Understanding child sex abuse

What is child sexual abuse?

There is no universal definition of child sexual abuse. However, a central characteristic of any abuse is the dominant position of an adult that allows him or her to force or coerce a child into sexual activity. Child sexual abuse may include fondling a child's genitals, masturbation, oral-genital contact, digital penetration, and vaginal and anal intercourse. Child sexual abuse is not solely restricted to physical contact; such abuse could include noncontact abuse, such as exposure, voyeurism, and child pornography. Abuse by peers also occurs.

Accurate statistics on the prevalence of child and adolescent sexual abuse are difficult to collect because of problems of underreporting and the lack of one definition of what constitutes such abuse. However, there is general agreement among mental health and child protection professionals that child sexual abuse is not uncommon and is a serious problem in the United States.

The impact of sexual abuse can range from no apparent effects to very severe ones. Typically, children who experience the most serious types of abuse—abuse involving family members and high degrees of physical force—exhibit behavior problems ranging from separation anxiety to posttraumatic stress disorder. However, children who are the victims of sexual abuse are also often exposed to a variety of other stressors and difficult circumstances in their lives, including parental substance abuse. The sexual abuse and its aftermath may be only part of the child's negative experiences and subsequent behaviors. Therefore, correctly diagnosing abuse is often complex. Conclusive physical evidence of sexual abuse is relatively rare in suspected cases. For all of these reasons, when abuse is suspected, an appropriately trained health professional should be consulted.