Sexual Abuse in Munchausen Syndrome by Proxy: Part 2 – Case Studies

In this post, I continue the series by reviewing one of two articles that focuses on the particular type of sexual abuse that appears to only happen in MSbP families. These are literally the only two articles we found focusing on this particular type of abuse.

Harmful Genital Care Practices in Children: A Type of Child Abuse

This 1989 article is the first one to be published. In it, authors Herman-Giddens and Berson describe several cases.

Case 1: Schoolteacher and 6-year old

A schoolteacher took her 6-year-old to the doctor because she had cough and abdominal pain, and upon examination, the healthcare professionals noticed the child’s vagina looked traumatized. The opening was bigger than it should have been, and hymen tissue was missing from where it should have been.

They interviewed the child, and the child reported the mother would wash her by using her finger, adding soaps and creams, and penetrating the child’s vagina, moving the finger in and out.

The child reported it was extremely painful. The mother was interviewed and corroborated the child’s story.

Empty classroom

Case 2: Schoolteacher and the 12-year-old

In this case, the 12-year-old was presenting for “leaking urine” and vaginal discharge, and reported her schoolteacher mother was always rubbing creams on her genitals to “tone things up”. The child’s pediatrician had already worked her up several times for vaginal discharge and “leaking urine” and never found these claims to be substantiated.

The child had already undergone three invasive medical investigations for this at age 5: a vaginoscopy, cystoscopy, and intravenous pyelogram.

This case is a great example of how MSbP perpetrators not only cause health care providers to wrongly believe their victim has a medical issue, but use this to their advantage to recruit the medical field to help them with their abuse. In this case, through these three procedures, the medical field added to the medical abuse and trauma this child was already enduring.

Case 3: Dad and the 6-year-old

In this case, a dad and mom were divorced, and the dad perpetrated medical sexual abuse on his 6-year-old because he purportedly believed that the daughter experienced “chronic chafing due to lack of poor hygiene” when visiting her mother.

He slept with the child, referred to her vagina as, “Boobley”, and asked about Boobley several times per day. He would rub creams and powders on Boobley.

Baby lotions and creams

Even though this situation came to the attention of healthcare providers, the authors report, “The child was seen twice more during the next several years, with increasingly abnormal findings on genital examinations”. This is a classic example of how instead of intervening, the researchers allow the abuse to continue so they can study it. This is similar to what happened in the Tuskegee Syphilis Experiment.

What do you call this?

I believe this type of abuse should be called “medical sexual abuse” and be defined as “ritual genital inspection and cleaning”.

  • The “medical” in medical sexual abuse covers the fact that this is seen as a medical intervention by the perpetrator, not some sort of sexual relationship as typically seen in sexual abuse of minors.
  • The “ritual” covers the fact that there is a ritual involved – the perpetrator conducts the abuse according to ritualized steps that she feels are necessary, the way people with obsessive-compulsive disorder conduct their pathological rituals.
  • “Inspection and cleaning” cover what the perpetrator believes she is doing when executing the ritual. She believes (or wants others to believe that she believes) that she is protecting the child through inspection (because she purportedly believes someone else is sexually abusing the child and she is looking for evidence), and/or thorough cleaning (she is just keeping the child clean).

I hope future researchers and journalists will look into this angle when studying MSbP from now on, and will use the terms “medical sexual abuse” and the phrase “ritual genital inspection and cleaning” when talking about this issue.

Want to read more case studies of medical sexual abuse?

See my next blog post in this series, which talks about the second scientific article on aberrant genital practices.

Images by Malate269 and ParentingPatch.


3 thoughts on “Sexual Abuse in Munchausen Syndrome by Proxy: Part 2 – Case Studies

  1. Monika, I know your working on a chapter for a book and all. But I still don’t know quite what your position on all this is. Learning more about a topic is always good. But you say you want to end child abuse by research. Not sure what you mean.

    I helped to get a man convicted of multiple felonies and get a very long sentence. What he did was less severe than what you have written about.

    If you offer any kind of counseling, or treat it as a public health matter, than that would mean committing the felony of non-compliance with mandatory reporting. The reason we have this is because middle-class child abuse always involves doctors.

    And it would always be yet another way that the parents can turn it back against the child, make it where the child is wrong and needs to be fixed.

    So it has to be always treated as a Child Protection and Criminal Prosecution matter. Only the court has authority over the parents.

    If you want to educate people before it rises to the level of any suspected child abuse, that would be fine except that the parents really do believe that they are right. They had children in order to prove this. So what you say will not be effective.

    In my PDM case the way it started was the youngest girl, 13yo, 8th grade, went to a youth center. We do have a publicly funded youth center. This sort of thing is very important.

    So this girl talked to an intern youth counselor. She said some things which did not sound right.

    This young intern proceeded to do exactly what the law required. To do anything else would have meant that she was committing a felony.

    She asked more questions and then without consulting any supervisor she wrote it up and faxed it CPS and police.

    Now this youngest girl was the one who had gotten the least of it, and she was the one most able to stand up for herself.

    Soon a police detective was tracking down the eldest daughter. Then they used a different detective to make a video interview of each family member. They have this real nice kiddie room with a nice carpet and furniture and stuffed animals.

    Then when they came for the defendant, he saw them and jumped into his car and started the motor. They blocked him in. When they put the bracelets on him, the wife said, “Officer I don’t think you understand, he is our only source of income.”

    I know the police officer who wrote the report. He did not have to include all of that, but I’m very glad that he did.

    Now getting a conviction turned out to be far harder than I had ever imagined possible, and my role expanded beyond what I had ever imagined.

    But again what this guy did was far less than the things you have described on this blog.

    This is how children are protected, by CPS and Police, and by the Courts.

    Anything which resembles therapy or recovery is just more abuse, a Second Rape upon the child.

    And most interesting, this guy’s entire Pentecostal church stood behind him, as they all have scapegoat children of their own.



    • Hi Nomadic,

      That is a very sad story you tell. Please let me say that I do not engage in comparing traumas. When you say what I went through was far less than what these kids went through, my response is I do not compare traumas, period. I’m glad you got the conviction.

      My point is just that there are different kinds of child abuse, and with MSbP, people have to be vigilant about seeing the “smoke” of ritual genital cleaning that leads inevitably to the “fire” of MSbP, just as the little girl reporting abuse in your story was the “smoke”, and after investigation, we find the “fire” of the dad abusing the kids. What if they had not listened to the little girl? That would have been bad. But people (including me, until recently) generally do not know that this behavior, ritual genital cleaning, is a sign that the child might be in the process of being tortured to death. Raising awareness of this is important – but not in the general population so much as in the healthcare system. And then setting up the healthcare system to mandatorily report it, and deal with it appropriately, will help.

      So I don’t disagree with the gist of what you are saying. I’m just pointing out that my point is a lot more narrow that I think you give me credit for. It’s just a very particular point specifically about MSbP and ritual genital cleaning and the healthcare system, and not a general point about child abuse, mandatory reporting, courts, etc.



  2. Very serious matter. In the PDM trial they tried to use pin worm examinations, trying to catch the worms with scotch tape, as an excuse. They were using these exams, probably not to abuse, but to call the girls liars.

    All very serious!

    Handcuffs and child protection, not therapy and recovery.



Please reply!

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s