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Section 19
Case Study: The Development of an
Adolescent Female Sex Offender

Question 19 | Test | Table of Contents


Carol Smith (fictitious name) is the youngest child and only daughter in a working-class family located in a South Texas rural community. Mr. and Mrs. Smith married at the ages of 18 and 17, respectively, due to an unplanned pregnancy which produced John. Within one and one-half years, the second son, Wayne, was born, followed by Carol 14 months later.

A watershed event occurred when eight-year-old Carol wandered away from the family home and stopped to watch a tetherball game in progress. The adolescent Hispanic males, who were the participants, decided to make her the "prize" of the game, i.e., whoever won got Carol. A 17-year-old won the game. Carol described the following events: "I got scared when they would not let me leave. They kept making me sit in a swing with K who I thought was my friend. After R. won, he took me into a garage where there was an old dirty mattress. He kept putting his fingers inside of me trying to stretch me so he could put his thing in. When he finished, two other boys came in and tried but theirs would not go in me."

When the adolescents allowed her to leave, she went home where only her oldest brother, 12-year-old John, was present. She showed him the blood resulting from the rape and he told her "to be sure and not tell Mom or Dad" or she would "get into trouble."

For the previous several years, they had been playing children's games of "Doctor, Doctor" and the "Dating Game." John acted as the suitor and Carol as the daughter, with ten-year-old Wayne acting as the father and the director, i.e., telling John to "kiss her here, touch her there." Within months of the rape, the children's game progressed to removing all of their clothes, and they began to engage in sexual intercourse. Over the years, the intercourse continued on a regular basis although Wayne was excluded from his voyeur role by threats and physical altercations perpetrated by John.

Carol became increasingly oppositional around age 10 and was continuously in trouble at school. She was diagnosed with a reading disability. She was drawn to peers who also did poorly in school and spent more time skipping school than being in class. She began using alcohol and drugs and became sexually promiscuous outside of the family around the age of 11.

At this time, Mr. Smith secured a contract job on the West Coast and temporarily moved the family there to reside in a small apartment so that he could be near them. With the stress and strain placed on the isolated, crowded family by a fatigued and frustrated father, sexual interactions increased between Carol and John. Carol was approximately 11 years of age while John was 15. It was at that time that Mrs. Smith acknowledged that she became aware of "something going on between the kids." Wayne eventually told his parents that Carol and John were having sex.

Upon returning to Texas, Carol's behavior at school became more unmanageable. At the school's urging, Mrs. Smith took the children to a local family treatment agency. Only Carol and John were seen on a regular basis. After each therapy session, in which the children promised not to have sex, they would return home and engage in intercourse. By this time, Carol had moved from waiting for what she viewed as nurturing interactions with John to manipulating and controlling him with threats of telling if he became scared of being caught and rejected her advances. Carol's peer interactions continued to deteriorate. She had at age 11-1/2 one unnoticed suicide attempt, i.e., she ingested the remainder of a bottle of her mother's medications. She slept for 48 hours, and her mother and father report they felt she was only fatigued.

At age 12, Carol was admitted to an inpatient psychiatric unit after a peer reported that Carol requested her to bring bullets to the school for a gun so that Carol could kill herself. Carol had stolen $80.00 from her father to buy the bullets. The theft of the money caused an uproar in this financially strapped family; and in their view, the theft of the money, not the suicidal ideation, was the leading reason for Carol's hospitalization.

During the 3-1/2 month hospitalization, the sibling sexual activity was not disclosed by her parents in weekly family therapy sessions nor by Carol in three-times-weekly individual sessions, nor in the inpatient milieu therapy until two weeks before the planned discharge date. Discharge was carried out as planned, with precautions to prevent further sexual contact. The treatment plan included intensive outpatient family therapy with a female family therapist.

Overt problems began to escalate again after John became disturbed one evening when Mr. and Mrs. Smith went out to dinner alone and left the three adolescents at home. In an age-inappropriate game of "cops and robbers," John reached out "accidentally" and grabbed Carol's breasts. Upon the parents' return, Carol and Wayne described the situation to them in detail. Although no physical abuse occurred, a great deal of emotional abuse was inflicted upon John. He voiced fear that family members would be separated because of his actions. He felt intense guilt and expressed suicidal ideations in an individual session with the family therapist. Subsequently, he was admitted to the adolescent inpatient unit of the hospital where Carol had been treated. During his admission, John was treated individually by a male therapist who began co-therapy with the female family therapist.

When John was nearing discharge, Carol ran away from home. After she was caught by the police, she was rehospitalized due to suicidal ideations and the inability of her parents to maintain control over her. There was a three-day overlap on the adolescent unit of the brother and sister. However, none of their peers became aware of the pair's previous sexual activity. After John left the hospital to return to his extracurricular activities and his on-grade-level academic work, Carol remained in the hospital, catering to male peers, isolating herself from female interactions, and threatening to run away from the hospital. She engaged in overt sexual tantalizing of male peers, which served to isolate her further from female peers. The consistent sexually inappropriate behavior was noted by staff, teachers, and other treatment providers, and the staff often expressed feeling a need to defend the adolescent males from Carol's advances.

Carol made the transition to sex offender after several months into this second hospitalization. While on a week-long furlough to visit Mrs. Smith's extended family in another area of the state, Carol sexually molested her seven-year-old male cousin, Mike. Carol and Mike were in a deserted farmhouse to which Carol had returned after a walk during which she had been sexually propositioned by a male she had come upon. Describing herself as "feeling horny but being afraid to go to the arranged meeting place" with the unknown male, Carol located Mike in the farmhouse. She proceeded to remove her clothes and his and attempted to insert his penis into her vagina. John viewed this activity through a window, entered the farmhouse and told Mike," Here, let me show you how this is done." At that time, John and Carol engaged in sexual intercourse.

This incident came to light two months later when Mike's mother and grandmother discovered pornographic pictures and sexually explicit words written on paper on Mike's desk. Mrs. Smith was notified by Mike's mother. When confronted, Carol denied any involvement with Mike and became argumentative and hostile. It took approximately two weeks of three-times-weekly individual sessions, plus the knowledge that John was breaking down in his denial of the incident, along with an interview with Children's Protective Services, before Carol acknowledged the offending act. No charges were filed at the request of Mike's mother, partly motivated by the wish to prevent other members of the family, such as Mike's grandfather, from finding out. Carol expressed remorse over Mike's feelings only after intensive interventions which had acknowledged her own feelings at eight years of age when she had been brutally raped. She denied any sexual pleasure derived from the act with Mike and reported only wanting to "show him what it was all about."

Residential placement was secured for Carol, and while there she increased her promiscuity by acquiring a new boyfriend almost weekly with her sexual offerings. She did make female friends but did not perceive them to be as important as the males. She also began engaging in self-mutilating behavior by gouging deep grooves in her skin with her fingernails. On two of her three runaways from the facility, she traveled hundreds of miles to large cities by hitchhiking and prostituting herself for rides. The staff at the residential facility deemed her treatment a failure and discharged her home after eight months.

At that time, Carol reported that she and Wayne had begun engaging in sexual intercourse during her visits home during the past year. Even while offending with Mike, Carol had remained in a defending mode with Wayne because as she described it: "When he started coming on to me, I just could not tell him no. I did not like it, but I did not want to make him angry at me." Of interest was that while Carol expressed fear of Wayne's anger, she was at least three inches taller and outweighed him by 20 pounds or more. She perceived herself as more vulnerable than her size may have suggested. At home, she is engaged in individual as well as family therapy once per week. The self-mutilating and running-away behaviors have not resurfaced. However, prognosis for this young woman is guarded, at best.
- Higgs MA, Deborah C, Margaret M. Canavan PhD, and Walter J. Meyer III MD; Moving from Defense to Offense: The Development of an Adolescent Female Sex Offender; Journal of Sex Research, Feb92, Vol. 29 Issue 1

Personal Reflection Exercise #5
The preceding section contained information about the case study of an adolescent female sex offender. Write three case study examples regarding how you might use the content of this section in your practice.
Reviewed 2023

Update
A meta-analysis of trends in general, sexual, and violent
recidivism among youth with histories of sex offending

- Lussier, P., McCuish, E., Chouinard Thivierge, S., & Frechette, J. (2023). A meta-analysis of trends in general, sexual, and violent recidivism among youth with histories of sex offending. Trauma, violence & abuse, 15248380221137653. Advance online publication. https://doi.org/10.1177/15248380221137653


Peer-Reviewed Journal Article References:
Assink, M., van der Put, C. E., Meeuwsen, M. W. C. M., de Jong, N. M., Oort, F. J., Stams, G. J. J. M., & Hoeve, M. (2019). Risk factors for child sexual abuse victimization: A meta-analytic review. Psychological Bulletin, 145(5), 459–489.

Barra, S., Bessler, C., Landolt, M. A., & Aebi, M. (2018). Testing the validity of criminal risk assessment tools in sexually abusive youth. Psychological Assessment, 30(11), 1430–1443. 

Cleveland, K. C., & Quas, J. A. (2018). Parents’ understanding of the juvenile dependency system. Psychology, Public Policy, and Law, 24(4), 459–473.

QUESTION 19
When did Carol make the transition to sex offender? To select and enter your answer go to Test
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