The Impact of Childhood Sexual Abuse on the Sexual Self

Childhood sexual abuse (CSA) is a trauma that can have long-term effects on survivors. It is interpersonal and sexual in nature, and most frequently committed by people known to the child and often, whom they trust.

As CSA occurs at a critical time in an individual's development, the sexual stimulation that occurs during these abusive experiences can disrupt the normal sequence of sexual development (Tharinger, 1990). These experiences overwhelm the children’s capacities, which implies that they don't have the tools and background to fully understand and deal with what is happening to them.

As a result, children and adolescents who sustained CSA may experience identity impairments that can be consolidated in adulthood, especially if CSA experiences and its related difficulties have never been tackled. They may have more difficulty defining their identity and have negative perceptions of themselves or their bodies, mixed with deep-seated feelings of shame and guilt that contribute to fueling these perceptions. In particular, the shame felt as a result of a CSA can be deeply distressing and potentially destructive to one's sense of self and place in the social and relational world (MacGinley et al., 2019). For many survivors, these identity impairments will manifest themselves in the sexual sphere, particularly in their sexual self-concept.

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The bad news: CSA events can affect sexual self-concept

Over the last few decades, several researchers have studied sexual self-concept, which has led to the recognition of this component of sexuality as essential to good sexual health. The sexual self-concept is defined as the representation of oneself as a sexual being. In particular, it refers to the ideas, thoughts, and feelings that individuals have about themselves as sexual persons (Deutsch et al., 2014). The sexual self-concept develops mostly during adolescence and adulthood, according to social expectations along with sexual growth and experiences (O’Sullivan et al., 2006).

Sexual self-concept is assumed to be particularly vulnerable to the effects of CSA (Keshet & Gilboa-Schechtman, 2017) due to the particularities of this trauma (i.e., a toxic mix of interpersonal harm, violent exploitation of one’s body, and a transformation of an act of connectedness into an act of submission; Foa & Rothbaum, 2001).

Notably, studies reported that several CSA survivors experience low sexual esteem and negative perceptions of sexuality or of themselves as sexual partners (Guyon et al., 2020a). Survivors may also perceive themselves as ‘‘sexual objects’’ (Gewirtz-Meydan & Ofir-Lavee, 2020; Hitter et al., 2017) that exist to meet the sexual needs of others. Some will even come to find a form of validation in sexually fulfilling others, as this is what they were valued for during these events (e.g., by receiving affection, gifts, compliments from their abuser). They may also view themselves as "evil" and "damaged" because "they must be deeply bad if it happens to them." In addition, some may believe that they are not worthy of love and affection. Thereby, survivors may come to integrate that they are worthless sexual beings, which can impact their capacity to form healthy intimate connections and experience a fulfilled sexuality (Gewirtz-Meydan & Ofir-Lavee, 2020).

These sexual self-concept impairments can be explained in the light of traumatic sexualization, one of the Traumagenic Dynamics (Finkelhor & Browne, 1985). This landmark theoretical framework postulates that traumatic sexualization occurs when victims’ sexual feelings and behaviors develop in a dysfunctional and developmentally inappropriate manner since their bodies were invaded without their consent, they were introduced to sex too early, and they could be rewarded and valued for being involved in these experiences. Thus, feeling like a sexual object, unlovable, and not valuing oneself as a sexual being may stem from this process of traumatic sexualization triggered by CSA events. These negative feelings and self-perceptions may be especially enhanced in survivors whose abuser was a caregiver, and where attachment issues are intertwined (Stevenson, 1999).

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The good news: It is possible to develop a positive sexual self-concept despite trauma

Although CSA experiences can have a profound impact on the sexual self-concept, it is possible to improve it and experience fulfilling sexuality. These negative self-perceptions are often longstanding and entrenched. Thus, rebuilding a positive and coherent sexual self will take time and self-compassion, as the road to recovery can be fraught with challenges and relapses.

Here are some suggested exercises that could have a positive impact on your sexual and general self-concept, based on empirical and clinical recommendations (Guyon et al., 2020b; Hitter et al., 2017; Maltz, 2012). It is also recommended to consult a professional who can assist you, as these exercises could lead, in some cases, to more distress. These professionals can ensure that you do not become completely deregulated or re-traumatized by helping you to identify your triggers and strategies to reduce distress.

*Remember that these exercises do not always apply to all survivors and that it is important to never overstep your own limits.

• Distinguish what belongs to the aftermath of CSA and what really characterizes your identity. Notably, it could help you to build a more coherent, positive, and holistic sexual self. In the same way, becoming aware of your negative self-perceptions and emotions of shame and guilt can help you understand how they may influence your behaviors, cognitions, and sexual well-being. This greater awareness of the impacts of CSA on the sexual self is an essential step in sexual recovery.
• Favour sexual authenticity over "fitting into the mould." In particular, wanting to match the social norms of beauty and performance at all costs can bring a lot of suffering and promote a negative perception of oneself. Don't be afraid to be yourself and even allow yourself to be different from others sometimes, especially in sexuality. Assuming who you are as a sexual being, in a real way, may help you develop more sexual confidence, which in turn will make it easier to respect your boundaries later on.
• Reflect on your sexual needs, desires, and values, in order to better know yourself as a sexual being. Doing this introspection by avoiding judgment or putting into perspective the place of CSA in the development of your sexual self-concept can give you access to more authentic sexuality that is less contaminated by your traumatic experiences.
• Explore and (re)discover your body and sensations in a general way (e.g. through dance, singing, yoga, walking, in daily tasks) in order to reconnect to yourself, your emotions, and the world around you. At the same time, it can be an opportunity to discover healthful activities that can help reduce stress and negative thoughts.
• Explore and (re)discover your body and sensations in intimate and sexual contexts (e.g. massages, masturbation alone, sexual activities involving a partner). To do this, it is important to focus as much as possible on the sensations experienced without judgment or aiming for performance (e.g., by trying to reach orgasm at all costs). As it is possible to experience unpleasant feelings while exploring sensations or even to have post-traumatic memories, it is critical to find strategies to reduce them (e.g., taking deep breaths, gradually exploring or avoiding certain areas of the body) or to stop exploring if it becomes too painful or anxiety-provoking.
• Compliment yourself every day. Take the time to recognize your qualities, abilities, and strengths but also to appreciate your body despite its imperfections. You and your body have overcome these traumatic events according to your resources and capacities; acknowledge your resilience in that regard. By shifting your focus away from your perceived flaws to your attributes and strengths, you can boost your self-esteem. Complimenting oneself can be difficult at first, especially because it can be hard to see positive aspects of yourself if you have had negative thoughts for a long time. It is possible to ask your partner or another significant person to help you identify the positive aspects of yourself.
• Communicate with your partner(s), especially in intimate and sexual contexts. The expression of emotions and sensations experienced during sexual activities is as important as the expression of sexual desires, needs, and limits. This way, you will be more likely to feel confident and able to enjoy this intimate moment. In addition, being able to communicate and assert yourself sexually is likely to strengthen your sexual esteem and sexual agency, as well as increase your connection to your partner.
• Do not underestimate the importance of social support. Reach for it. Numerous studies have shown that social support, especially from a loving partner or a community that shares similar experiences, contributes greatly to the recovery of survivors. It is not always easy to open up about one's wounds, but it can be easier with time. It allows us to release a weight that we have been carrying around for too long. Opening up about our experiences also allows us to regain power over our lives, especially by writing the end of this story from our own perspective.

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