A Question of Abuse

An influential group of therapists is promoting a new scare: children who molest other children. Those who question the murky evidence are said to be in denial. But it is the kids, taken from home and given intense therapy, who might be sufferering the most.

Tony Diamond is a troubled boy. Charming and tractable one minute, he may be flailing in rage or brooding in despair the next. Tony's classwork is outstanding; he reads widely and writes winningly. In a report on Napoleon, he quotes the "battleous" (and apparently bilingual) "military genius" as uttering the famous palindrome, "Able was I ere I saw Elba." Yet he fights and disobeys at school -- and in his short life he's attended several.

Like other boys his age, 12, Tony likes Star Wars and baseball. He takes care of a small menagerie at home -- a hamster, a rabbit, and a garrulous cockatiel. But he can be mean to his sister, Jessica, one year his junior, dark and soft where he is blond and slender, slow in class where he excels. Their relationship, it seems, is fierce -- fiercely affectionate and fiercely antagonistic. One evening, they sit next to each other, playing quietly. Another time, she climbs into the car and he slaps her.

Three years ago, in November 1993, San Diego County Child Protective Services pronounced Tony a grave danger to his sister. Jessie had told someone at school that her brother had "touched her private parts, front and back." Mandated by the 1974 Child Abuse Prevention and Treatment Act to report any suspicion of child abuse, even by a child and even without substantiation, Jessica's elementary school called the Child Abuse Hotline. A social worker elicited a record of Tony's earlier offenses: In elementary school, he used sexual language and looked under girls' skirts; at 4, he lay on top of Jessie in the bath.

San Diego Juvenile Court charged Tony with "sexual abuse" of Jessica "including, but not limited to, touching her vaginal and anal areas...placing a pencil in her buttocks," and threatening to hurt her if she "disclosed the molest."

"It would appear from a review of the case," the social worker wrote, "that Tony is a budding sex offender." Tony was 9 years old.

What followed for the Diamonds was a nightmare, executed by a system so zealous to protect children from perceived sexual abuse that it may fracture their families and crush their spirits in the process. First Tony and then Jessica were removed from their mother's home and placed in state custody. Only after more than two years of foster and group homes, treatment programs, and the representation of a private lawyer, would the family be reunited.

But blame for the Diamond family's travails cannot be assigned exclusively to San Diego County caseworkers, therapists, and judges. They, like many of the nation's journalists, politicians, and parents, suspect sex abusers are everywhere and include everyone -- the competent teacher, the friendly neighbor, the loving father. Now, sex abuse hysteria has delivered a new kind of perpetrator: "children who molest."

These kids, as young as 2, are diagnosed and treated, and sometimes prosecuted, for "inappropriate" behaviors like diddling, licking, putting things inside genitals, flashing, mooning, or masturbating "compulsively." They are accused of "coercion," though often the sex play is consensual.

Some kids have committed real sexual intrusions on other kids. But while these children are almost always aggressive in other ways -- they fight, steal, or set fires, for example -- the unproved assumption, deeply embedded in American psychological ideology, is that sex is a wholly different, and worse, category of behavior, profoundly symptomatic for the doer and inevitably traumatic for the done-to.

So, with little supportive evidence, the new children-who-molest experts have persuaded the child protective systems they work for that "sex-offense-specific" therapy is necessary for any kid with a "sexual behavior problem." They insist this therapy, whose methodologies derive from their own theories, can be practiced only by them or others they have trained.

When Diane Diamond invited a caseworker into her blue-and-beige adobe house, she had a naive faith in the helping professions. The quick, blond woman had undergone plenty of healing herself, by both traditional and new age practitioners, and in several Child Protective Services interviews she poured out her family's history in sentences studded with psychologisms.

She told the caseworkers that, pregnant with Jessica, she'd fled the children's father, who had beaten and raped her and had choked 1-year-old Tony; she reported that a man had exposed himself to Jessica in the park, and she'd tried to press charges; she said that the children might have been encouraged in sexual play by a babysitter years earlier. Diane told Child Protective Services she was concerned about her son's volatility and depression; she thought he might even be suicidal, and she hoped they'd help find him therapy.

Twenty years ago that might have happened. The school could have referred Diane to a child or family therapist to deal with the whole constellation of her children's needs. But today, teachers and social workers, undereducated in psychology and overtrained (often by law enforcers) in sexual abuse, tend to see sexual pathology and criminal exploitation in any situation that looks even remotely sexual.

So Diane's tale turned against her, becoming a sort of stationhouse confession about a criminally insane family: Tony had a history of abuse (a psychologist wrote that he had "witnessed" his mother's rape, though he was only months old); the possible abuse by a babysitter was recorded as though it were a certain and traumatic event; Jessica's glimpse of the flasher's penis was added to her list of victimizations. Because Diane was at the time more worried about Tony than about Jessica, who seemed OK, Child Protective Services decided Diane was "minimizing" the "molestation," and judged her incapable of protecting her daughter.

Tony was declared a "sex offender," made a ward of the San Diego dependency court, and removed from his mother's custody.

Panic over child abuse seems to sprout from the desert soil of San Diego as abundantly as neon fuchsia succulents and bougainvillea. The county has been the scene of a string of highly publicized false allegations of molestation, including satanic ritual abuse, going back to the 1980s. In 1992, a major grand jury investigation found the county's child welfare agencies and juvenile courts to be "a system out of control," so keen on protecting children from predation that it took hundreds of them away from their parents on what turned out to be false charges. The report called for "profound change" throughout the system.

Carol Hopkins, deputy forewoman of that grand jury, now chairs the Justice Committee, which works to overturn false convictions of satanic ritual abuse and child abuse. She says some of the changes were instituted, but that many of the same people are still working in the child protection system. When cases of kids accused of abuse started crossing her desk, with these same names on them, Hopkins felt queasy. "This," she thought, "is the next satanic ritual abuse."

San Diego Union-Tribune reporter Mark Sauer saw it coming, too. In the early 1990s, he watched psychologist Toni Cavanagh Johnson and social worker Kee MacFarlane presenting their work on children who molest at a professional conference held in San Diego. He was astonished. "First they state that there is no research -- that we really don't know anything about normal children's sexual behavior," he recalls. "Then out come the pie charts and graphs and they go on for an hour defining this new abnormality. And everybody is madly taking notes."

Sauer had reason to be suspicious of MacFarlane and the clinic she worked for, Children's Institute International in Los Angeles. His newspaper had published some of the only skeptical coverage of the 1980s McMartin Preschool satanic ritual abuse trials. Sauer knew MacFarlane as the woman who headed the team that interrogated nearly 400 children for the prosecution and found 369 to have been victimized in bizarre rituals including anal rape, animal mutilation, and kidnapping through secret tunnels. Except for one, none of the children mentioned abuse until they got to CII. After the jury saw MacFarlane's taped interviews, full of leading, hectoring questions, they voted to acquit the defendants.

Johnson, now the children-who-molest guru, had not yet joined CII at the time of the McMartin interviews, but became affiliated with the clinic and began working with MacFarlane in 1985. She left the clinic in 1990, and her tenure is not mentioned in her publicity materials. It was Johnson who first coined the diagnostic description, "children who molest," in a 1988 paper, while working with MacFarlane at CII's Support Program for Abusive Reactive Kids. Since then, her 1993 book, Sexualized Children: Assessment and Treatment of Sexualized Children and Children Who Molest, co-authored with psychologist Eliana Gil, has become the specialty's main text.

As in the satanic ritual abuse scare, the prophets of this plague claim the problem is enormous, but we don't see it because we aren't looking hard enough. "[Children who molest] make all of us uncomfortable," writes MacFarlane in her 1996 book, When Children Abuse, "so uncomfortable, we've had to deny their existence and/or minimize their behavior until now. We've called their behavior 'exploration' or 'curiosity' until they were old enough for us to comfortably call it what it is: sexual abuse of other children.

"Who are they?" she continues. "So far, relatively few have come to our attention."

In fact, arrests for juvenile sex offenses are up in many states. Although this demonstrates increasing alertness on the part of the juvenile justice system, it does not necessarily indicate that juvenile sex offenses are on the rise. Police records are unenlightening about what exactly is happening between children -- the courts label as a "sexual offense" everything from consensual fondling between different-age kids to forced sodomy. It's even harder to tell what's happening in the dependency courts, where younger kids are sent, because those records are confidential.

Moreover, the 1974 Child Abuse Prevention and Treatment Act offered an incentive to rout out alleged sexual abuse: States get federal matching funds for programs that identify and treat abused kids and prosecute their abusers, including minor offenders. Since then, child abuse reports have grown dramatically. But of the 2.9 million child abuse reports filed in 1993, two-thirds could not be substantiated.

Despite a near-absolute absence of normative data about what kids actually do sexually, literature on this new category of juvenile "deviance" is filling up the child abuse bibliographies. In 1984, there were no treatment programs for such kids. Today, the Vermont-based Safer Society Foundation database lists 50 residential and 396 nonresidential programs that treat "sex offenders" under 12. And at the 1995 Association for the Treatment of Sex Abusers conference, about 80 percent of the exhibition tables featured literature on such programs for children and adolescents.

As the diagnosis of "sexual behavior problems" gains currency in sex abuse circles, it is also on its way to wider ratification, which in turn will boost media attention, funding, and business. Two five-year, $1 million studies that provided therapy and evaluated the best treatment approach for hundreds of "sexualized" children under 12 are just wrapping up in Vermont, Oklahoma, and Washington. And if this major grant from the government's National Center on Child Abuse and Neglect (NCCAN) does not institutionalize the new sickness, some psychologists are promoting the inclusion of juvenile sex offending into the Diagnostic and Statistical Manual of Mental Disorders, or DSM, the canon of psychopathologies.

For more than two years, almost a score of adults -- foster parents, social workers, psychologists, and judges -- evaluated, disciplined, and relocated Tony, planned his treatments (few of which he received), supervised his relationship with his family, and generated thousands of pages of paper.

Tony was found to be in need of "boundaries." So he was placed with a foster mother, who kept him inside much of the day, stored his toys on an inaccessible shelf in the garage, and punished him when he was "manipulative," by making him sit on the stairs for hours. Later, the foster mother accused Tony of "sexual assault" for pushing against her while she was doing dishes. (Tony's court-appointed therapist, Philip Kaushall, interviewed the boy about the incident. "I don't believe he did it," Kaushall reported.)

From the start, Child Protective Services identified Jessie as the victim, though it will probably never be known how much of the sex play between the siblings was consensual. In fact, Jessie later told a social worker that one of the main incidents that put her brother in foster care didn't even involve disrobing. Tony "poked her with a pencil over the clothes. The pencil wasn't inside her body. He just hurt her a little and she didn't like it," the social worker reported.

Jessie was getting attention for talking about abuse. In May 1994, she told a different social worker her mother had sexually abused her by lying on top of her in bed. (She also said a social worker "wanted to molest" her, but this charge was not investigated.) Later, at least one psychologist would find the girl unable to "differentiate between imagination and reality."

When Jessie's mother, whose criminal record consisted of one unpaid fine for a broken taillight, explained that she'd reached across her daughter to turn off the electric blanket, Child Protective Services found her "in denial." The agency made a "true finding" of abuse, and took Jessie from Diane and sent her to a foster home, too.

What potential harm could justify removing two small children from a mother whose only observed transgression was a distrust of the child protective authorities?

Barbara Bonner, who is running the largest component of the five-year, NCCAN studies, in Oklahoma City, acknowledges that such interventions are "driven by values," because the science of child sexual development is so paltry.

"We will probably never know the harm [of children behaving sexually], because no one will ever do that with those kids -- let them get inappropriately involved with other children [in a clinical setting]," she explains. "They might become oversexually stimulated and prefer sexual behavior to sports, dance, or other more appropriate activities. They might become promiscuous as adults. But we don't have long-term outcomes. They may turn out to be normal."

Nonetheless, she says, "We recommend, as people who are hopefully knowledgeable, and as a society, what we consider to be appropriate and in the best interest of children." Her program's "sexual behavior rules" for 6- to 11-year-olds include not touching others' "private parts" or letting others touch or see theirs.

Toni Johnson also says that some sexual behavior among kids is OK. "Normal, healthy sexuality is what we need in children. There is no problem with that," she said in an interview. "You think we are out looking to condemn children's sexual behaviors. For the last eight years, I have been talking on this continuum. You are finding the extraordinary cases." What defines molestation, says Johnson, is sex that is aggressive or nonconsensual.

The position sounds reasonable, except that Johnson and her followers define unhealthy "aggression" on their own terms, often dismissing the children's experience -- most notably when the victim does not feel victimized. "I don't know if it's the degree of pleasantness or unpleasantness that ought to be the guideline that determines whether it is appropriate or not," says Bonner. "The victim should be defined by somebody other than the child."

But sexologist Leonore Tiefer suggests that even coercive aggression ought not necessarily be pathologized. "Kids push and hit and demand, until they're socialized," she said.

In fact, a study of 128 psychologically healthy Bryn Mawr College students, who wrote about their thrilling games of porn star, rapist, and slave girl when they were young, indicates that even "force may exist on a continuum" within normative child sex play. Definitions of consent are not cut and dried.

And therein lies the problem: Except in the most benign games of doctor between children of the same age, the children-who-molest experts generally rule out the possibility that any underage child can consent to sex.

In his "Pathways" workbook for youthful sexual transgressors, Bellevue, Wash., social worker Tim Kahn tells readers that to consent, "the partner must understand the proposed action, know what society's standards are for this action, [and] be aware of the consequences and alternatives." Then how can a child who is not a lawyer consent to sex? "Children don't know what they are consenting to," Kahn states. "They need to be protected from more manipulative or sophisticated persons."

So why not improve sex education, rather than stigmatize sex by rushing kids to a specialist? The reasoning lies in two main elements of children-who-molest theory. The first -- a corollary of the so-called cycle of abuse -- is that "age-inappropriate" behavior is a symptom that the perpetrator is himself a victim of abuse. (Where else, the logic goes, would a 7-year-old get the idea of putting a crayon, or a penis, into somebody's vagina?) Although this is sometimes true, even Johnson admits that plenty of kids who have sex are not abused. Yet the term "abuse-reactive" is used almost universally when describing "sex abusers" under 12, and social workers and law enforcement professionals facing "inappropriate" sexual behavior by children almost automatically suspect the parents.

The second element is the belief that sex acts by children are often more coercive than we think and therefore must be stopped, lest the perpetrator grow up to become a bona fide molester.

"[Adult] offenders will tell you they started out young, maybe masturbating in public," says Bill Southwell, co-chair of a countywide task force on juvenile sex offenders. (Southwell also supervised the San Diego County sheriff's child abuse unit from 1985 to 1988 and from 1991 to 1994, when it conducted some infamously flawed investigations.)

However, the fact that adult offenders experimented sexually as children doesn't mean that children who experiment become sex offenders; prison and clinical populations simply don't represent the general population, says Temple University psychology professor Bruce Rind.

In any case, the children-who-molest theorists argue that even if a kid is not being abused, and even if he won't become a grown-up abuser, "age-inappropriate" sex is a sign of emotional distress. Johnson alerts parents to be concerned if a child exhibits at least three "problematic" behaviors, like wanting to be naked in public, using dirty words after being told "no," or "touch[ing] the genitals of animals," and to seek professional help if he asks "endless questions about sex."

What's wrong with these things? "They make parents nervous," says Allie Kilpatrick, a social work professor at the University of Georgia who conducted a massive review of the literature on childhood sexual experiences, both wanted and unwanted, and administered her own 33-page questionnaire to 501 Southern women. Most of Kilpatrick's subjects had kissed and hugged, fondled and masturbated as adolescents, and more than a quarter had had vaginal intercourse. Her conclusion: "The majority of young people who experience some kind of sexual behavior find it pleasurable, without much guilt, and with no harmful consequences." A similar study of 526 New England undergraduates revealed "no differences...between sibling, nonsibling, and no-[sexual]-experience groups on a variety of adult sexual behavior and sexual adjustment measures."

Around the globe, just about everything Johnson considers worrisome is unremarkable. Clellan Ford and Frank Beach, in the classic 1951 Patterns of Sexual Behavior, examined 191 of the world's peoples, including Americans. "As long as the adult members of a society permit them to do so," they noted, "immature males and females engage in practically every type of sexual behavior found in grown men and women."

In fact, most sexologists say that the trauma of kids' sex usually comes not from the sex itself, but from adults getting upset about it.

Despite Child Protective Services' official intentions, Tony got almost no therapy until November 1994, when Philip Kaushall, a psychologist the county had appointed to supervise family visits, agreed to conduct joint sessions with Tony's mother. When he met the Diamonds that summer, Kaushall was shocked that the children were in foster care: He recognized troubles in the family, but nothing that warranted separation. In September, he began recommending to the authorities that the kids go home.

Around that time, Jessica started attending Daughters and Sons United, an incest treatment group, where she reported learning about "good and bad guilt," the latter of which she understood as "when you tell on somebody about something and you feel bad about it." She'd come out of those meetings angry and excited, recalls Diane. "And she'd go, 'I'm gonna report you, Mother,' every time she got mad." Meanwhile, Jessie's therapist was repeatedly asking the girl about "bad things that might happen" if the children went home, according to a social worker's report.

Both children's therapy continued, but what went on in Kaushall's office did not fulfill Tony's requirement to undergo "offender treatment" with a therapist specifically trained in children-who-molest theory. So, in October 1995, almost two years after the "offense," Juvenile Court put Tony in a "sexually reactive children's" group with social worker David McWhirter, among the county's most prominent therapists of juvenile offenders. (McWhirter also runs a treatment program for older children. See "Drastic Steps").

But soon McWhirter, who describes the children's group work as "soft confrontation," wrote Kaushall to inform him that Tony was disruptive. The boy didn't want to confess guilt, the first step required for "recovery," and was doubtful of the other kids' guilt, too. ("Mom," he reported one afternoon, "there's one kid in there for mooning!")

Kaushall encouraged Tony and Diane to cooperate, but he says that privately he felt McWhirter's approach might be a failure from the get-go. "There may be a need for therapy," says Kaushall. "But if you treat somebody specifically for a 'sex offense,' you are undercutting the treatment automatically, because you give them an identity as a sex offender, which is precisely what you don't want them to have."

The treatment of sex offenders, including little ones, is classic good cop-bad cop stuff. The theory sounds like children's rights propaganda: promote self-esteem and empathy, consent and equality. But the practice is anything but fair, and the rights of both kids and parents are all but disregarded. A patient receives no due process: As long as he protests his innocence, he is "in denial" and he can be dropped from the program -- without which he can't get out of state custody. Worse: His treatment, unlike a jail sentence, may go on indefinitely.

The American Civil Liberties Union Prison Project has sued a number of similar programs for adults, including one in Vermont, whose "drama therapy" portion compelled inmates to simulate anal rape while the therapist shouted obscenities at them. (The program's director, William Pithers, is now co-director of the Vermont component of the NCCAN study to devise treatment for sexualized children.)

Parents who take exception to either the charges or the treatment are considered part of the problem. Usually mandated to therapy themselves, they are counseled to overlook their own judgment, stop trusting their kids, and heed their betters.

And if parents do not bite the carrot of "cure," the stick isn't far away. "In cases where children are very young and families are not very cooperative, it may require a Dependency Court petition regarding neglect, failure to supervise, or other category addressing parental responsibility in order to compel parents to cooperate with recommended living arrangements and treatment plans," writes MacFarlane in When Children Abuse. In plain English: Resist treatment and risk losing your kid.

Diane Diamond's resistance to the state's approach to her family's problem became the main impediment to her getting her kids back. "You should be aware that your conduct at Tony's birthday party...was inappropriate and detrimental to your reunification efforts," wrote one caseworker, enumerating her transgressions. Among them: "You put your arms around Tony's neck and whispered into his ear."

Once the narrative was inscribed -- crazy mother makes boy a molester, victimizes girl -- no alternative story could be told. When Jessie confessed to a social worker, almost immediately, that she had "told lies" about her mother's alleged molesting, social workers presumed her to be exhibiting accommodation syndrome, that is, suffering the consequences of being removed from the life she knew and thus lying to put things back as they were.

Diane sold her car and hired a private lawyer to try to get her children back. She spent Christmas of 1994 alone, while the hearing was delayed. In February 1995, she had her day in dependency court -- and lost. Tony was sent to yet another foster home, where he began losing weight and hope. Jessie was in her seventh foster home, pleading to be returned to her mother. Kaushall wrote report after report to Child Protective Services that institutionalization and separation from their mother was damaging the children, and that Diane's home was the best place for them.

As it happens, after 18 months of holding a child in custody, federal law requires that the dependency court come up with a permanent plan -- to send him home, place him in long-term foster care, appoint a guardian, or terminate the parents' rights and refer him for adoption. Yet it took an additional seven months before Child Protective Services made arrangements to move Tony and Jessica back home. The final outcome of the Diamonds' case appears to be a combination of bureaucratic fatigue, Diane's refusal to give up her children without a savage fight, and Kaushall's intervention, which may have prevented the children from being put up for adoption.

The splintered family was reunited early this year, although Jessie will officially remain in state custody until this fall.

Over the past two centuries, the arbiters of deviance have moved from the pulpit to the clinic. But, as Barbara Bonner suggests, "normal" remains a moral category. And, just as 19th-century doctors who surgically "cured" masturbation and Progressive Era judges who sent girls to reform school for sexual "precociousness" were enforcing the social-religious order, today's diagnosers of "childhood sexual behavior problems" reveal a terror of pleasurable excess and an anger at kids who won't buckle under sexual taboos.

The same moralistic intolerance of desire quashes the behavioral research critical to stemming real perils, like the spread of AIDS and teen pregnancy. Congress' reauthorization of the National Institutes of Health in 1993, for example, specifically prohibited appropriations for sexuality surveys, moving those moneys to programs that promote premarital celibacy.

"This all reminds me of heroic gynecology [during the early 20th century], which regarded the birth process itself as a pathological thing," says Vern Bullough, a distinguished professor emeritus at SUNY who has written or edited over 50 books on sexuality. "What we've got now is heroic intervention in childhood sexuality by people who don't know what they are talking about."

Kaushall says he is equally disgusted. "There is no doubt in my mind that what was done [to the Diamonds] was 100 times worse than any problem they had to begin with. It was handled with a lethal combination of zealotry and incompetence."

Jessie, he believes, "has learned that when she talks about sex, everyone will drop their forks and knives and listen. She knows sex is a powerful weapon." The "sex offender" Tony suffered harshness and betrayal from adults; he is depressed and mistrustful. For both kids, Kaushall says, "the developmental harm of breaking a bond with the parent is tremendous."

On a bright Sunday in March, though, everybody seems OK. Jessie goes off to an "ugly dog show" with a church volunteer, and the rest of us drive to La Jolla to wade in the tide pools. Tony hugs his mom frequently, demands to go to McDonald's, and mopes when he doesn't get to. "I'm a survivor," Diane tells me, estimating that her ordeal has cost more than $30,000. She chats about "our plans" to move to Arizona -- or maybe Oregon, she says, because "we love the beach." She uses "we" often, as if to repossess that fragile pronoun.

Tony and I peel snails from a rock as Diane explains that I am writing about their family. His brown eyes become serious, and he asks: "Are you writing about cruelty to children in California?"

Judith Levine's second book, In Search of Innocence: America's Battle Over Children's Sexuality, is scheduled for publication in 1998 by Houghton-Mifflin.