What is child sexual abuse?

Child¹ sexual abuse is any interaction between a child and an adult (or another child) in which the child is used for the sexual stimulation of the perpetrator or an observer. A central characteristic of any abuse is domination of the child by the perpetrator through deception, force, or coercion into sexual activity. Children, due to their age, cannot give meaningful consent to sexual activity.

Child sexual abuse includes touching and nontouching behaviors:

• sexual kissing
• inappropriate touching or fondling of the child’s genitals, breasts, or buttocks
• masturbation
• oral-genital contact
• sexual or digital (with fingers) penetration
• pornography (forcing the child to view or use of the child in)
• child prostitution
• exposure or “flashing” of body parts to the child
• voyeurism (ogling of the child’s body)
• verbal pressure for sex

Who are the victims of child sexual abuse?

• Children of all ages, races, ethnicities, cultures, and economic backgrounds are vulnerable to sexual abuse.

• Child sexual abuse occurs in rural, urban, and suburban areas.

• It affects both girls and boys in all kinds of neighborhoods and communities, and in countries around the world.

Who are the perpetrators of child sexual abuse?

• Most children are abused by someone they know and trust.

• An estimated 60% of perpetrators of sexual abuse are known to the child but are not family members, e.g., family friends, babysitters, childcare providers, neighbors.

• About 30% of perpetrators are family members, e.g., fathers, brothers, uncles, cousins.

• Just 10% of perpetrators are strangers to the child.

• In most cases, the perpetrator is male regardless of whether the victim is a boy or girl. Heterosexual and gay men are equally likely to sexually abuse children. A perception that most perpetrators are gay men is a myth and harmful stereotype.

• Some perpetrators are female -- It is estimated that women are the abusers in about 14% of cases reported among boys and 6% of cases reported among girls.

• Child pornographers and other abusers who are strangers may make contact with children via the Internet.

• Not all perpetrators are adults - an estimated 23% of reported cases of child sexual abuse are perpetrated by individuals under the age of 18.

• Other common characteristics of perpetrators include:

  • a history of abuse (either physical or sexual)
  • alcohol or drug abuse
  • little satisfaction with sexual relationships with adults
  • lack of control over their emotions
  • mental illness in some cases

How prevalent is child sexual abuse?

• Some CDC research has estimated that approximately 1 in 6 boys and 1 in 4 girls are sexually abused before the age of 18.

• Other governmental research has estimated that approximately 300,000 children are abused every year in the United States.

• However, accurate statistics on the prevalence of sexual abuse of children and adolescents are difficult to collect because it is vastly underreported and there are differing definitions of what constitutes sexual abuse.

• Boys (and later, men) tend not to report their victimization, which may affect statistics. Some men even feel societal pressure to be proud of early sexual activity regardless of whether it was unwanted.

• Boys are more likely than girls to be abused outside of the family.

• Most mental health and child protection professionals agree that child sexual abuse is not uncommon and is a serious problem in the United States.

What are the risk and protective factors?

Research is still evolving around what risk factors presage child sexual abuse due to the difficulty involved in getting data.

However, some general characteristics have been identified:

Age

• Older children tend to be at greater risk for sexual abuse
• 0-3 y/o: 10% of victims
• 4-7 y/o: 28.4% of victims
• 8-11 y/o: 25% of victims
• 12 and older: 35.9% of victims

Gender

• Girls tend to be at greater risk of sexual victimization than boys.
• However, boys are more likely to be victimized by a perpetrator outside the family than girls.

Disability

• Children with disabilities are at elevated risk of abuse, particularly, if the disability impairs their perceived credibility, e.g., blindness, deafness, and mental retardation.

Prior history of victimization

• Those with a prior history of sexual victimization are extremely likely to be revictimized. Some research estimates an increased risk of over 1000%.

Family characteristics

• Absence of one or both parents is a risk factor
  -- Some research found that children living with only one biological parent at twice the risk of sexual victimization.
  -- Children living without both biological parents were at three times the risk of sexual victimization.

• Older children from father-only families were also at increased risk of sexual victimization compared to other children.

• Presence of a stepfather in the home doubled the risk of sexual victimization for girls.

Parental characteristics associated with increased risk

• Researchers have found that parents with a history of childhood sexual victimization are at an estimated risk 10 times greater for having a sexually abused child

• Multiple caretakers for the child

• Caretaker or parent who has multiple sexual partners

• Drug and/or alcohol abuse

• Stress associated with poverty

• Social isolation and family secrecy

• Child with poor self-esteem or other vulnerable state

• History of abuse among other family members (e.g., siblings, cousins)

• Unsatisfactory marriage or intimate partner violence for the mother

• Parents leaving child at home alone without adequate supervision

What are the effects of sexual abuse?

• Not all sexually abused children exhibit symptoms (some estimate up to 40% of children are asymptomatic) however others experience serious and long-standing consequences.
• Child sexual abuse can result in both short-term and long-term harm, including mental health problems that extend into adulthood.
• Sexual abuse can affect psychological, emotional, physical, and social domains of the child’s life, including increased risk for
  • Depression
  • Guilt
  • Fear
  • Post-traumatic stress disorder (PTSD)
  • Dissociative and anxiety disorders
  • Eating disorders
  • Poor self-esteem
  • Somatization, i.e., the expression of distress in physical symptoms
  • Chronic pain
• Behavioral problems can include
  • Sexualized behavior – which brings elevated risk for pregnancy and sexually transmitted infections
  • School/learning problems
  • Substance abuse
  • Destructive behavior
  • Sexual dysfunction in adulthood
  • Criminality in adulthood
  • Suicide

¹ For our purposes, the term “child” includes adolescents below the age of consent.