Child Sexual Abuse


It is often difficult for victims of child sexual abuse to disclose the abuse they suffer. Many child sexual abuse survivors wait until adulthood to tell someone and process the abuse they endured. Approximately 85% of minors who are sexually abused never tell, or delay telling, about the abuse.

There are many reasons why victims choose not to tell anyone about the abuse or report it to law enforcement. In most child sexual abuse cases, the perpetrator is known to the minor and is often a trusted adult or family member. Research indicates that the closer the victim is to the abuser, the less likely he or she will disclose the abuse. In instances where the perpetrator is a close family member, such as a parent or a grandparent, the victim may not say anything for fear of what will happen to his or her family if they do so. Along with the confusion they may experience as a result of being victimized, they may also be fearful of what will happen to them if they disclose the abuse. Additionally, many perpetrators use threats and intimidation to silence young victims. For some victims, sexual abuse may happen so often it becomes normalized.

Signs & Symptoms:

The signs of child sexual abuse vary, and it's important to recognize that the absence of signs and symptoms does not signal the absence of abuse. In the field, indicators are considered to be either physical or psychosocial, and a differentiation is made between higher and lower probability indicators. There are also different indicators for different age ranges, as noted below. 

Physical indicators
High Probability Indicators:

  • Pregnancy or sexually transmitted disease in children under 12 or 13
  • Semen in a child's vagina Injury or scarring inside the vagina or on the penis or scrotum

Lower Probability Indicators:

  • Several medical conditions, including urinary tract infections

Psychosocial Indicators
Higher Probability Indicators:

  • In younger children: Demonstration of sexual knowledge not ordinarily possessed by children. These may be sexually explicit statements, drawings, or behaviors toward people, animals, or objects (such as sexual aggression toward peers or sexual invitation toward adults). It is important to remember that some sexual behaviors are normal and age appropriate.
  • In younger children: Masturbation that is excessive (to the point of injury, occurring multiple times per day, or including objects or thrusting).
  • In older children: Sexual promiscuity among girls; and being sexually victimized by peers or non-family members.
  • In all children: Disclosure of sexual abuse. Only 1-5 percent of disclosures are considered to be false, so this is perhaps the highest probability indicator.

Lower Probability Indicators:

  • In younger children: sleep disturbances, regressive behaviors, self-destructive or risk taking behaviors, fear of the alleged offender, refusal to be left alone.
  • In older children: Eating disturbances, running away, substance abuse, self-destructive behaviors, and criminal behaviors.
  • In all children: Problems relating to peers, school difficulties, sudden behavioral changes. 

The above signs and symptoms information is courtesy of the U.S. Department of Health and Human Services.


We know that child sexual abuse has lasting impacts on survivors, their families, and significantly impacts our communities. The impacts on victims and survivors vary and most often include long-lasting physical, mental, and emotional issues.

Child sexual abuse creates substantial financial impacts as well. Costs include crisis services; medical treatment for victims/survivors (both short- and long-term, mental and physical); lifetime loss of income; expenses to the state and individuals as a result of the criminal justice process; and incarceration for perpetrators, including treatment and management (probation, the sex offender registry, etc.). According to a recent report released by the Centers for Disease Control and Prevention, the total lifetime estimated financial costs associated with just one year of confirmed cases of child maltreatment (physical abuse, sexual abuse, psychological abuse, and neglect) is approximately $124 billion. The same study found that the lifetime cost for each victim of child maltreatment who lived was $210,012.

Prevention & Reporting:

Investing in child sexual abuse prevention - indeed, the prevention of all types of sexual violence - is paramount to ending child sexual abuse. Child sexual abuse prevention includes a willingness to model and have honest discussions with children about healthy relationships. The prevention of further sexual abuse of children is also important. This includes reporting suspected sexual abuse (this does not mean you need to investigate the abuse; it just must be a good faith report that sexual abuse is suspected) to your local law enforcement or Child Protective Services. Don't wait for proof, make the report. For more information on child sexual abuse prevention efforts, visit our page on child sexual abuse prevention.  

Additional Resources:

National Children's Alliance
The National Children's Alliance provides training, support, technical assistance and leadership on a national level to local children’s and child advocacy centers and communities responding to reports of child abuse and neglect. 

National Children's Advocacy Center
The National Children's Advocacy Center is a nonprofit organization which provides training, prevention, and treatment services to fight child abuse and neglect.

Understanding Child Sexual Abuse Definitions and Rates
This fact sheet helps to break down definitions and rates of child sexual abuse, and discusses the importance of prevention.

Adverse Childhood Experiences (ACE) Study
The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being.

National Clearinghouse on Child Abuse and Neglect Information
This link offers resources on child abuse and neglect, including definitions, identification of signs and symptoms, statistics and data, risk and protective factors, perpetrators, the impact on individuals and society, and fatalities.

National Child Traumatic Stress Network
The National Child Traumatic Stress Network was established to improve access to care, treatment, and services for traumatized children and adolescents exposed to traumatic events.

Child Sexual Abuse - General information
This fact sheet, developed by the Maine Coalition Against Sexual Assault, includes general information on child sexual abuse, including information about disclosures, financial implications of CSA, and prevention.

Child Sexual Abuse - Long-Term Consequences
This fact sheet, developed with thanks to a data compilation from Darkness to Light, discusses the long-term consequences of child sexual abuse.