there may not be physical signs of sexual abuse, the emotional and psychological scars of such a crime on children is often lifelong.

Why CSA goes unreported or gets reported late

There are several reasons why cases of child sexual abuse go unreported or get reported very late. Many a time parents do not realise their child has been abused due to lack of physical injuries. Of all cases of CSA, just 33% have some form of physical injuries, says Dr Shaibya Saldanha, co-founder of Enfold Trust.

This could be why most parents are unaware of symptoms of sexual abuse.  “People feel that home and school are the safest places for their children. They entrust their children with others,” asserted Dr Shaibya, adding, “By the time they realize that their child has been sexually abused, parents are too shocked to react in a coherent manner. They approach the doctor, and then talk to close friends and relatives before deciding on taking the next logical step.”

Explaining why cases of CSA are often unreported, she says, “The medical and legal system are poorly equipped and there is no proper reporting mechanism. In cases where the child is in severe trauma, parents focus on the ward instead of worrying about registering a complaint, which is only justified.” A 2012 study by Ribert Giles titled ‘Behind the Net: Technology and the Forensic Interview’ on the National District Attorney’s Association website reads, “Further affecting the view of jurors in child abuse cases is the belief that sexual assault will produce either medical injury or scientific evidence. In the vast majority of cases where there is credible evidence that a child has been penetrated, only between 5 and 15% of those children will have genital injuries consistent with sexual abuse.” 

According to the National Crime Records Bureau (NCRB),  in 2016 there were 19,765 cases of rape under Section 376 of the IPC and under sections 4 and 6 of the Protection of Children against Sexual Offences (POCSO) – an alarming rise of 82% from the previous year.

This story was originally published on July 21, 2014. It has been republished with edits. 

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