5 de julho de 2019

What I learned from “An Examination of Assumed Properties of Child Sexual Abuse Based on Nonclinical Samples”.

Filed under: Notícias e política, Saúde e bem-estar — Tags:, , — Yure @ 12:59

“An Examination of Assumed Properties of Child Sexual Abuse Based on Nonclinical Samples” was written by Bruce Rind, Robert Bauserman and Philip Tromovitch. Below, what I learned by reading this text.

Moral panic.

The topic of sexual experiences in childhood or adolescence became relevant from the second half of the 1970s. The concern over child sexuality is typically American and spread to other countries from United States. This concern became a moral panic which infected science. It created the idea that adult/child sex, for example, is inherently harmful. Assuming harm is an attempt to turn a moral problem into a medical problem. And now, in the clinical field and among laymen, it is commonly believed that sexual experiences in childhood or adolescence are harmful, with frequent and intense harm for both boys and girls. For most people, such experiences are child sexual abuse. Which is true… for subjects in clinical or forensic populations. Some scholars even went as far as to say that all the problems that an adult could have are caused by a sexual experience in childhood or adolescence. By working with such assumption, we may end up offering a wrong treatment to victims of abuse. When a therapist uses pseudoscience, the patient comes out worse than when he entered.

There is a “child abuse industry”: people who profit from child abuse. The fight against child physical abuse and child verbal abuse isn’t profitable, but fighting child sexual abuse sells like water in a desert. That creates a sense of alarm in the population and democratic institutions. Remember Janet Reno? As sexual abuse causes more public outrage, companies and non-profit initiatives who advocate children’s rights focus on this form of abuse, leaving aside problems that are statistically more serious, such as physical abuse, verbal abuse, and parental neglect of children and adolescents. That’s not right: you should fight sexual abuse without neglecting other forms of child abuse. Otherwise, one type of abuse will distract us from fighting other types.

Abuse as a concept.

Let’s dare to ask: is it true that a precocious sexual experience is often traumatic, whether you are a boy or a girl? Researchers are not unanimous about precocious sex being inherently harmful. Do they all deserve to be called “abuse”? Or is this label being misused? Do not underestimate the power of a label. The prevalence of child sexual abuse varies from study to study because the definitions of child sexual abuse vary from study to study: what is considered abuse, when something is sexual and how old a person has to be to be considered a “child”? If the label is inaccurate, studies who use that concept will also be. When a child or adolescent has a sexual contact, but does not suffer as a result of the contact, which may have been consented to, what has been abused: the person or the prevailing moral code? Is the indiscriminate use of that term (abuse) to describe all of these contacts objectionable? Certainly, however, the use of moral terms as if they were scientific undermines the objectivity required by science. The indiscriminate use of such term predisposes us to a negative judgment of all such experiences, even the innocuous ones. Moreover, such misuse of negatively charged terms leads us to presume that violence was made to the minor, even in cases where such violence did not occur.

This is important because violation of moral standards does not necessarily harm anyone. Something can be “wrong” and be innocuous. When a person who has had a sexual contact in childhood or adolescence develops mental problems in adulthood, we tend to think that the “loss of innocence” is to blame, but we are actually supposed to look for alternative causes as well, such family environment, which may be more plausible causes. Caution is needed before attributing such imbalance to the contact. That’s because the effect of a sexual contact in childhood or adolescence is mediated by non-sexual factors: it is not the fact that the contact was sexual, but whether or not it was voluntary, whether or not it was painful, whether or not it caused shame or guilt. The damage depends on the context in which the contact occurs (if it was forced, painful, shameful, among other conditions).

Scientifically, “abuse” is the term designed to describe conduct that is likely to harm someone. The term “child sexual abuse” should then be restricted to sexual contacts without voluntary participation of all parties or contacts in which pain or shame were factors, as these are almost always harmful, either physically or mentally. Not all sexual experiences in childhood or adolescence deserve to be labelled “child sexual abuse”, since a considerable number of such contacts are neither forced nor harmful. The term “child sexual abuse” should only be used if the experience has been negative or if the child was coerced into it.

Methodology problems.

In a qualitative research, the researcher describes his findings narratively, not mathematically. As statistical studies sometimes validate narrative studies, both types of research should complement each other. The problem with qualitative studies is that, because they are offered in a narrative way, the author’s prejudices can be transmitted to the text. This, coupled with problems such as skewed sampling, makes qualitative research results inconsistent: each researcher concludes differently from the other. For example: if you are going to study child sexual abuse, or “adult/child sex”, you are not supposed to study only subjects in therapy for recovery of abuse effects, because you are only studying subjects who suffered from the contact, deliberately closing your study to people who have a different narrative. By emphasizing only negative occurrences, the person you are talking to will only remember negative occurences. It is not possible to know the nature of sex using clinical samples, unless we want to conclude that sex is harmful.

Meanwhile, someone who studies only positive accounts of adult/child sex has incurred in the same problem. Both will have skewed results, after skewing their samples, even if they interview three million people, because, if your sample is skewed, the number of people you interviewed doesn’t matter. Such studies, therefore, are not generalizable. If you need to conduct your study with a limited population, why not use a sample of college students, instead of clinical subjects, as the number of positive and negative reactions is more likely to be fairly represented?

This is specially true considering how the contact is experienced between the sexes. The results of a study conducted with girls only can’t be generalized to boys: at least in the case of the boy, voluntary participation in sexual contact in childhood or adolescence is not related to problems in adult functioning. The boy will probably grow normal, provided that the experience was not coercive. The damage most likely will occur if the child or adolescent is forced into the contact, in which case we can safely say they were raped (even though the use of legal terms in scientific works is very strange). The same does not occur with the girl, however, as she may suffer even when her participation is voluntary. Damage becomes even more common in an incestuous configuration.

Sexual behaviors are most often condemned by morals and not by science. Yet, we must remember that there are scientists who are also moralists. Because of that, both masturbation and homosexuality have been considered diseases before. Even oral sex was once considered a sick behavior. Our attitudes both towards masturbation and homosexuality only changed after we started to look into non-clinical subjects. Back when masturbation was taboo, researchers used the fact that most people in therapy also indulged in masturbation as a proof that masturbation causes mental illness. Remember how masturbation was once called “self-abuse.” That caused a moral panic centered on masturbation. People who masturbated feared that such occurrences would cause them ills, but such evils could be caused by their own fear of developing them. Also, it is the fight against masturbation that is behind the American custom of circumcising boys on a large scale. The same process was used to justify the belief that homosexuality is a disease: you only studied homosexuals who were already in treatment to cure their homosexuality, but not homosexuals who were happy with their condition.

The same is done now with precocious sexual relationships. If we want to know the truth about sexual contacts in childhood or adolescence, we need to study children and adolescents in general, not just those in the clinical population (Arreola et al, 2008; Arreola et al, 2009; Bauserman & Rind, 1997; Carballo-Diéguez et al, 2011; Condy et al, 1987; Dolezal et al, 2014; Kilpatrick, 1987; Lahtinen et al, 2018; Leahy, 1996; Mulya, 2018; Rind, 2001; Rind, 2016; Rind & Tromovitch, 1997; Rind & Welter, 2013; Rind & Welter, 2016; Rind et al, 1998; Sandfort, 1984; Sandfort, 1987; Tindall, 1978; Ulrich et al, 2005-2006; Wet et al, 2018). Comparing studies done outside the clinical population, the reader will see that sexual contact in childhood or adolescence not often produces damage, that rarely such damage is permanent, and that boys are less frequently injured than girls. Some people claim that such contacts have had a positive impact on their quality of life. In fact, some children or adolescents who had sexual experiences with an adult patiently wait until the adult has served their sentence, só they can reconcile and continue the relationship. To say that all these contacts are rape is to distort reality.

Confirmation bias.

A therapist who firmly believes that homosexuality is a disease will look for symptoms of such disease, which will make him more likely to blame homosexuality for all the problems that the patient has. The same holds true for a sexual contact in childhood or adolescence. You need to consider the whole history of your patient, rather than paying selective attention to this or that experience. So if a delinquent teenager had sex with his mother once at the age of ten but was beaten by his father every day, do not rush to say that the the incestuous episode is to blame for his delinquency. You can not conclude much if you choose not to pay attention to much. This is a sign of confirmation bias.

Correlation and causality.

Some studies pick subjects who had a sexual contact in childhood or adolescence and say that a percentage of people with a precocious sexual history also tends to have mental adjustment problems… but this does not prove that the contact caused these problems. That does not answer how much of that damage comes from the contact and how much comes from other sources.

For example: in the United States, whites have an intelligence quotient, on average, greater than that of blacks, but blacks are generally less socioeconomically favored as well. So we can not rush to say that such a difference of intelligence quotient is due to race, when it may well be caused by economic differences: if you are poor, you have fewer opportunities for intellectual development, less opportunity to exercise logic and mathematics, necessary for the development of the IQ.

In small communities, there are fewer churches and fewer crimes; in big cities, there are more churches and more crimes. Would you conclude that churches increase the number of crimes committed? However, both things (the number of churches and the number of crimes) are explained by the population density: in a place with a lot of people, there will be a lot of temples and a lot of crime.

In the case of sexual contact in childhood or adolescence, many of the young people engaging in such practice come from dysfunctional families. So how much of the damage attributed to these contacts is best explained by family imbalance? After all, in a bad family, the kid will seek affection from someone outside of home. Interpreting the experience of another person according to your prejudices does not change the experience as the person remembers. So, you are supposed to ask the interviewee how he feels about his sexual contact in childhood or adolescence, not only if he is depressed or stressed, if you want to establish a causal link (a pleasant experience is unlikely to have caused the maladjustment). At the same time, try to seek other explanations for the maladjustment as well. Studies show that a sexual contact in childhood or adolescence cause fewer problems than an unstable family.

We need to separate third variables if we want to know exactly how much damage these contacts cause. Knowing how much damage is attributable to the experience requires probing other variables: among those with mental disorders and a history of precocious sexual contacts, how many of them also suffer from domestic abuse, which could explain both things (the precocious sex and the maladjustment)?

The numbers.

Comparing different studies, we can notice that, outside the clinical population:

  1. 11% of girls react positively to sexual contacts in childhood or adolescence.
  2. 18% of girls react indifferently to sexual contacts in childhood or adolescence.
  3. 72% of girls react negatively to sexual contacts in childhood or adolescence.
  4. 37% of boys react positively to sexual contacts in childhood or adolescence.
  5. 29% of boys react indifferently to sexual contacts in childhood or adolescence.
  6. 33% of boys react negatively to sexual contacts in childhood or adolescence.

Therefore, two-thirds of the boys do not suffer from such contacts, but two-thirds of the girls do suffer. The reaction differences between boy and girl can be explained culturally: boys see sex as an adventure or learning opportunity, but girls see sex as an invasion or something immoral. Another explanation is that girls who engage in sexual experiences in childhood or adolescence tend to have this experience when they are still far too young: a 8-year-old girl having sex with a 30-year-old man is unlikely to enjoy what happened. Plus, girls are also the most frequent victims of incestuous rape. That being said, the high percentage of negative experiences among girls could signal that girls are forced into sex more often than boys.

Cultural considerations.

If you fight for the rights of children and adolescents, do not spend tax money to persecute children and adolescents, because laws against child sexual abuse also convict children who are doing libidinous acts to each other in a context of play (in Brazil, any libidinous act, whether voluntary or not, harmful or not, is punishable if one of the participants is less than fourteen years old, even if both participants have less than fourteen years, which implies that it is forbidden to date before the age of fourteen). Instead of forbidding certain forms of sex, wouldn’t it make more sense to prohibit elements that make sex harmful? One such element that favors harm is ignorance: minors are kept vulnerable because they are not informed about sex, since our society is ashamed to talk about it with them. Another reason why they are not informed is because giving sexual information enables informed consent.

“Children can’t consent” is a statement that relies on the social and legal concept of “informed consent”, that is, we are not talking about consent in the strict sense (permission or initiative), which can be issued by anyone who is able to speak. Furthermore, the presence or absence of informed consent does not predict harm or absence of harm, but the presence or absence of “pure” consent (simple permission or initiative) predicts. If they were informed, they would be able to give informed consent as well and nobody wants that. However, if you don’t talk about sex with your children, you are keeping them vulnerable to sexual advances, as they won’t be able to recognize them and tell them apart from regular affection.

However, of those who suffer from such a contact, most recover, so that permanent harm is a minority occurrence. Now: among those with a history of sexual contacts in childhood or adolescence and mental adjustment problems, how much of their mental imbalance is safely attributable to the sexual contact? Family problems and sexual contacts in childhood or adolescence are two often related occurrences: a toxic family predisposes the minor to seek love from another source. Physical abuse and parental neglect are more harmful than sexual experiences in childhood or adolescence.

Sexual contacts in childhood or adolescence are something that must be studied with reason, not with emotion. Because the sleep of reason produces monsters.

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