II. DEFINING THE PROBLEM OF CHILD SEXUAL ABUSE
Child sexual abuse is broadly defined as “any sexual activity perpetrated against a minor
by threat, force, intimidation, or manipulation.”18 This encompasses any sexual act that is
performed on a child or that is performed in the presence of a child.19 Importantly, this definition
continues to broaden as the understanding of childhood sexual abuse develops.20 The definition
now includes exploitation though prostitution and production of pornographic materials in
addition to physical sexual acts.21
A. The Prevalence of Child Sexual Abuse
Eighty percent of female survivors and sixty percent of male survivors of childhood
sexual abuse are abused by someone close to them, ranging from family members or friends, to
teachers and healthcare professionals.22 Familial abuse accounts for more than twenty-five
percent of child sexual abuse, while a person in the child’s social network perpetrates the abuse
sixty percent of the time.23 The risk of childhood sexual abuse rises with age for girls, but peaks
for boys when they reach puberty.24
The effects of this abuse are often devastating for victims who experience a range of
short- and long-term side effects.25 In the short-term, victims may experience Posttraumatic Stress
Disorder, develop sexualized behavior, feel depressed, or develop general behavioral issues.26 In
the long-term, victims can experience sexual dysfunction, have suicidal tendencies, develop
substance abuse problems and sleep disturbances, and have propensities to engage in self-mutilation.27 These effects are a result of the way that victims’ bodies process the abuse they
endured on a biological level.28 Medical researchers have found that victims of childhood sexual
abuse experience a permanent disruption in the brain’s ability to handle stress.29 When the body
experiences stress, it deploys cortisol, the hormone that helps the body cope with stress, and when
receptors in the brain receive cortisol, the stress levels are reduced.30 A study published in 2009
18 Delphine Collin-Vézina et al., Lessons Learned from Child Sexual Abuse Research: Prevalence, Outcomes, and Preventive
Strategies, CHILD & ADOLESCENT PSYCHIATRY & MENTAL HEALTH (July 18, 2013), http://www.capmh.com/content/7/1/22. Another
definition of child sexual abuse is “the exploitation of a child for the sexual gratification of an adult or older child. It can include any
sexual act performed with or in the presence of a child.” OLIVA, supra note 14, at 159.
19 OLIVA, supra note 14, at 159; Finkelhor, supra note 17, at 170–71.
20 Collin-Vézina et al., supra note 18.
21 OLIVA, supra note 14, at 159.
22 HAMILTON, supra note 4, at 10.
23 Finkelhor, supra note 17, at 172.
24 Id. at 171.
25 Miller, supra note 14, at 604–05.
26 Id. at 605; Beth E. Molnar et al., Child Sexual Abuse and Subsequent Psychopathology: Results from the National Comorbidity
Survey, 91 AM. J. PUB. HEALTH 753, 753, 757 (2001) (finding that a “strong, independent, statistically significant relationship between
[childhood sexual abuse] and the majority of mood, anxiety, and substance disorders” exists).
27 Miller, supra note 14, at 605; Joseph Nowinski, Childhood Trauma and Adult Alcohol Abuse: Shedding Light on the Connection,
HUFFINGTON POST (July 22, 2013), http://www.huffingtonpost.com/joseph-nowinski-phd/alcohol-abuse_b_3595743.html (finding a
connection between alcohol abuse and childhood sexual abuse); Beth E. Molnar et al., Psychopathology, Childhood Sexual Abuse and
Other Childhood Adversities: Relative Links to Subsequent Suicidal Behaviour in the US, 31 PSYCHOL. MED. 965, 969 (2001). People
who experienced childhood sexual abuse were more likely to attempt suicide. Id. at 966, 968. Compared with individuals who did not
experience sexual abuse as children, suicide attempts among victims were three to eleven times higher. Id. at 974.
28 Scott Mendelson, The Lasting Damage of Child Abuse, HUFFINGTON POST (Dec. 31, 2013), http://www.huffingtonpost.com/scott-