Sexual Abuse of a Disable Person

When people with a disability are sexually assaulted it often goes unreported. This can be due to a number of factors, it could be because they’re not taken seriously, because their disability prevents them from understanding sex and what a healthy sexual encounter looks like, or because they are embarrassed or ashamed that their disability prevented them from stopping the sexual abuse. The sexual abuse of a disable is illegal and morally wrong.


Statistics on Sexual Abuse on Disable Persons

Due to them often having people in their life who care for them or assist them with day to day tasks, people with disabilities are at higher risk for being abused sexually or otherwise. Under the law disability is seen as someone who has limitations in areas such as hearing, vision, mobility, mental, and self-care. Some disabilities, especially those which rely on someone to assist them with tasks, put people at higher risk for sexual abuse.

  • If someone is bed bound an abuser could take away their communication devices like phones and computers to prevent them from reporting the crime.

  • People who are deaf or deaf-blind might have difficulty in reporting the crime.

  • If someone with disabilities report sexual abuse they might be less likely to be believed and met with derision.

  • Some people with disabilities might not understand what touch is appropriate, especially if people are required to touch them to provide care.

  • People with cognitive disability might not understand or have been taught what is healthy sexual contact and what their rights are in terms of consent. They might not fully understand what is happening to them when they are sexually abused and they are more susceptible to being coerced or convinced that the sexual abuse is normal or that they are enjoying it.

  • If someone with a disability relies on the offender for regular assistance and care then the offender might hold their reliance against them and abuse the power to force or threaten someone into sex or sexual activities. Remember that consent gained under coercion, threats, or force is not considered as consent.



Consent to Sex

While consent is critical in any sexual activity, it is less straight forward when one of the parties has a disability. A lot of people with a disability aren’t given education about sex and consent in the way that people without disabilities are from a young age. In some cases a disability might make it difficult for someone to express consent and if someone has a cognitive or developmental disability under the law they are seen as unable to give consent.

For people who have disabilities that require the care and support of a third party, when that person is the perpetrator threats can be used to force “consent” from the survivor or the survivor might even feel like they can’t report the sexual abuse for fear of not having anyone to care for them. If your loved one requires assistance it is important to vet the caregivers and discuss with your loved one what is appropriate and inappropriate touch and make it clear that they can talk to you about any concerns with their caregiver.

How Sex, Rape, and Consent relate to each other.

Due to differing state laws, the legal definitions of sex, rape, and consent can vary widely depending on which state the crime was committed. One thing all the states agree on though is that consent is an important factor in determining whether the sexual contact is considered a crime or not.

Why Is Consent So Important In The Eyes Of The Law?

Each state has its own law regarding consent and what it looks like but consent is so important because it helps determine whether the specific sexual contact that was consented or not consented to was allowed and wanted by the sexually abused. There are three factors considered in all states when looking at consent in a sexual assault or rape case.

    • Consent: Was consent expressed either through words or unambiguous action that they agreed to the sexual acts in question?
    • Freely given consent: Was the consent given without any fraud, violence, coercion, or threat of violence?
    • Capacity to consent: In the eyes of the law, did the person have the capacity to consent?

Each state will have differing definitions of what these things mean and how they are interpreted but all states consider the above three factors.


Disable Person’s Capacity To Consent to Sex?

This is perhaps the least straight forward of the above three factors and the one point where each state has slightly different views. Even if consent was given by the sexual abuse survivor, if the court rules that they didn’t have the capacity to consent in the eyes of the law then their consent is overturned. Here are some of the factors which are considered when determining someone’s capacity to consent.

    • Age: Each state has an age of consent and if the victim is not at that age or above they are seen as not having the capacity to consent. In some states there is a Romeo and Juliet law which allows for consent to be given if someone is under the age of consent as long as the perpetrator is within the state’s predetermined age difference. For example most states allow a three year age difference to allow for young couples who are in a relationship.

    • Cognitive Disability: Does the victim have a mental or developmental disability or impairment that would leave them unable to consent or unable to fully understand what they are consenting to. In some cases a person with mental or developmental disability wouldn’t have been given sexual education and therefore wouldn’t be able to understand what they are consenting to.

    • Physical Disability: Does the victim have a physical disability that would leave them helpless to fend off unwanted sexual contact or stop the sexual contact if it goes beyond what they consented to.

    • Vulnerable adults: This refers to if the victim is elderly or ill or otherwise dependent on others for their care. This can lead to them being coerced into unwanted sexual contact because of the power the caregiver holds over them.

    • Relationship: If the perpetrator is seen to hold a position of power or authority over the victim then this can be seen as diminishing the victim’s capacity to consent. The victim might worry about the consequences if they don’t do as the perpetrator says. This includes teacher/student, police/detainee, parent/child relationships.

    • Intoxication: This is one of the factors that varies the most between states but in general if the victim was intoxicated with drugs or alcohol it muddies the waters of consent. In some states it really matters whether the drugs or alcohol were knowingly ingested or not as to the ruling on consent.

    • Unconscious: If a person is unconscious whether they are sleeping, sedated, passed out, or suffering from physical trauma that causes them to fall unconscious then they are seen as being unable to consent.


What Is Consent to Sex?

Consent is an agreement between two or more parties to allow sexual contact. We have discussed examples of consent below and you will see that consent can be non-verbal as well as verbal. Generally though non-verbal consent has to be overt and unambiguous. Verbal consent is a great way to make sure the boundaries of all participants are heard and respected.


How Consent Work?

Consent should happen every time you are engaged in sexual activity as it is a one time thing. Just because you allowed someone to do a particular sexual activity to you once does not mean that they will automatically be able to do it again. Also each sexual activity must be consented to. Just because you allowed your sexual partner to undress you and touch you, does not give them automatic permission to engage in any form of intercourse without your consent.


The Minute You Change Your Mind to Sex, Consent Is Withdrawn

This is a really important factor of consent that everyone needs to be aware of: any of the participants are allowed to change their mind at any time if they feel uncomfortable, unsafe, or just plain don’t want to do it anymore. If you clearly communicate that you want to stop then consent for that sexual activity is withdrawn and any further engagement is considered non-consensual and can be considered a crime.


What Does Consent Look Like?

    • Taking time to check in with other participants when the degree or type of sexual activity changes.
    • Asking permission before you move on to other “levels” of sexual activity. Eg oral sex, or any type of penetration
    • Unambiguous agreement to sexual activities. Eg. “Yes” or “I’m open to trying that”. It is important to note that if the agreement sounds hesitant or if it is in any way not an explicit agreement further clarification or discussion might be necessary.
    • Unambiguous physical cues to show you are comfortable moving on to other types of sexual consent. If you are unsure of what a physical cue means it is best to ask so that you can respect each other’s boundaries.


Consent Is Not Given If:

    • Someone disregards your no or any other word or action that shows you are not consenting to that sexual activity.
    • Assuming that appearance or behavior means someone is interested in additional sexual activity other than what has been consented to.
    • A participant is under the state legal age of consent
    • A participant is intoxicated
    • Anyone is pressured, threatened, or otherwise forced physically into sexual activity
    • Sexual activity is assumed just because you have done it in the past or you are in a relationship with that person.

Effects of Sexual Abuse

Depression

Depression is a mental illness not a choice and it is defined by “feeling down” or sadness or hopelessness for long periods of time. Due to the way it alters your thought patterns and behavior it can affect everything you do and even affect your relationships with other people. Anyone can suffer from depression, regardless of age, gender, sexual preference, religion, or ethnicity.

Following sexual abuse it is quite common for survivors to have the feelings associated with depression but it only becomes depression if these feelings persist over long periods of time. It might be worth speaking to a professional if you have feelings of sadness and hopelessness following sexual abuse so you can start working on it to try and prevent it from becoming depression.


If I’m Feeling Down, When Should I Get Help?

Following any type of trauma there are going to be negative emotions and therefore it is recommended to speak to someone about what happened to you so you can try and prevent mental illness as a result. However the minute your feelings of sadness and hopelessness begin to impede your life and stop you from doing the things you enjoy it is prudent to seek help.

 

Flashbacks

A flashback is where you relive the trauma or part of the trauma and the memories are so vivid you feel as if they are happening in this moment. You may feel as if the perpetrator is there with you or feel the physical pain you felt during the assault. During a flashback you will disassociate with reality. They can be triggered by a number of things but they are often related to the senses. For example certain smells, words or phrases, or a song can trigger a flashback.

What Can I Do If I Am Having A Flashback?

If you are having a flashback try the following things, not all may work for you but hopefully some of them will:

  • Remind yourself that you survived. By acknowledging that you are experiencing a flashback and in reality the event is over and you survived can help immensely.
  • Focus on your breathing to try and calm down and bring yourself back to reality. Close your eyes, place your hand on your stomach and take deep breaths. When you inhale your hand will move out as you breathe and when you exhale it will move in. Increasing the oxygen your brain is getting stops your body from panicking and helps you move out of the anxiety faster.
  • Use your senses to ground you in reality. Just as your senses can trigger a flashback, so they can be used to bring you back to reality and remind you that you are not experiencing the abuse again. Look around you and list items you can see, focus on smells around you, turn on some music or something to listen to, touch something textured or hot or cold. Using the senses is an effective way to tell your brain that you can’t be back in the abuse as the things you are seeing, feeling, hearing, and smelling don’t make sense in the flashback scene.
  • Make yourself feel safer. Whether that is making a cup of tea and wrapping a blanket around you or sitting in a locked room by yourself, do something that will help you feel safer and more secure until you have calmed down and the flashback has passed.

How Can I Prevent Flashbacks?

Flashbacks can feel very sudden but in truth there are some physical responses our body makes to triggers before the flashback occurs. If you can notice the warning signs of a flashback then you can take steps to calm yourself or busy yourself and prevent the flashback or you can manage the flashback. Early warning signs include:

  • Change of mood
  • Sweating
  • Change in breathing
  • Feeling like there is pressure on your chest

Another thing you can do is to work out what triggers your flashbacks and work out ways you can avoid these triggers or what you can do to cope if you come across any triggers. Triggers could be a number of things, often they are sensory reminders of the experience, an emotional memory, or if you are particularly stressed it can trigger a flashback. Some things you will be able to avoid but other things you might not be able to avoid at all so it is best to come up with a plan of how to cope with that trigger so it doesn’t cause a flashback.

 

PTSD

PTSD or post-traumatic stress disorder is quite common in survivors of a traumatic event. It manifests differently in everyone but generally PTSD is characterized by feelings of fear, stress, anxiety, difficulty sleeping or relaxing, and nightmares. Some sufferers might only feel fear and anxiety if they are triggered whereas other suffers might be plagued with constant fear, anxiety, and stress, making it difficult to function.

Here are the three main symptoms of PTSD though suffers might have any combination and any degree of the below symptoms.

  • Re-experiencing – reliving the traumatic event through nightmares, flashbacks, or intrustive thoughts
  • Avoidance – changing your behavior either consciously or subconsciously to avoid situations connected to the event. Avoiding activities you used to enjoy because you associate them with the traumatic event.
  • Hyper-arousal – feeling tense all of the time. This may also include being jumpy, prone to outbursts of aggression or crying, having trouble sleeping.


Self-Harm

Self-harm is where people deliberately inflict physical injury on themselves where the goal is not suicide. While this is usually done in private, that is not always the case.

Common forms of self-harm:

  • Biting
  • Cutting
  • Hair pulling
  • Burning
  • Skin picking
  • Scratching
  • Hitting with hands or another object

While the relationship between suicide and self-harm are complex, it is not always a warning sign of suicidal thoughts. Often it is used by survivors of traumatic events as a coping mechanism. It can be seen as a way to assert control over their body again or be seen as a physical pain which is much easier to deal with than the mental and emotional pain they are suffering from. Due to the short lived relief offered by self-harm it can create a cycle of self-harm. While suicide is not always the goal with self-harm due to the physical nature of the injuries they can result in complications that may be life threatening.


I Am Thinking Of Hurting Myself, What Can I Do Instead?

  • Take a walk to distract yourself. Stay present in the moment while you walk and notice everything around you in detail to stop your brain dwelling on the urge to self-harm or the feelings and memories that triggered that urge.
  • Remove yourself or the object you are planning to self-harm with from your sight until the urge passes.
  • Send a message or call a friend to keep yourself busy. Plus interaction with someone you care about and who cares about you can help both in the immediate moment and long term.
  • Close your eyes and take a deep breath in, counting to five, hold your breath and then count to five again as you exhale. Make sure your brain has enough oxygen to fend off panic and think rationally through what you are feeling.
  • Write down your feelings so you can get them all out. This can help you think through your thoughts and feelings and let them go for that moment.
  • Take a hot shower or bath until the urge fades. Remove any razors or objects you could use to self-harm first. Hot water has positive physiological benefits that will relax your body and allow your brain to then relax.
  • Draw on the parts of the body where you wanted to self-harm.
  • Rub ice across the body part you would normally self-harm
  • Do something destructive on newspaper or cardboard to help get your emotions or pain out.



If I Think Someone Is Self-Harming What Can I Do?

It can be difficult to spot someone who is self-harming due to the harm being carried out in private and the pain-staking lengths they go to when covering up the evidence of self-harm. Often you will notice changes in behavior rather than physical tells.

If you believe someone is self-harming here is what you can do:

  1. Ask general questions about how they are and what is going on in their lives.
  2. Tell them that you care about them and want to see them happy and healthy.
  3. Tell them that you have noticed that they are self-harming. They might feel comfortable enough to talk to you about it but they might also react badly or shut down the conversation. Don’t feel like you have done the wrong thing by bringing it up, as this is a positive first step. They know now that you care about them and that you are aware of their self-harming and they know that they have someone to talk to about it when they’re ready.


Sexually Transmitted Diseases

What Is The Difference Between STIs and STDs?

An STI is a sexually transmitted infection of bacterial or viral nature which can be passed between people having unprotected vaginal, anal, or oral sex. STI refers to the infection before it starts showing symptoms, after which it is referred to as an STD which stands for sexually transmitted disease. Both STIs and STDs can be transmitted during unprotected sex whether it was consensual or not. Birth control that doesn’t create a physical barrier between the sexual organ and the mouth or another person’s sexual organ isn’t effective against preventing STIs and STDs therefore condoms and dental dams are good birth control choices that can be used alone or in combination with other birth control methods.

I’m Worried I Might Have An STD

  • Get tested as soon as possible. Not all sexual assault exams include a test for STIs so make sure you specifically request one when you visit a doctor or hospital following a sexual assault. If time has passed since your sexual assault exam then you can visit a clinic to get tested for STIs.
  • Because you’re not showing symptoms doesn’t mean you’re clean. Some STIs don’t show symptoms for quite some time after infection so if you’ve had unprotected sex it is best to get tested so you can treat the infection before it worsens. You can get tested any duration after the sexual abuse.
  • Get help. Most STIs are able to be cured with antibiotics so you can take care of the problem quickly and easily without worrying about infecting other people. Viral STIs like herpes can also be managed through medications.

 

Substance Abuse

Substance Abuse is a common way sexual assault survivors deal with the pain following the event. Some of the reasons survivors turn to drugs and alcohol include:

  • Trying to numb the pain
  • Wanting to forget
  • Wanting to feel good
  • Fear that family and friends won’t believe them
  • Confusion about the experience
  • Self-consciousness or not feeling in control of their bodies
  • Not having a support system


How Can I Tell If Someone I Love Is Struggling With Substance Abuse?

  • New friends who also struggle with substance abuse
  • Stealing things or money to pay for their habit
  • Losing interest in past hobbies
  • Poor performance at work or school
  • Lying to family and friends to hide their substance abuse
  • DUIs
  • In trouble with the police


Disassociation

Disassociation is a detachment from reality. The severity can differ anywhere from daydreaming and escaping to a fantasy world right up to complex disassociation which prevents the sufferer from being able to function in the real world. This condition is the brain’s way of protecting the survivor from the trauma of the experience by creating a better, more idealistic world. The condition can be upsetting but is common in some degree or another with those who have experienced trauma.

 

Eating Disorders

Due to many survivors feeling a loss of control over their body as an effect of sexual abuse, many do turn to disordered eating as a way to assert control over their body. There are now a multitude of categories of eating disorders but the three main ones are:

  • Anorexia nervosa: The sufferer will severely restrict their food intake or in some instances starve themselves completely resulting in excessive weight loss. The reason behind the behavior is often not weight loss, rather a self-discipline, or controlling one aspect in their life to help them feel calmer. The behavior and rituals they employ will start to take on an obsessive nature the longer they suffer.
  • Binge eating disorder: The sufferer will eat excessively in one sitting in a manner that feels to them and is seen by bystanders as out of control. Often sufferers will feel a sense of shame and the binge eating is often private and can be followed by periods of starvation to “counteract” the binge. The eating isn’t in response to hunger cues but is usually triggered by emotions or, after a length of suffering, trigger foods.
  • Bulimia nervosa: a cycle of binge eating as above and purging the food as a way to appease the guilt at how much they ate. Purging can be done through vomiting or laxative abuse.


Why Do Sexual Abuse Survivors Develop Eating Disorders?

Following sexual violence the survivor might have negative body image and feel dirty, or unattractive, or worthless. In an attempt to cope with those feelings survivors try to use food as a comfort to feel better, to punish themselves by denying food, or to feel in control. In general it is a coping mechanism to stave off the overwhelming emotions. All three of the above eating disorders can cause serious long term damage to your health.


How Can I Tell If Someone Has An Eating Disorder?

  • Sudden weight loss or weight gain, faster than you would expect if someone was on a diet.
  • Seeming obsession with calories, food, and dieting.
  • Extreme rules around food such as foods they won’t eat, times of day to eat, or portion sizes.
  • Wearing baggy clothing to hide their weight loss.
  • Stained teeth or bad breath (for bulimia)
  • Trips to the bathroom during or after a meal.
  • Lowered body temperature and cold extremities.
  • Not liking to eat out or around other people
  • Rituals surrounding food such as chewing excessively, playing with food, leaving certain amounts on plate.
  • Surprising outbursts if they are unable to control their food or aren’t able to perform a ritual eg. If dinner is served late or a food is served that is against their rules.

 

Pregnancy

For any questions involving your physical health, including pregnancy it is best to contact a medical professional to ensure you are receiving the advice and care you need for your situation.


Sleep Disorders

Sleep disorders can have many different symptoms. Sufferers can have trouble staying asleep, trouble falling asleep, sleeping for longer or shorter than usual, night terrors, nightmares, and sleeping at different times of the day. Sleep disorders can exacerbate other physical, mental, and emotional problems that result from the sexual abuse so it is important to see someone about your sleep disorder.

 

Suicide

If you are having suicidal thoughts, just know that you are not alone and that suicidal thoughts aren’t permanent. Help is out there for you and there are a number of resources to support you through your recovery.

Where Can I Get Help?

  • Call the National Suicide Prevention Lifeline
  • Chat online at the Lifeline Crisis Chat
  • If you are a veteran call the Veterans Crisis Line or use their online chat service
  • If you are a LGBTQ youth visit the Trevor Project website.

 

Adult Survivors Of Child Sexual Abuse

The scary statistic surrounding child sexual abuse is that every nine minutes a child is sexually assaulted in the US. In the majority of child sexual abuse cases the child knows the perpetrator. Often they hold a position of authority over the child such as a medical professional, a teacher, a family member, or coach. The important thing is to remember that no matter the circumstances surrounding the sexual abuse it was not your fault.


What Effects Will A Child Of Sexual Abuse Experience When They Become An Adult?

A child will experience many short term effects following the sexual abuse but when they grow up and better understand what happened they might experience some other long term effects. Some of these will include:

Guilt:

It is normal for survivors to experience guilt for the sexual abuse, either due to the circumstances surrounding the abuse or for not being able to stop it. If the body experienced physiological reactions to sexual stimulation or if pleasure was felt during the sexual abuse that can also add to the guilt, shame, and blame the survivor feels. While these are normal feelings following sexual abuse, it is important to remember that it is the offender who should feel guilt and shame not you. They are accountable for the abuse, not you, especially not when the abuse happened when you were a child who placed their trust in the offender.

Having a hard time with intimacy or trusting in relationships:

If you were sexually abused as a minor it is likely that your first experience of sex and intimacy was the abuse therefore as an adult it is normal to struggle with intimacy and even trusting in a romantic or sexual capacity. Consensual sexual activity can trigger flashbacks in some survivors and there might be difficulty in setting boundaries that keep them feeling secure in relationships.

Self-esteem:

Low self-esteem is common among survivors of sexual abuse, especially when the abuse happened so young. Survivors can be left feeling dirty or worthless and often negative words or degradation can be a tactic offenders use to keep their victims silent. It also springs from having your words and personal safety ignored and violated. Low self-esteem can affect many areas of your life in such a negative way. It is important to remember that the sexual abuse speaks volumes about the attacker, not you and that you are a survivor.

Why Does This Still Affect My Life When It Happened So Long Ago?

In short there is no timescale for dealing with a sexual abuse, it can affect people in such different ways. Also when the abuse happens as a child due to them not being able to advocate for themselves the abuse can be an ongoing thing and further damage can happen when they try to talk to an adult about it and are either ignored, not believed, or blamed for the sexual abuse. Sometimes the child will be in survival mode and push down all the feelings while the abuse is happening and they will resurface much later in life.


How To React When Someone Tells You About Sexual Abuse?

If someone trusts you enough to open up about sexual abuse to you it is important to listen and help them feel comfortable and like they can trust you. Your reaction will determine if they will feel like they can speak to other people or even medical professionals or the authorities about what happened. It can be difficult to hear about bad things happening to people we care about but this interaction is about the survivor not you. So listen, give them encouragement, tell them you believe them and that you will support them in any way they need.

 

Brad Nakase, Attorney


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