Child Sexual Abuse
What is it?
Child sexual abuse is any type of sexual contact with a
child under the age of 18. Sexual contact includes any
type of sexual behavior, such as photographing the child
for pornographic purposes, touching, intercourse, or
exposure of the genitals. In most cases, the person
causing the abuse is related or well-known to the child.
Who is affected?
Over one million children in the United States each
year are abused in some way. Of this number, close to a
quarter are sexually abused. Males are more likely to
commit sexual abuse than females. Children who have
developmental handicaps are more likely to be sexually
abused than those who do not.
What causes it?
Sexual abuse occurs when an adult is sexually aroused
by children and acts on this impulse. Frequently, sexual
abusers are also drug or alcohol abusers.
What are the symptoms?
Children are often reluctant to tell that they have
been sexually abused because they are ashamed and afraid
of the consequences of telling. The abuser may threaten to
harm them or those close to them if they tell. The child
may begin to behave differently, becoming anxious and
fearful, having difficulty sleeping, displaying overly
sexual behavior, or showing signs of depression and
suicidal tendencies. The child may have frequent urinary
tract infections (UTIs), a sexually transmitted disease
(STD), or abnormal vaginal discharge. Young children who
have been sexually abused may have physical injuries to
the genital and/or anal area that make it painful to walk
or sit. Over the long run, abused children are more likely
to use drugs, become sexually promiscuous, have low self
esteem, exhibit extremely passive or aggressive behavior,
have difficulty with interpersonal relationships, perform
poorly in school, have frequent nightmares, and experience
depression that can lead to attempted suicide.
How is it diagnosed?
When sexual abuse is suspected, doctors and healthcare
professionals must carefully question those who care for
the child about the possibility of abuse. The doctor will
perform a thorough and gentle physical examination,
focusing specifically on the child’s genital and anal
areas. However, because sexual abuse includes any type of
sexual behavior with a child, there may be no physical
signs of abuse. The doctor will also study the child’s
medical history for signs of past abuse. He or she may
order some diagnostic tests, such as blood tests and
urinalysis, to look for signs of abuse and infection.
Suspected abuse must be reported to the local child
protective services agency. The person investigating the
potential abuse will also carefully and gently interview
the child.
What is the treatment?
The child is treated for his or her injuries, which may
require hospitalization. He or she may be placed with
relatives or a foster care family to protect the child
from further abuse. Any siblings of the child are also
examined for signs of abuse. A treatment team that may
consist of a pediatrician, social worker, and a
psychotherapist that work together to monitor the child’s
physical and mental health, with the goal of reducing the
long-term effects of the abuse.
Prevention tips
Early identification and treatment of childhood sexual
abuse is important to stop the pain and reduce the
likelihood of long-term psychological effects. People who
suspect that a child is sexually abused should call the
police or report these suspicions to their local child
protective services agency. Parents should be extremely
cautious before leaving their children alone in the care
of anyone until they are sure the caregiver is trustworthy
and caring. It is also important to teach children at an
early age which parts of their body are private, and how
to say no to and report unwanted touching.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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