HJNO Jan/Feb 2025

As a victim of childhood sexual abuse at the age of nine in the 1970’s, I realized preparing for this Journal topic — I am, unfortunately, far from alone. Centers for Disease Control and Prevention (CDC) says at least 1 in 4 girls and 1 in 20 boys in the U.S. experience child sexual abuse. About 90% of us were molested by someone we knew and once trusted or a family member. 1 I found it interesting to learn that most child molesters are not pedophiles. Pedophiles constitute a minority of those who sexually abuse children or who are child molesters. The vast majority of us were abused by a sexually frustrated male, and we were accessible, easy prey. 2 There have been notable advancements in prevention education over the decades, likely thanks to public figures like Donahue and Oprah, who helped break the silence around this issue. Efforts to teach children that some parts of their body are private, to identify a safe person, and to reject feelings of shame are important. Yet, despite these conversations, the prevalence of child sexual abuse remains alarmingly high. Asking a child to report abuse, while crucial, does not prevent abuse from occurring. Predators have groomed and preyed on children for centuries, and our recent efforts, while meaningful, have not deterred them. This vile scourge of childhood sexual abuse is rarely addressed openly. It is a subject so uncomfortable that polite society often avoids discussing it, leaving predators unchecked. That silence was broken last August, when Louisiana made worldwide news with a bold new law. The legislature introduced surgical castration as a potential punishment for those convicted of sexually abusing children under the age of 13. When I read about the castration law, I wanted to meet the lawmaker with the courage to be the first in the country to enact such a bold deterrent: Louisiana State Senator Regina Barrow. I believe the threat of castration is one of the most powerful tools available to stop a sexually frustrated man from abusing a child. At the very least, surgically removing the testicles of a convicted perpetrator stops the flow of testosterone in their body, which reduces the likelihood of reoffending — a critical issue given the high recidivism rates for this crime. As Barrow, president of the Louisiana senate, who may be all of 5 feet tall in heels, and I sat down in her capitol building office, I handed her two congratulatory cigars — one as a trophy from me, and the second as a trophy from all childhood sexual abuse victims — for having the heart and balls (forgive me, I couldn’t help myself) to get this legislation done. 1 Centers for Disease Control and Prevention. "Preventing Child Sexual Abuse." CDC. https://www.cdc.gov/violenceprevention/childabuseandneglect/childsexualabuse.html 2 Tourjée, D. “Most Child Sex Abusers Are Not Pedophiles, Expert Says.” Vice, April 4, 2016. https://www.vice.com/en/article/most-child-sex-abusers-are-not-pedophiles-expert-says/ HEALTHCARE JOURNAL OF NEW ORLEANS I  JAN / FEB 2025 21