Sexual abuse in childhood is bad for your health. Not only for emotional and mental health, but also for physical health over the entire course of ones lifetime.

By now many of us have heard of the Adverse Childhood Experiences Study (ACE), the far-reaching CDC study that took place over the course of 15 years. The study identified 10 adverse childhood experiences such as physical, sexual or emotional abuse, neglect, mental illness or incarceration of a parent, etc. Nearly 17.5 thousand individuals took part in the study which conclusively linked the prevalence of adverse childhood experiences to serious medical and social problems later in life. Of those 17.5 thousand men and women in the study, 20.7%, or approximately 3600, reported sexual abuse in their childhoods.

While the ACE study has come to be well known and (justifiably) impactful to our understanding of serious health issues in adulthood, it is the accidental origin of the study that causes me to have a visceral reaction.

In 1985 Dr. Vincent Felitti, a highly esteemed chief of Kaiser Permanente’s Department of Preventive Medicine in San Diego, CA, was following up on drop out patients in his obesity clinic. He was puzzled as to why nearly 50% of his patients dropped out of the study, many after losing significant weight.

During the course of conducting face-to-face follow up interviews, he asked questions to shed light on the correlation between weight and childhood development. In one interview he meant to ask the question, “At what age were you first sexually active?”  He mistakenly spoke, “How much did you weigh when you were first sexually active?”

The patient, a woman, replied, “40 pounds.” Thinking he had misheard the answer, Dr. Felitti misspoke the question again. The woman bust into tears and said, “It was when I was 4 years old with my father.”

When Dr. Felitti realized what he had asked, he recalls, “I remembered thinking, ‘this is only the second incest case I’ve had in 23 years of practice.’”

As he continued with the interviews, the results were the same. Dr. Feletti thought, “This can’t be true. People would know if that were true. Someone would have told me in medical school.”

The rest is, as we say, history. Dr. Felitti’s shock at finding similar stories (of the 286 people whom he and his colleagues interviewed, most had been sexually abused as children) led to further study that in turn prompted the CDC’s involvement in the full-scale study we now know as the ACE study.

It is true that in 1985, the reality and prevalence of childhood sexual abuse was just coming to be known. But I wonder about how much has changed. If the scenario of Dr. Felitti’s follow-up study were conducted in 2015 would the shock and incredulity be any less? How many survivors continue to struggle to be heard and receive validation that their physical symptoms are an outcome of childhood cruelty? Do we now truly understand that the effects of childhood trauma change, not only the emotional course of one’s life, but change the very physiology of one’s body?

I have read over the ACE study’s origins many times in the course of research and the sorrow I feel for the woman whose first sexual experience occurred at 4 years old (and all the survivors she represents) and my astonishment at the total lack of awareness of the interviewing doctor do not wane. I long for a better world for those whose childhoods set them up for a lifetime of emotional, mental and physical suffering.

The good news in this story is that Dr. Felitti allowed his assumptions and beliefs to be challenged. He allowed his eyes to be opened. He continued on to gather support to delve more deeply into the connection between adverse childhood experiences and the physical damage it creates and initiated a study that proves this connection conclusively.

In this month of sexual assault awareness it seems fitting that we do the same. Perhaps we are the community of individuals who allow our eyes to be opened to the 1 in 5 survivors in our midst.  Perhaps the change in awareness begins with those who gather the courage to allow their safe assumptions to be challenged. Perhaps we all begin to recognize both the long-term suffering of survivors and the need to seriously address this suffering to offer opportunities for healing.