Harder for male victims to open up

PETALING JAYA: Boys, who are victims of child sex abuse find it difficult to open up to parents or other adults, as they tend to believe that they should be strong enough to fight off the perpetrators, experts say.

Consultant paediatrician and adolescent medicine specialist Dr N. Thiyagar said some boys have lived with guilt or shame, feeling that they were not “man” enough to protect themselves.

He said instead of reporting incidents of sexual abuse, boys could manifest symptoms and experience post-traumatic stress disorder including anxiety and depression.

“Some may have sleep disorders, poor appetite or become withdrawn. Their performance in school could also be affected.

“Some may even present with sudden onset of bed-wetting or loss of bowel control,” he told The Star in response to how sexual abuse affects children.

Dr Thiyagar said this conclusion stemmed from several encounters with teenagers who exhibited bed-wetting, and upon further investigation, it was revealed that they were victims of sexual abuse.

He added that this adverse childhood experience – better known as toxic stress – has significant long-term health and social effects.

Studies have indicated sexual abuse as a serious condition among common childhood toxic stressors, which include poverty, physical abuse, mental illness among parents and a violent environment.

He also added that sexual abuse is associated with a higher risk of developing various illnesses in adulthood.

“Victims of sexual abuse have a higher risk for major depression, suicide attempts, non-communicable diseases, unemployment, premature deaths, sexual risk-taking (which may result in sexually transmitted infections), substance and alcohol abuses.

“Prevention of sexual abuse is crucial. As adults, we are responsible for ensuring a safe environment for the children.

“Children must be taught reproductive health tips including the concept of safe and unsafe touching in preschool itself,” Dr Thiyagar said, adding there should be a better surveillance system on child abuse in the country.

Prof Dr Sharifa Ezat Wan Puteh, a health economist and public health specialist said mental, emotional and behavioural problems such as anxiety, stress, depression, substance abuse, dissociative disorders as well as sexual dysfunction are all associated with sexual abuse.

And this, she added might persist into adulthood.

“That is why intervention and recognition of kids with sexual abuse are important.

“A study entitled ‘Neurological changes in brain structure and functions among individuals with a history of childhood sexual abuse’ noted that children with a history of childhood sexual abuse are associated with irregularities in the cortical and subcortical regions of the brain.

“These irregularities have been recognised to contribute to various cognitive, behavioural and psychological health outcomes later in life.

“Age of child sexual abuse onset was associated with differential neurological brain structures,” she said quoting the study.

Malaysian Human Rights Commission children’s commissioner Dr Farah Nini Dusuki said there must be awareness that boys could, and do, become victims of sexual abuse.

She said it was crucial to lift the cloak of shame and fear that often stops sexually abused children including boys from reporting, adding that programmes or systems should be in place to make it easier for them to come forward.

“We must debunk harmful traditional masculinity stereotypes including that boys should be tough and not show emotion.

“Adopt a gender-neutral approach to support services and reassure child victims that they are there to help all children, regardless of gender,” added Farah Nini.