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Violence and trauma

'I don't think I really had the language to say what was happening'

Senior Researcher at the Independent Inquiry into Child Sexual Abuse, Julienne Zammit, on a new report over abuse in healthcare contexts.

14 December 2020

More than 5,000 victims and survivors have shared experiences of child sexual abuse with the Truth Project, part of the Independent Inquiry into Child Sexual Abuse. The fifth in a series of thematic reports, this report explores sexual abuse in healthcare contexts. Below, I include quotes from Truth Project participants sexually abused in a healthcare context.

"He told me I had to get undressed, and I refused. He said he had to examine me, he had to do a thorough examination. I said, 'Why?' and he said because he's a doctor and he was the head of that unit and I had to do exactly what he said." 

These words are from a victim and survivor who was sexually abused in a healthcare context, the focus of the Inquiry's latest report drawing on accounts shared with the Truth Project. As current times so sharply illustrate, healthcare is a crucial pillar of our society, and is something that everyone should be entitled to, free from the threat of sexual abuse. Unfortunately, as these survivor accounts show, this has not always been the case. 

The report shines a light on the experiences of 109 victims and survivors who were sexually abused across a wide range of healthcare settings from the 1960s to the mid 2000s. Accounts describe sexual abuse in hospitals, psychiatric institutions, clinics and general practitioner (GP) practices.

Over half of participants described being sexually abused by doctors such as GPs, surgeons or psychiatrists. Many described the GPs as local or family doctors, and spoke about long-standing relationships where the doctor was trusted and well regarded by their families.

"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." 

The report highlights certain characteristics of healthcare contexts which perpetrators would exploit to carry out sexual abuse. This included the availability of small, private rooms, one-to-one examinations or curtains that could be drawn around patients. For example, one participant reported being sexually abused by her GP whilst her mother was present in the same room, on the other side of the curtain. 

Victims and survivors described being subjected to a wide range of sexual abuse, including fondling, exposing children to adult sexuality, and violations of privacy. Over half described suffering sexual abuse by penetration. A common theme that emerged was that sexual abuse was often perpetrated under the guise of medical or clinical 'examinations'. Some stated that medication and medical equipment were used to perpetrate the sexual abuse itself.  

"He put the instrument in me, I always remember, he looked at me and I just remember then thinking, I don't know what's happening. I don't know, it was really seriously uncomfortable in every way you can imagine." 

The report finds that whilst there was very little evidence of grooming in participants' accounts, this is perhaps not surprising. Perpetrators had routine access to children enabling them to examine and touch children without any need for 'special' explanation or persuasion. As children, survivors described being told not to question elders, having a lack of knowledge around medical procedures, and feeling naive and trusting toward those providing treatment.

"He then listened to my chest with his stethoscope and then asked me to get on the couch. I do this without question, he's my doctor and I am safe with him; that is what I thought, despite feeling uncomfortable." 

Where disclosure was concerned, participants described facing significant barriers such as the fear of not being believed, speaking out against the perpetrator as well as feelings of shame and embarrassment. One specific barrier cited by participants was that adults did not believe their reports of sexual abuse – not just because they were children, but also because they were labelled as sick patients.  

"I tried to talk to the doctor about not feeling safe and I was scared of the nurses and they were doing bad things. I don't think I really had the language to say what was happening but I can remember just the response of the doctor was like, you know, that I was a really, really sick person..."

Many victims and survivors felt they had no one to tell about what was happening. They also highlighted how the courage of other victims and survivors coming forward motivated them to disclose their own experiences as adults. Participants also said that being believed and supported helped them to recover, both elements at the heart of the Inquiry's Truth Project. Whilst it's due to close in 2021, for now we are still encouraging those who wish to share their account with the Truth Project to do so.

Survivors of child sexual abuse can share their experiences with the Inquiry's Truth Project in writing, over the phone, by video call or in person. Visit www.truthproject.org.uk or email [email protected]. Visit the Inquiry's website for more information about Truth Project analysis and the research programme.

Read more about the Truth Project here.