Frequently Asked Questions

How Prevalent is Child Sexual Abuse?

The real prevalence of child sexual abuse is not known because so many victims do not disclose or report their abuse. Researchers have suggested rates varying from 1% to 35%. Most professionals in the field of abuse use rates from 8% to 20%.Even if the true prevalence of child sexual abuse is not known, most will agree that there will be 500,000 babies born in the US this year that will be sexually abused before they turn 18 if we do not prevent it.

    • Adult retrospective studies show that 1 in 4 women and 1 in 6 men were sexually abused before the age of 18 (Centers for Disease Control and Prevention, 2006). This means there are more than 42 million adult survivors of child sexual abuse in the U.S.
    • The primary reason that the public is not sufficiently aware of child sexual abuse as a problem is that 73% of child victims do not tell anyone about the abuse for at least a year. 45% of victims do not tell anyone for at least 5 years. Some never disclose (Smith et al., 2000; Broman-Fulks et al., 2007).

Most people think of adult rape as a crime of great proportion and significance. Most are unaware that children are victimized at a much higher rate than adults.

  • Nearly 70% of all reported sexual assaults (including assaults on adults) occur to children ages 17 and under (Snyder, 2000).
  • Youths have higher rates of sexual assault victimization than adults. In 2000, the sexual assault victimization rate for youths 12 to 17 was 2.3 times higher than for adults (U.S. Dept. of Justice, Bureau of Justice Statistics, 2000).

What Are the Immediate Consequences for the Child Victim?

If child sexual abuse left physical scars instead emotional ones, people would be horrified. Sexual abuse can negatively impact every part of a victim’s life. The real tragedy is that it robs children of their potential, setting into motion a chain of events and decisions that follow the victim throughout his or her life.It is important to note that victims suffer a wide range of reactions to sexual abuse, both in magnitude and form. Resilient children may not suffer serious consequences, whereas other children with the same experience may be highly traumatized.

Emotional and mental health problems are often the first consequence and sign of child sexual abuse. However, it should be noted that some victims do not display emotional problems or any other immediate symptom in response to the abuse.

  • Children who are sexually abused are at significantly greater risk for later posttraumatic stress and other anxiety symptoms (McLeer et al., 1998), depression (Kilpatrick, et al., 2003; Tebbutt, et. al., 1997; Wozencraft, et. al., 1991) and suicide attempts (Dube et al., 2005; Waldrop et al., 2007).
  • These psychological problems can lead to significant disruptions in normal development and often have a lasting impact, leading to dysfunction and distress well into adulthood (Banyard, et. al., 2001; Briere et. al., 1994; Browne et. al., 1986; Molnar et. al., 2001; Polunsy, et. al., 1995; Saunders et al., 1999; Young, et. al., 2007).
  • Behavioral problems, including physical aggression, non-compliance, and oppositionality occur frequently among sexually abused children and adolescents (Dubowitz, et al., 1993).
  • Child sexual abuse has been linked to higher levels of risk behaviors (Acierno et al., 2000; Felitti et al., 1998; Springs & Friedrich, 1992; Walker et al., 1999).

Sexual behavior problems and over-sexualized behavior are a very common consequence of child sexual abuse. These are signs of abuse that are not always included on “what to look for” lists, probably because many find it unpleasant to think about. However, age-inappropriate behavior can be a very important and telling sign that abuse is or has occurred.

  • Children who have been sexually abused have over three times as many sexual behavior problems as children who have not been sexually abused (Giradet, et. al., 2009).
  • Victims of child sexual abuse are more likely to be sexually promiscuous (Kellogg, et. al., 1999; Noll, et. al., 2003; Paolucci, et. al., 2001; Saewyc, et. al., 2004).

Academic problems in childhood are common in children who are sexually abused. Victims perform at lower levels than their non-abused counterparts.

  • Sexually abused children tended to perform lower on psychometric tests measuring cognitive ability, academic achievement, and memory assessments when compared to same-age non-sexually abused cohorts (Friedrich, et. al., 1994; Sadeh, et. al., 1994; Trickett, et. al., 1994; Wells, et. al., 1997).
  • Studies indicate that sexual abuse exposure among children and adolescents is associated with high school absentee rates (Leiter & Johnson, 1997), more grade retention (Reyome, 1994), increased need for special education services (Reyome, 1994) and difficulty with school adaptation.
  • 39% of 7-12 year-old girls with a history of child sexual abuse had academic difficulties (Daignault and Herbert, 2009).
  • 7-12 year-old girls with a history of child sexual abuse were 50% more likely to display cognitive ability below the 25th percentile (Daignault and Herbert, 2009).
  • 26% of 7-12 year-old girls with a history of child sexual abuse reported that their grades dropped after they were abused and 48% had below-average grades (Daignault and Herbert, 2009).
  • A history of child sexual abuse significantly increases the chance of dropping out of school (Beitchman et al., 1992; Briere; Elliott, 1994; Browne and Finkelhor, 1986; Polunsy and Follette, 1995; Saunders et al., 1999).

Substance abuse problems beginning in childhood or adolescence are one of the most common consequences of child sexual abuse.

  • A number of studies have found that adolescents with a history of child sexual abuse demonstrate a 3 to 4-fold increase in rates of substance abuse/dependence (Kilpatrick, et. al., 2003; Acierno et al., 2000; Felitti et al., 1998; Springs & Friedrich, 1992; Walker et al., 1999).
  • Drug abuse is more common than alcohol abuse for adolescent child sexual abuse victims. Age of onset for nonexperimental drug use was 14.4 years old for victims, compared to 15.1 years old for nonvictimized youth (Kilpatrick et al., 2000).
  • Adolescents were 2 to 3 times more likely to have an alcohol use/dependence problem than nonvictims (Kilpatrick et al., 2000).

Delinquency and crime, often resulting from substance abuse, is more prevalent in adolescents with a history of child sexual abuse.

  • Adolescents who were sexually abused have a 3 to 5-fold risk of delinquency (Kilpatrick, et. al., 2003).
  • Behavioral problems, including physical aggression, non-compliance, and oppositionality occur frequently among sexually abused children and adolescents (Dubowitz, et al., 1993).
  • These emotional and behavioral difficulties can lead to delinquency, poor school performance and dropping out of school (Beitchman et al., 1992; Briere & Elliott, 1994; Browne & Finkelhor, 1986; Polunsy & Follette, 1995; Saunders et al., 1999).
  • Adolescents that reported victimization (i.e., sexual abuse or physical abuse) were more likely to be arrested than their non-abused peers (Widom & Maxfield, 2001).
  • Sexually abused children were nearly twice as likely to run away from home (Siegel & Williams, 2003).

The risk of teen pregnancy is much higher for girls with a history of child sexual abuse. This is likely due to over-sexualized behavior, a common consequence of child sexual abuse.

  • Girls who are sexually abused are 2.2 times as likely as non-abused peers to become teen mothers (Noll, Shenk, & Putnam, 2009).
  • 45% of pregnant teens report a history of child sexual abuse (Noll, Shenk, & Putnam, 2009).
  • Males who are sexually abused are more likely than their non-abused peers to impregnate a teen. In fact, several studies indicate that the sexual abuse of boys is a stronger risk factor for teen pregnancy than the sexual abuse of girls (Herrenkohl, et. al., 1998; Raj, et. al., 2000; Saewyc, et. al., 2004).
  • Most sexual abuse incidents reported by pregnant teens occurred well before the incident that resulted in pregnancy. Only 11-13% of pregnant girls with a history of child sexual abuse reported that they had become pregnant as a direct result of this abuse (Boyer & Fine, 1992; Herrenkohl, et. al., 1998).

What are the Long Term Consequences of Child Sexual Abuse?

The consequences of child sexual abuse often follow victims into adulthood. Most people have no idea that the effects of child sexual abuse are so pervasive in adult life. Although survivors of child sexual abuse are negatively impacted as a whole, it is important to realize that many individual survivors do not suffer these consequences. Child sexual abuse does not necessarily sentence a victim to an impaired life.Substance abuse problems are a common consequence for adult survivors of child sexual abuse.

  • Female adult survivors of child sexual abuse are nearly three times more likely to report substance use problems (40.5% versus 14% in general population), (Simpson and Miller, 2002).
  • Male adult CSA victims 2.6 times more likely to report substance use problems (65% versus 25% in general population), (Simpson and Miller, 2002).
  • Abused or neglected individuals 1.5 times more likely to report lifetime illicit drug use (Widom, Marmorstein, & White, 2006).

Mental health problems are a common long-term consequence of child sexual abuse.

  • Adult women who were sexually abused as a child are more than twice as likely to suffer from depression as women who were not sexually abused (Rohde, et. al., 2008).
  • Adults with a history of child sexual abuse are more than twice as likely to report a suicide attempt (Dube, et. al., 2005, Waldrop, et. al., 2007).
  • Girls who are sexually abused are 3 times more likely to develop psychiatric disorders than girls who are not sexually abused (Day, et. al., 2003; Kendler, et. al., 2000; Voeltanz, et. al., 1999).
  • Among male survivors, more than 70% seek psychological treatment for issues such as substance abuse, suicidal thoughts and attempted suicide (Walrath, et. al., 2003).

Obesity and eating disorders are more common in women who have a history of child sexual abuse.

  • 20 – 24 year-old women who were sexually abused as children were four times more likely than their non-abused peers to be diagnosed with an eating disorder (Fuemmeler, et. al., 2009).
  • Middle-aged women who were sexually abused as children were twice as likely to be obese when compared with their non-abused peers (Rohde, et. al., 2008).

Child sexual abuse is also associated with physical health problems in adulthood. It is theorized that this is a consequence of the substance abuse, mental health issues and other risks that survivors of child sexual abuse face.

  • Generally, adult victims of child sexual abuse have higher rates of health care utilization and report significantly more health complaints compared to adults without a CSA history (Arnow, 2004; Golding, Cooper, and George, 1997; Thompson, Arias, Basile and Desai, 2002). This is true for both self reported doctor’s visits and objective examination of medical records (Newman et al., 2000). These health problems represent a burden both to the survivor and the healthcare system.
  • Adult survivors of child sexual abuse are at greater risk of a wide range of conditions that are non-life threatening and are potentially psychosomatic in nature. These include fibromyalgia (Walker et al, 1997), severe premenstrual syndrome (Golding, Taylor, Menard, & King, 2000), chronic headaches (Peterlin, Ward, Lidicker, & Levin, 2007), irritable bowel syndrome and a wide range of reproductive and sexual health complaints, including excessive bleeding, amenorrhea, pain during intercourse and menstrual irregularity (Golding, 1996).
  • Not only do survivors of child sexual abuse have more minor health conditions, they are at greater risk for more serious conditions as well. Adults with a history of child sexual abuse are 30% more likely than their non-abused peers to have a serious medical condition such as diabetes, cancer, heart problems, stroke or hypertension (Sachs-Ericsson, et. al., 2005).
  • Male sexual abuse survivors have twice the HIV-infection rate of non-abused males (Zierler, et. al., 1991). In a study of HIV-infected 12-20 year olds, 41 percent reported a sexual abuse history (Dekker, et. al. 1990).

Adult survivors of child sexual abuse are more likely to become involved in crime, both as a perpetrator and as a victim. This is likely a product of a higher risk for substance abuse problems and associated lifestyle factors.

  • Adult survivors were more than twice as likely to be arrested for a property offense (9.3% versus 4.4%), (Siegel and Williams, 2003).
  • As adults, child sexual abuse victims were almost twice as likely to be arrested for a violent offense (20.4% versus 10.7%), (Siegel & Williams, 2003).
  • Males who have been sexually abused are more likely to violently victimize others (Walrath, et. al., 2003).

Although difficult to quantify, logic tells us that the consequences of child sexual abuse (substance abuse issues, mental health problems, becoming a parent as a teen and poor physical health) result in loss of earning potential over a lifetime.

  • An average of quality-of-life court awards (primarily lost earning potential) for a survivor of child sexual abuse is $115,000 in 2010 dollars (U.S. Department of Justice, 1996).

What are the Long Term Consequences of Child Sexual Abuse for Society?

Few have ever given thought to the tremendous impact child sexual abuse has on the economy and social fabric of our society. Child sexual abuse is at the root of many societal problems. If we examine each of the common individual consequences of child sexual abuse in light of the prevalence rate, we can see how child sexual abuse has ramifications for each and every one of us.Child sexual abuse plays an important role in the cost of mental health services.

  • The direct cost of mental health is more than $97 billion annually in 2010 dollars (Mark, et. al., 1998). Indirect costs add another $110 billion or more annually in 2010 dollars (Rice & Miller, 1996). If child sexual abuse victims have a doubled risk for mental health conditions (Rohde, et. al., 2008; Dube,et. al., 2005; Waldrop, et. al., 2007; Day, et. al., 2003; Kendler, et. al., 2000; Voeltanz, et. al., 1999), logic suggests that child sexual abuse is responsible for annual mental health costs of at least $20 billion.

Teen pregnancy is a long-term, expensive societal problem. Child sexual abuse is a major factor in teenage pregnancy rates.

  • The U.S. government estimates that teen pregnancy costs the nation over $9 billion annually (National Campaign to Prevent Teen Pregnancy, 2004). If the applicable research (Noll, Shenk, & Putnam, 2009) is accurate, logic suggests that over $2 billion of this is attributable to child sexual abuse.

Over-sexualized behavior, common for child sexual abuse victims, can lead to an increased risk of sexually-transmitted diseases.

  • Sexually-transmitted diseases cost this nation $8.4 billion annually (Kaiser Family Foundation, 1997). If the research is accurate (Zierler, et. al., 1991: Allers, et. al., 1993; Dekker, et. al., 1990), logic tells us that over $1.5 billion of this is attributable to child sexual abuse.

A huge body of research clearly demonstrates that individuals with a history of child sexual abuse are significantly more likely to have both minor and major health problems. The expense of these medical conditions is a burden to the survivor, the healthcare system and the taxpayer. Healthcare expense is one of the most critical issues facing Americans today. With 42 million adult survivors of child sexual abuse in the U.S., there can be do no doubt that child sexual abuse plays a significant role in our healthcare crisis.

Although there is little research on the relationship between child sexual abuse and poverty, there is a body of information on the relationships between teen pregnancy, substance abuse and mental health issues to poverty. Logic tells us that child sexual abuse plays a significant role in the high rate of poverty in the U.S.