The medical implications of Cleveland

SUMMARY. This article sets the ‘discovery’ of child sexual abuse in context and reviews the key issues for doctors now that the Inquiry Report has been published. In particular the author focuses on the controversy over diagnosis and ‘screening’ Not only is there a need for clarity on these issues, but also a need to restore basic trust between doctors, parents and children. She also urges development of multi-disciplinary training and working and explores the proposed ‘special assessment teams’, hut concludes that resources will he a major constraint     

A Glimpse of the Truth: Evaluating ‘Debate’ and ‘Role Play’ as Pedagogical Tools for Learning about Sexuality Issues on a Law and Ethics Module

Social work education is familiar with concepts such as social exclusion, marginalisation, anti-discriminatory and anti-oppressive practice. This familiarisation implies that students are adequately prepared to embrace equality and diversity, become ‘culturally competent’ and subscribe to moral and ethical standards including the rights of service users to respect and support regardless of sexual orientation. The ability of social work students to articulate and develop their own theories for practice and to handle personal issues when these conflict with ‘theories’ on equality and diversity are important aspects of learning. Educators teaching about sexual orientation issues however currently have fewer texts or support networks to draw on when addressing these. This paper looks at the effectiveness of ‘debate’ and ‘role play’ as pedagogical strategies and tools when teaching complex ethical issues on a law and ethics module. Dramatic and creative participative methods were used through the tools of debate and role play. These were used with students to explore a specific topic around gay adoption in the context of learning about anti-discriminatory law. The paper seeks to evaluate the outcomes of this approach by drawing on the students' post learning reflection.     

Fundamentals of Theory and Practice Revisited: Sex Therapy: Historical Evolution,Current Practice. Part 2

This is the second of a two‐part series on the treatment of sexual difficulties. It presents a systemic approach to sex therapy and uses illustrative case histories to explore: the interrelationship between the presenting person or couple; the ‘sexual’ as part of the relationship; the symptom; the medical considerations; the cultural context; and the framework and thinking of the therapist.     

Assessment and intervention in cases of suspected ritual child sexual abuse

Agency workers have been heavily criticized over their handling of alleged ritual child sexual abuse cases, particularly in respect of their assessments and interventions. However, a study of referrals to police and social service departments revealed that agency workers raised suspicions of ritual abuse in respect of both child ‘victims’ and adult ‘survivors’ very rarely. Furthermore, they did this only after an assessment which showed the cases to possess a number of ‘troubling’ features. While agency workers believed that all the child ‘victims’ had been subject to serious sexual abuse, virtually all of them were circumspect as to whether this had occurred in a ‘ritual’ context. Initially, agency workers were generally open-minded as to the experiences of adult ‘survivors’, but by the end of their assessments, they tended to be more concerned about their mental health and less concerned about issues of ritual abuse. Finally, agency workers appeared to act appropriately in terms of the types of intervention they used and the way in which they applied these. These results suggest that there should be more confidence in the ability of agency workers to respond to cases of alleged ritual abuse. Copyright © 2001 John Wiley & Sons, Ltd.     

Work,Bodies and Boundaries: Talking Sexual Harassment in the New Economy

This article examines sexual harassment in the context of the new economy and highlights the manner in which the changing nature of work — and in particular the acknowledged rise of sexualized ‘body work’ — troubles conventional understandings of what constitutes sexual harassment in the workplace and the means to address it. Using data from a small‐scale qualitative study of service workers and professional employees, we explore the ways in which those definitions of sexual harassment now fail to match participants' accounts of their working lives. We examine sexual harassment in the context of the rise of service roles that require forms of increasingly sexualized ‘body work’ from employees, increased demands for workers to ‘self‐manage’, and new flexible modes of employment that blur the boundaries between being ‘on’ and ‘off’ the job. We conclude that these ‘new’ modes of work may provide the conditions for the revival of ‘old’ stories which limit the capacity of individuals to recognize and label behaviours as ‘sexual harassment’.     

‘Becoming’ a possible threat: masculinity,culture and questioning among unaccompanied young men in Sweden

A debate on masculinity and immigration rose across Europe in 2015 after an incident with sexual harassments taking place in Cologne, Germany. The incident refuelled a debate positioning unaccompanied young men as a possible threat. This article is based on a research project where we during this time ethnographically followed 20 young men, having arrived in Sweden as ‘unaccompanied’ minors. The aim is to examine how the young men themselves talk about, reflect on and negotiate masculinity and gender during this period. The article concludes that masculinity cannot be approached as something stable easily being inherited or transferred from one’s origins. One difference for ‘unaccompanied’ young men is how conflicts or tensions emerging in relation to issues of gender and masculinity tend to be interpreted differently, and publicly, putting the young men in a ‘gendered situation of questioning’.     

Comprehensive neighbourhood mapping: developing a powerful tool for child protection

This paper proposes ‘comprehensive neighbourhood mapping’ as a schema for gathering and interpreting information within a given geographical area which is informed by imaginative thinking about the safety of children and young people from sexual crime. It would build upon current forms of profiling by local authorities, health authorities and central Government. CNM would actively involve local people, in partnership with agencies, in ‘mapping’ danger points and support points. Eight components are discussed, including environmental issues, locations of sex offenders, sites where teenagers meet and share information, supportive individuals and organizations. Some issues for pilot projects are discussed, including the need to set up planning and implementation groups and to integrate CNM into wider child protection and community safety strategies. CNM is grounded in an ecological perspective which sees partnership approaches as essential and believes an overarching view of neighbourhood needs, based on detailed local information and understanding of how different forms of harm interconnect, is crucial in developing child protection strategies. At times of acute official anxiety about community ‘lynch‐mob’ reactions to known paedophiles, CNM aims to build communities which instead are informed and thoughtful about child protection. Copyright © 2002 John Wiley & Sons, Ltd.     

‘I myself had a sweetie …’: re‐thinking female same‐sex intimacy beyond the institution of marriage and identity politics

This article is understood as an intervention into current debates around the question of rights in relation to sexuality and in particular to issues of same‐sex marriages and alternative family structures. As the interpretation of rights in relation to sexuality generally focuses on gay identities, this article reflects on the effects of these discourses on non‐normative modes of sexuality and intimacy. More specifically the article focuses on interviews conducted in Johannesburg on ‘mummy–baby’ relationships. By contextualising these relationships in the historical and cultural framework of sexual cultures and cultures of intimacy, this article argues that the South African history and cultures provided and provide a space which accommodates forms of female same‐sex intimacy that are not necessarily linked to metropolitan sexual cultures. The article discusses the tensions between non‐lesbian same‐sex intimacy and metropolitan lesbianism by focusing on homosociality as a gender theory. The article questions the regulatory functions of identity and problematises the practice of ‘coming out’ as always being a liberating moment.     

From spoils to weapons: framing wartime sexual violence

The way an issue is ‘framed’ (viewed and understood) has a profound effect on whether it is viewed as a priority for action by international organisations, states, and civil society. Wartime sexual violence used to be framed as a ‘women's issue’, but since the issue gained widespread notoriety in the mid-1990s, it has shifted to being understood as a ‘security issue’. Activists and campaigners have used this as an opportunity to press for more attention at international and national levels, and policymakers have given higher priority to the issue of ending wartime sexual violence. Yet framing wartime sexual violence in terms of security – and in particular, a focus on ‘rape as a weapon’ – comes at a cost. First, it isolates this violence conceptually from the wider context of gender-based violence before, during, and after active armed conflict, and other types of violence may receive little attention. In addition, the specific emphasis on ‘rape as a weapon’ affects the types of wartime sexual violence recognised and condemned by the international community, the kinds of ‘victims’ granted assistance, and the extent to which women and men are perceived as victims, empowered agents, or perpetrators.     

Researching Sexual Revictimisation: Associated Ethical and Methodological Issues,and Possible Solutions

This paper has been inspired by the processes of preparing for ethical scrutiny and seeking ethical approval for a series of studies examining causal mechanisms that might facilitate sexual revictimisation. The focus here is on just four of the issues that arose in the context of the first study: a web‐based survey. One of the aims of the survey is to test whether victims of child sexual abuse who experienced a period of psychogenic or dissociative amnesia demonstrate an exaggerated risk for adolescent/adult sexual assault during this amnesic phase. That is, cases where survivors report ‘suddenly remembering’ in adulthood that they were abused as children, but state that prior to this ‘remembering’ they had no prior knowledge of their abuse. The study design is considered to be the first ethical issue. To enhance the methodological robustness a strategy has been employed to reduce the erroneous inclusion of currently amnesic participants in the non‐abused comparison group. Secondly, consideration is given to the likely harms and benefits that might be incurred or bestowed upon the participants. Thirdly, problems of both re‐traumatisation and vicarious traumatisation in relation to the researcher are contemplated and juxtaposed against the possibility of the facilitation of post‐traumatic growth and a personal shift towards wisdom and generativity. Finally, the survey title was originally criticised as negating ‘fully’ informed consent and a defence is therefore offered that ultimately gained ethical approval. It is hoped that these deliberations and insights may prove useful to others in planning their own research and ethics proposals.     

Criminality and violence in intra‐ and extra‐familial child sex abusers in a 2‐year cohort of convicted perpetrators

Men convicted of sexual abuse against children are an important but understudied population. In this study, based upon lifetime police records, of the criminality of convicted child sex abusers, we undertake the first British comparative analysis of the criminality of intra‐ and extra‐familial abusers. In a cohort of 374 convicted male child sex abusers, 50% had convictions for ‘sex only’ crimes; 26% for ‘sex and other’ offences; and 24% for ‘sex, other and violent’ crimes. There were three ‘relationship‐to‐victim’ subgroups: ‘biological relatives’, consisting of fathers and other biological relatives (18%); ‘non‐biological relatives’ — cohabitees or stepfathers (10%); and 72% who were ‘extra‐familial’ offenders, having no family relationship to the child. This atypical pattern of abusers indicates a filtering process, in which intra‐familial abusers are less likely to be prosecuted than extra‐familial offenders. The main findings were: (i) biological relatives were more often ‘sex only’ offenders, but averaged more sexual offences than the other groups; (ii) non‐biological abusers has more ‘other’ criminal and convictions for violence, and were more similar to the extra‐familial offenders than biologically related abusers; (iii) extra‐familial abusers consisted of more ‘other’ criminal and violent offenders than the non‐biological abusers; (iv) non‐biological offenders, however, had a pattern of criminality more like the extra‐familial group than the other intra‐familial abusers. The violent men, often with long histories of both sexual and non‐sexual offending, pose particular problems for the criminal justice and child protection services. Copyright © 2000 John Wiley & Sons, Ltd.     

A Fit Person to Run a Home: Registered Homes Tribunal Interpretations of the ‘Fit Person’ Concept in the United Kingdom

ABSTRACT

The abuse of people living in residential care in the UK is well documented. A further wealth of information is available in the form of anecdotal accounts of those who have been employed in this sector but who, in a climate which is still somewhat hostile to ‘whistle blowers,’ are not prepared to formally report their concerns. A small but significant amount of hard evidence of abuse exists in the reports of the Registered Homes Tribunal decisions. This body has the jurisdiction to hear appeals concerning the running of registered and nursing homes in the UK. The circumstances portrayed range from issues of ‘bad practice’ to abuse which may be physical, psychological, or sexual, perpetrated by staff, home owners, residents, or visitors. Many of the cases which concern the tribunal focus on whether a given individual is a ‘fit person’ to run a home. It is the aim of this article to consider and reflect on the tribunals’ interpretation of that term, in relation to the operation and decisions of the tribunal.     

Family Constellation — A Therapy Beyond Words

Family Constellation, a psychotherapeutic approach associated with the name Bert Hellinger, has become a popular yet also controversial form of systemic therapy in the German‐speaking therapy community. ‘Family Constellation’ (Familienstellen) means the individual client's physical‐emotional positioning and re‐positioning of substitute family members in relation to each other, with help of a therapeutic group. Family Constellation is a one‐session approach that addresses family‐of‐origin issues. The therapeutic process is highly experiential, utilising multiple sensory modalities. Hellinger locates his model within phenomenology, and his practice has roots in several therapy schools. His model offers complementary therapeutic techniques in our ‘languaged’ world of family therapy.     

Housing and transport: access issues for disabled international students in British universities

This article explores two disabled people’s ‘Seven Needs’ to independent living, those of ‘housing’ and ‘transport’ issues, in relation to disabled international students in British universities. Firstly, students’ living arrangements, including issues related to the suitability of university accommodation to their disability-related needs, have been identified. Secondly, the choice and accessibility of transport used is examined. A range of barriers that this group of students encounter based on their double or multiple identities as ‘disabled’, ‘international’ and sometimes ‘mature’ or ‘postgraduate’ students has thus been identified and discussed. The article highlights the barriers that are reinforced and exacerbated by the interplay of students’ different identities, proposing ways of removing these difficulties.     

Exploiting the Fifty Shades of Grey craze for the disability and sexual rights agenda

This paper does not present a literary critique of Fifty Shades of Grey, nor does it aim to take sides in the fierce disputes about the ‘rights’ and ‘wrongs’ of the storyline. Instead, it examines these debates with curiosity. It becomes apparent that the popular trilogy by E.L. James has encouraged more open discussions about sex and sexuality amongst groups who, until recently, have taken a backseat. The significance and usefulness of drawing on these debates is highlighted. For instance, a revived openness towards sexual issues could be an advantage for disabled people seeking support with creating spaces and opportunities for intimacy. At the same time, there is a risk that ‘kinkphobia’ could inform some adult protection interventions. This paper reflects on the opportunities that would arise if disabled people would seek to make the most of the possibilities arising from the Fifty Shades of Grey craze.     

Playing safe: Media coverage of child sexual abuse prevention strategies

This paper examines the media coverage of preventing child sexual abuse. It draws on a content analysis of all press and TV news coverage about child sexual abuse that appeared in the UK during a complete 12-month period. The findings demonstrate that the bulk of the coverage was case-based, for example focusing on the Orkney case. There was very little opportunity for broader discussion of general issues of concern, including how sexual assaults against children might be prevented. The coverage of ‘prevention’ which did exist drew on a very narrow range of debates and was disproportionately concerned with abuse outside the home (abductions by strangers, or abuse within institutions such as schools or children's homes). Discussions about prevention were dominated by reactive news stories generated by particular ‘scandals’. The coverage was also largely drawn from a small constituency of official source agencies (such as government officials, court proceedings and police statements). There were few attempts to address the broader social conditions which might facilitate or inhibit sexual violence or to examine explicitly political analyses of the problem. The paper argues for a more diverse discussion about ways of preventing sexual violence against children, especially assaults by fathers, uncles, brothers and friends of the family. This demands close attention to the ways in which the mass media operate, as well as the priorities of source agencies. The paper points to factors within news production practices which both obstruct and facilitate debate about prevention and concludes by suggesting strategies to promote this issue as a vital part of the public agenda.     

Incest,paedophilia, pornography and prostitution: making familial males more visible as the abusers

In this paper I return to the survivor case study and sex offender data I used in my paper on conceptual models of the relationship between pornography and child sexual abuse in Child Abuse Review in 1997. Here I use them to show how paedophile typologies and sex offender classifications contribute to constructing the invisibility of the normal, ordinary, heterosexual family men who sexually abuse their own and other people's children on a very substantial scale. I also use it as the basis for developing a typology which constructs the connections between incest, paedophilia, pornography and prostitution in the form of a ‘Continuum typology of child sexual abuse and the characteristics of child sexual abusers’, and captures the crossover of victims and perpetrators and the overlap of intrafamilial and extrafamilial child sexual abuse and exploitation. This, in turn, becomes the basis for constructing a ‘Nosology of child sexual abuse classification’ which genders the abusers and takes account of both the overlap and the dominant discourse currently of policing and policy, in which ‘paedophilia’ and ‘child sex offending’ have become synonymous, and incest abusers are invisible. Copyright © 2001 John Wiley & Sons, Ltd.     

Sexual and gender identity work on social media

How do sexual and gender minorities use social media to express themselves and construct their identities? We discuss findings drawn from focus groups conducted with 17 sexual and gender minority social media users who shared their experiences of online harms. They include people with gay, lesbian, bisexual, trans, queer, asexual, non-binary, pansexual, poly, and kink (LGBTQ+) identities. We find that sexual and gender minorities face several challenges online, but that social media platforms provide important spaces for them to feel understood and accepted. We use Goffman's work to explore how sexual and gender minorities engage in ‘front region’ performances online as part of their identity work. We then turn to Hochschild's concepts of ‘feeling rules’ and ‘framing rules’ to argue that presentations of self, or front region performances, must include the role of feelings and how they are socially influenced to be understood.     

Highly religious young Catholics in Northern Ireland: Renewing the Catholic landscape?

This article explores findings from a 2022 survey of students associated with the Catholic Chaplaincy at Queen's University, Belfast. It is the first study to investigate the beliefs, practices, and experiences of highly religious young Catholics in Northern Ireland. It presents survey findings on beliefs, practices, and influences on faith; dynamics of increased religiosity; and views on Church teachings on same sex relationships, euthanasia, sexual relationships, and abortion. Women are more likely to disagree with Church teachings on these issues than men. The survey confirms the importance of family socialization but finds that a substantial minority experience religious change at university. Respondents prioritize renewal but disagree on how to prompt it: some advocate greater ‘openness’ to women, LGBTQ+, and others perceived as marginalized; and others feel ‘evangelization’ should be emphasized. ‘Post-secular Catholicism’ is used as a foundation for reflections on religious persistence among Northern Ireland's young Catholics, raising questions about their potential role in renewing Ireland's Catholic landscape in light of the synodal process underway in the Church.     

Sexual agency,risk and vulnerability: a scoping review of young Indigenous Australians’ sexual health

This review of qualitative research examining young Indigenous Australians’ sexual health highlights the profoundly social nature of young people’s sexual lives. Nineteen peer reviewed published papers were identified for inclusion. Findings reveal efforts made by some young Indigenous Australians to control their sexual lives, mitigate risk and maintain their sexual health. The review identified factors which are conducive to sexual health risks and vulnerability, including incomplete knowledge about STIs and safer sexual practices; gossip and ridicule concerning sexual activity and its consequences; damaging expectations about male prerogatives with respect to sexual relationships; limited inter-generational communication about sexual health issues; inadequate school-based sexual health education; and tensions between Indigenous and biomedical explanations of sexual health issues. Future research priorities include a focus on young Indigenous people in cities and towns across Australia, and in regional and remote settings in New South Wales and Victoria; understanding how Indigenous cultural values support young people’s sexual health; young men’s sexual and service-based practices; and the experiences of same-sex attracted and gender diverse youth. This research would inform the design and delivery of culturally safe and acceptable sexual health services and programmes, underpinned by an understanding of factors in young Indigenous Australians’ everyday sexual lives.