Related concepts:

Child molestation, Rape

Introduction to sexual abuse:

Some of the most poignant episodes of my pediatric training were long visits with children victimized by sexual abuse. I vividly remember sitting with tears streaming down my face after hearing how children had been scarred by those they trusted.

How sad that this is such an important subject to discuss.

What is sexual abuse?

Sexual abuse includes any activity with a child for the sexual gratification of an adult or significantly older child (generally more than 4 years older). Children's intense need for affection and nurturance from older figures makes them vulnerable. Adults and older children hold a position of tremendous power in their lives. It is the abuse of this power (and the abuse of children's trust) that is so damaging to children.

Sexual abuse falls into three different categories:

1. Molestation -- Defined as the touching or fondling of the genitals of a child, or asking a child to touch or fondle an adult's genitals, or using a child to enhance pleasure from sexual acts or pornography
   
   
2. Sexual intercourse -- Includes vaginal, oral, or rectal penetration
   
   
3. Rape

 

Who gets sexual abused?

The most common perpetrator of sexual abuse is either a family member or a close friend of the family. Sexual abuse by a stranger is quite uncommon.

Unfortunately no age is exempt from sexual abuse. About one third of cases occur in kids younger than six years of age, about one third in children ages six to twelve, and one third in children ages twelve to eighteen.

What are the symptoms of sexual abuse?

The most common way that sexual abuse comes to light is through the child's disclosing sexual contact to a trusted adult. Historically, a child's word was not taken seriously. During the last twenty years the pendulum swung to the opposite extreme -- if a child described sexual contact it was considered a fact, and the volunteering of such information was considered very strong legal evidence. Recently, the pendulum has returned to a more balanced position: Take it very seriously whenever a child mentions sexual contact, but understand that not everything said necessarily mirrors physical reality.

Children who have actually been abused will often recant their initial statement because they are afraid of their abuser or because their abuser convinces them that this is "their little secret." Several clues are associated with sexual abuse (but many children give no clues except what they say):

• Genital infections, redness, or discharge
  
  
• Burning with urination
  
  
• Urinary tract infection
  
  
• New onset of either bedwetting or stool problems
  
  
• Suddenly increased sexuality with peers, animals, or objects
  
  
• Seductive behavior
  
  
• Age-inappropriate sexual knowledge
  
  
• Regression
  
  
• Other dramatic behavior changes

 

Is sexual abuse contagious?

No

How long does sexual abuse last?

Most abuse begins with innocent physical contact.

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