Child Sexual Abuse I: An Overview 

Until the early 1970's child sexual  abuse was thought to be rare, and centered among the poor. Experts now agree that child sexual abuse has always occurred and still exists in all socio-economic groups. Increased public awareness has led to greater reporting; from 1970 to 1990, child sexual abuse reports increased more than other categories of neglect or abuse.  Despite this gain, child sexual abuse still remains vastly under-reported. 

Children and adolescents who have been sexually victimized are at increased risk for HIV infection, unplanned pregnancy and other negative outcomes. Unfortunately, the personal skills needed to prevent sexually-transmitted diseases and unintended pregnancies are exactly those eradicated by sexual abuse. People who work with youth must be aware of the possible connection; sexual abuse prevention must be a component of any program promoting adolescent reproductive and sexual health. 

Child Sexual Abuse Is Serious and Wide-Spread. 

• The American Medical Association defines child sexual  abuse as "the engagement of a child in sexual activities for which the child is developmentally unprepared and cannot give informed consented Child sexual abuse is characterized by deception, force or coercion. 
• Sexual abuse can include fondling, genital exposure, intimate kissing, and forced masturbation oral, penile or digital penetration of the mouth, vagina or anus. Child prostitution, pornography and cult (or "ritual”) abuse is specific activities also included in the definition. Incest is sexual abuse where the offender is  a family member. 
• Sexual abuse occurs in rural, urban and suburban areas and among all ethnic, racial and socioeconomic groups. A recent Department  of Justice report found that half of the women who reported rapes in 1992 were under the age of 18, 16 percent were under 12. 
• Most children are abused by someone they know and trust, although boys are more likely than girls to be abused outside of the family. A study in three states found 96 percent of reported rape survivors under age 12 knew the attacker. Four percent of the offenders were strangers, 20 percent were fathers 16 percent were relatives and 50 percent were acquaintances or friends. Among women 18 or older, 12 percent were raped by  a family member, 33 percent by a stranger  and 55 percent by  an acquaintance. 
• Abuse typically occurs within a long-term, on-going relationship between the offender and victim, escalates over time and lasts an average of four years. Offenders often develop a relationship with a targeted victim for months before beginning the abused Sexual abuse often occurs in successive generations of the same family.  In non-familial child abduction, one study found two-thirds of reported cases involved sexual assault. 
• In up  to 50 percent of reported cases, offenders are adolescents.  In 82 percent of accusations recently studied the accused offender was a heterosexual partner of a close relative of the child's. Researchers estimate that between 96 to 100 percent of accused abusers are recognizably heterosexual.  Another study found that almost half of offending fathers and stepfathers also abused  children outside their family. 
• Children are most vulnerable between ages eight-12.  The average age  for first abuse  is 9.9 years for boys and 9.6 years for girls.  Victimization occurs before age eight in over 20 percent of the cases. Another study found 24 percent of female child  sexual abuse survivors were first abused at age five or younger. 
• Estimates of  child sexual abuse rates vary  for many reasons. Less than 10 percent of set abuse  is reported to the policed.  Definitions of both abuse and the age of maturity affect frequency rates.  Protective services only record reported cases and typically focus on intrafamilial abuse, thus excluding non-caretakers. 
• Even in self-reporting surveys, abuse may be underreported because many people are afraid or ashamed to reveal victimization, have repressed memories of abuse, and refuse to participate in studies or deny that what happened was "real"  abuse.
• The National Resource Council estimates  the percent of the U.S. population which has been sexually abused to range from a low of 20-24 percent to a high of 54-62 percent of the population; the higher estimate includes sexualized exposure without touching, such as masturbating in front of the child.  The largest retrospective study on the prevalence of  child sexual abuse found 27 percent of women and 16 percent of men reported  abuse.
• Studies examining victimization of boys have recorded rates ranging from 3 to 31 percent of all men.  Male victimization is particularly hard to estimate due to beliefs that only girls can  be abused; that sex between older women and boys is desirable; that male victimization of boys indicates lack of masculinity and/or acquiescence by the child.   
• One study found less than 2 percent of abuse reports made by children and 6 percent of those made by adults were judged false, suggesting that false allegations are rare.  In one study, all but two children who revoked claims of abuse later disclosed new incidents of abuse. These researchers view revocation of abuse reports as part of the disclosure process rather than an indication of false claims. 

• The primary markers for increased risk for child sexual abuse for girls are having: few  friends, absent or unavailable parents, a stepfather and conflict with or between parents. 
• Other risk factors include: physical or mental disability; separate living arrangements from both biological parents; mental illness, alcoholic or drug abuse in the family; a parent who was physically or sexually abused as a child; homes with other forms  of abuse, prostitution or transient adults. 
• One study examined eight of these indicators in girls and found sexual abuse histories in 6 percent with no risk factor, 9 percent with one factor; 26 percent with two factors and 68 percent with three factors. Another study found 78 percent of sexually abused children studied had at least three risk factors. 
• Gay, lesbian and bisexual youth may be at greater risk because they tend  to be socially isolated and are easier targets. In one study, male sexual abuse survivors self-described as homosexual almost seven times, and as bisexual almost six times, more often than non abused peers. 

• Child sexual abuse often negatively affects long-term psychological and social well-being, although more than half of all sexual abuse survivors do not suffer the most extreme forms of psychiatric trauma. 
• Factors that worsen the severity include: younger age at first abuse, less developmental maturity, longer duration of abuse, occurrence of penetration, use of force, abuse by  a parent-figure or much older perpetrator, lack of support upon disclosure and absence of a caring non-abusing parent. 
• Psychological and behavioral effects of  child sexual abuse  may include low self-esteem, depression, anxiety, fear, hostility, chronic tension, eating disorders, sexual dysfunction, self-destructive or suicidal behavior, post traumatic stress disorder, dissociation, multiple personality disorder, repeat victimization, running away, criminal behavior, academic problems, substance abuse and prostitution. 
• Sexual abuse survivors are at higher risk for mental health and social functioning problems resulting from feelings of powerlessness, guilt, shame, stigmatization and low self-esteem.  Powerlessness damages coping skills and reduces ability  to protect oneself from further abuse.