RCGP Safeguarding toolkit

Sexual behaviours in children and young people can be seen on a continuum ranging from ‘normal’ and developmentally appropriate, from ‘inappropriate’ and ‘problematic’, to ‘abusive’ and ‘violent’.

Harmful sexual behaviour (HSB) is a term used to describe sexual actions that are outside what is safe for a young person’s stage of development. It includes actions that can harm either the child or young person themselves, or another person.

It can include:

• frequently and intentionally accessing age-inappropriate sexual material online
• using inappropriate language
• undertaking mutual sexual activity they are not ready for with peers
• sending and receiving illegal images
• sexual interactions where there are significant power differences, lack of consent, or through force or threats
• engaging in abusive or sexually violent sexual behaviour online or offline.

Peer-on-peer sexual abuse

Peer-on-peer sexual abuse is a form of harmful sexual behaviour where sexual abuse takes place between children of a similar age or stage of development. Child-on-child sexual abuse is a form of harmful sexual behaviour that takes place between children of any age or stage of development.

Research tells us:

• Under 18s are responsible for at least a third of recorded sexual offences against children and young people in the UK.
• Boys in early adolescence, around the time puberty starts, tend to display the most harmful sexual behaviour, although younger children and girls do sometimes engage in these behaviours too.
• Girls tend to be over-represented amongst the victims of harmful sexual behaviour.
• Those with learning disabilities and autism also tend to be over-represented amongst young people who have displayed harmful sexual behaviour.
• Around half of young people who have displayed harmful sexual behaviour have experienced sexual abuse themselves.

The vast majority of young people do not persist with these behaviours into adulthood. Children and young people who display harmful sexual behaviour are more likely than other young people to have a history of maltreatment and family difficulties. Some children and young people displaying harmful sexual behaviour have been sexually abused themselves, but most victims of sexual abuse do not go on to abuse others. It is a history of child maltreatment, rather than sexual abuse specifically, that is most strongly associated with later sexual offending.

Understanding the sexual behaviour of children and young people

The ‘Stop it now’ organisation has range of useful resources to help understand where a child’s sexual behaviour is expected for their age, or if it could harm other people.

Warning signs of harmful sexualised behaviour in children:

• seeks out the company of younger children and spends an unusual amount of time in their company
• takes younger children to 'secret' places or hideaways or plays 'special' games with them, for example, doctor and patient, removing clothing, especially games unusual to their age
• insists on hugging or kissing a child when the child does not want to
• tells you they do not want to be alone with a child or becomes anxious when a particular child comes to visit
• frequently uses aggressive or sexual language about adults or children
• shows sexual material to younger children
• makes sexually abusive telephone calls
• shares alcohol or drugs with younger children or teens
• views sexual images of under 18s on the internet or elsewhere
• exposes his or her genitals to younger children
• forces sex on another adolescent or child.

It is important to remember that not all sexual behaviour involving young people is problematic. Behaviour is more likely to be normative if it is:

• between young people of a similar age and developmental stage
• voluntary
• mutual
• limited in type and frequency
• balanced by a curiosity about other things
• light-hearted and spontaneous.

Responding to concerns about harmful sexual behaviour

There is little research on specific interventions for children who display harmful sexual behaviour, but there are indications that structured, holistic and family-oriented approaches are of value. Given that many young children displaying harmful sexual behaviour have themselves experienced abuse, interventions identified as effective with child victims are relevant: these include developmentally appropriate behavioural or cognitive behavioural approaches which are also trauma-informed and multi-systemic, intervening with both the child and their wider family. Research highlights the damaging effects of stigmatising young people as ‘mini adult sex offenders’, which may even increase the likelihood of reoffending.

It is important to take immediate action on any concerns about harmful sexual behaviour to:

• prevent the behaviour from escalating
• keep everyone involved safe.

Usual child safeguarding procedures should be followed.