A McGill-led study on the role played by shame in the continuing trauma suffered by survivors of childhood sexual abuse indicates that addressing shame should be a focal point of treatment. Clinicians should use strategies that normalize disclosure, validate survivors' feelings and integrate shame-resolution techniques into their therapy plans, the researchers suggested.
The study, published in Traumatology, offers the first comprehensive synthesis of 30 years of English-language research on the role played by childhood sexual abuse survivors' shame. It shows that unresolved shame is linked to serious health consequences, including depression, anxiety, PTSD and suicidal thoughts. It found that the shame persists over time and often prevents survivors from disclosing their experiences or seeking help. Even after speaking out, many survivors continue to struggle with these feelings for a long time, complicating the process of recovery.
Feelings of shame act as a barrier to disclosure and recovery
According to the estimates in the various studies, childhood sexual abuse affects 3 to 17 per cent of boys and 8 to 31 per cent of girls worldwide, though actual rates may be higher due to stigma and underreporting.
"Shame was the most common reason survivors gave for not disclosing abuse," said Rusan Lateef, first author of the study, who was a doctoral student at McGill University when she wrote the paper. She is currently a postdoctoral fellow at Université de Sherbrooke.
She emphasized that the way in which adults respond to disclosure can either ease or intensify this burden.
"Children often stay silent because of shame. Creating supportive environments at home and in schools and educating parents, teachers and other trusted adults to respond with empathy is essential to help children feel safe to speak up," Lateef said.
Gender norms and cultural expectations shape how shame is experienced
The study found that while survivors of all ages reported high levels of shame, there were important differences between different groups of survivors.
Female survivors expressed higher levels of shame than male survivors. The researchers speculate that this may be because male and female survivors internalize and experience shame differently, and that this can affect their recovery process.
For male survivors, shame is frequently tied to their sense of male identity and perceived reversals of masculine norms, as men are rarely seen as primary victims of sexual violence. One participant described its toxic power, while another captured its enduring impact: "Shame is actually what you are."
A need for more research
Despite the global impact of childhood sexual abuse, the researchers found that of the 101 peer-reviewed articles published between 1994 and 2024, nearly 90 per cent focused on survivors in Western countries. Only 15 studies focused exclusively on racially and ethnically marginalized participants.
"Cultural norms, gender expectations and fear of family dishonour profoundly shape how shame is experienced and explain why many survivors stay silent," said Lateef. She emphasized the need for more research into how shame is experienced by CSA survivors from marginalized racial and ethnic communities.
The paper: "A Scoping Review of Shame Among Child Sexual Abuse Survivors Across the Lifespan: Findings and Trends Over Three Decades (1994-2024) and Clinical Implications" by Rusan Lateef et al was published in Traumatology
DOI: https://doi.org/10.1037/trm0000613
Funding: This work was supported by a Joseph-Armand Bombardier Canada Graduate Scholarship from the Social Sciences and Humanities Research Council awarded to Rusan Lateef.
