At the outset of our presentation, we discussed problems with the term child sexual abuse. It is now appropriate to return to this issue in light of the empirical findings we have just presented. These findings strongly imply that it is misleading to label both the repeated rape of a young female child in an incestuous context and a willing sexual encounter between a mature male adolescent and an unrelated adult as child sexual abuse. It is misleading because abuse implies harm to the individual.

The empirical data, based on generalizable samples, that we have presented clearly suggest that only the first of these two scenarios is likely to produce harm for the individual. The second scenario is only abuse in that it violates contemporary social norms.

What is problematic is that the use of the term child sexual abuse in the latter case, whether by the media, legislators, or mental health professionals, conveys the meaning of harm to the individual as opposed to violation of social norms. This in turn reinforces, incorrectly, the notion that the adolescent in such an episode really was harmed psychologically or emotionally. This adolescent is then perceived to be a victim and treated as a victim, which can become a self-fulfilling prophesy in that he will become the victim he is supposed to be.

The reality of labeling effects has been well established in psychology and sociology. The history of sexual attitudes provides numerous examples. Masturbation was formerly labeled "self-abuse" after the 18th century Swiss physician Tissot transformed it from a moral to a medical problem. From the mid-1700s until the early 1900s, the medical profession was dominated by physicians who believed that masturbation caused a host of maladies ranging from acne to death. So destructive was masturbation seen to be in America in the 1800s that inventors created cages with locks and keys to keep children’s hands away from their genitals, boys underwent circumcision on a wide scale so that they would not have to wash under their foreskin and thereby potentially "abuse" themselves, and physicians such as J. H. Kellogg created products such as Kellogg’s Cornflakes to prevent boys from engaging in "self-abuse."

Countless people suffered pangs of guilt for having indulged and were mortified at the possibility of developing a disease or a disorder as a result. For example, the famous sex researcher Havelock Ellis recounted the case of a respectable married woman who was involved in a social purity movement. When reading a booklet that described masturbation, she became aware that she had been unwittingly engaging in this behavior. As Ellis noted, "The profound anguish and hopeless despair of this woman in the face of what she believed to be the moral ruin of her whole life cannot be well described."

Sex researcher Alfred Kinsey complained a half century ago that the scientific classifications of sexual behavior in his day were based on theology, not biology. In 1952 in the first edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders -- also known as DSM--sexual behaviors such as masturbation, homosexuality, fellatio, cunnilingus, and sexual promiscuity were codified as pathological--as forms of mental illness. Countless homosexuals suffered because their desires were labeled by the medical profession, and by the general public as well, as perversions. Indeed, the history of sexual attitudes shows that labeling sexual behaviors has generally been based on morality, not science, even when it is scientists rather than lay persons who are using the labels, and that labeling can have negative consequences.

In science, abuse implies that harm is likely to result from a behavior. The results for male college students who had experiences defined as CSA highlight the questionable validity of the construct child sexual abuse as defined and used in the professional literature. For these male subjects, 37% viewed their CSA experiences as positive at the time they occurred. In the two studies that inquired about positive self-perceived effects, 24% to 37% viewed their CSA experiences as having a positive influence on their current sex lives. Importantly, males who participated willingly in their CSA episodes were as well adjusted psychologically as control subjects. The positive reports of reactions and effects, along with normal adjustment for willing participants, are scientifically inconsistent with classifying these male students as having been abused. Their experiences were not associated with harm, and there appears to be no scientific reason to expect such an association. On the other hand, a minority of males did report negative reactions and negative self-perceived effects; moreover, unwanted CSA was associated with adjustment problems for them. For these students, the term abuse seems much more appropriate.

Some researchers have questioned their original definitions of sexual abuse after assessing their results. For example, Fishman defined sexual abuse of boys mostly on the basis of age discrepancies (that is, sex between a boy of 12 or less and someone at least 5 years older, or between a boy aged 13 to 16 with someone at least 10 years older), stating that age differences implied sufficient discrepancy in developmental maturity and knowledge to indicate victimization. He found that the males with CSA experiences in his study did not differ from controls on measures of adjustment and that they reported a wide range of reactions to their CSA experiences (mostly positive or neutral). In-depth interviews confirmed and elaborated the quantitative findings, leading Fishman to question his original assumptions. He noted that the men's stories altered his universal beliefs about the impact of inappropriate sexual experiences on children, and stated that "to impose a confining definition onto someone's experience does nothing to alter the realities of that experience for the person." Fishman concluded by arguing for the use of language of a more neutral nature rather than labels such as abuse, victim, and molestation--in short, for use of empirical and phenomenological criteria in conceptualizing early sexual relations, rather than using legal or moral criteria.

The foregoing discussion does not imply that the construct child sexual abuse should be abandoned, but only that it should be used less indiscriminately in order to achieve better scientific validity. Its use is more scientifically valid when early sexual episodes are unwanted and experienced negatively--a combination commonly reported, for example, in father-daughter incest. In general, findings from the review of college students suggest that sociolegal definitions of CSA have more scientific validity in the case of female children and adolescents than for male children and adolescents, given the higher rate of unwanted negative experiences for females. Nevertheless, because some women perceive their early experiences as positive, do not label themselves as victims, and do not show evidence of psychological impairment, it is important to be cautious in defining abuse for both males and females in attempts to validly understand these sexual experiences.