3. Victims and survivors spoke about changes in their physical health and behaviour as a result of being sexually abused as a child. Behavioural changes were sometimes described as an attempt to communicate that they needed help. Many struggled to believe that physical or behavioural changes went unnoticed or were not questioned. One Truth Project participant said: “I think it’s odd … to think that all of that can happen and nobody can notice it happening”.^[1] Failures to detect physical and behavioural changes left children feeling trapped. Nora said: “I remember saying a little prayer not to wake up in the morning as I really did not want to be there … there was no way out”.^[2]

“They missed all the physical signs”

4. Victims and survivors repeatedly said that there were clear physical signs that they were being sexually abused as children. They reported bleeding, swelling and pain. Often no one appeared to notice these visible signs or recognise that they could indicate sexual abuse. May was sexually abused in the 2000s and the 2010s. One day at primary school she told a staff member that she was bleeding from her bottom and that a man had hurt her. The staff member cleaned May up but did not take any further action.^[3]

5. Some victims and survivors had contact with healthcare services as a result of injuries sustained through sexual abuse. When she was primary school age, Rach’s father raped her so violently that her mother took her to hospital: “this was one of the only occasions my mum held me”. Rach had stitches and was admitted to hospital. Her mother told staff that her daughter had fallen on a stick. No one at the hospital appeared to question this and Rach was returned home, where her father continued to vaginally and anally rape her.^[4] One research participant described a GP visiting her at home:

“A GP was called … I was examined and he said he could find nothing. I’d been raped. There was blood on the bed. Yes. There was blood on the bed. I was five years old. The GP couldn’t find a problem.”^[5]

Child sexual abuse in ethnic minority communities research participant

6. Some victims and survivors said that medical professionals failed to identify clear signs of child sexual abuse. Between the ages of four and seven, Tiffany saw her family GP almost a dozen times with symptoms associated with urinary tract infections, but this sign of sexual abuse was apparently not recognised.^[6] Female victims and survivors sometimes started to take the contraceptive pill as children. Eve-Marie was sexually abused in the 1990s. As a child, she regularly attended a sexual health clinic with sexually transmitted infections. Aged 12, she was prescribed the contraceptive pill. No one appeared to recognise these physical signs of sexual abuse. Eve-Marie said: “nobody cared”.^[7]

7. In some cases, female victims and survivors became pregnant during childhood after being raped. Professionals sometimes failed to recognise that this indicated sexual abuse. Henrietta described giving birth aged 12 after being violently raped by her father. A social worker was aware of the pregnancy but failed to take action after Henrietta’s parents “concocted a story”.^[8]

“It was a cry for help”

8. Victims and survivors were often frustrated that no one picked up on the warning signs evident in their own behaviour. One Truth Project participant said: “there’s so many moments … where I was genuinely crying out to people and there was nothing, no one to listen to me”.^[9] Zachary said that his behaviour deteriorated so much that he was excluded from school, yet still no one considered what was behind this change. He said: “I wanted someone to notice … a teacher, or someone”.^[10] One Truth Project participant felt that his behavioural issues contributed to him being placed into care: “The care system had always made me out to be this awful child, but really … I was just acting out from what had happened to me”.^[11]

9. Many victims and survivors felt that they became more withdrawn as a result of being sexually abused – but no one asked them if anything was wrong. Savannah was sexually abused by a teenage babysitter. She remembered trying to create time on her own with her teacher by asking to stay behind and tidy the classroom at playtime, yet her teacher never asked her if she was okay.^[12] Ruben found out that social workers frequently described him as “withdrawn and troubled”.^[13] Despite this, Ruben said that his records do not show that there was any exploration of why this might have been.

10. Victims and survivors often said that their attendance at school suffered as a result of having been sexually abused, yet this was not recognised as a warning sign. Natalia grew up in the 1970s and 1980s. From the age of about three, she was sexually abused by her grandfather. She did not feel safe outside of her home and regularly missed school. One year, Natalia missed more than 200 days of school before anyone contacted her parents: “that’s how insignificant I was, no one noticed I was missing for a year”.^[14] Breen did not attend school at all during the four years in which she was sexually abused during the 2010s. Although social services were involved with the family, Breen said that they took no action in response.^[15]

11. Victims and survivors sometimes felt that the adults around them seemingly did not explore child sexual abuse as a possible reason for the deterioration in their mental health as children. Tonia was raped by her mother’s boyfriend for several years up until the age of seven. She was referred to children’s mental health services for anger management training. Despite this, and attempts to tell people what was wrong, she said that nobody explored why her mental health deteriorated so significantly.^[16] Adrienne was raped multiple times by groups of men as a child and saw a counsellor and a psychiatrist during this period. She said that she was labelled an “attention seeker”.^[17] She described her frustration at the assumptions made about the changes in her mental health: “I was ‘crazy’, because I was traumatised”.^[18]

12. Some victims and survivors felt that racism led to the adults around them ignoring changes in their behaviour, such as poor performance or attendance at school. One research participant felt that professionals saw him as a “difficult black boy”, which resulted in a failure to recognise that he was “a vulnerable person … who was actually crying out for help”.^[19] Alvita, who is of African-Caribbean heritage, experienced sexual abuse from the age of 7 until she was 14, during the 1990s and 2000s. As a result, she struggled at school and “never handed in a piece of work”. She said that “the teachers didn’t care … I used to think that if I was a different colour, brown, lighter, white, I would have been treated differently”.^[20]