Relationships Violence and Abuse What Is Childhood Sexual Abuse? By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. Learn about our editorial process Updated on November 14, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Ann-Louise T. Lockhart, PsyD, ABPP Medically reviewed by Ann-Louise T. Lockhart, PsyD, ABPP Facebook LinkedIn Ann-Louise T. Lockhart, PsyD, ABPP, is a board-certified pediatric psychologist, parent coach, author, speaker, and owner of A New Day Pediatric Psychology, PLLC. Learn about our Medical Review Board Print Jamie Grill / Getty Images Table of Contents View All Table of Contents Types Statistics Signs Impact Treatment Coping Childhood sexual abuse is considered any "completed or attempted sexual act, sexual contact with, or exploitation of a child." This type of abuse often involves the perpetrator using force or making threats. There are many behaviors that are categorized as sexual abuse, and physical contact does not need to be made between the offender and the child for something to be classified as sexual abuse of a child. Childhood sexual abuse is one of the most stigmatized issues in society and is recognized as both a violation of basic human rights and a serious public health concern. However, the prevalence of childhood sexual abuse can be difficult to accurately measure since it is underreported. Acknowledging a personal history of abuse takes enormous courage. With enough time, the right tools, and proper support, it is possible to move forward in a healthy way beyond the trauma of childhood abuse. Press Play for Advice On Healing From Childhood Abuse Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast, featuring former NFL player Reggie Walker, discusses how to heal from childhood trauma. Click below to listen now. Follow Now: Apple Podcasts / Spotify / Google Podcasts / Amazon Music Types of Childhood Sexual Abuse Types of abuse include but aren't limited to: Exposing a child to sexual activity or sexual content either in person or onlineIncestProducing, owning, or distributing child pornographyRapeSex trafficking or prostitution of a childSexual assault (including intercourse, fondling, masturbation of oneself, or forcing a minor to masturbate)Sexual harassment (such as calling or messaging a minor with obscene content) Using physical force or causing physical injury is not required for an act to be considered sexual abuse of a child. Legally, any sexual act between a child under the age of consent (which varies from state to state) and an adult is considered sexual abuse because children cannot provide consent. Childhood Sexual Abuse Statistics Research has shown that many children are affected by sexual abuse. There are also certain risk factors that may increase the likelihood of childhood sexual abuse. About one in four girls and one in 13 boys experience sexual abuse at some point during childhood. Studies show that children between the ages of 7 and 13 are the most vulnerable to childhood sexual abuse. Parents or caregivers who witnessed violence as children, or who struggle with substance abuse currently, may end up perpetuating a cycle of abuse. Single-parent homes, or families living in poverty with limited social supports, may be more vulnerable to sexual predators. Child Abuse Statistics Signs of Childhood Sexual Abuse It's important to know the warning signs that a child may have been sexually abused. There are both physical and behavioral symptoms which include: Abnormal sexual knowledge or behavior Avoidance of physical contact Attempts to run away Bleeding or bruising of genitals Blood on underwear (or torn underwear) Changes in hygiene (such as frequent bathing or no bathing) Frequent yeast infections Pain or burning in the genital area Self-harm Signs of depression Signs of post-traumatic stress disorder (PTSD) Sudden phobias or fears Sudden trouble at school Suicidal ideation Trouble walking or sitting A child may also start to be overly protective of their friends or siblings. This is known as taking on a "caretaker" role. Alternatively, they may revert to thumb-sucking or other behaviors of younger children. If you are a survivor of sexual assault, you can contact the RAINN National Sexual Assault Hotline at 1-800-656-4673 to receive confidential support from a trained staff member at a local RAINN affiliate. For more mental health resources, see our National Helpline Database. Grooming With childhood sexual abuse, the perpetrators often exhibit a pattern of behavior called grooming. This is a strategy used to disarm victims and their families into trusting them, making it more difficult to detect them as an abuser. For instance, perpetrators of childhood sexual abuse will often take on a father or mother figure role, sometimes even choosing professions that allow them close access to children. The perpetrator is also likely to develop close relationships with the child and their family. They may also "desensitize the child to touch," or touch them harmlessly many times before violating them sexually. The offender will hide behind these and other tactics to assure that their transgressions aren't revealed. Impact of Childhood Sexual Abuse Unfortunately, survivors of childhood sexual abuse experience consequences across all areas of their lives. These are known as adverse childhood experiences (ACEs). Physical A person who experiences childhood sexual trauma may have physical injuries and sexually transmitted infections (STIs). Traumatic experiences like sexual abuse have also been associated with an increased risk of chronic health conditions later in life, such as obesity, cancer, and heart disease. Psychological Mentally blocking out memories of past trauma is a psychological defense known as dissociation. Because they are so emotionally painful, recollections of abuse are often buried deep. Difficulty recalling childhood memories may be an indicator of past exposure to trauma like sexual abuse. If you suspect something may have happened to you as a child but you aren't quite sure, seeking treatment can help you to gain a better understanding. The consequences of childhood sexual abuse can manifest in various ways. Abuse in childhood is also linked to higher rates of depression, post-traumatic stress disorder, substance use, and risky sexual behaviors that may result in STIs or unplanned pregnancy. Hypersexuality or sex addiction is also more likely to occur in survivors of abuse. In some people, food addiction and other eating disorders such as anorexia and bulimia may also be triggered by sexual abuse. The risk of suicide increases for someone who has experienced childhood sexual assault. This includes suicidal ideation and attempted suicides. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. Effect on Relationships "Re-victimization" is also likely for a survivor of childhood sexual abuse. For instance, females exposed to sexual abuse as children are two to 13 times more likely to experience sexual abuse again as adults. In addition, someone who was sexually abused as a child is two times more likely to experience non-sexual domestic abuse by a future partner. How Childhood Abuse Changes the Brain Treatment for Childhood Sexual Abuse Trauma-focused treatments for childhood sexual abuse often include therapy to process the experience and medication to manage symptoms. If the family of a child who recently experienced sexual abuse is seeking treatment, they are often assigned a case manager who will connect them with a team of healthcare professionals. Psychotherapy There are several different types of therapies for survivors of childhood sexual assault. Depending on whether you are a child or adult survivor, your healthcare professional may recommend different treatments. For Children Trauma-focused cognitive behavioral therapy (TF-CBT) is a therapeutic approach specifically for children who are survivors of any type of trauma, including sexual abuse. TF-CBT has been found to be effective in lessening the symptoms of anxiety, depression, and PTSD associated with sexual abuse. It also helps address the child's underlying thoughts and fears related to the trauma. A child's parent or caregiver attends sessions with them (unless their parent is the perpetrator of the abuse). Any symptoms of PTSD the parent may have with regard to the abuse are also treated during these sessions. Family therapy may also be recommended in addition to TF-CBT. For Children and Adults Cognitive behavioral therapy (CBT) will also address any negative thoughts or feelings the person has related to the trauma. A therapist will work through these with a client, as well as address any undesirable behaviors the client is engaging in—such as substance use—that may be related to the trauma. Additional types of therapy that are for both children and adult survivors include prolonged exposure therapy (PET), cognitive processing therapy (CPT), and eye movement desensitization and reprocessing (EDMR). Prolonged exposure therapy and cognitive processing therapy have the person "re-live" the traumatic experience and form a new narrative. In this way, they regain power over their story. The aim is to be able to handle situations that may have previously triggered them, as well as reframe limiting beliefs such as "I am not safe" into more positive outlooks. Eye movement desensitization and reprocessing is a more experimental therapy and has not been proven to treat mental health conditions. A therapist will move their fingers in front of the client's face, as the client blinks rapidly and recalls the traumatic experience. Some theorize that this exercise triggers a shift in the way the brain stores memory. The Best Online Therapy Programs for Kids Medication Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants that may be effective for lessening the symptoms of anxiety that are common in survivors of sexual abuse. It is more common for adults to be prescribed SSRIs; however, a healthcare provider may prescribe a child SSRIs if they are diagnosed with a co-existing condition such as PTSD. Anti-anxiety medications may also be prescribed to survivors of sexual assault. Coping With Childhood Sexual Abuse In addition to seeking professional treatment, survivors of childhood sexual assault can add practices or routines to their lives that may help them cope with their trauma. Engage in Self-Care Taking care of yourself is always important, but especially so when you are coping with trauma. Eating a healthy diet, exercising, and getting adequate rest are all ways of regulating your body's nervous system, which can help with symptoms like anxiety and depression. You may also find that taking a break from watching or reading the news can help you control your environment. It can be triggering to see a news story about abuse, for instance, when you are trying to cope with your own experience. Don't Pressure Yourself While many people are sharing their stories of abuse to empower themselves, you may not want to do that. Remember that this is OK. If you're an adult coping with childhood trauma, remember that it's OK not to share your experience on social media or even tell your friends and family if you're not ready. If you do want to speak to someone, you could call a sexual assault hotline or speak with a mental health counselor or therapist. Journal Journaling is an effective way to express your thoughts and emotions. If you are seeing a mental health professional, you can even choose to share some of the thoughts you journal about with your therapist. Reach Out You don't have to be alone when coping with trauma. Even if you choose not to tell anyone what you're experiencing, you can still reach out to friends and family, or even find a new hobby or activity that might connect you with others. Socializing in a healthy way can help to lift your spirits as you progress in your recovery. A Word From Verywell With the right tools and support, recovery from childhood trauma is possible. Sexual abuse at any age is a very confusing and isolating experience. Survivors of abuse are not responsible for the actions of their abusers. Everyone deserves to live a life of freedom and recovery after a painful past. As an adult, coming to terms with our personal histories can prompt the pursuit of treatment and help us discover a brighter future for ourselves. 16 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Murray LK, Nguyen A, Cohen JA. Child sexual abuse. Child Adolesc Psychiatr Clin N Am. 2014;23(2):321-37. doi:10.1016/j.chc.2014.01.003 American Psychological Association. Sexual abuse. Rape, Abuse & Incest National Network (RAINN). Child sexual abuse. Centers for Disease Control and Prevention. Preventing child sexual abuse. Rape, Abuse & Incest National Network (RAINN). Children and Teens: Statistics. Centers for Disease Control and Prevention. Risk and protective factors. Runarsdottir E, Smith E, Arnarsson A. The effects of gender and family wealth on sexual abuse of adolescents. 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