epublishing store: Intro

Sexual Health eBook Volume1
Chapter 13

The Direct and Indirect Impact of Childhood Abuse & Neglect on Sexuality, Kelly J. Ace

Abuse and neglect, in their many forms, have the potential to significantly impact sexuality and sexual expression, especially when they occur during critical developmental stages. This chapter describes a variety of sexual concerns that survivors may experience, including sexual dysfunction, gender confusion, and problematic sexual behavior. It also discusses how sexuality may be affected by substance abuse, somatization, compulsive sexual behavior, and other attempts to cope with maltreatment-related distress. It concludes with a discussion of factors that can facilitate emotional and sexual healing.

In 2003 alone, U.S. child protection agencies reported approximately 906,000 founded cases of child abuse and neglect (Administration on Children, Youth, and Families, 2005). This figure does not include sexual and physical assaults that fall outside child protective service mandates, such as those committed by acquaintances and strangers in the community. It also does not include those cases that remain shrouded in secrecy or are difficult to prove in court. One recent, nationally representative community sample of 4,023 adolescents found that 1 in 10 adolescents had experienced multiple incidents of sexual or physical assault (Stevens, Ruggiero, Kilpatrick, Resnick, & Saunders, 2005). A similar survey of 967 adults found that approximately 40 percent of the men and 33 percent of the women had experienced some type of childhood maltreatment (Scher, Forde, McQuaid, & Stein, 2004).

Childhood abuse and neglect have the potential to profoundly influence survivors’ sexuality, relationships, and sexual expression over the course of their lifetime. Although many survivors experience pleasure, emotional satisfaction, intimacy, and personal growth through their sexuality, others experience significant sexual concerns that flow from their maltreatment-related distress and subsequent attempts to cope. The uniqueness of each child, their circumstances, and the nature of their maltreatment practically guarantee a highly individual outcome.

After describing various ways in which sexual concerns may manifest in survivors, this chapter concludes with a discussion of the emotional and sexual healing that survivors can experience. The psychological dynamics, rather than the sequelae specific to a type of maltreatment, are emphasized. In part, this is because forms of child maltreatment often coexist, so drawing conclusions about the “cause” of certain symptoms is difficult (Bagley & Mallick, 2000; Meston, Heiman, & Trapnell, 1999). More importantly, this shifts the focus from the maltreatment experience, which cannot be changed, to the survivor’s present experience—which can.

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