What Constitutes Sexual Abuse?


What constitutes sexual abuse? What’s the first step to take if you suspect that your child has been abused?

Dr. Greene's Answer

Sexual abuse falls into three different categories:
1) molestation, which is 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, which includes vaginal, oral, or rectal penetration;
3) rape.

Most abuse begins with innocent physical contact. A needy adult then makes this a routine. Once a routine is developed, it is not uncommon to progress to intercourse. 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.

Sexual abuse commonly comes to light through the child’s disclosing the incident of sexual contact to a trusted adult. Historically, a child’s word was not taken seriously. Over 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.

The best way to clarify a questionable situation is to have your child examined by a sexual abuse specialist. Most children’s hospitals have a sexual abuse team, or will be able to refer you to a specialist in your area.

A sexual abuse examination is comprised of two basic elements. First, and perhaps most important, your child would be interviewed by an expert who very gently elicits information from her about what might have happened. The interviewer will let your child set the pace and will use pictures or dolls to draw her out, without suggesting to her what might have occurred. This is generally followed by a physical examination of the external genitals, checking for any sign of trauma, laxity, or discharge. Sometimes this will be done with magnification, using an instrument called a colposcope. Samples may be sent for STD testing and/or DNA testing (if there is evidence of bodily secretions present). In at least half of the cases of child abuse that are confessed by the abuser, there are no findings on physical exam.

Medical Review on: June 18, 2008
About the Author
Photo of Alan Greene MD
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
Get Dr. Greene's Wellness RecommendationsSignup now to get Dr. Greene's healing philosophy, insight into medical trends, parenting tips, seasonal highlights, and health news delivered to your inbox every month.
Add your comment

Recent Comments

Is it sexual abuse if you were 10-11 and you’re sister touched your penis when you had an erection (not sexually because didnt know anything about the matter) . I asked her if i could see her genital (not in a sexual way again because i was too young to understant any of this). Now she gets upset with the most trivial things such as when we tell her to do homework. She cries alot but it could be because she is entering her teens, i also cried alot when i entered my teens. I feel so bad now because i think i might have traumatized her.

I would like to know if the following is considered as sexual harassment towards a kid. My sisters daughter who is now 20 told me the following that my husband had done towards her. She was lying in the room , alone. he came in and sat next to her . he started rubbing her back and then made his way down towards her behind. then he just pulled down her pants. She got a fright and sat up and asked what he was doing. He just looked at her and walked out the room. She has also said that he would feel her behind or hold it or smack it. Is this considered as sexual harassment and can charges be laid?

Based on the definitions yes, that is considered molestation; because of the touching and grabbing.

What if another male was touching your son in his gentian area without taking off his clothes he rubbed him in that are what should his charge be

What if what the child is stating has to many inconsistencies,I wouldhate to accuse any one over a false accusations.Children can lie I am a former teacher and I have witnessed it happen on several occasions.

Please look into it anyway..
I was sexually abused when I was 11.. I didn’t think anyone would believe me and so I didn’t say anything.
I am now 20 and still no one knows.
I wish I had been brave enough to say something. Please, listen to what the children are saying.. to this day my story has inconsistencies because as a child it was hard to understand what was happening at the time..
Even if their stories are inconsistent, please, help them.