Impacts

The impacts of child sexual abuse are different for each victim. For many victims, the abuse can have profound and lasting impacts. They experience deep, complex trauma, which can pervade all aspects of their lives, and cause a range of effects across their lifespans. Other victims do not perceive themselves to be profoundly harmed by the experience.

Some impacts on victims are immediate and temporary, while others can last throughout adulthood. Some emerge later in life; others abate only to re-emerge or manifest in response to triggers or events. As victims have new experiences or enter new stages of development over their life courses, the consequences of abuse may manifest in different ways.

For many survivors we heard from, the impacts of sexual abuse are experienced as cumulative harm, resulting from multiple episodes of sexual abuse and other types of child maltreatment over prolonged periods. During this inquiry, we heard from many survivors who were sexually abused in residential institutions – including orphanages, homes, missions and detention centres – and whose adverse life experiences before, during and following the abuse compounded its negative effects. For some, their vulnerability to sexual abuse and its adverse impacts was heightened by their loss of connection to family, culture and country. We heard that Aboriginal and Torres Strait Islander survivors have faced a heavier burden of cumulative harm due to a range of historical and contemporary factors. We also heard that because children with disability can face additional barriers to disclosure of child sexual abuse, they are vulnerable to further abuse and therefore cumulative harm.

Many complex and interconnected factors can influence the way that victims are affected by child sexual abuse. While no single factor can accurately predict how a victim will respond, some factors appear to influence either the severity or type of impacts they experience. These factors include:

• the characteristics of the abuse (such as the type, duration and frequency)
• the relationship of the perpetrator to the child
• the social, historical and institutional contexts of the abuse
• the victim’s circumstances, experiences and characteristics (such as age, gender, disability, prior maltreatment, and experiences with disclosing the abuse).

The sources of strength and resilience that some victims draw on over the course of their lives play a key role in how they cope with and manage the effects of the abuse. We heard that these sources of strength and resilience include: strong relationships and social support from families, peers and others; therapeutic activities; education, work and leisure activities; spirituality; cultural connection; and a variety of inner resources, such as optimism and hope.

Child sexual abuse can affect many areas of a person’s life, including their:

• mental health
• interpersonal relationships
• physical health
• sexual identity, gender identity and sexual behaviour
• connection to culture
• spirituality and religious involvement
• interactions with society
• education, employment and economic security.

For some victims, child sexual abuse can have fatal consequences.

The impacts of child sexual abuse most commonly described in research and in our private sessions and public hearings were mental health impacts. Of the survivors who provided information in private sessions about the impacts of being sexually abused, 94.9 per cent told us about mental health impacts. These impacts included depression, anxiety and post-traumatic stress disorder (PTSD); other symptoms of mental distress such as nightmares and sleeping difficulties; and emotional issues such as feelings of shame, guilt and low self-esteem. Notably, mental health issues were often described as occurring simultaneously, rather than as isolated problems or disorders.

After mental health, relationship difficulties were the impacts most frequently raised by survivors in private sessions, including difficulties with trust and intimacy, lack of confidence with parenting, and relationship problems. Education and economic impacts were also frequently raised.

For many people, these diverse impacts are interconnected in complex ways, making it difficult to isolate the specific impacts of child sexual abuse. These interconnected impacts can be experienced at the same time or consecutively, as a cascade of effects over a lifetime. For instance, we heard from many survivors that they developed addictions after using alcohol or other drugs to manage the psychological trauma of abuse, which in turn affected their physical and mental health, sometimes leading to criminal behaviour and relationship difficulties.

Part of the explanation for the profound and broad-ranging impacts of child sexual abuse lies in the detrimental impacts that interpersonal trauma can have on the biological, social and psychological development of a child. Child sexual abuse can result in profound trauma, affecting the chemistry, structure and function of the developing brain and potentially interrupting normal psychosocial development at every critical stage of a child’s formative years.

While the impacts of child sexual abuse in institutional contexts are similar to those of child sexual abuse in other settings, we learned that there are often particular effects when a child is sexually abused in an institution. These include impacts on spirituality and religious involvement, such as a loss of faith or a loss of trust in a religious institution, for those victims sexually abused in such settings. We also heard that distrust and fear of institutions and authority are particular features of the effects of child sexual abuse in an institutional context.

How institutions respond to child sexual abuse – including their reactions to disclosure, action taken following abuse, and broader prevention and protection measures – can have a profound effect on victims. Institutional responses have the potential to either significantly compound or help alleviate the impacts of the abuse. These include the responses of the institution where the abuse took place and the institutions that have authority over, or responsibility for, that institution. They include the responses of the police, criminal justice system, complaint and oversight bodies, support services and health services.

Throughout this inquiry we heard from many survivors about further impacts they experienced because institutions failed to respond appropriately to child sexual abuse. We also heard how some institutions responded in ways that were actively damaging – for example, by perpetuating the abuse or punishing victims for disclosing it.

Inappropriate or damaging responses by institutions can result in the sexual abuse continuing for the victim, as well as placing other children at risk. Victims and their families can be left feeling betrayed by the institutions they trusted, resulting in fear and distrust of, and contempt for, institutions. Survivors told us that these responses can not only compound the impacts of the abuse, but cause additional impacts and re-traumatisation. We heard that some victims were ostracised by the institution because of disclosing the abuse.

Survivors’ experiences of institutional responses were not universally bad. We heard of some responses that were a source of justice and support to survivors. Other survivors spoke of mixed experiences of institutional responses. We heard that appropriate responses can ensure children are safe and promote healing for victims, helping them to manage the effects of the abuse and move forward with their lives. However, there is a paucity of research on the impacts of appropriate responses to child sexual abuse.

In addition to affecting the victim, child sexual abuse has ripple effects that reach a wider network of people, including the victim’s family, carers and friends, as well as other children and staff in the institution in which the abuse occurred, the community and wider society. These ripple effects can be long-lasting, even affecting future generations.

While the experiences of parents, carers, siblings, partners, extended family and children (‘secondary victims’) are different to those of the victims, secondary victims can be significantly affected by child sexual abuse and how institutions respond to it. They, too, can suffer adverse impacts on their mental health, relationships, family functioning, employment, financial security and social connectedness.

We heard how child sexual abuse can have intergenerational impacts. Children of some survivors have been exposed to the debilitating effects of trauma on their parents and families, including mental health and relationship difficulties, alcohol and drug abuse and family breakdown. In some cases, including for victims who were sexually abused in residential care and Aboriginal and Torres Strait Islander victims, these effects can span multiple generations, perpetuating cycles of disadvantage and trauma.

Other people with a connection to the institution where the sexual abuse occurred – such as other children and staff at the institution, whistleblowers, and families of perpetrators – can also experience significant affects, for example on their mental health, social connections and employment.

Further, entire communities can be affected. We heard in private sessions and public hearings of Aboriginal and Torres Strait Islander communities, and religious and other communities, such as schools, experiencing negative collective impacts.

The ripple effects of child sexual abuse have adverse and ongoing social, cultural and economic impacts on broader society, as individuals, families, communities, institutions and services struggle to provide support and respond to the needs of victims and others affected.