Childhood sexual abuse (CSA) is defined by the World Health Organisation (WHO) as "the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society." CSA includes, but is not limited to, the inducement or coercion of a child to engage in unlawful sexual activity, prostitution or pornography.
While this definition covers a lot of ground, it does not indicate the impact CSA has on the life and development of a child. A study published in Development and Psychopathology in 2011 indicates that it was only around the 1980s that it was realized that CSA was much more prevalent than previously thought and that such abuse had negative consequences both during childhood and later periods of development.
The immense and established impact of CSA
The aforementioned study indicated that women who had suffered CSA showed a wide range of psychosocial and biological issues throughout their lives. The study mentions that these women had a higher risk of early onset of puberty, cognitive deficits, depression, dissociative symptoms, maladaptive sexual development, asymmetrical stress response, high rates of obesity, more major illnesses and healthcare utilization, persistent post-traumatic stress disorder (PTSD), self-mutilation, physical and sexual revictimisation, teenage pregnancy, premature delivery, and drug and alcohol abuse.
The harm CSA does, as this study shows, often tends to be multigenerational. The study says that children born to women who had survived CSA were at an increased risk of child maltreatment and overall maldevelopment. This study and many others since have insisted that proper education and appropriate counselling of all those who have survived CSA is necessary to avoid these psychosocial fallouts and to enable the survivors to lead full, healthy lives.
CSA and genitourinary diseases
A new study published in the journal Health Psychology goes further by claiming that psychiatric comorbidities arising from child sexual abuse can also lead to an increased occurrence of genitourinary diseases in the survivors, and proper counselling and preventive measures against the same are needed. Conducted by researchers at the University of Montreal, Canada, this study indicates that due to the psychological distress caused by CSA, survivors tend to ignore symptoms of urinary and genital diseases.
In a previous study by the same authors, published in the Journal of Pediatrics in 2017, it was revealed that survivors of CSA later showed a higher frequency of urinary tract infections, bacterial infections in the kidneys, penile disorders, inflammation of the cervix, uterus, vulva or vagina, vaginitis, ovarian cysts and menstrual problems. While the previous study included both male and female survivors of CSA, the recent one included only girls.
For this study, the researchers documented and analysed the medical records of 661 sexually abused girls and 661 matched controls (girls of a similar age who did not suffer CSA) between 1996 and 2013. After accounting for socioeconomic levels, any prior occurrence of genitourinary diseases and the number of years for which comprehensive medical data was available, the researchers found that the prevalence of diseases of the urinary system was as high as those of the genital system, indicating that just psychological counselling was not enough for these CSA survivors.
The researchers suggested that this high prevalence of genitourinary diseases later in life among CSA survivors occurs because of either of two reasons: The survivors might become hypervigilant and report even the smallest of changes in their genitourinary health, thereby leading to more prompt reporting and diagnosis of these diseases. On the other hand, the survivors may be plagued by a sense of shame or stigma and may avoid seeing the doctor for such problems since it may trigger memories of their abuse. The researchers hypothesise that the latter is more likely in the case of girls. It's therefore important, the study concludes, for healthcare professionals to assess these needs and maintain a balance of physical and psychological counselling for all survivors of CSA.
For more information, read our article on Urinary tract infection.
Health articles in Firstpost are written by myUpchar.com, India's first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.