The medical management of intersexed children: an analogue for childhood sexual abuse

1997

• “Medical procedures have often been used as analogues for childhood sexual abuse (CSA) and have been seen as opportunities to observe children’s memories of these experiences in a naturalistic context. Medical traumas share many of the critical elements of childhood abuse, such as fear, pain, punishment, and loss of control, and often result in similar psychological sequelae.”

• “The study which has come closest to identifying the factors likely to be involved in children’s recall of CSA is a study by Goodman (1990) involving children who experienced a VCUG test to identify bladder dysfunction. Goodman’s study was unique in its inclusion of direct, painful, and embarrassing genital contact, involving the child’s being genitally penetrated and voiding in the presence of the medical staff. Goodman found that several factors led to greater forgetting of the event: embarrassment, lack of discussion of the procedure with parents, and PTSD symptoms. These are precisely the dynamics likely to operate in a familial abuse situation.”

• “Children who had experienced more than one VCUG were more likely to have expressed fear and embarrassment about the most recent test and to have cried about it since it occurred. A few even denied that they had had the VCUG.”