As a society, we place a lot of trust in doctors, believing that they will follow a code of ethics when treating patients. But that isn’t always the case. 

The University of Southern California’s (USC) recent settlement arising out of the sexual abuse of its students by campus gynecologist George Tyndall brought this troubling problem back into the spotlight. While we may never understand why this occurs, understanding the resources available to those who may face these circumstances could be a step towards preventing the abuse. Awareness of these terrible crimes could help more people recognize the difference between appropriate and inappropriate doctor behavior.

How Common is Sexual Abuse By a Doctor?

In the USC case, more than 700 women accused the college’s campus gynecologist of sexual abuse. The school settled civil claims made by these women for more than one billion dollars and George Tyndall now faces 35 criminal counts of sexual misconduct from 2009 to 2016. The number of victims and large settlements garnered media attention for this case, but it is just one of a number seen recently.

In July 2017, a judge sentenced USA Gymnastics national team doctor Larry Nassar to 60 years in federal prison. In 2018, the state of Michigan sentenced him to another 175 years in state prison. In addition, Michigan State University also agreed to pay a $500 million settlement to victims.  

Physician sexual misconduct affects men as well as women. In 2018, dozens of men made allegations against Dr. Richard Strauss, claiming he engaged in sexual abuse of male students from 1978 to 1998 at Ohio State University. A 2019 report found that at least 177 male students and patients suffered sexual abuse at Strauss’ hands.

An investigation by the Atlanta Journal-Constitution in 2016 identified approximately 2,400 cases of doctor sexual abuse across the country. Unfortunately, that is likely only a small percentage of the actual abuses that occurred.

Many patients don’t report doctor sexual abuse for a variety of reasons. Some patients are simply confused as to whether they experienced sexual abuse. Seldom do we learn about what is and isn’t appropriate doctor-patient behavior. If victims were young, they may question their memories of the experience, believing they imagined it or may have disassociated from it altogether. 

What Qualifies as Sexual Abuse by a Doctor?

Sexual abuse is when a person uses force, power, or status to take advantage of another person to inflict unwanted sexual activity. Sexual abuse happens over a period of time and often involves children because they are less able to advocate for themselves or are easily taken advantage of. 

In the context of the medical field, a 2020 report by the Federation of State Medical Boards defined physician sexual misconduct as:

“Behavior that exploits the physician-patient relationship in a sexual way. Sexual behavior between a physician and a patient is never diagnostic or therapeutic. This behavior may be verbal or physical, can occur in person or virtually, and may include expressions of thoughts and feelings or gestures that are of a sexual nature or that a patient or surrogate may reasonably construe as sexual.” 

A 2017 analysis of cases in the U.S. found some patterns worth noting. The study looked for trends in 101 cases of doctor sex abuse and found:

• Most cases involved male doctors
• Nearly all the doctors in this analysis were under the age of 39
• Almost 95 percent were in private practice
• More than 70 percent of the doctors were not board-certified

They also discovered that most abuse occurs when the doctor is alone with the patient and that most abusive doctors repeated the abuse on patients. Doctors may start with grooming behaviors, actions designed to build trust, to see if the patient becomes upset. Grooming might include flirting, light touching, and flattery. This gives the abuser a chance to identify which patients are most likely to succumb to forced intimacy.

The abuse typically lasts for at least two years and involves different violations. Most whistleblowers in these cases are not other staff members but abused patients. There are also documented cases of hospital administrations that fail to report sexual abuse in their facilities. They may quietly settle with the victim and then ensure that the physician resigns from their employment. That doesn’t keep sexual abusers from practicing medicine, though.

What Patients Can Expect During a Medical Exam

You have the right to expect certain protections in a medical setting, including:

• Asking the doctor to stop doing anything that makes you uncomfortable
• Asking that someone else be in the room during your exam, including a friend, family member, or another healthcare professional such as a nurse
• Asking for a doctor who is the same gender
• Privacy when changing clothes and during the exam
• Having questions answered about what the staff are doing
• Provide information to you in the language you speak
• Asking the doctor to stop if something hurts

Patients should also have an understanding of what a doctor shouldn’t do because it is inappropriate, like:

• Examining your private areas without gloves
• Refusing to stop doing something that makes you uncomfortable
• Refusing to explain what they are doing
• Refusing to allow another person in the room
• Insisting that you undress the body areas under examination
• Asking inappropriate questions about your sexual activity

Patients should ask questions about what a doctor is doing during an exam if necessary. And they have the right to expect an answer.

How Do You Report a Doctor for Sexual Abuse

If you suspect doctor sexual abuse, you should first call the police. Sexual abuse by anyone is a crime. You should also contact the state medical board and file a complaint. It is up to a state medical board to revoke a doctor’s license.

You can contact any organization affiliated with the physician, like a hospital or clinic. They should immediately investigate your allegation. If they don’t, you might need legal help.

You should also consider getting a lawyer that specializes in sexual abuse. A lawyer will work with you to determine your legal rights and the actions you can take to ensure justice.

Child grooming occurs when an adult befriends a child in order to develop an emotional connection and trust, lowering the child’s inhibitions in order to perform sexual abuse. Grooming can extend to the child’s family, building a sense of confidence so that the family does not suspect the behavior and the child does not report it. 

Most child sexual abuse occurs in the residence of the victim or perpetrator (84% for children ages 12 to 17). In most cases, through grooming, children develop a sense of trust in the perpetrator that lead them into their home. It can be difficult to identify grooming behaviors because they are often disguised as caring, loving actions that can seem normal in a different context, but this blog will help you identify the signs of grooming. 

Stages of Child Grooming

Grooming is a manipulative technique that gradually lowers the child’s defenses over time, so it’s important to recognize its different stages: 

1. Targeting the child: The adult finds and becomes fixated on the child. Grooming begins when the offender grants the child special privileges, like rides to sports practice.
2. Earning the child’s trust: The adult next begins to gather information about the child’s needs and desires, whether social, emotional, or financial. The adult tries to fulfill them to establish trust and a relationship built on favors. 
3. Isolating the child: Once the child begins to trust the offender, they will try to create scenarios that provide one-on-one time to foster emotional bonds. This could include personal coaching, a trip, or an outing. 
4. Sexualizing the relationship: Like the grooming itself, the offender will sexualize the relationship gradually. They may begin with subtle actions, like talking about explicit topics or sharing inappropriate or pornographic images. These may progress to physical actions, like swimming with the child or wrestling, before engaging in an explicit sexual assault. 
5. Maintaining control: Once the abuse is initiated, the offender will try to sustain the abuse and its secret by emotionally manipulating the child. That manipulation might include threats of hurting the child or their parents or abandoning the support they’ve built the relationship on. Other abusers use their power to manipulate the child to believe that the actions aren’t wrong or won’t be believed. 

Common Grooming Behaviors

While these stages of grooming are commonplace, there are other indications of abuse parents should be able to recognize, including: 

• Gift giving
• Touching, hugging, and inappropriate physical contact
• Offering assistance, whether social, emotional, or financial
• Seeking online access to a child 
• Adults seeking a friendship with a child, rather than a more adult role, especially if he or she has other relationships that don’t seem age-appropriate 
• Adults with an inappropriate interest in a child’s sexual development 
• Pushing beyond the boundaries of a child’s comfort level with inappropriate jokes or games
• Intimidation
• Sharing sexually explicit material, like pictures or videos
• Communicating with a child secretly and without parental knowledge 

Protecting Your Child from Grooming

After reviewing these signs of child grooming, you may recognize these behaviors in some of the people in your life, but don’t automatically assume they are grooming your child. As we mentioned above, many of these behaviors may truly be supportive or loving gestures. Instead of using these signs as an indicator of guilt, use them to validate your intuition if you feel like something is wrong and to remain alert when new adults enter your child’s life. 

If, however, you do identify these behaviors in a person who you feel might be crossing a line, you should take action. Rather than accuse them of anything inappropriate, you should “confront them with kindness.” This approach is simple: Communicate to the person the boundaries you have around your child and why (including the specific behavior they exhibited that was out of line). Then ask them to respect and support those boundaries. 

If this person is innocent, they will apologize and respect your wishes for your child moving forward. On the other hand, if they are guilty of grooming your child, their behavior will likely stop. Once their behavior is recognized, perpetrators will stop grooming the child in order to protect themselves. 

Whether a friend or family member exhibits all of these behaviors or just one, the most important thing is to trust your instincts and stay informed. Learn how to recognize these signs of grooming and maintain a close relationship with your child so that you’ll notice if their behavior changes. If you understand these behaviors, you can step in to protect your child if something goes wrong.

Life doesn’t come with an instruction manual. This adage is particularly true when confronting child sexual abuse. If you suspect a child is being abused, your next step forward—who to talk to, how to help, whether to say anything—can feel incredibly difficult. But your greatest responsibility is to say something. 

Whether you’re a parent, family member, teacher, coach, friend, religious leader, or babysitter, by speaking up and defending a child, you could be changing the course of their life for the better. The following offers some tips on how to talk to your child if you do suspect sexual abuse. 

Talking to Your Child

It takes an incredible amount of courage for anyone to come forward with information about sexual assault, especially children. If your child tells you they’ve been sexually abused or they know a child who was abused, consider our suggestions below when determining how you may be able to help. 

If you suspect abuse before your child comes forward, it’s a delicate  situation to navigate. Addressing your fears about child sexual abuse may be your worst nightmare, but it’s important for trustworthy adults to step forward as advocates, especially when children are being taken advantage of. 

As you begin a conversation around child sexual abuse, consider the following suggestions:

• If your child has come forward, they are likely anxiously awaiting your reaction. Your first response might be panic, but you should try to stay calm and reassure them of your support. Thank your child for breaking their silence and let them know you’re on their side. 
• If you suspect abuse and want to have a conversation with your child, pick a time and place to do so where they’ll be comfortable. Try to be casual as you approach the topic, as being too serious may feel threatening. 
• As you continue the conversation, avoid leading questions (like “Did someone touch you in a private place?”) and instead offer them the time and space to tell their story uninterrupted and without judgment. Ask clear questions when the child naturally pauses in conversation. 
• Avoid judgment and blame, and reassure the child that they are not in trouble. Communicate that the child did nothing wrong, the abuser did, and they are too young to be blamed for adult actions. Be patient and allow the child to speak in their own time as they’re likely very frightened. 
• Immediately following this conversation, establish a safety plan. Eliminate any opportunities for the abuser to have unsupervised contact with the abuser and, if necessary, establish alternative care for the child. 
• Report the abuse. If the child’s parents aren’t involved, they should be your first contact. If the abuser is a family member, call the Virginia Department of Social Services CPS Hotline, open 24 hours a day, at (800) 552-7096. This is an important resource for reporting the crime regardless of the perpetrator. If the abuse involves an institutional employee, like a school, church, or other organization, you should also contact the leaders of that organization so that they can take internal steps to protect other children. 
• Ask for help. This is a terrifying time for your child, but it’s also a scary time to be their parent or caregiver. It’s hard to know which steps come next as you try to protect your child and ensure they move forward without negative consequences. As you consider how to navigate these uncharted waters, reach out to a trained counselor or call the Childhelp National Abuse Hotline at 800-422-4453. 

When it’s time to think about seeking justice and protecting your rights and those of your child, consult a Virginia child sexual abuse attorney like those at Breit Biniazan regarding how to care for your child’s present and future. Our experienced childhood sexual abuse lawyers will work tirelessly to hold the abuser accountable while providing your family with the compassionate support you need to navigate these difficult times.