National Health Strategy (1993) Help Where Help Is Needed: COl/tinuity

(~lCarefor feople with Chronic Mentallllne,\'s, Issues Paper No 5.

BREAKING THE LAST TABOO: CHILO SEXUAL
ABUSE BY FEMALE PERPETRATORS
Olfsol1, M. (1990) 'Assertive Community Treatment: An Evaluation of
the Experimental Evidence', Hospital and Community Psychiatry
-- ---, I
41(6),634-41. I
Pasnau, R. (] 987) 'The Remedicalization of Psychiatry', Hospital and I
Rellie Koollill .
CO/ll/llunity Psychiatry 38(2), 145-51.
Quadrio, C. (1988) 'Remedicalisation and Regression in Psychiatry', _95_0-"_o8682
Australian and New Zealand Journal of Psychiatry 22, 242-45. III Ihe past Iwo dc('adl's the /rulh aluJlathe sexual viola/ioll of children has heen
Rochefort, D. (ed) (1989) Handbook Oil Mental Health Policy ill the spokell over ami over. Finally, the magnitude of rhis problem is being recognised.
U"itcd States, New York: Greenwood Press. Vol//mes have been 'writ/ell abollt the prcI'ellti!m of and illterven/ion ill child
Rosen, A. (1992) 'Community Psychiatric Services: Will They Endure?', sexual ahuse, alld services (altho//gh inadequate) have been established. Sexual
CurreHt Opinioll in Psychiatry 5, 257-65. (fIJ//se IJy wom('1l /filii! recent!.v, has Ilee/l treated as {l taboo subject. The
Shern, R., R. Sudes and 1. Waizer (1989) 'Designing Community kllowit'dge 1IU1! rhe (}\'{'/Whellllillg proporlio/l cl child se.wol almse is perpe/ratcd
Treatment Systems for the Most Seriously Mentally Ill: A State hy nwles It'1; /he isslIl' (~/Ieml/le perpetrators wlexamined. IhlVillg 0111.\; recelltly
Administrative Perspective', Journal of Social Issues 45(3), 105-17. ///(/(/(' pro1!.l"t'ss in a 11lIrdJoughtl)((t/le to place gellder amI male power a//he
Singh. B. (1992) 'Mainstreaming Psychiatric Services', Medical Journal ('ell1n~ of all alIa lysis ofse.wal a/mse. practi/irmers and thcoreticians are
(~r Australia 156. 373-74. ,/fIlllerstam/a!JIy rehlctwlt to focus allY at/Clition cm female abusers. However, it is
Stein, L. and M.A. Test (1980) 'Alternatives to Mental Hospital /UHt' bccol1lillX dear that (/ significallt milwri/y of vic/ims (ire abused hy women

Treatment: I. Conceptual Model, Treatment Program and Clinical lIml it is esscntial/IIat IW child should b~ silenced by idcology which dcnies the
Evaluation', Archives of General Psychiatry 37, 392-97. rcali/y (ll/busc by females. This article examines the controversies surroundillK
Test, M.A. (1981) 'Effective Community Treatment of the Chronically the issue ufJemale sexual allusc awl/he sll'llggles which we have ill cOIl/rolltin!?
Mentally Ill: What Is Needed?', Jourl/al of Social Issues 37(3), 71-86. Ihis ahuse. All expla/lation oJsexual almse IJy wumcn wi/hillfcmini.l't
Tohin, M. (11)93) 'Inquiries at Lakeside and Ararat Hospitals: Lessons ullderstwu/ill!{ is proposcd. Current evidence on the prevalellcr ofIellla/e sexual
and Advances?', Australian wul New Zealand Journal of Psychiatry CI/mst! (llld c!lllracleristic:s oJperp(~/raturs is outlincd. Prac/ic:c implica/iu/lsJor
27, 333-40. practitioners wurkillg with child victims or adlllt survivors (Ire explored.
Whiteford, H. (1992) 'A National Mental Health Policy for Australia',
Medical Jourl/al ofAustralia 157, 510-11.
Whiteford, H., B. Macleod and E. Leitch (1993) 'The National Mental
A fcw years ago, it would havc been unimaginable to publish a paper
on childhood sexual abuse by female perpetrators. Political and
practice imperativcs urgently focused attcntion on the predominance of
Health Policy: Implications for Public Psychiatric Services in
male abusers, and concepts of power and patriarchy, as we sought to
Australia', Australian and New Zealand Journal of Psychiatry 27,
understand and intervene in childhood sexual abuse. This analysis
186-91.
remains of paramount importance for work in childhood sexual assault,
Wintrob. R. (1980) 'The Future of Psychiatry in America'. Australian yet the context has altered sufficiently to allow my willingness tu write

I
(111(1 New Zealand Journal {~r Psychiatry 14, 193-98.
such a paper. What has changed?

Renee Koonin is a Lecturer in the Department of Social Work and Social

! Policy at the University of Sydney.
I
.I
194 1 AIHtralil/J1 )ollrl/al of Socialls.wcs Vol. ]0 No. 2 Ma.v /995 Ii 195

1
I
i
\
 First, I have developed a deeper understanding of my own experience should never be regarded as being capable or sufficiently comprehending
and its political implications. I am an incest survivor. When I recalled that of giving consent. (In NSW the age of consent is 16 for girls and boys.)
I was sexually abused by my step-father as a child, I was devastated, but I In essence, sexual abuse is 'the exploitation of a child for the sexual
was not surprised. When I remembered that my mother had also abused gratification of an adult' (Fraser in Renvoize 1993, p. 34). The South
me sexually, my world fell apart. Nothing I believed, none of my work as Australian Governmcnt Task Force defined child sexual assault as 'the
a social worker, educator and activist had prepared me for this truth. imposition of explicit sexual activity on a child who lacks the power and
A feminist understanding of incest and childhood sexual assault, authority to prevent being coerced into compliance' (cited in Renvoize
gained from my years of practice and research as a social worker and 1993, p. 34). Such abusc can take many forms including exposure.
academic. led mc to maintain my focus on the abuse of male power as the fondling, voyeurism and exhihitionism to oral sex, sexual intercourse
cause of my predicamcnt. I labelled the intense and different feelings I (orul, anul and vaginal) and involvement with pornography and child
cxpericnced about my mother's abuse as personal and idiosyncratic, and prostitution. With respect to sexual abuse by women, any of these acts
felt even more isolated as I felt more shame, more responsible for having other than penile penetration is possible. Digital penetration and
hccn a victim of such a rare occurrence as sexual abuse by female penetration with objects docs occur.
perpetrators. That was until I met other women who were victims of
scxual abuse by their mothcrs, grandmothers, aunts, sisters and female Controversies
cousins and carers. My personal experience was also shared. There arc inherent risks involved in discussing child sexual abuse by
At the same time as I began to rcalise that my experience was not fcmale perpetrators. Acknowledging abusc by womcn may be uscd as an
unique, emerging research confirmed that sexual abuse by women may 1 excuse to deny the gcnder bias in sexual abuse (Forbes 1992-93). Critics
well not be as infrequent as we have previously understood. While the ·1 of the organisers of the National Conference on Female Sexual Abuse
majority of sexual abuse is perpetrated by male offenders, our held in London in March 1992 were concerned that the debates would
responsibility to child victims and adult survivors of female offenders serve to turn the clock back to the time when professional literature on
mcans that we dare not overlook this significant minority. child sexual abuse looked only at individualistic and unthreatening
Finally, und most importantly, I believe that UI1 exploration of sexuul I theorics of the causes of abuse. This psychiatric, psychological and
abuse by womcll provides all opportunity to enhullcc our comprehension family dysfunctioll literature either ignored the preponderance or male
or sexual abuse and that this is not contradictory with a feminist analysis. .\ abusers, or sought to arguc that the evidence was coincidental. inaccurate
Such insights will cnsure appropriate help for adult survivors and the i or incomplete. Wc are reminded that it was not until feminists forced the
childrcn for whom we care. Therc are both children and adults who are issue of male power into thc analysis of child sexual abuse that the central
disbelieved when they first disclose sexual abuse by a woman. Clearly, significance of gender was gradually acknowledged (Kelly 1988-89).
practitioners face uncertainty and discomfort as so many of their Thus, thcre is concern that any attempt to remove the spotlight from male
fundamental beliefs are challenged. In spite of these difficulties, theory abuse serves the political ends of providing fodder for what 'many policy
and practice lessons need to be drawn from our experience. makers, professionals, researchers and journalists urgcntly want to hear
and believc' (Nelson 1992). Critics view any emphasis on female abusers
What Is Sexual Abuse? as part of the effort to revert to a gcnder-neutral theory and practice of
Sexual abuse is defined as 'sexual contact, ranging from fondling to child sexual abuse (Forbes 1992-93) and a clumsy effort to re-emphasise
intcrcourse, betwecn a child in mid-adolescence or younger and a person mother blame and collusion. Media coverage of the London conference.
at least five years older' (Briere 1992, p. 4). By implication, sexual abuse which rcferred to the so-called 'discovery' of sexual abuse by women as
occurs when a person is involved in sexual activity that they do not the 'tip of the iceberg' was extensive (Heath 1992; Laurance 1992;
comprehend and to which they cannot givc informed consent. Children Marchant 1992;D Nelson 1992; Nelson and Oxford 1992; Sharpe 1992).

196 AIf,\'rraliall Joumaf (~rS(Jciaf f,\'.\IfC.f Vof. 30 No, 2 May f995

Knolli,,: BreakinR rhe La,fr Ta/mo 197
 I

III this respect, fears that a broad discussion of scxual abuse by womcn

I
womcn also abuse sexually is therefore difficult. Kelly (1991) argues that
will be used to dcflect attcntion from the abuse of power by men are well- in developing an understanding of women's oppression wc are engaged in
grounded. a process which includes documenting the forms and extent of male
In response. those who argue that attention must be focused on i violence and re-valuing women. These, and other factors, led to an

I
patriarchy are accused of not being willing to hear the truth, and of idealisation of women and their relationships. While privately we know
distorting evidence to support ideology (Forbes 1992-93). As a counter- the gap between our ideals and capacity to live by them, to speak publicly
olTensive, the politic~il credentials of those who urge that sexual abuse by is threatening in the extreme. Yet, failurc to name and confront issues of
women be placed on the political agenda are challenged. Purthcr. there is power among women has led to the downfall of many women's groups,
the qucstion of why any attention should be paid to the small minority of campaigns and relationships. It is in the interests of women and children
female abusers, whcn resources must urgently be focused on thc victims to confront the issue of abuse by women.
or childhood sexual abuse - 95 per cent of which is perpetrated by men.
I acknowledge these controversies and connicts and have scen the Developing Theory
debilitating effects of such polarisation on children's services, women's ,The greatest obstacle to womcn confronting the issue of sexual abuse by
groups and adult survivors of sexual abuse. The National Confercnce on women is the belief that this challenges feminism. Kelly (1991, p. 15)
Female Scxual Abusc resulted in an almost complcte breakdown in argues that 'feminist analysis of mcn's violence is only fragile if it is
communication between research, training and service organisations underpinned by essentialism: the belief that aggression is inherent in men.
which call themselves feminist and other service providers who are Masculinity and femininity are culturally and historically variable
speaking out on female sexual abusers. constructs, which individuals fit more or less comfortably'. A structural
To date in Australia we have managed to explore this issue without analysis of society examines the use of force and coercion to maiutain
the same degree of divisivcness. The challenge to focus our energies on powcr, whether the source of that powcr is gender, race, class, sexual
effective analysis, intervention in and prevention of child sexual abuse oricntation, physical or mental health. This force is frequently socially
remains. legitimated. A structural analysis provides the tools to explore women's
access to and use of violence, but this exploration has been largely
'Unspeakable Acts': Struggling to Face the Issue ot Abuse by avoided. Following this argument, 'thc most likely targets for violence by
Women women are children; the only social group over which women have
The difficulty womcn (particularly) face in confronting the issue of socially legitimated power' (Kelly 1991, p. 15). The sexual realm is an
s~xual abuse by females is easily understandable when we see how arca of power for men. Women acting out violently, sexually, are acting
readily the 'women dq it too' argument is used to deny the central out against the social construction of femininity, against all expectations,
importance of abuse of male powcr in scxual abusc (Crisp 1991). Liz hence the outrage attached to female perpetrators of sexual abuse.
Kclly (1991) coined the tcrm 'unspeakable acts' to illustrate our silencing Young (1993) argues that an analysis of power is only a partial
of these issues. Yet, she argues, that if we fail to develop feminist solution to understanding sexual abuse by women. While validating all
perspectives, we hand over the issue to those professionals who deny the feminist claims about the position of women in society, she asserts that
central significance of gcnder in sexual abuse and the media, and through some women, within the limited power that they have, can be 'abusive,
our silencc, continue the conspiracy to fail those who have suffered at the vicious, cruel, possessive, domineering, violent, manipulative, aggressive,
hands of women. It was in fact a small group of feminist women who first dishonest, self-deceptive, and criminal' (Young 1993, p. 114). While this
tacklcd the issue of sexual abuse by women at a confcrence in London in behaviour may be a reaction to patriarchal oppression we need to ensure
1990, although they requested no publicity (Kelly 1990i.', that our theory does not excuse adult women from responsibility for their
Womcn in society are the carers and protectors. To accept that some actions.

198 AII,Ilra!iclIl }olll'1la/ ojSocia/IJ,we,\" Vol. 30 No. 2 Ma~\' /995 Koonill: Breaking the Last Taboo 199
 To those who argue that because some women ahuse children sexually percentage of female abusers (ranging from 25 la 60 per cent), but in
wc should now consider gender to be irrelevant and ask, instead, 'Why do these cases the population studied was a clinical sample of imprisoned
people do it?', I offer Carol-Anne Hooper's (1989, p. 26) telling . sex offenders, incest offenders, serial rapists and male adolescents
response: 'Would anyone argue that because both men and women do attcnding a health centre (Hanks and Saradjian 1991).
housework, gender is irrelevant in either its distribution and meaning?'. There is a word of caution necessary in discussing sexual abusc by
But, this must not be used as an argument to avoid the evidence on sexual women. In examining any research, it is vital to consider language and
abuse by women. If we continue to do so, we are open to accusations by definitions clearly (Forbes 1992-93). Some studies include abuse by girls
survivors that we will not listen. We will silence children and leave the under the age of 18. Whilc this abuse is no less damaging for the victim,
ground vacant for anti-feminist theory and practice. It is possible to to call a child of scvcn or eight a perpetrator pre-supposes knowledge,
recognise that some women abuse sexually, without losing sight of the intent and comprehension beyond her years. Further, what constitutes
fact that the majority of sexual abusers are men. It is then feasible to abuse must be examined and some researchers extend definitions of abuse
explore that which is common and different between sexual abuse by men far beyond that presented in this article (Forbes 1992-93). One strategy
and women, and consider whether the understanding we have of male used to exaggerate the prevalence of abuse by women is to point out that
sexual abuse is relevant to women. they have access to children in their care and it is alleged that everyday
actions such as having the baby slcep in her bed, or touching the infant's
Current Evidence on Sexual Abuse by Women genitals while changing a nappy may be abusive (Crisp 1991; Groth
The information we have about women who sexually abuse is extremely 1Y79). Groth (1979, p. 192) concluded that sexual victimisation,of
limited. partly because of fewer numbers and partly because we do not children by women 'may not be as infrequent an event as might be
have the rich literature of survivors' accounts that exists in the case of supposed from the small number of identified cases' in spite of the fact
those abused by men. Published accounts of sexual abuse by women that he encountered only three women out of 253 adult offenders in his
include Sybil (Schreiber 1973), When You're Ready (Evert and Bijkerk professional work prior to 1979. These allegations are disputed by
19R7) and Ordillary Wonders (Green 1992). Finkelhor and Russell (1984). Russell (1986; 1984) further challenges the
Current statistic!'l indicate that sexual abuse by females is rarc. David notions that sexual abuse by women is under-reported because it may he
Finkclhof ami Dian<l Russcll (IYR4) estimate that five pCI' cent of abuse 01" perceived as less abusive than that perpetrated hy men; that women mask
girls and 20 per cent of abuse of boys is perpetrated by women. A section abusivc behaviour, that it may be unmeasured and unnoticed, less likely
of the 1990 repurt of the British National Society for the Prevention of to be reported, and that because males are more frequently the victims,
Cruelty to Children (NSPCC) stated clearly that their figures did not they are less likely to disclose.
support the 'tip of the iceberg' debate on women abusers. Russcll (1984) While it is essential to work with the most recent available research
examines a range of self-report studies which indicate that 27 per cent or and not' innate figures through dint of emotion or ideology, it must be
less of boys and tcn per cent or less of girls were sexually abused by a remembered that a couple of decades ago, abuse by mell was considered
woman. There are exceptions that reveal a higher incidence but in each rare. At lcast we have to be open to the possibility that sexual abuse by
case, the data are not generalisable (for example, studies of the childhood women may be more prevalent than we currently understand, and hence
experiences of incarcerated sex offenders) or the original data have been provide the opportunity for disclosure (Renvoize 1993). Is there any
lost and the validity of the analysis questioned (Russell 1984). Terry evidence to challenge current thinking on the prevalence of female sexual
Macdonald, Director of Child Protection Services at the Adelaide abusers?
Children's Hospital estimates that tcn per cent of the children they see It was courage8us women speaking out about their abuse as children
have becn sexually abused by a woman (Crisp 1991). Hanks and that first alerted us to the staggering incidence of sexual victimisation of
Saradjian (1991) report on seven studies which indicate a much higher children. Similarly, adult survivors of sexual abuse by women are coming

200 Au.\'(raliol/ }olll"llol o!Socia/ Ismes Vol. 30 No. 2 Ma)' /995 Koonin: Breakil/g the uul Taboo 201
 forward, saying that until now they have felt doubly silenced, After the "baby battering" and no one wanted to accept that mothers - gentle
Natiunal Conference on Female Sexual Abuse in London, the radio Madonna figures that they were - could possibly ever deliberately harm
program, 'This Morning' opcncd a hotlinc inviting callers to talk about their own children, so today there is the same reluctance to believe that
abuse by women. In une day, they received over 1,000 calls, 90 per cent mothers could scxually abuse their own offspring.... Now, many years
of whom stated they had never told anyone (Elliott 1993). In April 1993, on, it seems possible that [wc] ... may have to accept that perhaps as
a television program callcd 'Unspeakablc Acts', was screened by the much as 25% of sexual abuse is directly committed by women' (Renvoize
BBC. The Broadcasting Support Services Helpline received 160 calls by 1993, p. 115). It is essential in this debate not to make unsubstantiated
women abused as children by females immediately after the screening. c1ainls about incidence or prevalence and some evidence is contentious
National self-help groups for survivors of female abuse have been (Forbes 1992-93). What is vital is that our research and practice is
cstablished in America and thc Unitcd Kingdom. Closer to humc, a group conducted in such a way that we do not close off potential sources of
for women abused by females in childhood was established after the information.
Incest Confest held in Sydney in July 1992. None of this gives us
incidence or prevalcncc figures, but we are hearing from people who What Do We Know About Women Abusers?
were silcnt until now. ! Again, bccause of fewer numbers, knowledge about women abusers is
sketchy and frequently contradictory, so it is difficult to draw
Is there any direct evidence from children that the incidcnce of sexual !.,
abuse by women may be higher than we currently believe? ChildLine is a conclusions. Kathleen Faller published a study on 40 women, 14 per cent
• of abusers seen in one program during 1978-87. Her research revealed a
national helpline for children operating throughout the United Kingdom.
In the seven years since the organisation was establishcd, 300,000 written different pattern of offending than that found for men. Nearly three-
case records have been documented. There are 2,700 calls received daily quarters of the won1en abused alongside men (compared with 18.5 per
and it is estimated that 10,000 calls per day do not get through. Of these cent of men in this category). In 24 of the 29 cases, the children's report
calls, 15 per cent relate to reports of sexual abuse of which ten per cent of of the abuse suggested that the men had initiated the abuse, that the
children report a female as the abuser. In the period April I990-March children cxperienced'the female abuse as less intrusive and/or that the
1991, 8,663 children rang ChildLine about sexual abuse. Of these, nine women did not want to participate in the abuse. However, Faller cautions
pcr ccnt reported a woman as the perpetrator with boys more likely to bc us about accepting the leadership role of the male unquestioningly.
abused by womcn - onc pcr cent of girls, 12 per cent of boys (Harrison Children evidence more emotional distress in recounting instances when
1993). women abused them, and since over three-quarters of these women were
Christine Lawson is critical of the research into fcmale sexual abuse. the child's mother, it was possibly more threatening to admit that their
She asserts that the survey approach may be an unreliable method of primary nurturer was an abuser. Fifteen per cent of the women who
assessing repressed experiences, and that most of thc documented cases abused were single mothers who were defined as 'merged' with their
come from clinical literature. She argues, therefore, that prevalence children, relating to them as surrogate partners, and ten per cent defined
studies must be designed specifically to address the diversity of as psychotic (Faller 1987). Kelly (1991) questions whether these latter
behaviours surrounding the experience of this abuse (Lawson 1993). two categories are acceptable forms of explanation, since they have been
Finkelhor (1979) agrees that surveys which ask specific questions about rejected for men, Does pathologising women make them less responsible?
female abuse yield a higher prevalence rate than general questions. Faller includes adolescent abusers in her study which, I would argue,
Renvoize concludes that 'although most of the material presently requires separate analysis and discussion. Only one of the women who
available shows that comparatively few females are involved ,.. it seems abused was a non-custodial abuser. Thirty-four (85 per cent) of the
just as likely that the truth about female abuse may be very different. Just women were mothers to at least one of the children they abused while 55
as the late 19605 when Henry Kempe wrote about what was then called per cent abused only their own children. The 40 female perpetrators

202 Australian JOltrlwl (!( Soci(/I/Hue.~ Vol. 30 No. 2 May /995 Koollin: Breaking tlte Lt:ut Tahoo 203
 abused 63 victims, with twenty-four (60 per ccnt) victimised two or more actcd uut as teenagers). Women also tend to act out on themselves via
children (Faller 1987). self-punishment and self-destructive behaviour such as starving and
In their research into women abusers, Helga Hanks and Jacqui cutting themselves, prostitution and placing themselves in very dangerous
Saradjian (199\; 1992) identified a number of categories and situations (Matt hews 1993).
charactcristics of abuscrs. They may be womcn who initiate abuse with Knowledge about the responsiveness of women offenders to
thcir own children, women who abuse in conjunction with men, women intervention is also clouded. Reporting on a group work program with six
who abuse as part of a married couple, lesbian women, women who abusc women offenders imprisoned at Styal in the UK, Jane King (1989)
children with learning difficulties or disabilities, women who abuse concludes that the participants' responses varied from total denial to I
adolescents as well as women who participate in ritual abuse. Common to shame and regret, with commitment to changing their behaviour.
all these groups is the fact that alrnost all of them were abuscd as childrcn Matthews (1993) found that women tend to find it more difficult than
and other forms of maltrcatment, particularly emotional abuse, are men to forgive themselves, and take longer to move out of the shame and
prcscnt. Mothers who abuse children commonly see the child as an guilt. Women's anger towards themselves tends to be more deeply
extension of themselves. entrenchcd. They are quicker in developing empathy for their victims.
Matthews. Matthews and Speltz (1989. cited in Hanks and Saradjian
IYY I) found three distinct categories of women abusers in their research: Practice Implications
Teacher/lovers who arc usually involved with adolescent and/or pre- Understanding that women abuse sexually has practice implications at
pubescent boys. They want to teach them 'about sex. three levels: primary prevention, work with adult survivors and
Male coerced offenders who initially abuse in conjunction with a male intervention with children. Intervention with women offenders is a
hut may later abuse independently. This type of abuser is extremely separate topic which is outside the scope of this article. Feminists have
dependcnt and non-assertive. been at the forcfront in recognising the widespread prevalence of
Predisposed offenders who have been sexually abused themselves childhood sexual assault and forcing the issue onto the political agenda.
from a very young age. They initiate the abuse themselves and usually Education campaigns need to be maintained and extended. It is essential
abusc thcir own children. Their intention appears to be non- that the internationally acclaimed prevention campaigns in Australia, 'such
threatening cmotional intimacy. as No Excuses, Never, Ever in NSW; should continue. While the
Jane Kinder Matthcws and Ruth Mauhews developed a program for predominance of abuse by men needs to be clearly stated, it is important
working with female child sexual offenders and have analysed their work that public information includes the fact that sexual victimisation by
with 36 participants (Matthew, \993). In common with male offenders, women does occur. We have to use every available means to force
they come from chaotic, abusive backgrounds, feel they do not belong abusers to stop, to inform society of the harmful effects of abuse and to
with and have a low status among their peers. They are often friendless campaign for adequate resources. We need to reach all people to inform
and will do almost anything for acceptance. But there are differences. the community that sexual abuse by women exists. If women are being
Nonc of the women they worked with coerced others to offend. They use coerced by men to abuse, they need to feel it is safe to report this. Thus,
force or violence less frequently, and to a lesser degree than males, and womcn's health services and domestic violence services are uniquely
arc less likely to use threats to silence their victims. They found that placed 10 assist women and prevent abuse and to make explicit the nature
fewer women deny the abuse initially and are more willing to take of the abusers' 'past and present relationship with men' (Forbes \992-93
responsibility for their behaviour. In contradiction to this, Rina McCary, p.IIO). A bettcr understanding of post-natal dcpression and less idealised
working in Glasgow, finds that because of women's investment in the visions of motherhood will enable women to express doubts, fears and
nurturing/caring role, denial can be greater. Men generally start abusing negative views towards small children more easily. Some women
at an earlier age (only two of the 36 women with whom they worked experience sexual responses to infants while breast feeding, yct find they

204 AIIstraliall ./OIII"/wl oISociaf Issuc.\· Vol. ]0 No. 2 May 1995 KOOII;Il: Breaking the Liut Taboo 205
 arc unable to share this with anyone. Honest. non-judgemental yet themselves as objects of their mothers' sexual gratification.
uncompromising discussion of these feelings can help prevent those The research indicates that many children abused by women arc also
women experiencing difficulties with boundaries from translating feeling sexually abused by men. It is thus virtually impossible to differentiate the
into action. Service providers need accurate information about female impact of the abuse by women, and it seems logical to anticipate
sexual abuse, with input from survivors. At the same time, care must be interactive and cumulative effects of multiple abuse. However, in Sgroi
taken to ensure that this information is not misused to blame women, to and Sargent's (1993) study, all seven of the adult female clients reported
further the interests of homophobics or to distort the reality that the that sexual abuse by a close female relative was the most damaging and
majority of sexual abuse is perpetrated by men (Young 1993). shameful form of abuse they experienced, and the opportunity to express
What does acknowledging that females abuse sexually mean for· this needs to be encouraged. Russell (1986) counters this by arguing that
working with children and adult survivors of sexual abuse by women? some theorists who believe that the incidence of female perpetrators has
First, it is esscntial to remember that the key issues present in working been artificially kept down consider that female perpetrators are often
with sexual abuse by men - the feeling of total violation and betrayal of considered to be less abusive, and the child may indeed have found the
trust - are present in those abused by women. The central importance of experience pleasurable. The subjective experience of the abuse therefore
working to ensure the safety of the child, to regain trust. to enable the nceds to bc explored fully.
victim to break the silence, to be believed, to understand that the abuse For girls abused by women, the differentiation and definition of self
was not their fault, to grieve, mourn and express anger is unchanged. In becomes exceedingly complex. By powerfully communicating that there
working with adult or adolescent survivors, the issues or self-destructive is no separation, achieving autonomy is fraught with difficulty. Women
behaviours, developing self-esteem and personal power, expressing survivors report fears that they will become like their mothers, for
feclings, coming home to her/his body, intimacy, sex and sexuality and example dependent 011 men, abusive towards their children or unable to
parenting all need to be addressed. free themselves of their mother's domination, even when she had died.
What special features need to be considered when working with those This difficulty of separating has implications for the child's personal
scxually abused by women? Children who report abuse by women need development as an autonomous individual, a partner, a mother or
urgently to he believed. Sgroi and Sargent (1993) report that a history of potential mother. Some women avoid contact with women while others
sexual abuse by womell lends to be disclosed later in therapclltic spend lime in groups of womcn but avoid intimacy, either sexual or non-
relationships. They arguc th3t this may be because the victim waits until sexual. Questions about sexuality are evident and the literature suggests
sthc is feeling safer in the relationship and thus more confident of being evidence of homophobia in some women abused by women (Young
believcd. On the other hand, some clients do not remember earlier in the 1993).
process and Sgroi and Sargcnt propose that the failure of therapists to Practitioners working with children or adult survivors sexually abused
explorc the possibility of such a history could give an implicit message by women need to resolve their own anxieties about female sex abusers.
that such disclosure in unacceptable. Additional shame may be The abuser is often viewed as one-dimensional - a demonic monster or a
experienced because this type of abuse is ·unusual'. Clearly then, saint - by the victim and they need help to accept the abuser as a multi-
practitioners need to explore whether the client remembers childhood dimensional human being, with strengths and weaknesses, who
sexual contact from both m31es and fem~les. committed a serious offence, and who may be subject to a criminal
Disclosure and maintaining the reality of sexual abuse is difficult no charge. This is only possible if the worker is able to take this stance.
matter what the gender of the abuser. Sgroi and Sargent (1993) found that Group work with girls and women abused by women has particular
it was harder for survivors to hold onto the understanding that their implications. If the girl is the only one in the group sexually abused by a
mothers abused them because of the stereotype of the nurturing mother woman, she may feel even more isolated. Fear of disclosing a taboo topic
and the cognitive dissonance between this image and the reality of may make her even more unlikely to talk about her experience. If it is not

206 AII,\'(ra!iall Journal (!( Sociallssll(!.~ Vol. 30 No. 2 Ma.,>, 1995 Koonin: Breaki/lR the Lasl Taboo 207
 possible to form a group with more than onc girl sexually abused by a York: Free Press.
female, it may help to include someone physically abused by a woman. It Forbes, J. (1992-93) 'Female Sexual Abusers: The Contemporary Search
should be remembered too, that girls sexually abused by a woman may for Equivalence', Practice 6(2), 102-11.
also feel particularly threatened in an all women's group at first. Green, L. (1992) Ordinary Wonders, Toronto: Women's Press.
Groth, N. (1979) Men Who Rape, New York: Plenum.
The Way Forward Hanks, H. and 1. Saradjian (1991) 'Women Who Abuse Children
The purpose of this article is to urge all of those working with children Sexually: Characteristics of Sexual Abuse of Children by Women',
and adult survivors of sexual abuse to remember that women can and do Human Systems: The Journal of Systemic Consultation ami
sexually abuse. I know this is u challenging fact to confront. I am not Management 2, 247-62.
wanting to minimise the significance of gender in our understanding of Hanks, H. and J. Saradjian (1992) 'The Female Abuser', Commlmity
child sexual abuse, nor distort facts. I simply want us tu do all we can to Care 22(Junc), vii-viii.
prevent abuse and to allow those who are sexually abused to feel free 10 Harrison, H. (1993) 'Female Abusers: What Children and Young People
speak their truth, to be believed and helped to heal. Kathy Evert (Evert Have Told ChildLine'. In M. Elliott (ed), Female Sexual Abuse of
and Bijkerk 1987, p. 175) concluded her autobiography with the words: Childrell, Essex: Longman, 95-98.
I have, with careful help, Heath, V. (1992) 'Breaking the Last Taboo on Sex Abuse', Evelling
reclaimed my soul, Sentinel 14 April.
And my responsibility now Hooper, C. (1989) 'If Women Do It Too ... ', Community Care 16
Is to go on with my life. November, 26-27.
And our respunsibility together, you and I Kelly, L. (1988-89) 'From Politics to Pathology: The Medicalisation of
Is to help save as many others as we can along the way. the Impact of Rape and Child Sexual Abuse', Radical Community
Clearly, the opportunities for further research and best practice need to be Medicine Winter, 14-18.
grasped. Kelly, L. (1990) Records of Feminist Conference on Child Abuse,
unpublished papers, Child Abuse Studies Unit, University of North
References Lundun.
Bricrc. J.N. (1992) Child Ahuse Trauma: Theory and Treatment of the Kelly, L. (1991) 'Unspeakable Acts', Trouble and Strife 21 (Summer), 13-
Lasting Effects, California: Sage. 21.
Crisp, L. (1991) 'The Last Taboo: Nursery Crimes', The Bulletin 20 King, J. (1989) 'Female Abusers: A Reeipe for Change', Community
August, 78-82. Core 27 April, 24-26.
Elliolt, M. (1993) Female Sexual Abuse v/Children: 71w Ultimate Taboo, Lauranee, J. (1992) 'Sexual Abuse by Women: Child Victims Ignored',
Essex: Longman. The Times 1 April.
Evert, K. and I. Bijkerk (1987) When You're Ready, California: Launch Lawson, C. (1993) 'Mother-Son Sexual Abuse: Rare or Underreported? A
Press. Critique of the Research', Child Abuse and Neglect 17, 261-69.
Faller, K.C. (1987) 'Women Who Sexoally Abuse Children', Violence Marchant, C. (1992) 'The Unheard Victims of Sexual Abuse by Women',
(Ind Victims 2(4), 263-76. Social Work Today 9 April.
Finkclhor, D. (1979) Sexually Victimised Chi/drefl, New York: Free Matthews, J.K. (1993) 'Working With Female Sexual Aoosers'.ln M.
Press. Elliott (ed), Female Sexual Abuse of Children, Essex: Longrnan, 50-
Finkelhor, D. and D. Russell (1984) 'Women as Perpetrators'. In D. 60.
Finkclhor (cd), Child Sexual Abuse: New Theory and Research. New

20B AI/,l"Irafiall }ol/I"/Ia{ of Social IssIleJ' Vol. 30 No. 2 May 19')5 Knolli,,: Breaking the Lnsl Tabon 209
 Nelson, D. (1992) 'Evidence of Sex Abuse by Women Increases', The IMPOSED STRUCTURES AND CONTESTED
Independent I April.
Nelson, D. and E. Oxrord (1992) 'Barrier or Disbelier Conrronts Victims MEANINGS: POLICIES AND POLITICS OF
Who Seek Therapy', The Independent I April. PUBLIC PARTICIPATION
Nelson, S. (1992) 'Deadlier Than the Male?' The Guardian 2S March.
Renvoize, J. (1993) Innocence Destroyed: A Study of Child Sexual Abuse,
London: Routledge. Karel; Willis
Russell, D. (1986) The Secret Trauma: Incest in the Lives (J/Girls and
Women, New York: Basic Books.
Russcil, D. (1984) Sexuul Exploitation: Rape, Child Sexuul Abuse und 711 is article explores the concept of structured community participation inltealtll,
Workplace Harassment, California: Sage. which refers to f{roups that are established by health decisiOlHnakers to provide
Schreiber, F.R. (1973) Syhil, London: Penguin Books. a 'community' viewpoint of health issues and services. The imposed nature of this
Sgroi, S.M. and N.M. Sargent (1993) 'Impact and Treatment Issues for form ofparticipat;on is, however, potelltially problematic in that it may 110t
Victims or Sexual Abuse by Female Perpetrators'. In M. Elliolt (cd), ellsure tha( the cO/llmltllity's views are heard. Rather, stmcfllred commwlity
Pemale Sexual Abuse (~f Children, Essex: Longman. participatiol1 may entrench dominal1t iflferests. Drawing on ti,e expedellces of
Sharpe, R. (1992) 'When Mother Love Can Hurt', The Illdependelll on District lIealth Forwlls ill Tasmania, this article explores issues surrounding this
SlInday 29 March. form of participation and argues that the political context of participation must be
Young, V. (1993) 'Women Abusers: A Feminist View'. In M. Elliott fully understood ifit is to be effective. A recognition o/the differences between
(ed), Female Sexual Abuse a/Children, Essex: Longman. hureaucratic and community needs and interests is essential to the success of
structllred community parlicipation.

I t is widely accepted that community participation in health planning

and service delivery should result in services and policies that are more
appropriate and responsive to the users' needs. Moreover, service
planners and providers can learn by including users in planning,
development and evaluation. 'All health services have something to learn
from those who use them, and the greater the input from the source users,
the more appropriate the services provided are to the needs of the users'
(McCarthy cited in Cameron 1992, p. I).
Community participation has a diversity of forms, and varying levels
of effectiveness. One form of participation that has been implemented by
governments, in the context of the new public health, is what I have
termed 'structured community participation'. In exploring this notion, this
article questions whether t,his form of participation coincides with the
accepted definitions of participation. The experiences of District Health

Karen Willis lectures in Socioiogy and Poiitics 01 Health in the School of

Nursing at the University of Tasmania.

211
210 AIHfraliall JOllmal of Social hmes Vaf. 30 No. 2 May 1995