Child sex abuse common, leads to lives of quiet despair -- and chronic illness

In yesterday's ACE poll -- a series of questions from the simple version of the Adverse Childhood Experience Study questionnaire developed by the Centers for Disease Control and Prevention -- 142 people (out of 369) said they'd been sexually abused before they were 18. As mentioned in previous posts, our polls are completely unscientific. And this series is really just to get the conversation started about the ACE Study and child trauma.

So, we can't say anything like "38 percent of our community was sexually abused as a child". We can only know that too many people are living with a memory of a horrible experience or experiences that has likely affected their lives in profound ways, including their health.

The ACE Study, which follows 17,000 people in San Diego who are members of the Kaiser Permanente health care maintenance organization, found that 20.7 percent -- one out of five people -- had been sexually abused before the age of 18; that rate was higher in women (25 percent, or one out of four), and lower in men (16 percent). Washington State, which did its own ACE survey in 2009, found that 12 percent of the population had been sexually abused -- 17.5 percent for women and 7 percent for men.

Most research shows that child sex abuse is higher than reported in Washington State. The researchers say the difference may be because the Washington survey was phone-based -- people answered these questions over the phone while talking to someone they didn't know. The ACE survey was a paper survey filled out by people in their homes, and they knew that it would be given to their doctors. There's a difference in degree of comfort there.

Okay. Enough with the numbers. They're appalling. And the lives altered....unspeakable. Literally. Of all the questions on the ACE Study, this is probably the one that addresses an issue that remains the least talked about, privately and publicly. What can you say about a grandfather who regularly rapes his six-year-old granddaughter? Or a military officer who brings his friends over to have sex with his daughter? Or a priest who fondles a choir boy? Or, as someone said in the comments on the poll yesterday, an optometrist who "took my hand and put it on his pants, over his penis. I was so young I didn't know what it was all about. Thank God he's dead now."

“It’s like you’re running all of your life,” said Ella Herman, 70, in an interview we did last year. Herman says she was sexually molested when she was a child, starting at age 4, by two uncles and a school bus driver. In her 20s, she weighed 115 pounds; she’s weighed as much as 300 pounds. She’s 5 feet 4 inches tall.

Herman was a member of Kaiser Permanente in San Diego. She owned and ran a successful day care center for 12 years before she had a heart attack at age 60. She joined a weight control clinic for the severely obese in the early 1990s, when Dr. Vincent Felitti, who ran the clinic, wanted to find out why people who were successfully losing weight were dropping out. One day he talked about the link he had found between child abuse and weight gain. That was a turning point for Herman.

“I remember him saying that he had read 25 charts,” recalled Herman, who is now retired and living in Mississippi. “And almost all of them had been sexually molested as kids, even the men. I started crying and another woman was crying and crying.”

Felitti went on to found the ACE Study with Dr. Robert Anda at the CDC. A big wake-up call for him was that many people in his weight clinic who were obese found that food was a solution, not a problem as he and the clinic had been addressing it. For many it was a barrier, a protection. One man told Felitti that, as a skinny, scrawny child, he was beat up nearly every day at school. When he gained a lot of weight, the kids stopped beating him up. Even as an adult, he was afraid to lose the weight. Another woman, who'd been raped at age 19, and had gained 100 pounds, said that being "overweight was being overlooked," and that's how she preferred it.

Other people who suffered child sex abuse or other trauma have chosen other solutions for their pain -- alcohol, prescription drugs, workaholism, risky sexual behavior, etc. It's not that people don't recognize that these solutions aren't bad for them. It's just that the pain of abandoning those protective solutions is greater than the pain of their consequences.

“Being obese really affects my body,” said Herman. “I have arthritis, lumbar spinal stenosis, got a heart stent. I take about 24 different kinds of meds a day. There’s just too much gone wrong.”

However, until she joined the Kaiser weight clinic, Herman had never connected her innate inability to lose weight with her fear of being sexually abused.

“I did not connect it at all,” she said. “I’ve lost 100 pounds about five or six times. Then the first time some man would say something to me about how I looked nice, I’d gain it back. Nobody talked about it before Dr. Felitti, and that’s the reason it had such a big impact on me. No one seemed to recognize this was going on. And then I found out it’s going on with a lot of people and I wasn’t the only one.”

Since she grasped the link between her extreme reluctance to lose weight with her childhood sex abuse, she’s made slow but steady progress to becoming a happier person, she said. And she told Felitti that she was willing to talk openly about this, because she wanted to do whatever she could to prevent the abuse she suffered in her life from happening to others.

We thank all of you who participated in yesterday's poll. For those of you who answered, "Yes", you no doubt recalled your experiences, and that isn't easy.

This is the fourth in a series of posts that accompany questions from the simple version of the ACE Study questionnaire developed by the Centers for Disease Control and Prevention. There are 10 questions on the simple ACE Study questionnaire, and for the rest of this week and next, we'll be putting one question out each day in a poll. Today is the fourth question. Each day I'll take a look at some of the research — ACE, brain development, and epigenetic — to provide more information and context. I encourage you to take the simple ACE test for yourself. There's also a link to the full 200-question survey.

Tagged: child trauma, ACE Study, obesity

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