Every high-risk field learns the same lesson eventually: rules, vigilance, and culture aren’t enough to keep people safe. It takes a system that proves protection is working. Medicine, aviation, and cybersecurity all learned it. Sexual abuse has just reached the same point.
The case for protecting children and vulnerable adults makes itself; the commitment has never been the problem. The tools are a different story in that they are important but incomplete.
By the number—from United Educators (UE)
Publicly reported education losses of $250,000+ rose from 22 (2016) to 118 (2024); the $10-million-plus tier rose from 2 to 25.
Sexual misconduct’s share of UE’s claim costs rose from roughly 10% to 30% in four years; it’s the costliest category.¹
And it is not a problem of the past: the first nationally representative study of youth-serving organizations found child sexual abuse no less common today than a generation ago—about 1 in 27 still experience it.²
Why now: Abuse itself isn’t rising, but the share that surfaces is, and so is its cost. Reopened statutes bring past abuse to court, and those cases are showing what counts: evidence created at the time, not defenses assembled decades later. Extended statutes mean today’s protection will face the same judgment years from now. Survivors are more willing to come forward, as they should be. And juries price the harm higher every year. The cost has outrun what insurance can cover, to the point where some organizations now ask not how they work with children and vulnerable adults, but whether they can.
You Can’t Insure Your Way Out
At the extreme sits the largest single-child abuse verdict on record—$485 million, New Mexico, 2023—settled for $400 million between three children.³
Even limitless insurance only covers one kind of consequence, financial losses, and not even all of that.
The damage runs from the inside out:
People: harm to the child or vulnerable adult that the institution exists to protect. Nothing undoes it.
Mission and trust: an institution that fails the people it exists to protect has failed at its purpose.
Operations: an allegation alone can consume an institution for months.
Regulatory exposure: Title IX findings, federal investigations, Clery Act violations.
Leadership: the presidents and boards may not survive the fallout.
Finances: insurance covers legal liabilities (settlements, judgments, and defense costs) but not lost revenue or funding.
The traditional toolkit of background checks, training, policies, and reporting reaches almost none of these. Only reducing the risk itself addresses the full list: lower the chance of abuse, catch it early, and reduce the consequences if it occurs.
Tools Built to Demonstrate, Not to Reduce
The current toolkit wasn’t designed to reduce risk. It grew out of the Catholic Church’s crisis, when the aim was to show it was taking abuse seriously. The tools that followed were instruments of demonstration: they show effort, but cannot keep pace with a living risk as it evolves.
Through reporting, the tools go beyond prevention. But reporting waits, usually until someone actually suspects, and lives or dies on whether that person acts.
Consider New Mexico State University where two basketball players said teammates had assaulted them repeatedly. One asked a coach for help. According to the lawsuit, the coach laughed and asked, “What do you want me to do about it?” The settlement was $8 million.
Reporting failed at the first hurdle. But because people are fallible—distracted, overloaded, unsure—relying on any one person is a systemic failure, not an individual one.
What Every High-risk Field Figured Out
Medicine: Once, it accepted bloodstream infections in intensive care as unavoidable; never acceptable, but simply thought inevitable. Then Peter Pronovost drove those infections down by up to 66% across more than 1,000 hospitals through system design and measurement, not more rules.
Cybersecurity: Once, it relied on walls. It still builds them, but now assumes they’ve been breached and hunts for intruders continuously. Detection systems watch for what the walls can’t.
Neither field abandoned prevention. The pressures differed; the change did not. Each added a system and continuous measurement to make prevention reliable.
Every statistic our field records is outcome data—prevalence, losses, verdicts—with nothing about protection. For a harm that hides, what could be measured? The protection itself. On top of outcomes, medicine started checking that the sterile steps were followed, every time, line by line. The same checking applies to abuse: are controls working, is attention holding, and is drift caught? Answer those continuously, and the record and the defense create themselves.
The approach has a name, and it’s called safety science. Medicine’s version is patient safety. Ours is sexual abuse safety.
Four Commitments to Sexual Abuse Safety
Sustained continuously and together:
Own: The people doing the actual work must build the controls, because they know where sexual abuse risk lives. Controls are concrete: who rooms with whom on a team trip, or who is present during a medical exam. In building them, they come to own both the problem and the solution, and that ownership commits them to the system that sustains those controls.
Systematize: A living system carries the discipline that willpower alone cannot sustain. Controls that depend on individual vigilance will eventually fail, whereas controls built into the system are designed not to.
Measure: Track whether the system is working continuously, not just at an audit. In the same study, abuse was lower where monitoring was systematic and sustained—early evidence measurement works here too.⁴
Improve: Act on what you learn and share it. Cybersecurity pools threaten intelligence so the sector can defend faster than any single institution. Higher education could pool something richer: de-identified data on where the risk lives, which controls actually work, and where protection drifts, so a lesson learned once is learned everywhere.
“Abuse risk has changed in every dimension; the tools haven’t.”
BOTTOM LINE
Abuse risk has changed in every dimension; the tools haven’t. Medicine never doubted that the deaths were unacceptable; it lacked a reliable way to prevent them. Our field now has what medicine lacked, just when insuring the gap is no longer an option.
Change starts smaller than you’d think. Take one program and ask whether the moments that call for judgment under uncertainty are surfaced and addressed or are quietly slipping through.
The case for rethinking sexual abuse risk management has never been stronger.
United Educators, Large Loss Report (2022–2025), ue.org. Counts of publicly reported awards and settlements are education-wide (K–12 and higher education); claim-cost shares are from UE’s own book of claims.
Assini-Meytin, L. C., McPhail, I., Sun, Y., Mathews, B., Kaufman, K. L., & Letourneau, E. J. (2025). Child sexual abuse and boundary-violating behaviors in youth-serving organizations: National prevalence and distribution by organizational type. Child Maltreatment, 30(3), 499–511. https://doi.org/10.1177/10775595241290765
G.S. v. Acadia Healthcare Company, Inc., et al. (Rio Arriba County, New Mexico), July 2023—a $485 million jury verdict, the largest single-plaintiff child sexual-abuse verdict reported in the U.S.; resolved by a $400 million settlement across three children’s cases (Acadia Healthcare SEC filing, October 2023). A foster-care case, cited as a measure of the scale abuse litigation now reaches.
Assini-Meytin et al. (2025), the same study cited above: child sexual abuse was lower in youth-serving organizations with systematic, sustained monitoring and implementation. The study reports an association, not proof of cause.