Public Health Approach to Sexual Abuse

Abstract

In this book, we have assessed the impact of framing sex offenders, and especially people who sexually abuse children, as monsters and predators who must be excluded from the human community. The exclusion of sex offenders is accomplished, in the criminal justice system, by imposing long prison terms as the first line of defense against lawbreakers. We have had little to say about criminal penalties for sex offending. Instead, our focus has been on the civil and quasi-civil measures of depriving offenders of their liberties, and therewith their basic human dignity, after they have served their prison sentences. After all, from the perspective of the monster metaphor, sex offenders cannot be changed by either punitive measures or treatment; they can only be contained and segregated. And the notion that they have a residual dignity as persons strikes many people as ludicrous. There is no evidence, however, that punitive criminal or civil measures have been effective in preventing sex offending. In this chapter, we shall outline an alternative to containment and segregation strategies for dealing with people who commit violent sexual abuse: public health. We cannot here develop a complete public health approach to sex offending, both because of limitations and space and limitations of expert knowledge, but we will present what we believe is at least a program for future research. Chemical dependency has long been regarded as a public health problem, and that framework is now being suggested as an alternative, or at least a complement to, its criminalization (Bishop 1919; Hunter et al. 2012). Similarly, sex offending behavior, to the extent that it has an element of compulsion, shares features with chemical addiction, and should also be framed as a public health problem.