Parental and community views on determinants of sexual abuse of adolescent girls with disabilities in Bangladesh

doi:10.21203/rs.3.rs-2003688/v1

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Parental and community views on determinants of sexual abuse of adolescent girls with disabilities in Bangladesh

https://doi.org/10.21203/rs.3.rs-2003688/v1

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Adolescent girls with disabilities are more susceptible to sexual abuse, according to studies conducted around the world. Adolescent girls with disabilities had roughly double the lifetime risk of sexual assault compared to non-disabled girls. Current evidence is empirically limited and there is an urgent need to explore the underlying causes of sexual abuse to disable girls from a local perspective. By leaving the underlying determinants of sexual abuse to disable girls unexplored, it may further exacerbate vulnerability.

The purpose of this study was to identify the determinants that influence sexual abuse of adolescent girls with disabilities from the perspective of their parents and the wider community. A qualitative descriptive study was conducted among parents of victims and different community groups in five localities of Rajshahi district. Four themes were developed from interviews with participants including victimization, perpetration, vulnerability and risk, and protection of adolescent girls with disabilities. Emerging sub-themes were defined as determinants of sexual abuse. Victimization was perceived with victim centered determinants including disable girl’s physical disability, misunderstandings about inappropriate behavior and inability to report an abuse. The household centered determinants were poverty with limited social capacity of family, maternal unawareness and low level of education, and inability to access legal aid. Participants selected determinants of perpetration, including offender’s economic and political power, opportunities to negotiate after abuse, and inappropriate touching sometimes treated as permissive care. The two main determinants cited that increase the vulnerability and risk of sexual abuse were poor living arrangements and living away from biological parents. As recommendation, emphasis was placed on ensuring strong family connections with disable girls for protection and social support from relatives and neighbors as well as fostering empathy among all.

Sexual abuse has significant negative health implications for the individual health of the victims. According to studies, girls with disabilities are more likely to experience sexual abuse. (C. Basile et al. 2016). Adolescent girls with disabilities are almost twice as likely to be sexually assaulted in their lifetime as non-disabled girls (Ledingham, Wright et al. 2022). A survey of 16 million young children in 25 countries found that nearly one-third of young children and adolescents with disabilities experience emotional and physical abuse, while 20% experience neglect and one in 10 experience sexual abuse (Zuyi Fang 2022).

Sexual abuse of adolescent girls is a serious problem in Bangladesh. The study found that among 8000 unmarried adolescent girls (between 15–19 years), 34% were sexually abused at least once a year (BBS 2016). Research also points out that the victim's experience of abuse can lead to trauma, which can result in to panic, depression, isolation, irrational self-loathing, guilt and other such emotions (Kolk 2000).

As cases of sexual assault are widely underreported for fear of social stigma (Rennison 2002, Cullen et al. 2000), true rates cannot be inferred from reported cases. Existing data on sexual assault may not reflect the actual social environment and reasons why the abuse occurs. In this context, it is challenging to comprehend how vulnerable adolescent girls with disabilities are to sexual assault. By leaving the underlying causes of sexual assault unaddressed, perpetration rates could rise and vulnerable adolescent females with disabilities would be even more vulnerable. (Cook, 2000). Additionally, it might be argued that the available data on the topic of sexual abuse of adolescent girls with disabilities is not fully collated. As a result, efforts to inform programs related to the protection of adolescent girls with disabilities are impractical. Parental and community perspectives are uniquely important to understanding the situation of sexual abuse of adolescent girls with disabilities. This study collected parental and community views on sexual abuse of adolescent girls with disabilities. Analysis of these views illustrates areas for abuse.

This paper aims to provide a local picture of sexual abuse of adolescent girls with disabilities based on case-based discussions with parents and various community groups. The discussion generated parents and community views about how victimization and perpetration occur, What vulnerabilities and risk they face with and what they suggested to protect adolescent girls with disability. The discussion elicited views from parents and communities about how victimization and offending occur, what vulnerabilities and risks they face, and what advice they have for protecting adolescent girls with disabilities. The introduction of the study will provide a basic definition of sexual abuse and disability. The specific perspectives of victims, non-victims, and local parents on sexual assault are then discussed.

Sexual abuse

The majority of studies defined sexual assault as any penetration of the victim by the offender's body part or object whether genital, oral, or anal without the victim's consent. Women are more susceptible to sexual harassment than males since it is a gender induced crime. More victims are females with impairments than are females without disabilities. The present study concentrates on adolescent females with disabilities, despite the fact that female adolescent with disabilities are susceptible to sexual abuse because of the very gendered nature of the crime. Sexual abuse as a term includes unwanted, non-consensual sexual acts that include force, touching, intimidation or violence (Cynthia El Khoury et. al;2021). Many researchers define the term more vaguely, such as suggestive looks, comments that are subject to different interpretations depending on the context. Researchers rely on lists of specific behaviors that may or may not be empirically developed and may or may not have a theoretical basis (Fitzgerald, 1990). Although these lists may differ across studies, generally the behaviors fall into one of four categories: (a) gender abuse, such as insulting or degrading sexist comments; (b) unwanted sexual attention such as requests for dates after being refused; (c) sexual bribery/coercion and (d) attempted sexual abuse (Fitzgerald et al., 1993).

Study design and sampling

This qualitative descriptive study was conducted in five urban areas of Rajshahi city, northwestern Bangladesh. The study was conducted among parents of disabled adolescents and different groups from the community residents. To select participants, we contacted the NGO namely Action on Disability and Development (ADD) and collected a list of disabled children with their addresses. Then we sorted only the names and addresses of disabled teenage girls. Next, we identified neighborhoods where adolescent girls with disabilities lived. We reached out to the selected communities to find the reported cases of sexual harassment. Based on community reports, we compiled a list of sexual assault cases to interview parents of victims. We used snowball technique, we selected parents who had seen or heard of sexual abuse of disabled adolescent girls in their neighborhood. Later, we discussed with local ward counselors in areas where sexual abuse of disabled adolescent girls occurred to clarify the research objectives. Finally, we moved on to the parents for interviews. We spoke to community participants including school teachers, religious leaders, social workers, service holders, daily wage earners and local elites who control the case.

Table 1

Number of participants interviewed.
Household level participant	Number	Male	Female
Parent of victim	32	14	18
Parent of non-victim	14	4	10
Community level participants
Parent who witnessed abuse	23	4	19
School Teacher	5	2	3
Religious leader	5	5	0
Social worker	5	1	4
Service holder	10	7	3
Daily earner	18	12	6
Local elites	5	4	1

Data collection

Based on the literature review, we set key interview questions in the interview guides for in-depth interviews and key informant interviews. We collected data on participants' views on victimization, perpetration, risk and vulnerability and factors that protect adolescent girls with disabilities. Interview guides were prepared in Bengali for the respondent’s convenience. We conducted in-depth interviews with parents and key informant interviews with school teachers, social workers and local elites.

Data analysis

We recorded the interviews and transcribed them verbatim in Bengali. For data analysis we used the framework approach in which we systematically coded participants' views and examined emerging patterns and themes. We used a team approach to minimize individual bias where four people were involved in coding and interpreting the data. We coded each transcript individually in hard copy by researcher who conducted interview and who did not conduct interview. To begin coding we defined a list of a priori codes and later we used inductive codes. We grouped the coded data into a table to visualize patterns across categories and concepts and allow for systematic analysis. We also tabulated similar and dissimilar patterns of perspective. Then, we elicited participants' accounts of each view and opinion that helped to generate themes and sub-themes.

Ethical considerations

We ensured informed consent from each participant prior to the interview and obtained permission to record the discussion. We provided details on the study's objectives and participation requirements. We told them that their information would be kept private and that they had the freedom to leave the interview at any moment and for any reason. We gave the participant the freedom to choose a semi-private place and time for discussion at their convenience and privacy.

Participants characteristics

We interviewed 32 Parents of victim and 14 parents of non-victim and 71 community members. Among the group of parents of victim, the most common family size was with four children and few were two children. The group of non-victim parents twelve families had two children each and two of them had four children. In the group of parents of victim, most families had male as main earner while in few families both male and female were earner. Most of the mothers of victim had no formal education while some of them had primary level education. Most of the mothers of non-victim had a completed graduation degree and some of them had secondary level education. Among the parents of victim were daily earner. The parents of non-victim were mostly service holder and only father and was earning and mother was house wife. In the case of few of parent of non-victims’ parents both of them earned. Most of the victim’s families had monthly earning 7000–10000 taka and few of them earned more than 10000 taka per month. Among the non-victim’s family, most of them earned 16000–20000 taka per month while none of them earned below 10000 taka.

In this section presents the parental and community perspectives about victimization, perpetration, vulnerabilities and risk, and protection. Participants in the study were either parents of the victims or members of the community where the sexual harassment took place. Participants from both groups expressed their reasoned views, pointing out the factors contributing to the victimization process.

Theme	Subtheme	Participant views
Victimization	Victim’s physical incapability	“In our country, girls with disabilities are sexually harassed. Because they are physically disabled. If someone tries to harass them, they can't stop. People with speech impediments cannot tell the truth, nor can they name who sexually harassed them. As a result, the perpetrator always gets a chance to torture the disabled girl. The disabled girl can be easily brought under control. As a result, young girls are most at risk of being abused.” Community member, teacher
	Disable girl’s misunderstanding about inappropriate behavior	“I spoke to my daughter about the incident she faced. Talking to her I realized that she does not understand any inappropriate act by anyone. When I asked her what she did when the person touched her sensitive body part. She replied that she was listening to his gossiping and did nothing."- Parent of victim
	No reporting	“One perpetrator abuses several times because he knows that the girl will not report it. And for a girl with intellectual disability cannot report. These are the reasons why an abuser gets opportunity to harass girls with disability.” Community member, Service holder
	Being poor and Less social power	“We are poor and cannot protest my daughter's abuse. If we don't earn one day, we can't support our family. There is nothing we can do if someone abuses our daughter unfairly. Who to complain to? People will tell us that we cannot take care of our daughter. They will blame us because it is easy to question a poor and weak family.” Parent of victim
	Mother’s unawareness and low level of education	“Parents need to be more aware to protect their children from sexual abuse. If the mother is not aware of the daughter and cannot provide security to the daughter, then in most cases, abuse takes place. Again, if the mother is less educated and does not understand the issues of the daughter being abused, then the fate of the daughter will be bad. There are some bad people around who are looking for opportunities to abuse. A girl with a disability will not understand and will accept a loss. So, parents need to be very aware.” Communality member, religious leader
	Psychological barrier accessing legal aid	“Who would I go to if my daughter was sexually abused? What can the people of the area say? Even if the people of the area give humanitarian support, they will not come with me against the offenders. So how do I fight alone? Will there be any support for me if I go for legal help? Those who have money get favor from the law, they will not help me. So, I think I will not get justice.” Parent of victim
Perpetration	Being powerful economically and politically	“I reported to the ward counselor about my daughter’s abuse but he could only arrange a meeting with them. They gave some money. That’s all! The same person will harass girls again because nobody will punish him. They are rich. His father is a big contractor of road construction in this area. Also, he is in a position of a political party.” Parent of victim
	Offender’s opportunity of negotiation after abuse	“The person who abused my daughter tried to abuse other girls too. His father gave us 10 thousand taka as compensation. No other punishment was ordered for him. So, he thought no one could punish him if he abused more because he could negotiate with the victim. He always tries to abuse other girls.”-Parent of victim
	Inappropriate touch shown as permissive care	“All our relatives love and care for my daughter. My nephew who is older than my daughter sometimes still holds her as a child. I politely forbade him not to treat her like that because my daughter is not a toddler. My nephew replied that he is her brother and he takes care of her.” - Parent of victim
Vulnerabilities and risks	Poor living arrangement	“Our house is broken and there is no main door. Neighbors come and go without permission. We need gentle permission to enter a home that we do not have. If we had a main gate, we would keep the door closed and open it when someone knocked. All the good and bad neighbors come whether I am at home or outside. I don’t know everyone’s motives. I don't know if any of my neighbors abuse my daughter because my daughter is mentally handicapped.” -Parent of victim
	No living with biological parents	“My husband and I used to stay in Dhaka for work and my daughter stayed with my mother in this city. We couldn't take her with us because we had no one to take care of her while we were at work. So, we kept her with my mother. But my mother was old and could not take care of her properly. The abuser took this opportunity and attempted several times for rape. But somehow she was saved.” Parent of victim
Protection	Growing empathy	“If I have a disabled child in my family, I need to show empathy for the child. To be sympathetic to the child is equally important for all the members of the family. The issue of empathy should start with the family. In this way we ourselves will be able to protect disabled adolescent girls.” Community member, teacher
	Family members connectedness	“Me and my family all care for my disabled girl. We know she may not be able to do anything physically but she has emotions. She expects we should give her equal importance. If we don’t always keep her among us and she will separate himself. Then her tendency will be to stay out of the house most of the time. In this case, there is a possibility of sexual harassment by other people.”-Parent of non-victim
	Social support	We all have to play a responsible role. We need to know what the risks are for children with disabilities, especially girls. Whenever we see a child with a disability at risk, we have to take action immediately. -Community member, social worker

Theme 1: Victimization

This section explored parents and community views about the reasons for which a disable girl becomes victim to sexual abuse. Both parents and the community agreed that girls with disability are easy victims to sexual abuse.

Parents and community members agreed that disabled adolescent girls are more likely to experience sexual abuse than disabled boys. Most parents consider poverty and poor social power are the key factors that influence a perpetrator to abuse a disable girl. Some parents of victim explained that a poor family is incapable to protest any assault due to their economic weakness and having less social power. Most of the community members argued that a poor family is often unaware of the protection of a girls with disability. These issues often contribute to the victimization process. Community members also mentioned maternal unconsciousness and low level of education as important factor for victimization.

Both community and family members perceived that sexual victimization happens because of the physical disability of the victim. Community members noted that the victim herself cannot sense the possible risk of abuse. In some cases, the victim also cannot figure out any unwanted actions by a perpetrator. Majority of the parents of both victim and non-victim think Physical disability is one of the significant risk increasers for sexual abuse to an adolescent with disabilities. They cannot defend or report when someone violates their personal boundaries. Parents of victims said in some cases, disable girl cannot tell who abused her. In a question that who are the perpetrators for a disable adolescent girl, a number of parents of both victim and non-victims and community participants think relatives especially, cousin and brother in law abuse a disable girl. Community members further added that sometimes neighbors and family friends abuse a disable girl.

Community participants said that many parents especially from low income group have psychological barrier accessing legal aid. They fear being close to legal activities and the institution such as the court and police station. Also, the they are captured with fear of social stigma. This psychological barrier is widely known across community and a perpetrator understands this barrier. Community added that poor people’s limitation of accessing legal aid encourages a perpetrator to abuse disable girl.

Theme 2: Perpetration

In this section, we explored views about the forms of perpetration occurs to a disable adolescent girl. Community members think abuse to a disable girl is easy because the offender is from the close circle including relatives or neighbor mostly. They further added that the occurrence of inappropriate touch is shown as permissive care to a disable child. Parents and the community both think disable girl’s mis-understanding about inappropriate behavior is also contribute to the perpetration attempt of an abuser. Community members think that disable girl’s inability to report the incident is another encouraging point for the perpetrator to abuse. Few community members mentioned that widespread community sense of caring and showing sympathy to a disable child is also a form of abuse. Parents narrated that perpetration is often influenced by the opportunity of negotiation after the abuse. They further explained that both relative and non-relative perpetrators try to normalize the offence of sexual abuse by paying compensation to the victim’s family after the incidence. One of the mothers shared her experience about how her daughter’s abuse incidence was normalized with money as compensation, saying,

“My eldest daughter was mentally handicapped. She was raped by a young man, the son of a local political leader, when she was 14 years old. We went to the ward councilor for arbitration. But the trial ends with the decision to pay us 10,000 taka as criminal compensation. "If my daughter needs more money for her treatment, they would pay and the offender should be forgiven. I had no one to ask for justice. I just cried inside myself helplessly." IDI-7, parent of a victim.

Both parents and community members reported that a caregiver sometimes abuse the girl. In case of working parents, the disable girls are left to a relative who have time for taking care of.

A member of the community described his experience of abuse, saying,

“My niece was disabled on her feet. He could not walk alone. Her father was a day laborer and her mother were a housemaid. They kept their daughter with her aunt (her uncle's wife) during work. We didn't even think that she would abuse girls as an aunt. My niece was then 16 years old so taking care of everything like bathing, dressing, feeding was not easy. One day her aunt beat her and took her clothes off so she obeys her. When her mother returned from work, she reported the incident. The parents had nothing to do with it. " IDI-9, Community member

One father of a victim described how his son-in-law abused his young daughter because she was physically disabled saying,

“My son-in-law used to come and stay in our house often. He would bring sweets for my little girl and spend time playing with her. I trusted him because he was close to us. Since, I am busy with work, and my wife also work outside so we cannot take care of my daughter every hour. I never thought that he would be involved in such a heinous act as a close relative. But he raped her and fled.” IDI 12, Parent of a victim.

Theme 3: Vulnerabilities and risks

This section explored the views and opinions of parents and community about the vulnerabilities and possible risks of disable adolescent girls.

A number of parents of both victim and non-victim and community members said that poor living arrangement creates greater vulnerabilities of sexual abuse to a disable adolescent girl. Participants explained poor living arrangement that included not having a house structure that provide privacy, comfort and protection. A school teacher explained how disabled girls from a poor family are more likely to be sexually abused saying,

"We know a disabled adolescent girl from a solvent family in our area. The girl is only cared for by her parents. Outsiders cannot meet her. On the other hand, everyone shows care for a disabled girl from a poor family. Anyone who has contact with his parents can get home. According to the report by her parent, the neighbor tortured her (attempted rape) when she was 17 years of age. So, he was pretending to be caring but actually he was creating space to abuse. " IDI -14, Community member, school teacher.

Community members feel disabled girls of working parents are more vulnerable to sexual abuse. Parents who work are out of the house from morning to afternoon every day. These long hours of parental absence create vulnerability for a disabled girl. Not being with a biological parent is another factor that creates vulnerability for a disabled girl. Poor security in the family and community was also cited by community members as a factor in creating vulnerability. A perpetrator tries to abuse a disabled girl when he finds her separated from her family members. When a disabled girl is isolated, it becomes easier for an abuser to approach her.

One parent of a victim described the difficulty of caring for and protecting a child with a disability, saying, “It is a burden to always take care of a girl. My daughter is a 15 years old child. I have problems especially when she wants to go to the toilet and take a bath. I can't handle all the cleaning activities of her.” IDI 12, Parent of a disable adolescent girl.

Theme 4: Protection

This section outlines some important areas that communities and parents think should be considered to ensure the protection of adolescent girls with disabilities.

Most parents and community members have voiced the need for increased empathy among family, relatives and community members. Adolescent girls with disabilities are bounded by these three levels. Parents feel that a disabled child should be considered as their child and a boy as his sister. Community members also emphasize on understanding the emotions and grievances of a disabled girl. The parent said that others should think of the victim’s family when their child is sexually assaulted. Asked how to foster this empathy in people, community members said parents should teach their children to be kind and helpful to others. Parental groups opined that older people show empathy towards disabled girls so that juniors will learn how to deal with disabled children.

A family member's connectedness to a child with a disability is another key to ensuring protection against sexual abuse recommended by community members. Both parents and community members cited their social support as protecting children with disabilities from abuse. Participants answered questions about the type of social support needed for children with disabilities, saying that support can be providing attention and care when needed. Parents believe that social support helps children with disabilities feel comfortable, joyful and confident outside the home.

Few studies have documented people's views on sexual abuse of adolescent girls with disabilities from the perspectives of parents and communities (Alriksson-Schmidt, Armor et al. 2010). This study analyzed the views of parents and community members regarding victimization, perpetration, vulnerability and risk and protection of disabled adolescent girls from sexual abuse. The results of this study show that the victimization process was perceived by parents and communities with several factors. But there is difference of views between parent and community about the incidence of sexual abuse to girls with disability. When sexual abuse occurs, parents show greater empathy with the girl while the community sympathizes with the girl and blames the parent. These mixed views and parent blaming are common among community members when they are politically conservative (Anderson et al., 1997). A study conducted in the USA found social dominance orientation as a factor influencing community members to blame the victim's parents (Sidanius et al., 1996).

Community and parent perspectives have shown how adolescent girls with disabilities are sexually victimized. Participants felt that 'being poor and having less social power' was responsible for sexual victimization, especially rape. Other studies on this subject imply that the desire for power may be a driving force behind sexual abuse. (Brownmiller, 1975; Burt, 1980;). Studies of a rape victim revealed that socioeconomic status-based power inequalities inside the rape scene may affect how the community views the incident. (Lonsway & Fitzgerald, 1994; Ward, 1995). Poor people are generally less connected to other social groups and therefore have limited opportunities to participate in social discussions about sexual abuse and to be aware of susceptibility (Runarsdottir, Smith et al. 2019). Also, a poor family is more likely to be unaware of the protection of a girl with disability due to the low education level of the parents. Another study found that low levels of awareness and maternal education are important for sexual abuse of their daughters (Preethi and Somasundaram 2020). Participants believe that the socioeconomic status of both victims and perpetrators may influence community views and

judgments about abuse. A poor family is considered incapable of resisting any assault. These problems often contribute to the victimization process.

The community emphasizes a disabled girl's mother's poor understanding of boundaries, which increases her susceptibility to potential sexual abuse. They argued that a mother is close to the daughter so she should know the places where the girl could be a victim. Community members also noted that mothers' inability to distinguish between appropriate and inappropriate behavior may increase the likelihood of victimization (Zimmerman GM, Posick C 2016, Marisa H. et al. 2012). The study also found that sometimes relatives and neighbors who are male offenders can abuse a disabled girl. In most cases a male cousin or a socially accepted brother abuses but disabled girls do not disclose the experience despite being able to speak. The widespread practice of patriarchy at the societal and family level may be one of the reasons for this silencing behavior of disabled adolescent girls (Pratto, 1996; Eagly and Wood, 1999;).

Participants cited physical disability as a major risk enhancer for sexual abuse of disable adolescents girls. Girls with disabilities cannot defend or report when someone violates their personal boundaries (Kaur and Garg 2008). The victim herself may not understand the potential risk of abuse when she accompanies a perpetrator (Dessie, Bekele et al. 2019). In some cases, the victim cannot detect any unwanted actions by a perpetrator (Kaur and Garg 2008, Mackin ML, Loew N, Gonzalez A, et al 2016). Both community and family members agree on this.

Another area of exploration that this study has accomplished is the perception of how perpetration occurs. Most community and parent opinions suggest that perpetration against a disabled adolescent girl from a low-income family is extremely common. Participants, including parents and the community, felt that perpetrating against a disabled girl is easier than perpetrating against an able-bodied adolescent. While other studies have suggested that a perpetrator abuses an able-bodied woman when given the opportunity (Plummer and Findley 2011), this study collected people's opinions to suggest that as offender usually grows the sense that a disabled girl will not be able to report if she sexually assaulted. This influences them to perpetrate a disabled girl and pave the way for abuse. The community explained that a perpetrator knows that a disabled girl has poor understanding of what abuse is (Tutty, Moorey et al. 2010). They also have a lower likelihood of disclosing any past incidents of sexual abuse. (Alriksson-Schmidt, Armor et al. 2010). Some other community members also feel that a disabled girl is not capable of reporting any experience of sexual abuse that work as increaser of their chance to be sexually abused.

Parents groups think that most economically powerful people are perpetrators. This finding is consistent with other research that also supports that economic power is a factor that influences an offender to abuse (Jennifer L. Matjasko, Niolon et al. 2013). Participants explained how serious sexual offence like rape are socially normalized. Parents shared their experiences of the perpetrator paying money or in-kind to the victim's family as compensation after an incident of abuse. It is a socially practiced way of normalizing the tension between the victim's and the perpetrator's family which is an obstacle to getting justice for the victim's family. Parents feel that perpetration can be committed by a relative, a neighbor and a caregiver. Parents often trust and rely on relatives because relatives also sympathize with a person with disability. Both parents and community members reported that a caregiver sometimes abuse disable girls. This finding is similar to other studies (Kohn and Verhoek 2011).

The study also documented views about the vulnerabilities and risk of sexual abuse of disabled adolescent girls. Parents and community participants felt that poor accommodation could create vulnerability in their home as a place in particular. Because poor living arrangements represent families as poor. Both parents and the community consider this as a conditioning factor that makes disabled adolescent girls susceptible to sexual abuse. Given that if a girl with a disability has a parent who works outside, the girl is more susceptible to sexual abuse (Murray, Nguyen et al. 2014). Working parents cannot accompany their disabled daughter so someone they know takes the opportunity to approach her. Girls who have disabilities are therefore especially susceptible to sexual assault. Another point both parents and community members agreed on is that girls with disabilities who do not live with their biological parents are particularly vulnerable to sexual abuse. Social workers explained that a disabled child, especially a girl, needs affection, appreciation and acceptance as well as protection. This is essential for children with disabilities who are targeted for abuse. Only parents can provide this emotional support to their children. Community participants felt that although penetrative abuse of a disabled adolescent girl was less common, the other non-penetrative abuse was more prevalent. Because parents cannot provide sufficient time to their disable girl. Being a poor family and social security were also cited by community members as factors creating vulnerability. A perpetrator tries to abuse a disabled girl when he finds her separated from her family members. When a disabled girl is isolated, it becomes easier for an abuser to approach her.

Communities and parents have mentioned a number of measures that can reduce the susceptibility of disabled adolescent girls to sexual abuse. In the first place they refer to increased empathy among all from family, kin and community level. Although there are some challenges to fostering empathy in people, empathic responses to the needs and caregiving needs of a disabled adolescent girl can increase her safety against abuse (Batson, Fultz et al. 1987, Lam, Silani et al. 2015, Hein, Morishima et al. 2016, Mathewsa and Collin-Vézinab 2016). Another recommendation that came from both communities and parents was family connections with adolescent girls with disabilities. Other studies have emphasized this recommendation to reduce susceptibility to sexual abuse (Stone, Luo et al. 2015, User, Alink et al. 2016). Comprehensive social support is sought by both community participants and parents to enhance protection of disabled adolescent girls against sexual abuse. This is a similar recommendation to that suggested in other studies (Rittmannsberger, Weber et al. 2022).

Limitations and strength of the study

This study has several strengths and limitations related to data collection and analysis. The first positive was that we could talk directly to the parents of the victims. Direct face-to-face interviews allowed us to discuss their thoughts extensively and understand their concerns deeply. It was also possible to capture their facial expressions during the interview which helped the study understand the severity of the incident and the importance of their views. A second positive aspect of this study was the opportunity to visit sites of abuse. This has helped the study to understand the perspective of the physical environment in which abuse occurs. Also, it was possible to directly discuss with the people of the community and observe their social status and social environment. This helped the study connect their position with their opinion. A third aspect of strength was that the study collected data from multiple sources that validated the findings.

In addition to strengths, this study has some limitations. The first point of limitation was that we could not interview any offenders. It could help us understand the perpetration process more clearly and it could be helpful to generate different opinions about the abuse. The second and final point of limitation is that considering the sensitivity and confidentiality of the research problem respondents may not disclose all the subjects they have been victimized.

This study explored the parents and community perceived determinants of sexual abuse of adolescent girls with disabilities. Being poor and having low social power, low levels of maternal education and lack of awareness, physical disability and mental barriers to accessing legal services are considered to be factors that may increase susceptibility to victimization. The factors that influence a perpetrator include economic status and power grabs, opportunities for socially driven negotiation of offence, confidence that a disabled girl is unable to report the incident, disabled girl’s misunderstanding and social acceptability of inappropriate behavior of a perpetrator. Perceived factors for vulnerability and risk of sexual abuse were poor accommodation and living away from biological parents. Community and parents made some recommendations to protect adolescent girls with disabilities including increasing empathy among all, maintaining family connection with the disabled girl and social support.

Icddr,b: International Centre for Diarrheal Diseases Research, Bangladesh

ADD: Action on Disability and Development

NGO: Non-Government Organization

Ethics approval and consent to participate

This study was a part of the honors dissertation of the first author (Student ID 05023228) in the Department of Anthropology, University of Rajshahi. The Department of Anthropology and the Dean's Office of Social Sciences, Rajshahi University carefully reviewed and approved the study methodology. The ward counselor's office at the community level was informed about the study and verbal consent was obtained. In addition, verbal consent was obtained from parents, community members and adolescent girls with disabilities for interviews. The consent process included an explanation of the nature of the study, its importance, and objectives. The consent process guarantees data confidentiality and also declares that participation was voluntary and refusal to participate does not result in loss of any rights or privileges. Participants were told that they had the right to withdraw their participation in the study at any time during the interview.

Consent for publication

The informed consenting process included participant’s signature or thumb sign on the consent paper. Availability of data and materials

This study collected and analyzed data not available outside the research team due to commitments in the consent form. This data can only be shared by the corresponding author upon valid request

Competing interests

All the authors declared not conflict of interests.

Funding

This research was conducted at own expense of the first author. No research grant was received.

Author’s contribution

Md. Khobair Hossain conceived the idea and designed the study, conducted the interviews, analyzed the data, interpreted the participants' statements and opinions, and drafted the manuscript. Md. Nazrul Islam was involved in drafting the paper and conducted the literature review. Md. Hafizur Rahman conducted transcription of interviews, coding and summary writing. S.M. Shafiul Alam and Tarana Mustari interviewed the victims and their guardians. Md Kamal Pasa supervised the research and reviewed the paper critically for intellectual content and approved the final version for publication.

Acknowledgement

We are thankful to all the participants of this study for their cooperation and time for the interviews. We also appreciate the supportive role of the NGO ADD for their coordinated effort to find adolescent girls with disabilities and victim cases.

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Parental and community views on determinants of sexual abuse of adolescent girls with disabilities in Bangladesh

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Abstract

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Study design and sampling

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Data analysis

Ethical considerations

Results

Participants characteristics

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