Case 34

Sexual violence in the home in Japan


  1. To show that the care of a victimized child becomes difficult or even impossible when the parent/guardian is uncooperative.


  1. To show that when no organization takes responsibility for the care of a victimized child and the parent/guardian behaves in an unethical manner, the situation becomes unremediable.


Narrative Case

The victim is an 11 year-old girl with 4 older and 2 younger brothers of which the eldest was 16 years old. She was taken to the emergency department by ambulance due to severe abdominal pain and was found to be 30 weeks pregnant. It was suspected that one of the elder brothers had impregnated her, but the details were unclear. [1]


The parent refused an interview visit by the child consultation and protection centre and missed an opportunity for the girl to have help from agencies. [2]


When the girl was admitted to the paediatric department after delivery [3] her mother came and took her away without permission, and afterwards, returned to take the baby. The mother then moved out of her home without notice. Care for the victimized child could not be provided. [4]


Learning Points

[1] In cases of sexual abuse by a family member, it is difficult to clarify the details.

[2] The mother refused intervention by a public institution, and the responsible staff did not intervene because the mother insisted, “the girl is the baby’s mother, let her bring it up”

[3] Comprehensive teamwork by responsible sectors is important such as the departments of paediatrics, obstetrics and gynaecology and psychiatry, with expert government or NGO sector teams.

[4] The horizontal cooperation in [3] is difficult because of the vertical administration system, which prevents sharing of information.


Background information

  1. It is thought that there was domestic abuse.
  2. As there is no law in Japan requiring the reporting of the girl’s pregnancy to responsible sectors/organizations, the intention of the family is given priority over the care of the victimized child.
  3. Communication between the child consultation centres in different local governments does not occur because of independent management by the separate local governments. Therefore when a family moves to another city, follow up is virtually impossible.



As it is so difficult for victims of sexual abuse by a family member to report the crime, the full extent of these crimes is unknown.

  1. Record keeping of child abuse consultations began in 1990 in Japan. Consultations have increased over the years with 1,101 consultations in 1990, 11,631 in 1999, 37,323 in 2008 and 59,862 in 2011.
  1. Abuse by type in Japan (1999): Records of consultations and notifications of abuse provided by the child consultation centre.

1) Physical abuse constituted 53% of the child abuse consultations/notifications. The assault records showed:

  1. Contusions and bruises in 69.9%
  2. Burns in 13.4%
  3. Head trauma in 12.1%
  4. Fractures in 5.5%
  5. Stings in 2.7%


2) Negligence or refusal of protection (neglect) constituted 32% of the child abuse consultations/notifications. Neglect records showed

  1. Negligence in 60%
  2. Deserted child/left behind in 35%
  3. School ban in 4%


3) Psychological abuse constituted 9% of the child abuse consultations/notifications. This showed an increase by about 2.5 fold compared to other types of abuse. In most cases, psychological abuse overlapped with other types of abuse.

4) Sexual abuse constituted 6% of the child abuse consultation/notification. Around

6% of sexual abuse cases led to pregnancy

  1. Age Composition of abuse cases (2006). Total number 37,323 (100%)
  1. Type of abuse cases (2006)

In cases of child abuse, the parent/guardian generally does not give a detailed account of the abuse, so it is impossible to assess the situation fully.

An urgent task is the construction of a comprehensive network between the different agencies involved including police, medical departments such as paediatrics, obstetrics and gynaecology and psychiatry, and expert government teams to work as “The One Stop Centre” providing physical and mental support to child abuse victims.



  1. Child abuse statistics and types of abuse

Case 33

Sexual violence in a 17 year old girl in Japan


  1. To show that the victim of domestic violence often has poor knowledge about such violence.
  2. To show that, in many cases, young people do not realize that their date partner has treated them violently.
  3. To show the importance of notifying organisations working to prevent domestic violence

Narrative case

A 17-year old high school girl visited an obstetrics and gynaecology clinic for the prescription of oral contraceptives accompanied by a partner. After several visits for repeat prescriptions, the clinic staff noticed unusual behaviour by the girl’s partner. He always phoned the clinic to ask how the girl behaved and what she said in the clinic. After talking with the girl, the staff noticed signs of domestic violence [1].

The clinic decided to give the girl only short term prescriptions thereby aiming for more frequent visits and to have more time to talk with her. After many visits, she finally told them that she received frequent violence such as hitting, kicking, shooting by an air gun, and being forced to have sex without contraception [2].

The clinic notified a nonprofit organization (NPO) acting against domestic violence about this case. After 4 months, the NPO and the girl contacted her elder brother, the most intimate and reliable person of her relatives, for approval for the NPO’s intervention in this matter [3]. As she did not confide in her brother initially, her abusive relationship was prolonged.

With concrete advice and support by the NPO, the girl could behave in a more independent manner and finally separated from her partner after painstaking effort [4].

Learning Points

  1. Without an understanding of domestic violence, people, especially young people, do not recognize that they are victims of domestic violence. Educating pre-teens, teenagers, and young and older adults about domestic violence is essential
  2. There are many young people who do not recognize that violence from a date partner is domestic violence. There is a need for all healthcare workers to be able to recognize domestic violence as victim rarely come forward.
  3. An adviser close to the victim of domestic violence is important.
  4. In many cases, consultation with a specialized organization is important in changing the victim’s awareness of domestic violence and finding a solution to it. It is vital that staff in sectors which come into contact with victims of domestic violence are educated about it.

Background information

Sex education in Japanese schools is insufficient.


  1. Positive responses from 3,293 adults to a domestic violence questionnaire concerning such violence when 20 years old or younger (2012) showed:
  • Physical assault and/or psychological attack and/or sexual coercion:14% for females, 6% for males.
  • Physical assault: 8% for females, 4% for males.
  • Psychological attack: 8% for females, 4% for males.
  • Sexual coercion: 7% for females, 1% for males.

2. Responses to a domestic violence questionnaire 4413 responders out of 5000 questionnaires for high school and university students in Gifu Prefecture (2013)

  • Physical assault: 10% for females, 6% for males.
  • Psychological attack:34% for females, 24% for males
  • Sexual coercion: 16% for females, 3.% for males



  1. Survey on violence between men and women
  2. Women’s counselling centre. A year’s worth of consultations.
  3. Dating and domestic violence.


Case 32

Sexual violence in a 14 year old girl in Japan


  1. To show an example illustrating that lack of knowledge about sex can lead to an unwanted pregnancy.
  1. To show adult exploitation of a mobile phone dating site to obtain sex with a child.


Narrative Case

A 14-year-old girl became pregnant after having sex with a man met through a mobile phone dating site [1].

The girl thought that intense physical exertion engaged in during a club activity at school was the cause of cessation of her menstruation and did not realize that she was pregnant. Her family did not notice anything amiss [2].

Her mother thought that her daughter had a bowel problem, not morning sickness, and brought her to the hospital. At the hospital, the physician failed to notice that the girl was pregnant. By the time it was realized that the girl was pregnant, she was beyond the upper limit of gestation for an abortion. She had to stop attending high school to give birth to the baby. Her family informed the school that she would be hospitalized, due to illness, until after graduation. The school, however, generously gave her a Graduation Certificate. A district welfare commissioner became aware of the situation and advised the family to consult with a lawyer; the man was accused of having sex with a minor and arrested, and found guilty in court. The baby was adopted and raised by the girl’s family [3].

Learning Points

[1] In Japan, there are many men having sex with girls met through mobile phone dating sites knowing that the girl is a minor.

[2] The high school girl was entirely ignorant of the risk of pregnancy after sex. Young people need to be urgently educated about sex, menstruation and pregnancy in school to prevent such incidences. There is a need for cooperation between schools, health centres and the police.

Background information

  1. Dating sites were introduced with the i-mode service of mobile phones in 1999, and the Child Prostitution and Child Pornography punishment law was enacted the same year. However, the prevalence of young girls carelessly dating and having sex has not yet improved.
  2. Sex education in schools in Japan is insufficient.
  3. Sexual violence perpetuated by adult males remains tolerated.  It should be categorically repudiated as a matter of social awareness and responsibility


  1. Teenagers giving birth:
  • 1985    17,877 live births
  • 2002 21,401 live births
  • 2007 15,250 live births (1.4% of the total live births; 5 teenagers/1000 total females gave birth; 39 teenagers 15 years old or younger gave birth).
  • 2010 13,546 births (1.2% of the total live births)
  1. Teenage abortions:
  • 1995   26,117 abortions (6.2 teenage abortions/1000 total females)
  • 2001   46,511 abortions (13 teenage abortions/1000 total females)
  • 2007   23,985 abortions (7.8 teenage abortions/1000 total females)
  • 2010   20,650 abortions
  • 2011   20,903 abortions      

After 2002, there was a decrease in teenage abortions. One possible factor was access to birth control pills. However, birth control pill usage was only 3% in women aged 16 to 49 years old in Japan. Another possible factor was support by local government.

In order to alleviate loneliness and to obtain money, young people including minors are easy prey to sexual predators. Society should protect the rights of boys and girls.


  1. Maternal and child health information. (2009). Responding to young pregnancy, childbirth and childcare. November: No 60.  
  2. Maternal and child health information. (2009). Responding to young pregnancy, childbirth and childcare. November: No 60
  4. Satako O. Way of life of the teenage mother.