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Sexual Abuse: Overview

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KEY POINTS

  • Any sexual activity, even if the child agrees, between a child and an adult may be sexual abuse. This includes improper touching, showing sexual pictures or showing genitals to a child, or having any sex with a child.
  • Children may not tell anyone that they are being abused. They may be afraid or unsure that the abuse is wrong. The child may not tell anyone what has happened because the abuser threatened the child or told them to keep it secret. Learn the signs of abuse.
  • If you suspect child sexual abuse, contact the local police or child protective services, no matter who the abuser is.

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What is sexual abuse?

Any sexual activity, even if the child agrees, between a child and an adult may be sexual abuse. Sexual abuse may include:

  • Touching a child’s genitals or rubbing of the adult's genitals on the child
  • Having any kind of sex with a child
  • Showing genitals to a child
  • Showing sexual pictures to a child
  • Using the child to make pornographic pictures or videos

It is never OK for an adult to have sex with a child, even if the child seems to agree or even seems to want it. The adult is always the one in the wrong. Most abusers get the child to trust them rather than forcing the child to have sex. Many abusers do not believe that they are doing anything wrong. They may seem to love children.

Most abusers are people that the child knows such as relatives, friends, or neighbors. Most child sexual abusers are male but females can also abuse children. Both abusers and abused children can come from any age, race, religion, or income level.

What are signs of sexual abuse?

Children may not tell anyone that they are being abused. They may be afraid or unsure that the abuse is wrong. The child may not tell anyone what has happened because the abuser threatened the child or told them to keep it secret. Signs of sexual abuse may include:

  • Having vaginal or rectal bleeding, pain, itching, swelling, or discharge
  • Having trouble walking or sitting
  • Being depressed or withdrawing from family members and friends
  • Being secretive
  • Either avoiding or being unusually interested in things of a sexual nature, acting sexual, or drawing sexually related pictures
  • Acting afraid or avoiding a certain person
  • Having sleep problems or nightmares
  • Having stomach pain, bedwetting, urinary tract infection, or a sexually transmitted disease
  • A return to younger behaviors such as thumb sucking
  • Refusing to go to school or letting the quality of schoolwork go down
  • Saying that their bodies are dirty or damaged, or being afraid that there is something wrong with them in the genital area
  • Trying to run away
  • Being angry or aggressive
  • Trying to commit suicide

Can sexual abuse be prevented?

Even small children can be taught how to avoid abuse. Teach your child the proper names of body parts. Teach children that their bodies belong to them, and that no one has a right to touch or hurt them in any way. This applies to strangers as well as people they know. They must know that it is OK to say "NO" to anything that makes them uncomfortable, even if it is a family member or friend. It is best not to talk about good touch and bad touch, because the child may think a bad touch is only something that hurts them such as scraping their knee. Sexual contact may not hurt, or may even feel good to a child.

Screen babysitters and day care providers. Select daycare and other programs that have a parent “open door” policy. Drop in without warning to see how things are going. Don’t leave your child with adults you do not trust, even if your lack of trust is "just a feeling."

Talk to your kids about problems they may find online such as sex and violence. Be honest and specific. This helps them know what it is when they see it. Help them talk about what they don’t understand, what scares them, or what upsets them. Teach your children that people online may not be who they seem. Someone saying they are a 13-year-old girl could actually be a 50-year-old man. If your child is exposed to any type of child pornography while online, immediately report this to the National Center for Missing and Exploited Children at 800-843-5678.

Talk about secrets and that they should tell you if they’ve been told to keep a secret. Teach children to tell someone such as a parent, a trusted teacher, school nurse, or guidance counselor if someone asks them to keep a secret. Children should be taught to respect adults and caretakers, but they should not do something that they think is wrong just because an adult tells them to do it. Reassure them that they won’t get in trouble by talking about anything that’s happened to them.

Short, simple talks through childhood and the teen years are helpful. Take advantage of "teachable moments." A news story, neighborhood gossip, and TV shows can all be ways to start talking with older children and teens.

What if I think a child might be abused?

If you suspect a child is being abused, carefully and calmly ask the child about it. Be careful not to judge or blame. Listen and let the child talk freely. Tell the child that it is not their fault and that they will be protected from the abuser. If a child tells you that they have been abused, take it seriously.

If you suspect child sexual abuse, contact the local police or child protective services, no matter who the abuser is. You can also call the Childhelp National Child Abuse Hotline, available 24/7, at 1-800-422-4453.

If a child you know has already been abused, get help for the child. The child should see a healthcare provider, and may need to see a mental health professional. The parent of an abused child may also need help. It is painful to know that your child has been abused.

For more information, contact:

Developed by Change Healthcare.
Pediatric Advisor 2022.1 published by Change Healthcare.
Last modified: 2021-12-07
Last reviewed: 2018-07-09
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2022 Change Healthcare LLC and/or one of its subsidiaries
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