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

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated June 7, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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When one person imposes or forces unwanted sexual behavior on another, it is usually defined as sexual abuse or molestation. Sometimes, threats, violence, and intimidation may be employed, but sexual abuse can also be coercive. The person who initiates the unwanted behavior can be referred to as the sexual abuser or molester. When someone is too young to provide legal consent for sexual activities, it is generally defined as child sexual abuse. In adults, sexual abuse can include assault, rape, and sexual harassment. Sexual abuse may not be restricted to race, ethnicity, sex, gender identity, sexual attraction, or culture. Anyone can experience sexual abuse, and it can happen anywhere. Survivors of sexual abuse may benefit from working with a therapist to cope with and heal from their experiences.

Getty/Xavier Lorenzo
Are you having a hard time discussing sexual abuse?

Child sexual abuse

When a teenager or adult engages in sexual activity with a child or uses a child for sexual gratification, it is typically described as child sexual abuse. Legally, child sexual abuse can be classified as all sexual acts committed by an adult on a minor.

According to statistics compiled by the Department of Justice, one in nine girls and one in 53 boys under 18 may experience sexual abuse by an adult. Girls between the ages of 16 and 19 are generally four times more likely to be raped, sexually assaulted, or experience an attempted rape than females in other age groups. In addition, 88% of perpetrators of sexual abuse are usually male. 

Cases of sexual abuse often occur in adult-child relationships, and in most cases of child sexual abuse, the perpetrator is known to the child. However, abuse can also take place between children. 

93% of child sexual abusers are typically known to the person they abuse. Child sexual abusers can be family, friends, babysitters, neighbors, and teachers. Abuse by strangers usually accounts for only 7% of cases. 

Sexual abuse can come in numerous forms, and it is not always obvious, especially to a child. It can happen through physical acts or acts that do not involve physical contact.

Physical acts of sexual abuse can include:

  • Fondling, touching, or kissing the sensitive parts of a child or forcing the child to reciprocate by making them touch the abuser's sensitive areas

  • Sexual intercourse

  • Inserting fingers, tongue, or objects into a child's vagina or anus

Non-touching sexual acts can include a broad range of activities, including the following:

  • Posing a child in a provocative, sexual way to take photos or videos

  • Showing pornography to a child, such as through direct messages to the child or through social media

  • Talking to a child about sex in inappropriate ways

  • An adult exposing their genitals in front of a child


Warning signs and symptoms of sexual abuse

The immediate psychological symptoms displayed by someone following sexual abuse of any kind may include fear, shock, disbelief, and emotionally shutting down. The psychological symptoms may intensify over time, and the impacted person may experience mental health concerns, such as depression, anxiety, and post-traumatic stress disorder (PTSD).

Physical signs of sexual assault may include:

  • Blood in the vagina

  • Blood or tears in the anus

  • Marks or bruises in the vaginal or rectal area

  • Symptoms of sexually transmitted diseases (STDs), such as gonorrhea, HIV, and chlamydia

  • Sores or warts on the vagina or penis

  • Painful urination or bowel movements

Children who experience or witness sexual abuse are often unable or unwilling to discuss it. They often feel confused, scared, or unsure about what is happening to them, especially when the abuser is someone they love and trust. A child’s parents or guardians can watch for unusual behavior and warning signs, such as:

  • Sleep problems or suddenly experiencing nightmares

  • Clingy behavior

  • Becoming antisocial or withdrawn

  • Listless or secretive behavior

  • Uncharacteristic mood swings, like anger, crying, and sadness

  • Changes in appetite

  • A sudden fear of being left alone with someone

  • Using grown-up, sexual words

  • Drawing inappropriate sexualized pictures

  • Engaging in sexual games, either with their toys or with other young children

It can be important to remember that every child may go through phases and exhibit some of the signs mentioned above. Therefore, these signs do not necessarily mean a child is experiencing sexual abuse. However, if a few of these signs are present, an adult should observe and ask questions to ensure the child is not being harmed.

What are the psychological effects of sexual abuse?

Common effects seen in those who have experienced sexual abuse can include the following:

  • Depression

  • Accidental pregnancy

  • Discrimination and social stigma

  • Post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD)

  • Anxiety

Are you having a hard time discussing sexual abuse?

Studies have concluded that people who experience sexual abuse as children are usually more likely to develop serious psychological and mental health issues as adults and may be at greater risk of substance use disorders.

Two professors at the University of New Hampshire, Dr. David Finkelhor and Dr. Angela Browne suggested that four trauma-causing factors usually play a role in a survivor's life. 

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 can vary from child to child. For instance, if an abuser rewards a child after abuse with gifts and positive attention, they may begin to correlate sex with rewards. As adults, they may use sex to get what they want. On the other hand, if the abuse includes force and violence, they may grow up to associate sex with fear and helplessness.


Due to the uneven power balance between an adult and a child, children are usually powerless at the hands of their abusers. When an abuser uses manipulation and coercion, the child’s helplessness generally increases because they can wrongly begin to see themselves as having agreed to the abuse. This feeling of powerlessness often worsens if authority figures or parents refuse to believe or support them.


When sexual abuse makes a child believe they did something shameful or immoral, or when people react negatively to their experiences of abuse, the child can develop feelings of guilt and self-blame. Adult survivors tend to look back and feel they must have done something wrong to invite the abuse or that they should have been able to fight back or stop what was happening to them. Sometimes, they even harbor guilt about their body's natural, biological responses, for example, if the abuse caused them to experience sexual arousal.

Problems with sexual intimacy due to betrayal

Difficulty developing relationships may also result from sexual abuse as a minor. When a person’s first sexual experience is negative, especially at a young age, every sexual encounter after that may lead to an emotional reaction, flashbacks, or anxiety. Sometimes, adult survivors cannot find joy in their consensual sexual experiences.

Adult survivors can learn how each factor affects them and potentially move past these trauma factors. They can also begin to understand they were not to blame for what happened, and psychotherapy can play a crucial role in helping someone overcome the effects of sexual abuse.

Therapy for survivors of sexual abuse

Often, people who are sexually abused, whether they are children or adults, are fearful of coming forward because of the stigma associated with the crime. However, getting support can be essential for healing. Online sexual abuse counseling may be a convenient service for survivors to use.

Benefits of online therapy

If you're feeling hesitant about beginning therapy, contacting someone through an online platform from a familiar space like your home may be a more straightforward first step than looking for a local therapist who is accepting new patients. Therapists’ offices often have waitlists as well, which can be nerve-wracking for someone trying to reach out for help. BetterHelp connects most people to a therapist within 48 hours.

Effectiveness of online therapy

Therapy is not usually a one-size-fits-all solution, and many types of therapy can be helpful for people who have experienced sexual abuse. The mental health symptoms that can arise from sexual abuse can be varied, but frequently, people who have experienced this type of trauma experience depression and PTSD. Talking to a therapist can help significantly with both these conditions. In addition, research shows that online therapy can be an effective treatment for PTSD and other mental illnesses.


Anyone can be a survivor of sexual abuse, and the signs of sexual abuse in children and adults can be physical or psychological. Often, children are too scared or confused to tell anyone about what is happening to them. Parents and caregivers can look for signs and gently ask questions to determine if someone is sexually abusing their child. Many people who experience sexual abuse growing up can develop mental health challenges in adulthood. However, therapy can help people heal, and online therapy can be an effective and convenient option for seeking professional help.

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