I’ve heard it too many times in the past few months. In the wake of the stories from Seattle’s ex-mayor Ed Murray to Hollywood film producer Harvey Weinstein to actor Kevin Spacey to comedian Louis C.K. to Alabama judge Roy Moore and whoever is next, the same maddening question eventually surfaces, “Why did the accuser wait all these years to speak up about being sexually abused?”

I’ve heard this question asked in outrage: If only the victim(s) had spoken up, others would have been spared abuse. I’ve heard the question posed as some kind of indictment of the victim: Surely if the allegations were true the victim wouldn’t have waited all these years to speak up.

Beyond the common and truly valid reasons for victims to wait decades or even forever to speak up, these questions make my therapist blood boil. Just how many ways are there to deny the cruel reality of individuals who were sexually violated? Or perhaps this is just another version of victim blaming: blame the victim for not speaking up about a deeply painful and abusive experience that has caused immeasurable shame and self-doubt, not to mention a lifetime of anxiety triggers. As if speaking up later than sooner somehow invalidates the reality and the lasting damage of sexual violation.

In my calmer moments, I can appreciate that perhaps this is a teachable moment. Waiting years or even decades to speak up about abuse may not make logical or even intuitive sense. But then again, there is little about sexual abuse that is logical or intuitive. As with most aspects of sexual abuse, the reasons survivors don’t speak up are individual and nuanced.

The list of reasons that survivors don’t speak up is long and varied. Here are just a few of those reasons:

• Trauma. Survivors don’t speak up because they can’t. Being sexually abused is often experienced as a terrifying and traumatic event. We know that the human brain processes traumatic experiences partially or even not at all. It is most usual to remember traumatic events in random shadowy snapshots and in some cases, the memory is blocked from memory completely for years or even decades. Survivors often don’t speak up because they can’t make sense of an experience that they have little or no memory of.

• Shame. Being sexually violated, whether as a child or adult, is a deeply embarrassing, dehumanizing and shaming experience. I know of no other crime where the victims feel shame and often blame themselves. Most child or adult survivors unrealistically believe that in some way the abuse was their fault. I should have said no, fought my abuser off, seen it coming, etc. The very human experience of shame causes us to pull back, to become quiet, to hide.

• Fear. Victims of sexual abuse often fear that if they speak up they will face retaliation from their abuser. Survivors also fear that if they speak up they won’t be believed, or worse yet, they will be blamed for the assault. Abusers wield an enormous amount of power over their victims which, in most cases, guarantees their silence.

• Confusion. Being sexually abused as a child, or even as an adult, is deeply confusing.  A child may simply lack the vocabulary to tell of their experience. When the tables of power are turned and those with more power and authority use that power to abuse, their victims are often left with a great deal of confusion. What was once trusted is no longer safe.

So maybe it’s time to remember that there are really only three words that need to be said: I believe you. There are no better, more validating or healing words to speak to anyone who steps forward to tell of their abuse, regardless of the length of time they have waited to speak their truth.

Perhaps it is also time to set aside skepticism and judgement and to accept the truth of survivors with compassion and understanding. And most of all, let us recognize the courage and strength it takes for any victim of sexual assault, whether child or adult, to speak their painful truth, whenever that truth is spoken.