Child sexual abuse

Child sexual abuse refers collectively to a wide range of sexual acts in which children are used in various ways for sexual gratification. The age of consent is culturally very different and regulated differently worldwide. In Germany, there are the legal terms Sexual Abuse of Adolescents, of Protected Persons, of Children and of Persons incapable of Resistance.

The sexual acts may be with, on, in front of or involving children and may include physical contact (so-called hands-on acts) or exclude it, as is the case with so-called hands-off acts. These include, for example, possession and consumption of child pornography or inciting a child to share pornography. The perpetrators are adults, but also older and clearly more developed children and adolescents, not always, but predominantly male, and often from the child's social environment. There is usually a power imbalance between the child and the perpetrator, often a relationship of dependence, and not infrequently a relationship of trust.

The spectrum of acts ranges from "voyeuristic appraisal of the child's body" and fleeting touching to manipulation of the child or by the child of his or her own genitals to oral, vaginal or anal penetration ("extremely rare"). Photographing or filming acts of abuse is also subsumed under the term sexual abuse.

The sexual abuse of children is punishable, in Germany according to § 176 StGB (sexual abuse of children), according to § 176a StGB (severe sexual abuse of children) and according to § 176b StGB (sexual abuse of children resulting in death), in Austria according to § 206 StGB (severe abuse) and according to § 207 StGB (abuse) and in Switzerland according to Article 187 StGB.

Forms of sexual abuse

A large part of sexual abuse is probably committed worldwide in the family or close environment of the victims. The other point is violent crimes committed by perpetrators against victims unknown to them beforehand. The issue of child prostitution occupies an intermediate position.

From the perspective of psychology, a distinction can be made between different forms of abuse. These include abuse without physical contact (e.g. watching porn films), with physical contact (e.g. mutual touching), non-penetrative (e.g. mutual touching of genitals), with penetrative contact (e.g. oral sex), with paraphilias (e.g. sadism) and ritualised abuse.

A considerably growing problem is represented by child pornography as an apparent hands-off variant of child sexual abuse, which has spread considerably in the so-called Darknet. As early as 2005, Ahlers and colleagues pointed out the problem, which was growing on a large scale, associated with the production, use and distribution of child pornography products and which had "increased considerably" even then with the further development of technical possibilities on the one hand and the anonymity of the Internet on the other. "The production of child pornography", the authors state unequivocally, "is documentation of sexual child abuse", the consumption "indirect sexual child abuse" and sale and distribution "sexual economic exploitation of children for commercial purposes".

Evidence of sexual abuse

General indications can be: self-injurious or other injurious actions, withdrawal, fear of contact, aloofness, strongly sexualized language, conspicuous playing with the own genitals. Symptoms such as unexplained behavioural abnormalities, marked drop in performance, secondary enuresis and defecation, abdominal pain, anorexia as well as dissociative disorders, which for example show themselves in neurogenic symptoms such as paralysis or movement disorders without neurological findings, can indicate a sexual abuse situation, but can also be a misinterpretation of such indicators.

In each case, the individually always different situations of families and personalities and reactions of the children are to be considered. In the context of a medical history and examination, the synopsis of the child's statements, injuries to the genital and anal regions, the detection of semen, the discovery of foreign bodies in the vagina or anus, the detection of sexually transmitted diseases and sexually conspicuous behaviour of the child provide indications of sexual abuse. Evidence of injuries in cases of concurrent physical violence and sexual abuse are also indicative. These include injuries that are untypical of falls, injuries of different ages and some of which have not been treated, delayed visits to a doctor and frequent changes of doctor, as well as signs of neglect (reduced general and nutritional condition, underweight and developmental disorders). When talking to the parents, protective claims are often found that cannot explain the present pattern of injuries.

In the examination to determine sexual abuse, the knowledge of the examining physicians or forensic pathologists about examination techniques, norm variants of infantile anogenital structures with differentiation from abuse-associated findings and healing processes is crucial. The result is often uncertain.

Methods of forensic analysis must meet scientific standards. Repeated, urgent asking of suggestive questions to potentially affected children can lead to a false suggestion of abuse (cf. Worms trials).

Abuse cases in schools often remain undetected for years. Among the reasons cited for this are, for example, dependencies among colleagues, good collegial contacts of the perpetrators, overtaxing of other teachers and the perpetrators' claim to privacy vis-à-vis their colleagues.

On the question of indications of sexual abuse, Volbert and Galow point to possible risks. There would be