Sexuality & Culture, 4(2), 67-81 (2000)
Rind, Tromovitch, and Bauserman:
Politically Incorrect - Scientifically Correct
Thomas D. Oellerich
School of Social Work, Ohio University, 148 Morton Hall,
Athens, OH 45701 (firstname.lastname@example.org
The response to the Rind, Tromovitch, and Bauserman (1998) study was
surprising. But the response of the American Psychological Association (APA)
was, to say the least, startling and distressing. Rather than responding to the
outcry provoked by this study with a discussion of the right of and importance
for scientists to publish unpopular findings, the APA chose to distance itself
from the study. This distancing included the assertion that child sexual abuse
(CSA) causes serious harm and that "such activity should never be
considered harmless ..." (American Psychological Association, 1999;
emphasis in the original). Additionally, the statement ignored the
recommendation of Rind et al. to differentiate abusive sexual behavior from the
This paper addresses these two issues. First, it asserts that the idea that
adult/nonadult sexual behavior "should never be considered harmless"
is not based on the evidence. Second, it supports the importance of
differentiating abusive and nonabusive adult/nonadult sexual behavior both in
the research and practice arenas. Additionally, this paper explains why a
professional organization, such as the APA, would distance itself from the Rind,
Tromovitch, and Bauserman's report. Lastly, it makes recommendations with
respect to responding to the problem of adult/nonadult sexual behavior.
First, the blanket statement that the sexual abuse of children is harmful to
its victims is false. And its falsity has been attested to since the
"discovery of child sexual abuse." For example, in 1975, David Walters
identified as one of the major myths surrounding CSA was that it caused lasting
psychological harm. He asserted that what harm may be experienced by the child
was due to factors extrinsic to the sexual abuse itself:
Most of the psychological damage, if any, stems not from the abuse but from
the interpretation of the abuse and the handling of the situation by parents,
medical personnel, law enforcement and school officials, and social workers
Four years later, Finkelhor (1979) proposed an ethical justification for
prohibiting adult/child (defined as a prepubertal youngster) sexual behavior.
The reason for using an ethical justification was that the justification based
on psychological harm lacked cogency. According to Finkelhor, it was empirically
weak since "it is possible that a majority of these children are not
More recently, the Past President of the APA, Martin Seligman (1994), argued
that the case for CSA being a "special destroyer of adult mental
health" (p. 232) was far from proven. The existing research indicating
harm, according to him, "abandoned methodological niceties" (p.233).
These studies were characterized by sampling bias, lack of adequate control
groups, and a failure to consider alternative explanations for the findings. He
wrote: "Once the ideology is stripped away, we still remain ignorant about
whether sexual abuse in childhood wreaks damage in adult life and, if so, how
Of significance is the fact that the weight of the evidence, when objectively
considered, has supported the notion that CSA is neither necessarily nor
typically harmful. For example, Constantine (1981) reviewed 30 studies. He found
20 report at least some subjects without ill effects; 13 of those conclude
that, for the majority of subjects, there is essentially no harm; and
six even identify some subjects for whom, by self-evaluation or other
criteria, the childhood sexual encounter was a positive or possibly beneficial
experience (p. 224).
In his review of 25 studies, Conte (1985), taking issue with Constantine's
using the research "to make a case for 'legitimate instances of child-adult
sex,'" concluded that "a review of the literature describing the
effects of sexual abuse on children leads irrefutably to the ambiguous
conclusion that sexual abuse appears to affect some victims and not others"
Similarly, Browne and Finkelhor (1986) reviewed 28 studies. They found that
among adults who had experienced CSA less than 20 percent evidenced serious
psychopathology. They noted with concern the efforts of child advocates to
exaggerate the harmful effects for political purposes because of its potential
to harm the victims and their families:
advocates [should] not exaggerate or overstate the intensity or
inevitability of [negative] consequences [because] victims and their families
[...] may be further victimized by exaggerated claims about the effects of
sexual abuse (p. 178).
Kendall-Tackett, Williams, and Finkelhor (1993) reviewed 45 studies. They
found that up to 49 percent of the sexually abused children suffered no
psychological harm. They concluded that a lack of symptoms could not be used to
rule out sexual abuse since "there are too many sexually abused children
who are apparently asymptomatic" (p. 175). Further, among the children who
were symptomatic, symptom abatement occurred for most within two years with or
without treatment. These authors also found that when sexually abused children
in treatment were compared with nonabused children in treatment, the sexually
abused were less symptomatic than their nonabused clinical counterparts (p.
In 1997, Rind and Tromovitch conducted a meta-analytic review of seven
studies on the effects of child sexual abuse. Unlike prior reviews which were
based primarily on clinical samples, this review involved studies that used
national probability samples: four were from the United States, and one each,
from Great Britain, Canada, and Spain. The findings indicated that child sexual
abuse "is not associated with pervasive harm and that harm, when it occurs,
is not typically intense" (p. 237). The findings of Rind, Tromovitch, and
Bauserman, which caused the recent maelstrom, simply confirmed this earlier
Moreover, it has not been demonstrated that CSA has any influence upon the
adult personality. For example, Beitchman, Zucker, Hood, DaCosta, Akman, and
Cassavia (1992) reviewed 32 studies. They concluded that the evidence suggested
that CSA has serious long-term effects, but that it was not clear to what extent
these effects were due to CSA per se (p. 115). Levitt and Pinnell
(1995) concluded, based on their review of the literature, that "the
traditionally accepted link between childhood sexual abuse as an isolated cause
and psychopathology in adulthood lacks empirical verification" (p.151). The
Rind, Tromovitch, and Bauserman study(1998) indicated that CSA is non-causative.
They reported that CSA-adjustment relations became nonsignificant when family
environment was controlled for. Indeed, the evidence tends to confirm Seligman's
earlier conclusion that
the case for childhood trauma - in anything but its most brutal form -
influencing adult personality is in the minds of the inner-child advocates. It
is not to be found in the data (p. 235).
Thus, contrary to the APA's assertion that CSA should never be considered
harmless, quite the opposite is the case. That is, the empirical evidence gives
no reason to consider CSA as necessarily or even usually harmful.
Second, based on their findings, Rind, Tromovitch, and Bauserman made the
important recommendation that the scientific community use more neutral terms to
study the phenomena of adult-child and adult-adolescent sexual behavior. In
their view, abusive sexual behavior would be reserved to situations involving an
unwanted sexual encounter with negative reactions. Those situations involving a
willing encounter with positive reactions would be labeled simply adult-child
sex or adult-adolescent sex (p. 46). One might wish to further refine
this recommendation (e.g., abuse should be defined when the child/adolescent is
unwilling regardless of whether their action was negative or not).
Nevertheless, their recommendation was designed to move the scientific
community beyond the victimological paradigm that has dominated the study of and
response to CSA thus far. In this paradigm, the child or adolescent is viewed as
a passive "victim" (Feierman, 1990). This is based on the conviction
that the child or adolescent is incapable of experiencing sexual desire or
initiating sexual contact. According to Okami (1990), this conviction
"attributes participation in peer sexual behavior to 'curiosity' and
participation in adult/nonadult sexual behavior to 'coercion'" (p. 93).
Even behavior that is self-reported as positive by the child or adolescent is
defined by the victimologists as abusive. According to Okami (1990), the
victimological paradigm reflects a Victorian idealization of children as sexless
innocents. This is politically correct, but is both historically incorrect (Bullough,
1990) and scientifically incorrect (Ceci, & Bruck, 1995; Friedrich, Grambsch,
Broughton, Kuiper, & Beilke, 1991; Friedrich, Fisher, Broughton, Houston,
& Shafran, 1998; Lamb, & Coakley, 1993).
The victimological paradigm has been responsible for much of the biased and
polemical research that, as Seligman noted, has characterized this area of study
(Okami, 1990). An alternative paradigm is needed; one which, as recommended by
Crittenden (1996) in the handbook on child maltreatment of the American
Professional Society on the Abuse of Children, considers this behavior
"more as a common variant of human behavior than as abnormal
behavior"(p. 166). Perceiving adult/non-adult sexual behavior in this
manner would increase the likelihood of an unbiased approach to the study of
adult/non-adult sexual behavior. It also would permit, as Crittenden points out,
the application of what is known about normal sexual behavior to cases of what
is now referred to as CSA. This is hardly possible if the scientific community
insists on referring to all adult-child and adult-adolescent sexual
behavior as abusive.
To recognize the distinction between abusive and non-abusive does not
preclude identifying the interaction as immoral and/or illegal. Conte (1985)
pointed out that decisions concerning the appropriateness of adult/nonadult
sexual interactions involve ethical, legal, and religious principles. By way of
example, robbery is unlawful not because it results in psychological harm but
because society has decided that people have a right to their own property. Put
another way, the question of the effects of child sexual abuse should not be
confused with the moral and/or legal issue of dealing with this behavior. As
argued earlier by Kilpatrick (1992), at the very least, in professional and
scientific discussions, if not in moral and legal ones, abuse is something to be
established as a conclusion rather than simply being accepted as a premise.
Why, then, might many in the scientific and professional community take the
position that CSA is harmful and ignore the suggestion for the use of more
neutral terminology in the study of CSA? Part of the answer, I believe, is the
effort to avoid being vilified by the victimologists. Their attacks on anyone
who seeks to bring a measure of rationality and objectivity to this problem is
well known (Okami, 1990; Neimark, 1996). Consequently, anyone who calls for
rationality and objectivity with respect to CSA will typically preface their
remarks along the line taken by Seligman (1994): "So this preface: I
believe sexual abuse is evil. It should be condemned and punished" (p.
But there is an additional reason - money. As noted by Dineen (1999), the
psychology industry (which she defined broadly to include psychologists,
psychiatrists, psychoanalysts, clinical social workers and psychotherapists)
needs victims to justify the expansion of its domain and, thus, it
"manufactures victims." A similar point was made earlier by Tavris
(1993) with respect to the incest-survivor recovery movement. CSA is a problem
widely exploited by professionals according to Costin, Karger, and Stoesz
the rediscovery of child abuse by the middle class has also led to the
growth of a child abuse industry composed of opportunistic psychotherapists
and aggressive attorneys who have prospered from child sexual abuse,
exploiting adults who have evidence of having been abused and encouraging
memory recall from those who haven't. ... Clearly, the psychological paradigm
of child abuse has been a godsend ... for mental health professionals looking
for new diseases. Unfortunately, one of the casualties of this new industry
has been adult victims, who risk being victimized yet again, this time by a
child abuse industry seeking out new forms of economic growth. ...
... Ironically, a public that is sympathetic to the plight of abused and
neglected children fails to understand that it foots much of the bill for an
out-of-control and demand-driven legal and psychotherapy industry.... (p. 7)
According to Dineen, Tavris, and Costin et al., then, child sexual abuse has
become an arena of opportunism for and exploitation by some in the mental health
industry. And it is a quite lucrative arena. For example, according to Nathan
and Snedeker (1995),
In 1983, [the National Center for Child Abuse and Neglect] had only $1.8
million to spend on all types of abuse research and demonstration projects (of
that, only $237,000 went to sex-abuse studies). Following the McMartin scandal
the next year, NCCAN's budget more than quadrupled, and included $146,000 to
Kee MacFarlane to interview and examine more McMartin children. (In addition,
CII [Children's Institute International], MacFarlane's agency, received
$350,000 in 1985 from California funds, making the institute that state's
first publicly funded training center for child-abuse diagnosis and treatment)
Further, in most settings, children who have been sexually abused are
routinely offered treatment even if asymptomatic (Beutler, Williams, and Zetzer,
1994). Finklehor and Berliner(1995) estimated that among substantiated cases of
child sexual abuse, from 44 percent to 73 percent receive psychotherapy. A
recent report of the National Institute of Justice (Miller, Cohen,& Wiersema,
1996), indicated that victims of child sexual abuse were much more likely than
victims of other crimes to receive mental health care. These data showed that up
to 50% and more of CSA victims received mental health care as compared with no
more than 4% of victims of other crimes. And the average cost of mental health
services for the typical victim of child sexual abuse was nearly sixty times
greater than that for the victim of another crime ($5,800 vs. less than $100).
There is also the cost associated with the derivative of CSA, viz., repressed
memory therapy. For example, in Washington state's Crime Victims Compensation
Program, the average cost associated with treating adults whose claims were
based on repressed memory of childhood sexual abuse was approximately four times
the average claim in other mental health claims (Loftus, 1997; Parr, 1996). The
average cost of non-repressed memory claims was less than $3,000, while that of
the repressed memory claims was more than $12,000, with one claim exceeding
$50,000. In just over four years, the citizens of Washington paid out over 2.5
million dollars for 325 repressed memory claims. The primary diagnosis in most
of these claims was Multiple Personality Disorder (MPD). It was not unusual for
the claimant to have dozens or even hundreds of personalities - one claim
involved over 700 alter states and another over 3000. All thirty were still in
therapy three years after their first memory surfaced, and sixty percent (18)
were still in therapy five years after their first memory surfaced. As noted by
Piper (1994), treatment for MPD entails long and costly therapy. It is not,
according to him, cost-effective. Repressed memory therapy offers the perfect
example for what Campbell (1994) referred to as therapists operating
"rent-a-friend" agencies with long-term leases (p. 20). These well
serve the therapists' interests but not those of their clients.
This suggests the question: what do the consumers and public at-large get in
return for their money. With respect to the treatment of children and
adolescents who have been involved in adult/nonadult sexual behavior, they get
little or nothing. Finkelhor and Berliner (1995) reviewed 29 studies concerned
with the effectiveness of treating sexually abused children. Of the 29 studies,
17 used a pre-post design. While nearly all reported positive improvement, it
cannot be said that the improvement was due to the treatment. As Finkelhor and
Berliner note, longitudinal studies have shown that sexually abused children
improve over time with or without treatment (p. 1409). Three of the 7
experimental design studies compared treatment and no-treatment groups. These
found significant effects of treatment, but the reviewers commented that their
"relatively small-scale designs ... detract from their scientific
weight" (p. 1414). Among the quasi-experimental studies which had
equivalent groups (3 of the 5 reviewed) there was no advantage for children
receiving therapy compared with children not receiving therapy. While these
reviewers took an optimistic posture with respect to the outcome of therapeutic
intervention, they noted that current research is methodologically flawed and
concluded that the effectiveness of sexual abuse treatment has yet to be proven
However, the weight of the evidence in this review parallels those found in
naturalistic studies on the effectiveness of child and adolescent psychotherapy,
namely that they have little or no effect (U.S. Department of Health and Human
Services, 1999; Weisz, Weiss, & Donenberg,1992; Weisz, Weiss, Han, Granger,
& Morton, 1995). These findings are reinforced by evidence from studies on
continuum of care programs for children and adolescents. One of the more
ambitious of these was the Fort Bragg Project (Bickman, 1996). The U.S. Army
spent 80 million dollars to demonstrate that "a continuum of mental health
and substance abuse services for children and adolescents was more
cost-effective than services delivered in the more typical fragmented
system" (p. 689). The project offered in- and out-patient services to more
than 42,000 child and adolescent dependents of military personnel in the Fort
Bragg (North Carolina) area for more than five years from June 1990 to September
1995. It was considered a model program by the American Psychological
Association's section on Child Clinical Psychology and the Division of Child,
Youth and Family Services Joint Task Force.
The study showed that the program produced better access to treatment, higher
levels of client satisfaction, and fewer restrictions on treatment. The cost,
however, was higher and the clinical outcomes were no better than those at the
comparison site. The findings led Bickman "to question the assumption that
clinical services provided in the community are effective" (p. 699).
But if it is not effective, can therapy for CSA be harmful? According to
Seligman (1994), the answer to this question is: yes. He cautioned against
therapy for the sexually abused and noted, for example, that it is often
asserted that the sexually abused need to relive the experience and experience a
catharsis in order to improve. Despite the fact that catharsis has a long
history as a therapeutic technique, there is no evidence that it works (Bushman,
Baumeister, & Stack,1999; Seligman, 1994). On the contrary, as Seligman
suggested, reliving the event may be harmful since it heightens the event in the
child's mind and interferes with the natural healing process (pp. 234-235).
In the area of treating adults with repressed memory therapy, this also may
be harmful (Stocks, 1998). A study of the state of Washington's Crime Victims
Compensation Program is suggestive, though not probative, of the harm that can
occur in therapy for repressed memories of sexual abuse (Loftus, 1997; Parr,
1996). Between 1991 and 1995, in the state of Washington, 325 repressed memory
therapy claims were awarded victim compensation. Loni Parr, a nurse consultant,
and staff employees reviewed 183 of these claims. They randomly selected 30 from
these in order to gain a preliminary profile of the cases. Their findings are
Overall, the status of these claimants deteriorated during treatment. Before
recovering memories, three (10%) had attempted or thought of suicide; after
recovering memories, 20 (67%) were suicidal. Before memories, only 2 (7%) had
been hospitalized; after, 11 (37%) had been. Before the emergence of memories,
only one woman (3%) had engaged in self-mutilation; after, 8 (27%) had mutilated
themselves (Loftus, 1997).
Further, before entering therapy, twenty-five (83%) of the patients had a
job; after three years of therapy, only 3 (10%) were still employed.
Twenty-eight (93%) were married when they entered therapy; within five years, 18
of the 28 (64%) were divorced or separated. Twenty-one of the patients had minor
children and one-third (7) lost custody of their children during therapy. All
were estranged from their extended families (Loftus, 1997; Parr, 1996).
These patients were in therapy longer than other mental health patients, and
evidenced a high rate of mental and emotional problems, all of which arose and
worsened during therapy. In fact, the longer the patients were in therapy the
more disabled they became. The primary diagnosis in these cases was Multiple
Personality Disorder, and it was not unusual for claimants to have dozens or
even hundreds of personalities; one person had over 3000! The findings of this
study buttress the conclusion of Ofshe and Watters (1994):
Examining the fad diagnosis of MPD, the cruelty of recovered memory therapy
becomes particularly clear. Thousands of clients have learned to display the
often-debilitating symptoms of a disorder that they never had. They become
less capable of living normal lives, more dependent on therapy, and inevitably
more troubled (p. 223).
Rather than distancing itself from the Rind, Tromovitch, and Bauserman study,
the APA as well as the scientific and practice communities could have used the
1. Educate the community about the myths surrounding the problem of CSA. This
includes laying to rest the myth that because a sexual activity violates a moral
and/or a legal code that it is thereby necessarily or even usually
psychologically harmful. In other words, it is time, as suggested by Rind and
Tromovitch (1997), to stop equating wrongfulness with harmfulness in sexual
The perpetuation of this myth is unethical and has possible iatrogenic
effects, as noted sometime ago by Schultz (1980). He wrote:
We seem to arbitrarily create "norms" for minors and then justify
departures from them as traumatic. Such fabrication is professionally
unethical and possibly damaging to minors involved in sexual behaviors with
others. What inappropriate trauma ideology does is to pit the professional
(true believer) against the child or the parents who may feel differently. The
risk is that a type of self-fulfilling prophecy emerges that manages to
produce the problem it claims to abhor, but which it, in fact, must have in
order to sustain the ideology it is based upon (p. 40).
An example of this "pitting" of the professional against the child
was provided by Germaine Greer in 1975. She wrote of the experience of one of
her school friends:
From the child's point of view and from the commonsense point of view,
there is an enormous difference between intercourse with a willing little girl
and the forcible penetration of the small vagina of a terrified child. One
woman I know enjoyed sex with her uncle all through her childhood, and never
realized that anything was unusual until she went away to school. What
disturbed her then was not what her uncle had done but the attitude of her
teachers and the school psychiatrist. They assumed that she must have been
traumatized and disgusted and therefore in need of very special help. In order
to capitulate to their expectation, she began to fake symptoms she did not
feel, until at length she began to feel truly guilty for not having felt
guilty. She ended up judging herself quite harshly for this innate lechery
(cited in Schultz, 1980, p. 39).
2. Undertake research in the area of adult/nonadult sexual behavior that is
shorn of the ideological bias that has contaminated much of the research in this
area. A beginning move in this direction necessitates limiting the label
"child sexual abuse" in the scientific literature to those instances
where the sexual behavior is abusive. Abusive sexual activity can be defined as
an unwanted sexual experience that may involve coercion, threat, and/or
3. Stop automatically referring the sexually abused for therapy. CSA is not
a psychiatric disorder or a syndrome (Finkelhor, & Berliner, 1995).
Rather it is an event or series of events in a person's life. Treatment is
indicated only when there is a currently demonstrable harm. To treat the
asymptomatic child/adolescent is comparable to a physician treating
child/adolescent for bicycle accidents. Many who have a bicycle accident do not
require treatment. When they do need treatment, it is for the clinical condition
rather than the event responsible for that condition. In other words, the
asymptomatic child or adolescent should not be treated.
However, even when there is demonstrable harm, treatment should be
recommended only with caution since it may, as pointed out by Seligman, only
worsen the harm by interfering with the natural healing process. According to
Seligman, the overreaction of parents and police, and early therapeutic
intervention to undo "denial," and later therapeutic intervention to
recover the "repressed" memory and then reliving the experience may do
more harm than good. Thus, he recommended to parents whose child has been abused
or who were themselves abused that they "turn the volume down as soon as
possible" (p. 235).
The excessive and unnecessary provision of CSA treatment also takes resources
from other victims and other victim needs (Costin et al., 1996). Lastly, and
most importantly, it also makes the accurate evaluation of treatment
effectiveness impossible since the treatment pool is contaminated by including
those who do not need treatment in the first place.
4. Advise prospective clients of the risks of serious side-effects associated
with therapy. They have the right to know the probabilities of a successful
outcome versus a non-successful outcome, i.e., of getting worse and of not
improving. Prospective clients have a right to know whether the treatment they
are to be exposed to is empirically validated, is still experimental or has been
discredited by sound research. With this information, prospective clients can
make an informed decision as to whether or not to subject themselves or their
children to the risks associated with therapy.
The Rind, Tromovitch, and Bauserman study of the impact of CSA among college
students is politically incorrect but scientifically correct. It has a number of
important implications for the research and practice communities. Among the more
important is the need to stop exaggerating the negative impact of adult/nonadult
sexual behavior, as suggested earlier by both Browne and Finkelhor, and
Seligman. Another important implication is for conducting research that does not
approach the issue of adult/nonadult sexual behavior with a political ideology
as often has been the case thus far. And finally it is time to stop the common
practices of 1)assuming that CSA causes psychological harm, and 2) routinely
recommending psychotherapeutic intervention.
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