Photo by Lum3n from Pexels
Source: Photo by Lum3n from Pexels

It’s the people we know and trust, not strangers, who are most likely to engage in harmful sexual behavior. There has been a tidal wave of accusations of sexual abuse committed against women and/or children from powerful men in media and politics including Harvey Weinstein, Kevin Spacey, Louis C.K., and Roy Moore, the former judge running for Senator in Alabama's special election, and there will probably be many more, spurred on by the #MeToo movement.

What makes these cases so maddening is that many people were aware of the accusations for decades, yet did nothing to address the sexual behaviors. Victims themselves, possibly out or shame or fear may keep their experiences as dark secrets, perhaps forever.

These are examples of “open secrets,” similar to those that swirled around Jerry Sandusky before he was convicted of sexually assaulting a dozen boys. They are similar to those that swirl around teachers, priests, scoutmasters, and many others who interact with children in the course of their work or volunteer activities—people charged with keeping children safe.

Why does it take an appalling critical mass of victims, and time, before we’re willing to acknowledge that people we admire or trust are capable of sexually abusing a child, or sexually harassing or assaulting a woman? We’ve learned that there really is no useful profile of those who sexually abuse; they often appear to be regular, normal folks. We often don’t see child abuse because it is committed by people we know or love or admire.

Sexual abuse affects a staggering number of children in our country: nearly one-quarter of girls and 5 to 8 percent of boys will experience child sexual abuse before they turn 18. We, and many others, have devoted our careers to ending child sexual abuse. One belief that contradicts our argument that child sexual abuse is preventable is the idea that people who sexually abuse children are so deranged as to be unstoppable, untreatable, and incorrigible, that all that can be done is wait until they are detected and then lock them up for years and place them on public sex offender registries for life.

If we want to effectively fight child sexual abuse, there needs to be a paradigm shift in the way we address it. We should not wait until after the fact before taking concrete steps to prevent it.

Policymakers often say there isn’t enough money to fund prevention efforts but then spend enormous amounts after abuse has happened. For example, states have estimated that they spend tens of millions to maintain sex offender registries, yet research indicates these do little or nothing to improve child safety. 

We should demand governmental support for effective prevention programs and policies. For example, middle-school programs have been shown to reduce peer-on-peer sexual harassment and violence. Other logical, but as yet untested, policies include limiting one-on-one adult-child situations in school and extra-curricular activities. Importantly, more support is needed to develop, test and disseminate effective prevention strategies.

We can no longer wait until victims come forward before we act against child abuse, and we can no longer look at this issue solely through the lens of law enforcement. Yes, punishment is a necessary part of a comprehensive approach to child sexual abuse, but it cannot be the only approach.

Our nation has supported successful public health campaigns for children that reduced the risk of physical abuse, bullying, teen pregnancy, polio, vehicle-related injuries, and accidental poisoning. We can do the same with child sexual abuse only if we insist on treating it for what it is: a preventable public health problem.

Elizabeth J. Letourneau, Ph.D.
Director, Moore Center for the Prevention of Child Sexual Abuse
Professor of Mental Health, Johns Hopkins Bloomberg School of Public Health

Howard Dubowitz, M.D., M.S., FAAP
Director, Center for Families
Professor of Pediatrics, University of Maryland School of Medicine

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