-Veena Joshi

Child Sexual Abuse (CSA) impacts millions of children in India. One out of every two children in India experiences some form of CSA. In 96 per cent of the reported cases, the abuser is somebody known to the child. If not addressed or healed, CSA can impact how a person thinks, acts or feels over a lifetime, resulting in short and long-term physical, mental and emotional health consequences.

It is often difficult for children to disclose that they have been sexually abused. This may be due to the lack of appropriate knowledge or vocabulary to articulate or express the abuse. The signs of CSA are also not always visible. Therefore, it is important to keep an eye on the subtle or drastic changes in the child’s behaviour as well as emotional and physical traits.

Here are some of the warning signs or indicators of sexual abuse that you can look out for.

1. Social Indicators

• Social withdrawal or over-pleasing behaviour: The sudden need to stay aloof or socially withdraw can be some social indicators. Children tend to display this behaviour as they might feel ashamed and guilty and thus want to isolate from people and activities. It can lead them to think that the abuse is their fault and nobody will like them. Separation can also be a form of protection from further abuse. The child may also show an over-pleasing behaviour by trying to please everyone around them. To cope with the feeling of guilt and shame, children try to compensate by trying to prove to others that they are good children.  
• Increased hostility and aggression: Abused children can have outbursts of anger. Anger is a sign that something is wrong.  
• Drastic changes in achievement patterns: A sudden drastic decline in achievement patterns be it in academics or extra-curricular activities can occur because the child becomes so pre-occupied with the abuse that they are unable to concentrate and study. In contrast, the child could also become a perfectionist or high achiever as a result of their sense of shame; the child needs to prove to others and to themselves that they are worthy as an individual.

2. Physical Indicators

• Psychosomatic illness: An illness that involves both the mind and body is called a psychosomatic illness. In other words, the physical symptoms people experience are related to psychological factors rather than a medical cause. Psychosomatic illnesses are not imaginary. The term ‘psychosomatic’ refers to real physical pain which is influenced by the mind and emotions rather than any medical cause, like an accident or infection. A psychosomatic illness is aggravated by emotional stress and shows in the body as physical pain and other symptoms. Children often display stress through their bodies because they haven’t yet developed the language they need to communicate how they feel. For example, a child who is having a hard time at school may have frequent stomach-aches and may be sent home or asked to stay at home.  
• Pain or swelling in the genital area: Contact abuse, especially penetration of an object or penis, can cause pain and swelling in the genital area. 
• Repeated urinary infections: Contact abuse, especially penetration or fondling, can lead to repeated urinary infections.

3. Sexual Indicators

• Children who have faced sexual abuse can develop misconceptions about sex (in sexual expression or in sexual relationships). Often, they may believe that a sexual touch or act is a way of expressing love or receiving love, so the misconception formed is that ‘sex is equal to love’ (sex = love) or they may believe that if they have done anything wrong, the punishment would be to perform a sexual act. Depending on the context and the pretext under which the sexual activity (abuse) has been initiated, for example, love, affection, punishment, education; the child will develop their own perception or idea about sex, and it will be reflected through the child’s behaviour and choices. 
  
• Sexualised behaviour or the initiation of early sexual activity: Children who have undergone sexual abuse, as discussed, may indulge in sexual activities, which are not age-appropriate. For e.g. a four-year-old child who is exposed to pornography may try to act out the sexual actions with their friends through a game. 
• Use of abusive sexual language: Children who have been sexually abused tend to use sexualised or abusive language, which is not age-appropriate. For e.g. using sexual words to express their anger or to irritate someone.
  

4. Psychological Indicators

• Eating or Sleeping Disturbances: For some children, the overwhelming feeling associated with the abuse may lead to a loss of appetite. For e.g. if a child has been sexually abused where she was asked to perform oral sex, she would be unable to eat food and would vomit after her meals. For others, food can be de-stressing, so they may indulge in over-eating. Lack of sleep can occur because of recurring nightmares or over-alertness in order to ensure protection. Children who are unable to sleep at night often seem lethargic and sleepy during the day. They may be unable to concentrate at school or in tuitions.
  
• Anxiety or Indifference: When a child distrusts those who are meant to protect them, a common response can be living in constant anxiety. Manifestations can include nightmares, looking frequently over their shoulder, over-alertness and hyper-vigilance. The child might also become indifferent or passive, essentially losing hope, as they feel that there is nothing they can do or nobody can help to stop it. 
• Depression: Victimisation of sexual abuse is a form of complete powerlessness over one’s body and actions. Often, children feel that there is nothing that can be done (learned helplessness), thus, leading to depression.  
• Suicide Attempts: Victims of sexual abuse often blame themselves for what has happened, thus, accepting the outward shame and inward guilt (I did something wrong therefore I am at fault). This leads to self-hatred because of the sense of responsibility for what occurred. This, coupled with the powerlessness to resist the abuse, could lead to depression, which could eventually lead to suicide. 

5. Sure indicators of Sexual Abuse

As mentioned earlier, there is no guaranteed way to determine sexual abuse as these are only indicators, except in the following situations:

• Pregnancy: If a girl child who has reached puberty conceives and becomes pregnant, it is a sure sign of a case of CSA. 

• Sexually Transmitted Infections: Sexually transmitted diseases or infections comprise a wide range of infections and conditions that can be transmitted only through sexual activity. Multiple episodes of sexual abuse increase the risk of contracting sexually transmitted infections for children.

• Disclosure: If the child tells you themselves.

However, it should be noted that if children show one or more of these indicators, it does not necessarily mean they have been sexually abused. These changes may be due to many other reasons, but it is important to be aware of the warning signs or indicators of CSA to be able to prevent it. 

If you suspect that a child has experienced or is experiencing sexual abuse, please report your concerns to Childline on 1098. You can also call Arpan on +91 9819086444 for free counselling or therapeutic support.

Arpan is a Mumbai-based award-winning organisation working towards addressing the issue of Child Sexual Abuse in India.

Veena Joshi is the Communications Manager of Arpan

Also Read: What is child emotional abuse?