As a pediatrician, I work with sexually assaulted teens. They deserve full investigations

As a pediatrician who specializes in child abuse in the South Bronx, I see teenage girls every day who have been sexually assaulted, often by older teenage boys. Sadly, very few of the perpetrators are ever held accountable for the crimes they have committed.

Why? The victims have everything to lose by coming forward: They blame themselves. Law enforcement officers doubt the veracity of their claims and make them feel like they “wanted it.” If kids in school get wind of the assault, they take sides and some call the victim a slut or whore. Their parents blame them for going to the party, and for not telling them sooner about the assault.

Testifying terrifies assaulted teens, so very few cases go to court.

Not surprisingly, I saw much of that play out last week when watching the Senate hearings about the possible sexual assault of Christine Blasey Ford by Supreme Court nominee Brett Kavanaugh, and when hearing President Trump publicly deride Ford’s testimony on Tuesday. It struck me that sexual assault is handled and perceived in the same way whether it involves high schoolers in the South Bronx or prep-schoolers in the Washington, D.C., suburbs.

I routinely tell parents that we don’t have control over the criminal justice system or whether the perpetrator goes to jail. Parents often tell me their child is afraid to leave the house, and, in some cases, they have to switch their child’s school. I advise them to focus on reassuring their child that they love her, believe her, and will support her no matter what.

I advise them to encourage their child to engage in therapy even though she says she just wants to forget about the assault and move on with her life. (Teen boys can also be victims of sexual assault, and need the same kind of care that girls need. In this essay, I focus on girls.) I tell them that the physical trauma usually doesn’t have long-term consequences, while the emotional trauma can cause scars for life: Teen sexual assault victims are at increased risk of depression, substance abuse, domestic violence, suicide, and numerous other health problems.

The United States has come a long way in how it handles domestic violence. Not long ago, law enforcement officers would tell abusive husbands to walk around the block and cool off. Today, women are offered orders of protection and the abuser is readily removed by law enforcement from the household.

We need this kind of sea change when it comes to teen sexual assault. We must find better ways to identify it, treat it and, best of all, prevent it. One way to help prevent it is to make dating violence part of sex education in schools for preteen kids.

I often testify in child abuse cases. When I am asked if the victim is credible, my response to the cross-examining attorney is that determining credibility is not my job. My job is to provide the facts as I learned them in my role as a child abuse pediatrician, just as I do for all of my patients’ medical concerns.

My clinical expertise and experience working with girls who have been sexually assaulted tells me that the possible assault involving Kavanaugh requires a formal investigation by trained professionals — what all cases of possible sexual assault deserve.

Having seen and been part of such investigations, here’s how the best ones work: Professionals trained in conducting forensic interviews talk with the victim, the alleged perpetrator, witnesses, individuals who may have had prior knowledge of the assault, and any others pertinent to the investigation.

There is no cap on the number of individuals asked (or subpoenaed) for interviews. There is no cap on the number of days the process takes. The point is to gather enough information to make an informed decision and ensure that justice is upheld.

Senators aren’t qualified to do forensic interviews, and they may do more harm than good. In last week’s hearings, many asked leading questions, which do not yield the most accurate information and can confound an investigation. I was disheartened to see the outrage exhibited by some of the senators and by Kavanaugh, which in my experience can intimidate victims of sexual assault and make them recant their disclosures.

It takes a strong teen and, in this case, a strong woman, to stick with her story in the face of withering opposition. I applaud Dr. Ford for coming forth. Though she may not know it, she is standing up for the all the girls who don’t get justice and, through her actions, may be responsible for many more to get it.

Nina Agrawal, M.D., is board certified in child abuse pediatrics. She practices in The Bronx, New York, and is a member of the American Professional Society on the Abuse of Children. The views expressed here are her own.