How To Recognize Sexual Abuse? Who Can Experience Sexual Abuse?

By: Sarah Fader

Updated February 02, 2021

Medically Reviewed By: Stephanie Chupein

Content/Trigger Warning: Please be advised, the below article might mention trauma-related topics that include sexual assault & violence which could potentially be triggering.


When one person imposes or forces unwanted sexual behavior on another person, it is defined as sexual abuse or molestation. Sometimes, threats, violence, and intimidation are used in the attack. The person who initiates the unwanted behavior is known as the sexual abuser or molester.


When someone is too young to give consent and is used in sexual activities, it is defined as child sexual abuse. In adults, sexual abuse includes assault, rape, and harassment. Sexual abuse is not restricted to race, ethnicity, sex or gender identity, sexual attraction, or culture. Anyone can experience sexual abuse: children, women, men, elders, teens, disabled people, and LGBTQ+ individuals. Unfortunately, sexual abuse can happen anywhere - at school, at home, at daycare, at work, at a friend's house, at a park, and within any kind of a relationship.


When an adult or teenager engages in unwanted sexual activity with a child or uses a child for their own sexual gratification, it is described as child sexual abuse. Legally, the term “child sexual abuse” is an umbrella term, which classifies all sexual acts committed by an adult on a child or a minor.

Sexual abuse against a child is considered to be a criminal act as children are in no position to give consent to any kind of sexual activity. Molesting a child is one of the vilest things anyone can do yet it happens every day. According to a 2014 study conducted by UNICEF, entitled Hidden in Plain Sight, approximately 120 million young girls experience sexual abuse at one point or another. In the United States, a little child is abused every eight minutes.

While both children of any gender and sex can experience sexual abuse, girls are generally at a higher risk than boys. One in three girls and one in seven boys will be assaulted before they turn 18. Researchers are only beginning to collect information on the risk for children who are gender nonconforming or transgender. 

Generally, cases of sexual abuse tend to occur in an adult-child relationship. But abuse can happen when both the abuser and the one being abused are children. Abuse generally happens at the hands of a family member - father, uncle, cousin, stepfather, or even a sibling. This sometimes makes it more difficult for the person experiencing the abuseto come forward or understand that something bad is happening to them. If they do come forward, their parent or guardian may not believe them because it's easier to ignore the problem than confront something ugly.

Statistically, 30% of abusers are close family members, 60% of abusers are extended family, friends or acquaintances like a babysitter, a neighbor, a family friend etc., and abuse by complete strangers accounts for 10% of the cases. The large majority of abusers are men. There are some women who abuse children, but they are in the minority.

Sexual abuse can come in numerous forms and it is not always overt and clear, especially to a child. It can happen through physical (touch) acts and non-touching ones.

The physical acts of sexual abuse can include the following:

  • Fondling, touching, kissing the private parts of a child, or forcing the child to reciprocate by making them touch the abuser's private areas
  • Having sex with the child (i.e., rape.)
  • Inserting fingers, tongue, or objects in a child's vagina or anus

Non-touching sexual acts can include a broad range of activities but commonly these acts may be:

  • The abuser poses the child in a provocative, sexual way and takes their pictures - usually, the child is either naked or dressed to suit certain fantasies (e.g.,schoolgirl uniform)
  • The abuser shows porn to the child
  • Talking to the child about sex in a way that is uncomfortable for the child
  • The abuser exposes their genitals in front of the child

It is also possible to sexually abuse children without ever coming into contact with them. There is a growing problem around the world of child pornography being sent, shared, and viewed by millions of people in the privacy of their homes and offices. Taking any kind of part in such activities is akin to physically participating in the sexual abuse of a minor. If you know anyone who is involved with child pornography, even if all they are doing is viewing images, please report them to the authorities. In order for the cycle of abuse to stop, abusers need to be stopped and they need to get help.


Oftentimes, those who have been abused, both children and adult, are fearful of coming forward with their stories because of the stigma associated with the crime. Even though they are the ones who were wronged, they are made to feel dirty and ashamed while the perpetrators of the crime go free. This is something that needs to be changed culturally and socially in order to raise awareness on the issue and decrease the number of people who experience abuse.


The immediate symptoms, which may be displayed by someone following an attack, are fear, shock, and a sense of disbelief that this actually happened. Long term, the psychological symptoms may intensify, and the impacted personmay suffer from mental health issues such as PTSD.

A physical examination of the genital area is typically needed in order to determine sexual abuse becausesigns are not always visible on the body. These signs may include:

  • Blood in the vagina
  • Blood or tears in the anus
  • Bite marks or other bruises in the vaginal or rectal area
  • Signs of diseases such as gonorrhea, HIV, chlamydia etc.
  • Sores or warts on vagina or penis
  • Painful urination or bowel movements

Children who experience or witness sexual abuse are often unable or unwilling to discuss it. They may be feeling confused, scared, or unsure that something bad is happening to them, especially when the abuser is someone they love and trust. The onus is often on the parents or the guardians of the child to keep an eye out for unusual behavior and warning signs such as:

  • Problems with sleeping or suddenly experiencing nightmares
  • Clingy behavior
  • Becoming antisocial or withdrawn
  • Listless, secretive behavior
  • Display uncharacteristic mood swings, like anger, tears, or sadness
  • No longer eating or eating more than usual
  • A sudden fear of being left alone with someone
  • Using grown-up, sexual words
  • Drawing inappropriate sexualized pictures of engaging in sexual games either with their toys or with other young children - this is often a child's subconscious way of talking about the abuse and reaching out to an adult

It's important to remember that every child goes through phases where they may exhibit some of the symptoms mentioned above. It does not immediately mean that they are being abused in any way. However, if a few of these signs are present, as the adult, you should ask more questions and probe a little further to ensure your child is not being harmed in any way.

A prepubescent child who has not yet started to menstruate should not have blood in the vagina. If you see blood or other symptoms like scars and bruises, speak to a doctor immediately and have your child go through a thorough checkup.


Common effects seen in children who experience sexual abuse can include the following:

  • Depression
  • Accidental pregnancy
  • Discrimination and social stigma
  • Post-traumatic stress disorder and complex post-traumatic stress disorder
  • Psychological trauma
  • Anxiety

The National Institute of Drug Abuse conducted a study on sexual abuse and came to the conclusion that women who experienced sexual abuse as children were more likely to develop deep psychological and mental health issues as adults. They were also at a greater risk for developing an alcohol, drug, or other substance abuse problem.

As these children grow up, they often carry the shame of what happened to them as a child into adulthood and continue to suffer from the symptoms mentioned above. Their grown-up lives are largely shaped by those traumatic experiences.


Two professors at the University of New Hampshire, Dr. DavidFinkelhor and Dr. Angela Browne, conducted a study and suggested that four trauma causing factors play a role in a survivor's life.Finkelhour is also the director of the Crimes Against Children Research Center, and Browne

  1. Traumatic sexualization: Exposing a child to inappropriate sexual behavior when they are too young to understand it can impact how they feel and react to sex as they grow up. The experience will vary from child to child. For instance, if a child is rewarded for the abuse with gifts, attention etc., they will begin to correlate sex with rewards. As adults, they may use sex as a way to manipulate a situation or get what they want. On the other side, if the abuse includes force and violence, they may grow up to associate sex with fear and helplessness.
  2. Betrayal: When the abuse happens at the hands of a loved one, or when someone whom the child trusts fails to protect them from the abuse or, worse, choose to believe that the abuse did not happen, the child grows up feeling betrayed. It skews their ability to form trusting relationships in the future.
  3. Powerlessness: Every child is utterly helpless and powerless at the hands of their abusers. When manipulation and coercion is used, their helplessness increases because they become fearful of their abuser and trapped in a situation they can't get out of. This feeling of powerlessness gets worse if authority figures or parents refuse to believe or to support them.
  4. Stigmatization: When the child is made to feel like they did something shameful or immoral, or when people react negatively to their experiences of abuse, the child can be plagued by guilt and blame. Adult survivors tend to look back and feel that they must have done something wrong to incite the abuse or that they should have been able to fight back or stop what was happening to them. Sometimes, they even harbor feelings of guilt about their body's natural, biological response to the abuse (i.e., arousal).

Self-esteem, problems with sexual intimacy, or problems with developing relationships may also become an issue. When the first sexual experience for someone is a negative one, especially at a young age, every sexual encounter or relationship after that can lead to an emotional reaction, flashbacks, trigger, PTSD, or anxiety. Sometimes, the adult survivor is unable to find any joy in their consensual sexual experiences.

In order for adult survivors to move past these trauma factors, they have to understand how each factor affects them individually. They also have to understand that they were not to blame for what happened. This is why psychotherapy is a beneficial treatment method for sexual abuse.

In addition to speaking to a psychologist or therapist, group therapy has also been proven to be very effective for both survivors and family members because they can relate to others and see that they are not alone.BetterHelp’s sister platform, TeenCounseling, also supports those over the age of 13.

If you’re interested in learning more about online therapy, you probably want to know how effective it is. Therapy isn’t one size-fits-all, and that’s true no matter if you’re stepping into and office or sitting down in front of a computer. But to give you an idea, the efficacy of online therapy has been studied quite a bit when it comes to PTSD. One study took veterans who were seeking therapy with the U.S. Veterans Affairs clinics and divided them into two groups: one group had traditional therapy, the other received their treatment through videoconference. At six months, both groups had similar levels of improvement.

You may see some of the same benefits to online therapy that the study did. If you’re feeling a great deal of stigma or concern about beginning therapy, for whatever reason, contacting someone through a medium you’re comfortable in a space you’re familiar in may be an easier first step than heading into an office. Offices also sometimes have wait lists, which can be nerve-racking for someone trying to reach out. BetterHelp connects most people to a counselor within 24 hours.

In case some personal anecdotes would also be helpful, here are some reviews by recent BetterHelp users about their counselors:

“After working with a number of different therapists in my life, Mary has been the easiest one to open up to with just about everything. She has incredible insight and has been able to navigate me though sexual trauma, familial related anxiety, religious guilt, and so forth. She listens attentively, brings new thought strategies to light, and recommends relevant books for further reflection. I have only been with her for 2 months now, but I can comfortably say I have found a therapist for life.” Read more on Mary Cabarles.

“I am so grateful to have had Lisa as my therapist. I was and am still dealing with intimacy issues that stem from years of childhood trauma. I have been carrying this baggage for years and I still am. After only two months of working with Lisa, I feel a lot of that baggage being lifted and my perspective has changed considerably. Lisa is not only empathetic but also rational. She affirms your feelings while giving a logical explanation as to why you feel the way you do. It helps validate my feelings and makes me feeling more accepting of them that I’m not just irrational. I would recommend her.” Read more on Lisa Savinon.


What can you do as the parent or guardian of a child? Be diligent, look out for warning signs, and keep the lines of communication between yourself, your child, and other members of the family open and clear. Make sure that you have an open and trusting relationship with your child so they can come to you with their problems. When they are old enough to understand certain things, sit down with them and have an honest conversation about their body parts, about sex, love, and what is appropriate behavior and what isn't.

There are lots of resources and guides available online that can help you figure out the best way of approaching this type of conversation or handling a situation like this. If your child is or has been the affected by sexual abuse, get them the help they need as soon as you can.

It is important for a parent who learns that their child has been sexually abused to stay calm and maintain themselves as a safe place for their child.

In these cases, the sooner that someone begins treatment, the better. If a survivor can be helped when they are still a child, the chances of them growing up to lead a normal life that is free from psychological problems are greater than someone who did not receive the necessary help. Parents of children who experienced sexual abuse may also need to engage in therapy to help support their children. If an adult comes forward in your life and relates their abuse, urge them to also get help.

Don't be judgmental or make them feel ashamed or guilty. It's important for the survivor's mental health and self-esteem that they get the love and support. They should be taught not to carry any guilt or shame because the abuser is the criminal.

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