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.

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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.