What is Child Sexual Abuse?
Child sexual abuse is one of the most horrible things that can happen to a child.
Child sexual abuse is a form of child abuse that includes sexual activity with a minor. A child cannot consent to any form of sexual activity, period. When a perpetrator engages with a child this way, they are committing a crime that can have lasting effects on the victim for years. Child sexual abuse does not need to include physical contact between a perpetrator and a child.
Child sexual abuse refers to any sexual contact with a child or teen. It includes many different acts. Some of these are touching the vagina, penis, or anus of a child; having a child touch the abuser’s vagina, penis, or anus; putting an object, penis, or finger into the vagina or anus of a child; and showing a child pictures or movies of other people undressed or having sex.
Child sexual abuse, also called child molestation, is a form of child abuse in which an adult or older adolescent uses a child for sexual stimulation. Forms of child sexual abuse include engaging in sexual activities with a child (whether by asking or pressuring, or by other means), indecent exposure (of the genitals, female nipples, etc.), child grooming, or using a child to produce child pornography.
Child sexual abuse can occur in a variety of settings, including home, school, or work (in places where child labor is common). Child marriage is one of the main forms of child sexual abuse; UNICEF has stated that child marriage “represents perhaps the most prevalent form of sexual abuse and exploitation of girls.” The effects of child sexual abuse can include depression, post-traumatic stress disorder, anxiety, complex post-traumatic stress disorder, propensity to further victimization in adulthood, and physical injury to the child, among other problems. Sexual abuse by a family member is a form of incest and can result in more serious and long-term psychological trauma, especially in the case of parental incest.
The global prevalence of child sexual abuse has been estimated at 19.7% for females and 7.9% for males. Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the child, most often brothers, fathers, uncles, or cousins; around 60% are other acquaintances, such as “friends” of the family, babysitters, or neighbors; strangers are the offenders in approximately 10% of child sexual abuse cases. Most child sexual abuse is committed by men; studies on female child molesters show that women commit 14% to 40% of offenses reported against boys and 6% of offenses reported against girls.
The word pedophile is commonly applied indiscriminately to anyone who sexually abuses a child, but child sex offenders are not pedophiles unless they have a strong sexual interest in prepubescent children. Under the law, child sexual abuse is often used as an umbrella term describing criminal and civil offenses in which an adult engages in sexual activity with a minor or exploits a minor for the purpose of sexual gratification. The American Psychological Association states that “children cannot consent to sexual activity with adults”, and condemns any such action by an adult: “An adult who engages in sexual activity with a child is performing a criminal and immoral act which never can be considered normal or socially acceptable behavior.”
There are also other forms of child sexual abuse. Sexual abuse can happen to boys or girls of any race, ethnicity, or economic background. Sexual abuse is not a child’s fault. The only person responsible for this kind of behavior is the abuser.
People who sexually abuse children usually know the victims before making sexual contact. Abusers can be anyone, even someone the victim used to look up to, like, or trust, such as a neighbor, babysitter, friend, or member of the family or household.
Most of the time, because abusers are often older, bigger, or more powerful than the victims, children are afraid of what will happen if they don’t cooperate with the abuse or if they tell someone. Sometimes abusers will threaten or hurt victims in other ways to make them do what they want.
The age of children protected by child sexual abuse laws is different from state to state. In most states, sexual contact between an adult (18 years or older) and someone under 16 years old is child sexual abuse and is against the law, even if the abuser believes the young person agreed to the sexual activity. Children and young teens are protected from any sexual contact by adults and older teens because, when there is such a difference in power, sexual contact is harmful.
Child sexual abuse may be perpetrated by a family member, friend, or stranger. Typical behaviors associated with child sexual abuse include:
- Sexually suggestive language
- Oral sex
- Prolonged kissing
- Vaginal intercourse
- Prolonged groping
- Anal intercourse
- Forcing a minor to watch pornography
- Sexual aggression
What Is Incest?
Incest is defined as sexual contact between people so closely related that they may not legally marry, often immediate family or first tier family members such as aunts, uncles, cousins, or grandparents. In certain contexts, the term has been expanded to include sexual contact with caregivers upon whom an individual depends for care (such as a step-parent, a babysitter, or a teacher).
Incest generally occurs as child sexual abuse by an older family member to a younger child or teenager.
Please see our incest page for more information regarding incest.
How Common Is Child Sexual Abuse?
Per Darkness to Light, it is highly likely that you know a child who has been or is being abused.
Most people think of adult rape as a crime of great proportion and significance and are unaware that children are victimized at a significantly higher rate than adults.
Nearly 70% of all reported sexual assaults (including assaults on adults) occur to children aged 17 and under.
Youths have higher rates of sexual assault victimization than do adults. In 2000, the rate for youths aged 12 to 17 was 2.3 times higher than for adults
The crimes of child sexual abuse are under-reported.
- Experts estimate that 1 in 10 children are sexually abused before their 18th birthday.
- 30% of children are abused by family members.
Child sexual abuse is far more prevalent than most people realize. It is likely the most prevalent health problem children face with the most serious array of consequences
About one in seven girls and one in 25 boys will be sexually abused before they turn 18.
This year, there will be about 400,000* babies born in the U.S. that will become victims of child sexual abuse UNLESS WE DO SOMETHING TO STOP IT.
- As many as 60% are abused by people the family trusts.
- About 35% of victims are 11 years old or younger.
- Nearly 40% are abused by older or larger children.
Stranger danger is a MYTH.
Research shows that the greatest risk to children doesn’t come from strangers but from friends and family. People who abuse children look and act just like everyone else. In fact, they often go out of their way to appear trustworthy, seeking out settings where they can gain easy access to children, such as sports leagues, faith centers, clubs, and schools.
93% of juvenile sexual assault victims know their attacker, and often it is someone in their family or circle of trust.
Who Sexually Abuses Children?
The word pedophile is commonly applied indiscriminately to anyone who sexually abuses a child, but child sex offenders are not pedophiles unless they have a strong sexual interest in prepubescent children. Under the law, child sexual abuse is often used as an umbrella term describing criminal and civil offenses in which an adult engages in sexual activity with a minor or exploits a minor for the purpose of sexual gratification. The American Psychological Association states that “children cannot consent to sexual activity with adults,” and condemns any such action by an adult: “An adult who engages in sexual activity with a child is performing a criminal and immoral act which never can be considered normal or socially acceptable behavior.
Pedophilia is called pedophilic disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and is defined as a paraphilia ((previously called sexual perversion and sexual deviation, a person with paraphilia experiences intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals). Pedophilia includes intense and recurrent sexual urges towards and fantasies about prepubescent children that have either been acted upon or which cause the person with the attraction distress or interpersonal difficulty.
The International Classification of Diseases (ICD-11) defines pedophilia as a “sustained, focused, and intense pattern of sexual arousal—as manifested by persistent sexual thoughts, fantasies, urges, or behaviors—involving pre-pubertal children.”
In popular usage, the word pedophilia is often applied to any sexual interest in children or the act of child sexual abuse. This use conflates the sexual attraction to prepubescent children with the act of child sexual abuse and fails to distinguish between attraction to prepubescent and pubescent or post-pubescent minors. Researchers recommend that these imprecise uses be avoided because although people who commit child sexual abuse are sometimes pedophiles, child sexual abuse offenders are not pedophiles unless they have a primary or exclusive sexual interest in prepubescent children, and some pedophiles do not molest children.
Pedophilia was first formally recognized and named in the late 19th century. A significant amount of research in the area has taken place since the 1980s.
Although mostly documented in men, there are also women who exhibit the disorder, and researchers assume available estimates under-represent the true number of female pedophiles. No cure for pedophilia has been developed, but there are therapies that can reduce the incidence of a person committing child sexual abuse. The exact causes of pedophilia have not been conclusively established. Some studies of pedophilia in child sex offenders have correlated it with various neurological abnormalities and psychological pathologies.
Those who molest children look and act just like everyone else.
There are people who have or will sexually abuse children in churches, schools, and sports leagues.
Abusers can be neighbors, friends, and family members. People who sexually abuse children can be found in families, schools, churches, recreation centers, youth sports leagues, and any other place children gather. Significantly, abusers can be and often are other children.
- About 90% of children who are victims of abuse know their abuser.
- Only 10% of sexually abused children are abused by a stranger.
- Approximately 30% of children who are sexually abused are abused by family members.
- The younger the victim, the more likely it is that the abuser is a family member. Of those molesting a child under six, 50% were family members. Family members also accounted for 23% of those abusing children ages 12 to 17.
- About 60% of children who are sexually abused are abused by the people the family trusts.
- Homosexual individuals are no more likely to sexually abuse than heterosexual individuals.
Most adolescent sex offenders are not sexual predators and will not go on to become adult offenders.
Most adolescent offenders do not meet the criteria for pedophilia and do not continue to exhibit sexually predatory behaviors.
Adolescent sex offenders are more responsive to treatment than adults. They do not appear to continue to re-offend into adulthood, especially when provided with appropriate treatment.
What Are Some Signs An Adult Is Sexually Abusing A Child?
Keeping children safe can be challenging since many perpetrators who sexually abuse children are in positions of trust. Keeping a child away from the perpetrator may mean major changes in your own life, even if you are outside of the child’s family. It isn’t always easy to identify child sexual abuse—and it can be even harder to step in if you suspect something isn’t right. If a child tells you that someone makes them uncomfortable, even if they can’t tell you anything specific, listen. Talk to someone who can help you figure out if this is something that must be reported, such as a staff member from your local sexual assault service provider. In the meantime, if you are the parent or have influence over the child’s schedule, avoid putting the child in a potentially unsafe situation.
Be wary and cautious of an adult who spends time with children and exhibits the following behaviors:
- Does not respect boundaries or listen when someone tells them “no”
- Engages in touching that a child or child’s parents/guardians have indicated is unwanted
- Tries to be a child’s friend rather than filling an adult role in the child’s life
- Doesn’t appear to have age-appropriate relationships
- Talks with children about their personal problems or relationships
- Spends time alone with children outside of their role in the child’s life or makes up excuses to be alone with the child
- Expresses unusual interest in a child’s sexual development, such as commenting on sexual characteristics, or sexualizing normal behaviors
- Gives a child gifts without occasion or reason
- Spends a lot of time with your child or another child you know
What Are Some Signs and Symptoms of Child Sexual Abuse?
Child sexual abuse victims may exhibit a wide range of immediate reactions, both in magnitude and form. Resilient children may not suffer serious consequences, whereas other children with the same experience may be highly traumatized. Some victims do not display emotional problems of any other immediate symptom in response to the abuse.
It’s not always easy to spot sexual abuse as perpetrators often take steps to hide their actions. Some signs are easier to spot than others. For instance, some warning signs might be noticed by a caretaker or parent, and are often red flags that the child needs medical attention. Listen to your instincts. If you notice something that isn’t right or someone is making you uncomfortable—even if you can’t put your finger on why—it’s important to talk to the child.
Signs that a child is being sexually abused are often present, but they are often indistinguishable from other signs of childhood stress, distress or trauma. Direct physical signs of sexual abuse are not common, but may include:
- Bruising from mouth, rectum, or vagina
- Bleeding from mouth, rectum, or vagina
- Redness from mouth, rectum, vagina
- Bumps around the vagina, mouth, or anus
- Scabs around the mouth
- Blood on the sheets, underwear, and clothing
Urinary tract infections, sexually transmitted diseases, and abnormal vaginal or penile discharge are also warning signs.
Child sexual abuse victims often exhibit indirect physical signs, such as anxiety, chronic stomach pain, and headaches.
Behavioral signals are common among sexually abused children. Some of these are
- “Too perfect” behavior
- Unexplained anger and rebellion.
- Sexual behavior that is inappropriate for the child’s age
- Bed-wetting or soiling the bed, if the child has already outgrown these behaviors
- Not wanting to be left alone with certain people or being afraid to be away from primary caregivers, especially if this is a new behavior
- Tries to avoid removing clothing to change or bathe
- Use of alcohol or drugs at an early age can be a sign of trauma such as child sexual abuse.
- Excessive talk about or knowledge of sexual topics
- Resuming behaviors that they had grown out of, such as thumbsucking
- Nightmares or fear of being alone at night
- Excessive worry or fearfulness
Age-By-Age Symptoms of Child Sexual Abuse:
Children may respond to sexual abuse in many different ways, which can vary depending on their age, gender, culture, personality, and family structure. In many cases, your child’s behavior will show you how he or she is feeling because children often express their feelings through their actions rather than through words. This can be true for children and adolescents of all ages. In addition, the way in which these feelings are expressed will probably be different depending on your child’s age.
The following section identifies some common behaviors that you might see in preschoolers, school age youth, and teenagers who have experienced sexual abuse.
Signs of Trauma in Preschoolers (ages 2-‐5)
- They may become anxious and clingy, not wanting to separate from their parents at daycare or at the babysitter’s house.
- They may seem to take a backward step in development: sucking their thumbs, wetting their beds, refusing to go to sleep, or waking up at night even though they passed these stages long ago.
- They may become aggressive in their play with other children, with their parents, or with their own toys.
- They may also act out some aspect of their abuse in their play An example would be using toys to act out hiding from a “monster.”
- They may play the same game over and over again, like piling blocks and knocking them down, dropping toys behind furniture and retrieving them, or crashing the same two cars over and over again.
- They may express “magical” ideas about what happened to them, which will affect their behavior. For example, “bad things happen when I am too happy.”
- Although they say they are having fun in an activity they may look sad, angry, or intense in a way that, to an adult does not look like they are having fun.
- They may engage in sexual behavior that is inappropriate for their age, such as trying to touch another child in his or her genital area. However, children who have not been sexually abused may behave in this way for other reasons as well.
Signs of Trauma in School Age Children (ages 5 to 13)
- They may experience “magical thinking. For example, the child may believe that someone died because he or she had bad thoughts about that person.
- Sexualized play and behavior is also seen in this age group.
- Thinking that they may have caused the abuse gives children a sense of power and control, while helplessness painfully reminds them that they are both young and dependent upon others.
- They may blame themselves completely for what happened to them during the abuse as a way to make up for feeling so helpless during the abuse.
- They may have frequent nightmares and difficulty falling and maintaining sleep
- Their lack of control over the abuse may give them the feeling that their future is uncertain, which can lead some kids to act in dangerous and reckless ways.
- There may be a major change in their scholastic performance. It’s common for children to have problems concentrating during school following this major trauma.
- On the other hand, they may become intensely focused upon school and schoolwork as a way of distracting themselves from their upsetting thoughts and feelings.
- They may test you on set rules about bedtime, chores, or homework; as well as becoming oppositional, defiant, testy, and/or withdrawn.
- They may have problems in their friendships.
Signs of Trauma in Teenagers (age 13 to 18)
- Teens often feel that no one could possibly understand what they’re going through. This feeling of isolation can easily change the teen’s relationships with friends and parents.
- Teens may believe that the abuse was their fault
- They may choose to involve themselves in risky behaviors, such as experimentation with drugs, sexual activity, or outright refusing to go to school. This is an attempt to handle the anxiety and avoid those feelings of helplessness.
- Teens may feel that their future is limited; that they are damaged forever by the abuse, so planning for the future is completely pointless.
- Teens may create a negative opinion of themselves as they weren’t able to avoid or control the abuse that happened to them.
- Teens may also have revenge fantasies about the people or individual responsible for their abuse, which can lead to feelings of guilt for having such feelings.
- A teen trying to avoid the triggers and reminders of their trauma may find that they prefer being alone rather than risking seeing people or places that trigger them.
- Self-injury and parasuicidal acts are quite common in teens. With the right treatments and support, these problems can be resolved and overcome.
What Are The Risk Factors for Childhood Sexual Abuse?
While no child is immune, there are child and family characteristics that significantly heighten or lower the risk of sexual abuse.
The following risk factors gathered from Darkness To Light are based on reported and identified cases of abuse:
Family structure is the most important risk factor in child sexual abuse.
Children who live with two married biological parents are at low risk for abuse. The risk increases when children live with step-parents or a single parent. Children living without either parent (foster children) are 10 times more likely to be sexually abused than children that live with both biological parents. Children who live with a single parent that has a live-in partner are at the highest risk; they are 20 times more likely to be victims of child sexual abuse than children living with both biological parents.
Gender is also a major factor in sexual abuse. Females are five times more likely to be abused than boys.
The age of the male being abused also plays a part. 8% of victims aged 12-17 are male. 26% of victims under the age of 12 are male.
Age is a significant factor in sexual abuse. While there is a risk for children of all ages, children are most vulnerable to abuse between the ages of 7 and 13.
The median age for reported abuse is 9 years old.
However, of children who are sexually abused, more than 20% are abused before the age of 8.
Race and ethnicity are an important factor in identified sexual abuse:
- African American children have almost twice the risk of sexual abuse than white children.
- Children of Hispanic ethnicity have a slightly greater risk than non-Hispanic white children.
The risk for sexual abuse is tripled for children whose parent(s) are not in the labor force.
Children in low socioeconomic status households are three times as likely to be identified as a victim of child abuse.
Children who live in rural areas are almost two times more likely to be identified as victims of child sexual abuse.
Children who witness or are the victim of other crimes are significantly more likely to be sexually abused.
Family and acquaintance child sexual abuse perpetrators have reported that they look for specific characteristics in the children they choose to abuse.
- Perpetrators report that they look for passive, quiet, troubled, lonely children from single parent or broken homes.
- Perpetrators frequently seek out children who are particularly trusting and work proactively to establish a trusting relationship before abusing them.
- Not infrequently, this extends to establishing a trusting relationship with the victim’s family as well.
When Does Child Sexual Abuse Occur?
You may be surprised to know that one in seven children experience the sexual abuse from other adolescents occur between the hours of 3 and 7 PM, with 3-4PM the peak of occurrences.
Most adolescent offenders do not meet the criteria for pedophilia and do not continue to exhibit sexually predatory behaviors, as adolescent sex offenders are more responsive to treatment than adults. They do not appear to continue to re-offend into adulthood, especially when provided with appropriate treatment.
As many as 40% of children who are sexually abused are abused by older or more powerful children.
The younger the child victim, the more likely it is that the perpetrator is a juvenile. Juveniles are the offenders in 43% of assaults on children under age six. Of these offenders, 14% are under age 12.
Juveniles who commit sex offenses against other children are more likely than adult sex offenders to offend in groups, to offend at schools, and to have more male victims and younger victims.
The number of youth coming to the attention of police for sex offenses increases sharply at age 12 and plateaus after age 14. Early adolescence is the peak age for youth offenses against younger children. A small number of juvenile offenders – one out of 8 – are younger than age 12. Females constitute 7% of juveniles who commit sex offenses.
Child sexual abuse often takes place under specific, often surprising circumstances. It’s helpful to know these circumstances because it allows for the development of strategies to avoid child sexual abuse.
81% of child sexual abuse incidents for all ages occur in one-perpetrator/one-child circumstances. Six to 11-year-old children are most likely (23%) to be abused in multiple-victim circumstances.
Most sexual abuse of children occurs in a residence, typically that of the victim or perpetrator – 84% for children under age 12 to 17, there is also a peak in assaults in the late hours of the evening.
Not everyone who sexually abuses children is a pedophile.
Child sexual abuse is perpetrated by a wide range of individuals with diverse motivations. It is impossible to identify specific characteristics that are common to all child molesters.
Situational offenders tend to offend at times of stress and begin offending later than pedophilic offenders. They also have fewer victims (often family) and have a general preference for adult partners.
Pedophilic offenders often start offending at an early age and often have a large number of victims (frequently not family members).
70% of child sex offenders have between one and 9 victims, while 20% have 10 to 40 victims.
What are The Long-Term Effects of Child Sexual Abuse?
Child Sexual Abuse is a root cause of many health and social problems we face in our communities.
Consequences to children and to our society begin immediately after the abuse begins
- 70-80% of sexual abuse survivors report excessive drug and alcohol use.
- One study showed that among male survivors, 50% have suicidal thoughts and more than 20% attempt suicide.
- Young girls who are sexually abused are more likely to develop eating disorders as adolescents.
- More than 60% of teen first pregnancies are preceded by experiences of molestation, rape or attempted rape.
- Both males and females who have been sexually abused are more likely to engage in prostitution.
- The CDC estimates that child abuse costs us billions annually.
- Sexually abused children who keep the abuse a secret or who “tell” and are not believed are at greater risk for psychological, emotional, social, and physical problems, often lasting into adulthood.
When a child is abused outside of the family, the family can support the child, but when the abuser is in the family, the family cannot provide the same kind of support or security.
If for whatever reason, the parent who is not abusing the child learns of the abuse and does not stop it or blames the child for the abuse, that can be very damaging for the child.
As the very people who are supposed to protect them are the ones causing the abuse, incest can damage a child’s ability to trust. Incest survivors may suffer difficulties with developing trusting relationships.
Child sexual abuse is a public health problem of enormous magnitude.
The Center for Disease Control (CDC) recently estimated the lifetime burden of a new substantiated case of nonfatal child maltreatment to be $210,012 per victim. This includes immediate costs, as well as loss of productivity and increased healthcare costs in adulthood. While this estimate is for all forms of child maltreatment, there is evidence that the consequences of child sexual abuse are equivalent to or greater than the consequences of other forms of child maltreatment.
This estimate is comparable to that of many other high profile public health problems, indicating the impact and seriousness of the issue of child maltreatment.
For example, the lifetime costs of stroke per person were estimated at $159,846 (2010 dollars). The total lifetime costs associated with type 2 diabetes were estimated between $181,000 and $253,000 (2010 dollars) per case.
What are Long-Term Consequences of Childhood Sexual Abuse In Adolescents?
People choose to deal with the feelings associated with being abused in many different ways. However, sometimes people choose behaviors and coping mechanisms that are problematic. Child sexual abuse (CSA) has lasting consequences for victims. The real tragedy is that it robs children of their potential, setting into motion a chain of events and decisions that affect them throughout their lives.
These long-term consequences can include:
Emotional and mental health problems are often the first consequence and sign of child sexual abuse.
Children who are sexually abused are at significantly greater risk for later post-traumatic stress and other anxiety symptoms, depression and suicide attempts. These psychological problems can lead to significant disruptions in normal development and often have a lasting impact, leading to dysfunction and distress well into adulthood.
Child sexual abuse has been linked to higher levels of risky behaviors.
Substance abuse problems beginning in childhood or adolescence are some of the most common consequences of child sexual abuse.
A number of studies have found that adolescents with a history of child sexual abuse demonstrate a three to four-fold increase in rates of substance abuse/dependence. Drug abuse is more common than alcohol abuse for adolescent child sexual abuse victims.
Age of onset for non-experimental drug use was 14.4 years old for victims, compared to 15.1 years old for non-victimized youth.
Adolescents are 2 to 3 times more likely to have an alcohol use/dependence problem than non-sexually abused people.
Delinquency and crime, often stemming from substance abuse, are more prevalent in adolescents with a history of child sexual abuse. Adolescents who were sexually abused have a three to five-fold risk of delinquency.
Behavioral problems, including physical aggression, non-compliance, and oppositionality occur frequently among sexually abused children and adolescents. These emotional and behavioral difficulties can lead to delinquency, poor school performance, and dropping out of school.
Adolescents that reported victimization (i.e., sexual abuse or physical abuse) were more likely to be arrested than their non-abused peers.
Sexually abused children were nearly twice as likely to run away from home.
Academic problems in childhood are a common symptom of sexual abuse.
Sexually abused children tended to perform lower on psychometric tests measuring cognitive ability, academic achievement, and memory assessments when compared to same-age non-sexually abused peers.
Studies indicate that sexual abuse exposure among children and adolescents is associated with high school absentee rates, more grade retention, an increased need for special education services, and difficulty with school adaptation.
- 39% of 7 to 12-year old girls with a history of child sexual abuse experienced academic challenges
- 7 to 12 year-old girls with a history of childhood sexual abuse were 50% more likely to display a cognitive ability under the 25% percentile.
- 26% of 7-12-year-old girls who have a history of sexual abuse reported that their grades dropped after the abuse, and 48% of them had lower-than-average grades.
Having a history of child sexual abuse greatly increases the chances the child will drop out of school.
The risk of teen pregnancy is much higher for girls with a history of child sexual abuse. This increased risk for pregnancy at a young age is likely due to over-sexualized behavior, another common consequence of child sexual abuse.
Girls who are sexually abused are 2.2 times as likely as non- abused peers to become teen mothers. 45% of pregnant teens report a history of child sexual abuse.
Males who are sexually abused are more likely than their non-abused peers to impregnate a teen. In fact, several studies indicate that the sexual abuse of boys is a stronger risk factor for teen pregnancy than the sexual abuse of girls.
Most sexual abuse incidents reported by pregnant teens occurred well before the incident that resulted in pregnancy. Only 11 to 13% of pregnant girls with a history of child sexual abuse reported that they had become pregnant as a direct result of this abuse.
Sexual behavior problems and over-sexualized behavior are very common consequences of child sexual abuse.
Age-inappropriate behavior can be a very important and telling sign that abuse is occurring.
Children who have been sexually abused have more than three times as many sexual behavior problems as children who have not been sexually abused. Victims of child sexual abuse are more likely to be sexually promiscuous
What Are The Long-Term Consequences of Child Sexual Abuse in Adults?
Please also see adult survivors of childhood sexual abuse for more information.
Substance abuse problems are a common consequence for adult survivors of child sexual abuse.
Female adult survivors of child sexual abuse are nearly three times more likely to report substance use problems (40.5% versus 14% in the general population)
Male adult child sexual abuse victims are 2.6 times more likely to report substance use problems (65% versus 25%) than the general population
Obesity and eating disorders are more common in women who have a history of child sexual abuse.
20 to 24-year-old women who were sexually abused as children were four times more likely than their non-abused peers to be diagnosed with an eating disorder.
Middle-aged women who were sexually abused as children were twice as likely to be obese when compared with their non-abused peers.
Mental health problems are an incredibly common long-term consequence of child sexual abuse.
Adult women who were sexually abused as a child are more than twice as likely to suffer from depression as women who were not sexually abused.
Adults with a history of child sexual abuse are more than twice as likely to report a suicide attempt.
Females who are sexually abused are three times more likely to develop psychiatric disorders than females who are not sexually abused.
Among male survivors, more than 70% seek psychological treatment for issues such as substance abuse, suicidal thoughts and attempted suicide.
Child sexual abuse is also associated with physical health problems in adulthood.
It is theorized that this is a result of the substance abuse, mental health issues and other consequences that survivors of child sexual abuse face. Generally, adult victims of child sexual abuse have higher rates of health care utilization and report significantly more health complaints compared to adults without a child sexual abuse history.
This is true for both self-reported doctor’s visits and objective examination of medical records.
These health problems represent a burden both to the survivor and the healthcare system. Adult survivors of child sexual abuse are at greater risk of a wide range of conditions that are non-life threatening and are potentially psychosomatic in nature. These can include:
- (PMDD) Severe Premenstrual Syndrome
- Chronic headaches
- Irritable Bowel Syndrome
In addition, adult survivors frequently experience reproductive and sexual health complaints, including excessive bleeding, amenorrhea, pain during intercourse, and/or menstrual irregularity.
Not only do survivors of child sexual abuse have more minor health conditions, but they are also at greater risk for more serious conditions as well. Adults with a history of child sexual abuse are 30% more likely than their non-abused peers to have a serious medical condition such as diabetes, cancer, heart problems, stroke, and/or hypertension.
Male sexual abuse survivors have twice the HIV-infection rate of non-abused males. In a study of HIV- infected 12 to 20-year-olds, 41% reported a sexual abuse history.
Adult survivors of child sexual abuse are more likely to become involved in crime, both as a perpetrator and as a victim.
This is likely a product of a higher risk for substance abuse problems and associated lifestyle factors.
How Can I Help My Sexually Abused Child?
It is important to recognize that not all children are affected in the same way by sexual trauma.
Children are resilient by nature and have the potential to heal and recover if offered help and support in a timely fashion. How you respond to your child can have a profound impact on how able they are to recover from abuse. By taking some key steps early on you can help strengthen your child’s trust, sense of safety and potential for healing. The lives of children who have been sexually abused will be changed, but as with other types of traumatic events, there are many wonderful examples of adults who have healed from childhood abuse and are living healthy and productive lives.
While children recognize unpleasant or frightening feelings they may not have a full concept of child sexual abuse until adulthood. Some children may be ready to talk about the abuse and deal with it soon after it happens. Others may need to move more slowly, gradually testing the safety of their relationships and addressing the issues as they unfold over time. Children do best with a combination of love from caregivers and support from a counselor with a specialization working with children who have experienced sexual trauma.
Are there any personal strengths that help protect your child from the negative effects of a trauma such as sexual abuse? Are there any resources in your child’s environment, such as a mentor or a community center, which adds to this protection?
Research on resiliency, or the ability to recover from change and challenges, looks at how individuals exposed to trauma, violence, and other events that place their physical and emotional well-‐beingat risk are able to successfully cope with and overcome these challenges.
According to the literature, the healing process begins with creating a support system and opportunities to meet your child’s basic developmental needs.
Your child is able to give meaning to events and experiences within their lives. Creating meaning from an experience of abuse can help your child identify lessons learned, personal strengths developed, or relationships that were strengthened by the abuse. These basic needs are the foundation under which resiliency is formed. Children whose basic needs are met are more likely to develop the confidence and skills needed to cope with child sexual abuse. Additionally, your child’s ability to develop healthy coping mechanisms frequently begins with an adult’s belief in the child and his or her resiliency.
As a parent, you have the power to help.
Expressing your love, comforting them, being sensitive to their feelings and vulnerabilities are important ways for you to support your child. Tell your child often how much you love them. In addition, here are some specific things you can do to help your child with the recovery process.
Tell your child that they are not to blame for the abuse.
Even though children are never, ever to blame, it’s not always easy to convince them of this, and they’ll probably need to hear it from you many times. This is because children often feel that they’re to blame for what has happened. They tend to feel responsible not only for the actual abuse but for causing pain to people they love once the abuse has been uncovered. This is especially true when family members have separated as a result of the abuse. Shouldering guilt for the abuse and its consequences is an intolerable and unfair burden for children to bear.
Without intervention, children are more likely to suffer more serious, long-term emotional effects.
Help your child find relief from guilt.
When adults take responsibility for what has happened, this helps the children to find relief from guilt. As a parent, you can take an important step to help your child heal by reassuring them that they are not to blame for the abuse and it was the older person’s responsibility to stop it. You might emphasize that any changes that have resulted from the abuse are because of the abuser’s behaviors – and not because of what the child did or did not do. Because of the child-centered way that young children make sense of the world around them, they naturally place themselves as the “cause” of much of what they experience.
Because of this developmental tendency to take responsibility for things over which they have no control, (bad weather, parents fighting, financial woes), this message may have to be repeated over time and in different ways.
Make sure your child knows that you believe them.
The act of abuse was a profound betrayal of your child’s trust. More than ever, your child needs to know that you believe in them and that they can trust you and count on you. By acknowledging the harm that was done to your child and by getting them help and taking steps to protect them, you will be helping your child re-establish a sense of trust and safety.
Help your child see that you’re someone they can talk to.
If your child has been abused, provide opportunities for conversation, but let your child be the one to bring up the subject. If they do, listen to them carefully, let them express their feelings, answer their questions as best you can and comfort them. Sometimes parents think that talking about the abuse will cause children more pain or “just make things worse”. But children need to know that there is a loving parent or adult with whom they can be honest, and who will acknowledge their pain and accept their feelings.
Let your child know you will do whatever you can to keep them safe
This is very tough if you’re not sure how fully you’ll be able to safeguard them. Without making false promises, make sure your child knows that you are committed and determined to take whatever steps you can to protect them. When a child sees caring adults acknowledging the abuse and taking steps to intervene, the child learns that they are worth protecting.
Support your child by getting them treatment
Observe your child to see if they are showing signs of emotional distress. If their feelings or behaviors are concerning to you or others, consider bringing them to a specialist who can offer the child a safe place to express themselves, and offer you some guidance and support to help your child recover.
Why isn’t Child Sexual Abuse Wildly Reported?
Identified incidents of child sexual abuse are declining, although there is no clear indication of a cause as to why this number has dropped. The number of identified incidents of child sexual abuse decreased at least 47% from 1993 to 2005.
Even with declining rates of reported sexual abuse, the public is not fully aware of the magnitude of the problem, as only about 38% of child victims disclose the fact they have been sexually abused.
Some never disclose. But why?
There are many reasons that a child may not report sexual abuse. Some of these reasons include:
- The victim doesn’t know that sexual abuse isn’t normal.
- The victim doesn’t know that incest is a form of abuse.
- The victim may not realize that there is help available.
- The victim may be afraid of the consequences of reporting the abuse.
- The victim may think that no one will believe them if they report the abuse.
- The victim may be afraid of how others will react.
- The victim may have been threatened by the abuser.
- Some children might be afraid that other people will be mad at them
- They may fear that they’ll be taken away from their family
- The often feel shame and embarrassment regarding the abuse.
- Younger kids, whose language skills aren’t fully developed, may have a hard time talking about the abuse.
How Do I Report Child Sexual Abuse?
Child abuse is not just a family problem. It’s a social health issue. Child abuse is everyone’s business. We urge everyone to be a child’s advocate and report child abuse and neglect. If you see or hear something suspicious, say something. Speak up. Report it! You may save a child from further harm, or you may even save a child’s life.
Remember that disclosure can be a scary and difficult process for children, and many kids take weeks, months, or years to reveal what happened to them.
If a child discloses to you, stay calm, comforting, and reassuring.
You may ask them directly if anyone has touched their bodies in a way that made them scared or uncomfortable, or if anyone has forced them to do something that they did not want to do. Your child might be nervous about your response to their disclosure, and your reaction will play an important role in how they continue to cope with the abuse following their confession to you.
It is important that your child sees that you love and support them, regardless of what they say to you.
Okay, now what do I do?
The answer is simple. Anyone who witnesses abusive behavior towards a child or gets a direct disclosure can and should report it! Keep in mind, child abuse takes many forms including physical, emotional, verbal, sexual, neglect, exploitation, Shaken Baby Syndrome, bullying, and more.
If a child is in danger, call the police immediately. Get the report on paper.
You may also try Darkness to Light’s website.
If you suspect a child is being abused or neglected, or if you are a child who is being maltreated, contact your local child protective services office or law enforcement agency so professionals can assess the situation. Many States have a toll-free number to call to report suspected child abuse or neglect. To find out where to call, consult the Information Gateway publication, State Child Abuse and Neglect Reporting Numbers.
Anyone can report suspected child abuse or neglect. Reporting abuse or neglect can protect a child and get help for a family it may even save a child’s life. In some States, any person who suspects child abuse or neglect is required to report. To see how your State addresses this issue, read the Information Gateway publication, Mandatory Reporters of Child Abuse and Neglect.
Child Welfare Information Gateway is not a hotline for reporting suspected child abuse or neglect, and it is not equipped to accept reports of this nature. Information Gateway is not equipped to offer crisis counseling. As a service of the Children’s Bureau in the U.S. Department of Health and Human Services, Information Gateway does not have the authority to intervene or advise in personal situations.
Childhelp® is a national organization that provides crisis assistance and other counseling and referral services. The Childhelp National Child Abuse Hotline is staffed 24 hours a day, 7 days a week, with professional crisis counselors who have access to a database of 55,000 emergency, social service, and support resources. All calls are anonymous. Contact them at 1.800.4.A.CHILD (1.800.422.4453).
Child Sexual Abuse Hotlines:
The Childhelp National Child Abuse Hotline is staffed 24 hours a day, 7 days a week, with professional crisis counselors who have access to a database of 55,000 emergency, social service, and support resources. All calls are anonymous. Contact them at 1.800.4.A.CHILD (1.800.422.4453).
CACs coordinate all the professionals (legal and social services) involved in a case. If you’re unsure about whether to make an official report or just need support, contact a child advocacy center. They will help you evaluate your suspicions. To find one near you, contact National Children’s Alliance at www.nca-online.org or 1-800-239-9950.
Helplines have staff specifically trained operators to deal with questions about suspected child sexual abuse. Call Darkness to Light’s Helpline, 1-866-FOR-LIGHT to be routed to resources in your own community, or call the ChildHelp USA National Child Abuse Hotline, 1-800-4-A-CHILD
Child Sexual Abuse Resources:
1in6 – An organization that helps male child sexual abuse survivors.
Survivors of Incest (and sexual assault) Anonymous – Self-help group designed around the 12 steps of Alcoholics Anonymous.
Effects of Survivors of Incest long essay detailing the long-term effects and coping mechanisms adopted by victims of incest.
The book Secret Survivors: Uncovering Incest and its Aftereffects in Women contains extensive information pertaining to the effects of incest on an individual and a family unit.
The Courage To Heal is about surviving and healing after child sexual abuse.
Fred The Fox Shouts NO! – by Tatiana Kisil Matthews – Fred the Fox helps parents and caregivers introduce the concepts of “private parts” and safety with people we know. Through open communication with the people that love him most, Fred learns he has a strong voice inside and how to use it.
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