Warning: this column may contain content that may be triggering for some readers.
This past year in my practice, I began to see both male and female clients who presented with a past history of child sexual abuse. Unfortunately, the statistics prove that someone misusing alcohol or other drugs most likely has some form of child abuse in their past as well. Add that this person identifies with the LGBTQ community, and the numbers change dramatically.
We are all familiar with the broad term "child abuse." Usually, the focus is on the physical abuse inflicted on a child. There are actually several forms of childhood abuse besides physical, including sexual abuse, emotional abuse and neglect. For this column, I will be focusing on sexual abuse, specifically for individuals that identify in the LGBTQ+ community.
According to the Centers for Disease Control and Prevention, child sexual abuse is a significant but preventable adverse childhood experience. By the organization's definition, "child sexual abuse refers to the involvement of a child (person less than 18 years old) in sexual activity that violates the laws or social taboos of society and the child does not fully comprehend, does not consent to or is unable to give informed consent to, or is not developmentally prepared for and cannot give consent to any form of sexual activity."
For the general American population, the numbers are staggering; here are just a few:
• Approximately 3.7 million children experience child sexual abuse each year in the U.S.
• 1 in 4 girls and 1 in 13 boys experience child sexual abuse at some point in childhood.
• 90 percent of child sexual abuse is perpetrated by someone the child or child's family knows.
Unfortunately, these numbers are much worse if the child identifies LGBTQ. As actual numbers are difficult to come by and remembering that most research is flawed by definition when researching our community due to an inability to capture true LGBTQ numbers, in general terms, most research shows that LGBTQ youth are more likely to have experienced sexual abuse than heterosexual youth. For example, national estimates range from 40 to as high as 80 percent of homeless youth identifying as LGBTQ, which also leads to higher rates of sexual trauma.
It's also important to keep in mind that one's sexual orientation or perceived orientation has nothing to do with child sexual trauma.
A good question here though is why are these youth more vulnerable? Many experts believe it's about acceptance from family and other important systems like school, friends, religion, community and more. This non-acceptance leads one to hide their true self, which in turn leads to all sorts of mental health issues, including shame and low self-worth.
Consider that perpetrators target their victims, including, of course, the process of grooming them. Given the intense rejection by family members and others, it makes sense that most perpetrators would believe they can abuse queer youth with little to no fear of consequences.
Our LGBTQ youth are already labeled as different by society and when rejected by peers as well as family, who will believe them if they come forward? There is also fear of being found out if they were to tell a trusted adult about what happened to them. This leads then to shame; shame is most often what prevents us from talking about this significant but preventable adverse childhood experience.
Shame by definition is a condition of humiliating disgrace, intense guilt or shortcoming. In my practice, I often phrase the feeling of shame as feeling like "being the mistake." Shame lives in fear and darkness; so now is the time to bring the shame around this traumatic experience into the light.
Shame can affect and eventually permeate every aspect of one's life if left untreated. More common mental health consequences from child sexual abuse include depression, anxiety and PTSD; common behavioral consequences include substance misuse, risky sexual behavior and increased risk for suicide attempts — not to mention the increased risk of suicide ideation.
For LGBTQ adults, another consequence associated with child sexual abuse is re-victimization during adulthood. This may include higher risk of sexual trauma/victimization, intimate sexual partner violence and engaging in sexual practices that are re-traumatizing for the person. Coupled with our community's statistically higher rates of substance use — including the current opioid crisis — and mental health therapy focusing incorrectly doesn't allow for a safe space of trust for the victim to disclose past child sexual abuse.
Still, if it seems that these statistics are painting a bleak and stark picture, they don't have to anymore. We can begin to talk about this more openly, to show unity and support. Though there is research and studies being done that focus on treatment after abuse occurs, there has been little done on preventing abuse from occurring. This means that our community can continue those efforts and work toward acceptance, especially the rejection still happening in families.
Today, more and more informed therapists are trained in "trauma-informed care." This now includes trauma from growing up LGBTQ as well. If you have child sexual abuse in your past, know that you are no longer alone; know that there is help. Please consider finding a clinician trained in trauma-informed care and also gay-affirmative therapy. Know that you can move away from shame and toward your authentic self. There is Hope!
Mark McMillan, LMSW, CAADC is a behavioral health therapist and certified addiction therapist at the Center for Relationship & Sexual Health. He can be reached by phone at 248-399-7447.
