French sexual abuse, incest commission wants to strengthen 'chain of protection'

Doctors are the weak link in reporting sexual violence against children and incest in France, says a commission charged with formulating policies to tackle the issue – adding the country's entire "chain of protection" needs to be strengthened. When victims have come forward, nothing happens in four out of 10 cases.

A French commission on incest and sexual violence against children found that 90 percent of victims were women and girls. © iStock/Tero Vesalainen

“There are 160,000 children who are victims of sexual violence each year, and we must go find them to protect them,” reads the interim report of the Independent Commission on Incest and Sexual Violence Committed Against Children (Ciivise) published Thursday.

The commission was created in March 2021 by President Emmanuel Macron with the aim of devising policies to address incest. This was after the issue made national headlines with the publication of a book by Camille Kouchner on incest in her family.

Based on the model of a commission on sexual abuse in the Catholic Church, Ciivise is now halfway through its mandate. It published 20 recommendations to put in place a “culture of protection” in France after interviewing 11,400 victims and 40 experts.

Who are the victims?

Based on 5,750 responses to a questionnaire sent out by the commission, the vast majority – 90 percent – of victims of childhood sexual violence are women and girls, and 80 percent of incidents of sexual violence involving children or adolescents are crimes of incest.

The median age of incestuous violence is 7 years old for girls and 8 years old for boys, and most do not reveal it until at least 10 years later.

There is no typical perpetrator, according to the commission, which insists that incest is committed across society.

However, the report says that in nearly one out of three cases, the perpetrator is the father. For girls, the abuser is most often the father, big brother, half-brother, uncle, grandfather, cousin or stepfather. For boys, the abuser is most often a big brother, half brother, father, cousin, uncle or grandfather.

In all cases, perpetrators take advantage of the trust relationship they have with the child.

The need to identify victims

The report highlights the important role of doctors in detecting cases of sexual abuse and incest, but says their role in reporting remains far too small.

Only five percent of cases are reported by doctors, who should have clear mandate to raise suspicions, according to the commission.

“All professionals must allow for the revelation of violence and initiate protection for the child,” says the report, pointing to doctors, but also teachers and judges.

• French incest commission says accusations against fathers 'not taken seriously'
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These people must say and do something if there is any suspicion, even before the child brings it up.

The commission recognises the special situation for doctors, who are some of the best placed people to recognise sexual violence, but who hesitate to report because of medical secrecy laws.

The recommendation is to put in place a specific mechanism for doctors to report, and to support their doing so.

Protecting doctors who speak up

There are exceptions to medical secrecy laws, insists the report, which calls for suspending any disciplinary measures against doctors during investigations into sexual abuse and incest.

The child psychologist Eugénie Izard was sanctioned in December 2020 by French medical board after she notified authorities about abuse against a child.

The commission is calling for an overhaul of how cases of sexual violence against children and incest are treated in court. Some 70 percent of complaints are dismissed.

One of the recommendations is that children be heard under a specific protocol, which is “neutral and benevolent”, and that judges be required to watch the recordings, and not just read the transcripts.

"We judges have a culture of written dossiers and transcripts of hearings. But observing the fear, disgust, the expressions of a child who is evoking a scene does not have the same impact as reading it,” explained former juvenile court judge Edouard Durand, co-president of the commission.

🔎La CIIVISE publie aujourd'hui ses conclusions intermédiaires.

🗣️En quelques mois, la CIIVISE a reçu plus de 11 000 témoignages. Elle a auditionné de nombreux experts, effectué des déplacements dans plusieurs services spécialisés.#inceste #ViolencesSexuelles pic.twitter.com/LYXNYwpMdJ

— Commission indépendante inceste (@CIIVISE_contact) March 31, 2022

Improved psychological support

French society must also guarantee specific physiological care for victims, says the report, which says that only half of victims today get medical treatment, and only 8.5 percent report having received specific trauma care.

If victims receive treatment within the year after the violence, they can heal must fast and avoid entrenched problems of long-term trauma.

The commission recommends that all medical costs be reimbursed by the social security system, and that victims can choose whatever doctor they want to help them.

Quick implementation

Though the commission’s report is only an interim one, and it has another year to go, it says its recommendations can be implemented now, “without waiting. They can be put in place efficiently. They will guarantee more protection for children.”

Implementation will of course mean allocating resources to different institutions and professionals involved in child protection, and among other aspects that the commission will explore in the next year is the global cost of sexual violence on children.

(with AFP)