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IICSA Independent Inquiry into Child Sexual Abuse

Child sexual abuse in healthcare contexts

Key findings from the research

Overall the research findings, drawn from the descriptive, quantitative analysis of the 109 participants’ accounts and the qualitative analysis of the accounts of nine participants, indicate there are some particular characteristics of child sexual abuse specific to healthcare contexts. The key research findings are:

  • Participants’ vulnerabilities were heightened in the context of healthcare due to the unique nature of the position of trust and authority occupied by healthcare practitioners. Participants reported they were often alone for examinations and procedures or isolated from their chaperones.
  • Perpetrators were commonly male GPs or healthcare practitioners with routine ‘clinical’ access to children, meaning that their behaviour was not questioned by other staff, parents or children, even when they recommended procedures that were not appropriate or needed in order to sexually abuse children. Perpetrators abused their positions of trust and authority and many perpetrated child sexual abuse under the guise of medical/clinical procedures and examinations, which in some cases involved the use of medical equipment or medication.

I'd been going there since I was in the womb, you know. Like, it was a family doctor, it was just down the road ... a trusted person to me and I was taking myself to the GP when I was a child.

Truth Project participant sexually abused in a healthcare context

 

  • There was very little evidence of grooming in participants’ accounts. This is perhaps not surprising given the routine and easy access that perpetrators had to children that allowed them to examine and touch children without any need of ‘special’ explanation or persuasion. The accounts did indicate there were, at times, manipulation of children, and the manipulation or collusion of staff.

... what he did was – under the guise of performing a medical test, called a high vaginal swab, he used that as an opportunity to rape me.

Truth Project participant sexually abused in a healthcare context

 

  • Participants’ accounts revealed that the healthcare needs of many, but not all, of the participants were related to physical, psychological and sexual abuse by family members, and neglect; some had no family support; some were bullied and/or excluded or had stopped attending school. Children attended health institutions seeking treatment, care and recovery. Instead, they were sexually abused by healthcare professionals in positions of power and in violation of their professional duty to do good for their patients. Participants’ accounts showed that the abuse of positions of trust and institutional failures in child safeguarding contributed to their increased health and psychological difficulties.
  • As children, only a quarter of participants reported that they were able to disclose the sexual abuse. Accounts of the qualitative sample showed that although many disclosed the sexual abuse to trusted adults such as their parents or a healthcare professional during childhood, very few were believed and some were dismissed by healthcare professionals as sick or ‘crazy’. Participants revealed that their vulnerabilities were often heightened due to their illness at the time of the sexual abuse. Communication difficulties, and adults’ beliefs that children had mental illnesses, meant they were not listened to, or people did not take appropriate action to safeguard them.
  • Participants’ accounts revealed that there were no clear processes through which participants and their families could disclose sexual abuse in healthcare contexts. In residential healthcare settings, children had no one to turn or talk to, to disclose sexual abuse. Participants described a lack of appropriate safeguarding or effective responses to allegations of sexual abuse by healthcare practitioners.
  • Similar to findings from participants sexually abused in other institutional contexts, those in healthcare contexts suffered lifelong mental health impacts. Participants were fearful of healthcare professionals, leading to avoidance of contact with them in later life. They reported feeling betrayed by perpetrators who had abused their positions of trust and by perpetrators’ colleagues, as they did not intervene to prevent or stop the sexual abuse. This led to subsequent broader distrust of authority, systems and adults.

I just see [doctor/perpetrator] fingerprints on everything, you know, on every – you know, ... I look at my life and I just see his fingerprints ...

Truth Project participant sexually abused in a healthcare context

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