I’m An Emergency Physician. Here’s What I Want Parents To Know About Child Sexual Abuse.

Threats of retribution and revenge seem to be everywhere in our public discourse. They may play well in some arenas, but when it comes to protecting kids from sexual abuse, they can backfire — badly.

As an emergency physician who works in a children’s hospital, I provide medical care to pediatric patients who are brought to the emergency room because they experienced sexual abuse. Statistically, 1 in 4 girls and 1 in 20 boys are sexually abused during childhood. Researchers have documented many reasons why children may not readily disclose abuse, such as guilt, shame, feeling that they are at fault, fear for their safety, or concern that no one will believe them.

There’s another barrier to disclosure that has been largely overlooked by parents and professionals alike, one that I’ve repeatedly encountered in my conversations with children and adolescents: Young people are less likely to disclose sexual abuse if they are taught that their loved one will retaliate with violence.

Here is the scenario that that I see far too often: A teenager, statistically female, presents to the emergency department after being sexually assaulted. When I ask her if her parents know about what happened, she begs me not to tell a particular person, typically her father, because “he told me that if this ever happened, he would kill the person who did that to me.”

That teenager might decide not to disclose the abuse to protect her father from the perceived consequences he might face if he retaliated against the perpetrator of her abuse. She may consider whether she would rather suffer in silence and risk being raped again or risk losing her father if he were to get hurt, killed, or arrested while pursuing the person who abused her.

Instead of vowing retribution, we should assure our children that we will always love them, no matter what happens, and that they should feel safe talking with us about anything and everything.

To be clear, this is not just about fathers and daughters; I have seen people of all ages and genders struggle with these impossible calculations. Further complicating the matter, more than 80% of perpetrators of childhood sexual abuse are known to the victim and may even be part of their family. Countless kids have told me they were afraid to say anything because they did not want one member of their family, whom they love and trust, to be harmed while going after the family member who had abused them.

Sometimes, children are so scared about how an adult might react that they fail to report the abuse — and are repeatedly raped — for years before finally being brought in for emergency care. In these cases, the abuse is often discovered by someone like a teacher or counselor, and the child’s parents still do not know about the abuse.

Parents and loved ones might think they are helping their kids feel safer by threatening retribution. Some might even think that promising to take matters into their own hands is helpful. Perhaps they know that fewer than 3% of rapists ever receive a felony conviction.

While our justice system clearly needs reform, how we talk with our kids about sexual violence also needs attention. When parents and other loved ones tell their children and teenagers that they would take matters into their own hands, they are adding to their child’s burden, not easing it. Even if these threats are not intended to be taken literally, kids often take them at face value anyway.

After seeing the harm that this messaging can cause to kids who face abuse, I have come to believe that these types of statements are misguided. Threatening to retaliate against someone who hurts their child allows an adult to have the illusion of control without doing the difficult work of considering what kind of help might truly be needed from them if the child were to experience sexual abuse.

If you are a parent or a loved one and you want a child to tell you if someone ever hurts them, please do not teach them that you will ever resort to violence to punish the perpetrator. Instead of vowing retribution, we should assure our children that we will always love them, no matter what happens, and that they should feel safe talking with us about anything and everything. Organizations like RAINN provide additional guidance regarding how to approach these conversations.

If they have faith that we will always act in their best interest no matter what happens, young victims of sexual abuse will not feel forced to weigh whether they would rather seek our help or protect us from the possible consequences of our reactions.

Dr. Alexis Cordone is a board-certified emergency physician pursuing further subspecialty training in pediatric emergency medicine at Yale New Haven Health and a Public Voices Fellow of The OpEd Project. Any views expressed are the author's own.

If you or someone you know has been sexually assaulted, you can call the National Sexual Assault Telephone Hotline at 1-800-656-HOPE (4673) or visit hotline.rainn.org.