Universal Precautions--for Child Sexual Abuse

As a parent of sibling sexual trauma, I have found support in a handful of web-based groups. A few are specifically for parents of sibling sexual trauma and others are for parents of any child who was sexually abused. By definition, I am meeting other parents who are motivated to seek out support and information online, and we may not represent all parents in our situation. But I have yet to encounter a parent who didn’t feel deeply that they failed their child. Keeping our children safe and protecting their sexuality are among a parent's most basic, important jobs. But even the most caring, proactive caregiver cannot protect their child from a threat they cannot see and do not understand.

It’s a refrain I hear over and over, with countless variations on the details but the same tragic result. “I did what I was supposed to. I was so careful. But I had no idea I had to worry about ____. And now it’s too late.”

We are the parents who did background checks on our childcare providers. We talked to our children about what parts of their body were private. We didn’t let them have sleepovers unless we knew the family well. We checked in with them and reassured them they should tell us if anything made them feel bad or scared. We looked to see if there were sex offenders living in the neighborhood. We monitored our children's media and online habits. We even talked to them about unwanted sexual experiences in our own childhoods.

But, almost without fail, the violation came from the person we least expected. In most cases we hadn’t even consciously judged the person to be safe; rather, the thought that this person or circumstance might not be safe never even entered our minds. We had no idea that our child’s sense of safety, trust, and sexual integrity could be forever shattered by:

• a biological parent

• a biological sibling

• a same-gender sibling, step-sibling, friend, or cousin

• a female

• a grandparent we had known to be a good parent

• a favorite aunt or uncle

• everyone’s favorite teacher, coach, clergy, camp counselor

After the fact, we look back and see that one thing we could have done that would have saved our child. We wonder how we could have so badly misjudged the character of the person who is responsible.

Yet realistically, how could we have known? Very often, there simply were no warning signs. Who is able to imagine that their own partner, parent, friend, sibling–even their own child–could possibly sexually violate a child? Do we need to trust no one, to teach our children that everyone in their lives is a potential threat? Wouldn’t that just take away their ability to trust and feel safe in a different way?

***

During the 1980’s, AIDS was an emerging pandemic. It was new, untreatable, deadly, incredibly stigmatized and feared. Medical care providers realized they needed to protect themselves from contact with the blood of HIV+ patients. They started to use protective gear such as gloves, face shields, and disposable needles. But they quickly ran into a dilemma–when should they take precautions? How could they determine which patients were likely to carry the HIV virus? Many people either didn’t know, or weren’t able or willing to tell their provider their HIV status. In addition, the sight of a doctor putting on gloves and a gown signaled “AIDS!” to everyone in view. Patients felt humiliated and offended, and sometimes even refused treatment to avoid the stigma.

Rather quickly, it became apparent that no one could tell who was HIV+ and who was not by looking, or even by asking. So the strategy of universal precautions was born. Anyone providing direct medical care would use bloodborne pathogen protocols with every patient, no matter how unlikely it seemed that they might be carrying the HIV virus. Everyone was protected, and no one was stigmatized. It has become so commonplace that today we would be alarmed to be examined by a doctor not wearing gloves.

***

What if we made universal precautions a cornerstone of child sexual abuse prevention? Not the only strategy, but a first line of protection? What if we shifted away from trying to sniff out who to trust and who not to trust, and toward identifying habits and behaviors that we can all take, all the time, to reduce opportunities for children to be subject to sexual trauma?

Some child sexual abuse is caused by individuals who are very motivated and calculating, who will find a way no matter what. But a whole lot more is made possible by impulse and opportunity. This is especially true of sexual trauma caused by siblings and other young people, and of first-time offenses. If we can prevent a young person from crossing the line that first time, we save both children--the child inching towards that line of abusive behavior and the child who may fall victim to this behavior--from trauma and shame and heartache.

To protect children, we need to set aside our stereotypes and look at the reality of child sexual trauma. We need to open our minds to face who can be responsible for it, in what situations, and what leads up to such a devastating choice. We need to be willing to take universal precautions, even within our own families.

It's NOT Your Fault

“If only I had gotten up and left sooner, I could have stopped it.” That’s what I repeatedly told myself after I recovered my memory of being molested by my brother. I was 42 when I remembered. I was ten when it happened.

It’s common for survivors to blame themselves. We may think we should’ve stopped it, or that because we didn’t resist, say no, or tell anyone, that it’s our fault. We may have felt that we participated in the behavior and therefore are to blame. If we continued to return to the person who violated us for affection or attention, we may blame ourselves.

If our young bodies were physically stimulated, our minds didn’t yet know how to interpret this. We weren’t yet emotionally or intellectually equipped to understand or handle these sensations. Thus, we may think ourselves complicit in the actions and feel responsible for what was done to us.

Through my healing process, therapists told me: “It’s not your fault; you did the best you could with what you knew at the time; IT’S NOT YOUR FAULT, AND IT’S OKAY.” With much repetition of these statements, spanning years, I finally learned and accepted these facts to be true.

I ultimately stopped blaming myself.

Now I have the perspective to think: In what world should a child be responsible for keeping herself from being molested while in the “safety” of her own home?

The fact is, in the moment, we freeze in the face of fear and shock from being sexually violated, whether that’s through physical assault, through images, or even words alone. Adding coercion or threats magnifies the fear. We can’t move. We can’t act. We become trapped. We later blame ourselves for not stopping it.

The longer we hold in this belief of self-blame, the more engrained it becomes. Helping victims understand that they are not to blame is crucial in helping survivors heal. Furthermore, when all members of society understand and exemplify this reality, we can only hope that survivors will be less afraid of speaking out.

To survivors, I repeat: IT’S NOT YOUR FAULT.

To the rest of the world, I proclaim: IT’S NOT THE VICTIM’S FAULT.

To each other, we declare: IT’S. NOT. OUR. FAULT.

If you've met one...

In his work raising awareness about neurodiversity, Dr. Stephen Shore makes the point, “If you’ve met one person with autism … you’ve met one person with autism.” The same concept is true of sibling sexual trauma. If you’ve met one family affected by sibling sexual trauma … you’ve met one family affected by sibling sexual trauma. If you’ve heard one survivor’s story of sibling sexual trauma … you’ve heard one survivor’s story of sibling sexual trauma. If you have joined in a journey of healing with one person who has caused sexual harm to a sibling … you have joined in one person’s journey. There are commonalities between experiences of sibling sexual trauma but also an extremely wide range of possibilities and variables.

We are on the cusp of an exponential increase in awareness about sibling sexual trauma among social service providers, thanks to the work of the RCEW Sibling Sexual Abuse Project, Brad Watts, and others. This is so needed, and so welcome. If you are a professional doing research in this field, or a practitioner working to educate yourself about this possible trauma in your clients' lives, please accept my gratitude on behalf of all whose lives have been directly affected by this invisible pandemic.

We need well-designed research to understand the reality, the patterns, the risk factors, and the most effective treatments and interventions for everyone affected by sibling sexual trauma. We need practitioners who are aware of the prevalence and dynamics of SST, and we need tools and best practice guidelines. A wonderful free resource for professionals was just unveiled today: content from the February 2022 National Sibling Sexual Abuse Conference for Frontline Sectors in the UK. Session videos and materials will be available until mid-March 2022 at https://www.sarsas.org.uk/conference-information-pack/.

As we all learn together, I offer the following suggestions and cautions.

1) You are more experienced than you realize. You might think you’ve never worked with a client who was affected by sibling sexual trauma. But given the statistics, you almost certainly have. You just don’t know who those clients are. Perhaps they did not feel comfortable talking about it, or didn’t feel it was relevant. Maybe they were so young they didn’t even know it was traumatic, or they had buried it so deep it did not even come to their mind or memory.

2) Take even expert advice and understanding with a grain of salt. (Including this website and blog.) The body of published literature is growing, but every statistic or conclusion comes with a big asterisk. So many studies have had to rely on a very small sample size, or could only access cases that were reported to some kind of authority or families who followed up with some kind of treatment. Longitudinal studies with any valid measure of long-term outcomes for survivor, offender, or family are sparse. The stigma around SST means information collected is especially susceptible to bias, both in self-reporting and in practitioners' perceptions. Population-wide surveys or a comparison to any type of control group are rare.

3) In one sense, sibling sexual trauma is a narrow subject, a specific subset of sexual assault and abuse. Yet it is also a very broad subject, an experience that affects every aspect of life. Siblingsexualtrauma.com is an extensive website, but in reality it only scratches the surface of the topic. It does however offer the beginnings of help to those who have harmed, those who have been harmed, and their parents and family members.

4) Sibling sexual trauma shatters lives. It also shatters our stereotypes about sexual assault, sexual offending, child sexual development, sibling and family relationships, and so much more. Any serious look at the reality of sibling sexual trauma–as a population wide phenomenon or as an individual circumstance–requires us to set aside so many preconceived images, so many assumptions of how the world operates. It requires us to think outside our usual categories and labels. Can a child be a child abuser? Aren’t sibling relationships safe and lasting? Can a girl really sexually assault a brother? Can a prepubescent child actually be aroused by touching a biological sibling? How can a child still love and want to live with the person who sexually violated them? How can another child never want to see their own sibling again? Do children who cause sexual harm grow up to be adult offenders?

5) With so many unknowns, so many variables and such a complex situation, everyone involved in a real life case is going to make mistakes. It’s inevitable. This includes every family member and every professional. We are all learning and adjusting. Try to be gracious to yourself and others. Allow yourself and others to admit mistakes, learn from them, and take corrective action.

Sign up below if you would like to follow this blog, which will include links to future publications on sibling sexual trauma, articles on various facets of SST, and guest blogs offering a variety of stories and perspectives. And don’t forget to check out the wealth of information for professionals from the 2-year Sibling Sexual Abuse Project National Conference.