What do you need to know about child sexual abuse?

Child sexual abuse is a significant but preventable public health problem. Child sexual abuse is an abuse of trust, power, and authority. It is a crime. One in four girls and one in 13 boys will be sexually abused before they turn 18 years old¹. Children who have been sexually abused might also experience verbal, emotional, or physical abuse². 

Experiencing sexual violence as a child or teen makes it more likely the survivor will experience sexual violence in adulthood³. Child sexual abuse is a type of adverse childhood experience, or ACE, which is a traumatic event experienced in childhood⁴. ACEs can have long-term physical, mental, emotional, and behavioral effects, including chronic health problems, mental illness, and substance misuse in adulthood. According to the CDC, ACEs are common and costly. 64% of adults have reported experiencing at least one ACE by the age of 18.⁵ Preventing ACEs could potentially reduce many costly health conditions. 

Prevention

Child sexual abuse is preventable. We can all play a role in creating safe, stable, and nurturing relationships and environments that help children and families thrive. CDC’s Essentials for Childhood Framework proposes strategies for communities to promote the types of relationships and environments that help children and families thrive.
The public health approach to preventing child abuse and neglect includes actions parents and caregivers, neighborhoods, schools, employers, and everyone in a community can take to promote the safety and well-being of children. CDC’s Child Abuse and Neglect Prevention Resource For Action provides examples of evidence-based strategies:

• Strengthen economic supports to families 
• Change social norms to support parents and positive parenting 
• Provide quality care and education early in life 
• Enhance parenting skills to promote healthy child development 
• Intervene to lessen harms and prevent future risk

Forms of child sexual abuse

A person sexually abuses a child when they expose the child to sexual acts or behaviors. This can include touching or non-touching acts. Child sexual abuse can look like⁶: 

• Sex acts that involve penetration
• Any sexual touching between an adult and a child, or sexual touching between children when there is a significant difference in age, development, or power⁷ 
• Voyeurism (An adult looking at a child’s naked body)
• Exhibitionism (An adult showing one’s own naked body to a child) 
• Exposing a child to pornography or abusing a child in the production of pornography⁸ 
• Child sexual exploitation, such as trafficking 
• Internet-based child sexual abuse, such as creating, depicting, or distributing sexual images of children online; and stalking, grooming, or engaging in sexually explicit behaviors with children online

Warning signs that a child may have been sexually abused

Everyone reacts to sexual assault differently, and that includes children. Children may display various indicators of sexual abuse⁹. Some common signs that a child has been sexually abuse include¹⁰:

• Physical signs, such as bruises, bleeding, or sore genitals
• Indirect bodily reactions like anxiety or chronic pain
• Emotional signs like fear, sadness, or mood swings
• Behavioral changes, like a change in eating habits, refusing to be left alone with certain people, or not wanting to remove clothes at appropriate times like bathing
• Inappropriate sexual behavior with objects or other children, or knowledge about sexuality that is not age- or developmentally appropriate

Reasons children may not come forward

The majority of cases are never reported¹¹. 

A child may not come forward about sexual abuse because:

• They love or trust the person who sexually abused them
• They fear the consequences of coming forward for themselves or their families
• The person who abused them used force, manipulation, or threats to keep them from telling others
• They may not understand what is happening or have the language to explain it

Victims of child sexual abuse

Children of all ages, including teenagers, can be sexually abused. One in three victims of completed rape experienced their first rape between ages 11 and 17, and one in nine women reported experiencing rape when they were ten years old or younger¹². Gay, lesbian, and bisexual students in grades 9-12 report being forced to have sexual intercourse when they did not want to more than their heterosexual peers (17.8% versus 5.4%)¹³.

People who sexually abuse children

Signs that a person may be sexually abusing a child

People who sexually abuse children may find ways to test and push a child’s boundaries before they abuse them in a process called “grooming”¹⁴. A person may groom a child by paying special attention to them, touching them, giving them gifts, or asking them to keep secrets. Grooming is a way for people who abuse children to gain their trust and normalize abusive behaviors.

Warning signs that a person may be sexually abusing a child include¹⁵:

• Showing an unusual interest in a particular child or a particular age or gender of children
• Socializing more with children than with adults
• Attempting to be alone with children
• Hugging, touching, kissing, tickling, wrestling with, or holding a child even when the child does not want this affection
• Encouraging a lack of privacy around the home and expressing voyeuristic behaviors such as watching them bathe 
• Discussing inappropriate topics with a child
• Lacking an interest in normal adult sexual relations but being overly interested in the sexuality of a particular child or teen

Relationship to the child

People who sexually abuse children are often someone the child knows and trusts. In fact, 90% of child victims know the person who abused them¹⁶.

Those who sexually abuse children are members of our communities and may hold positions of power or influence. There are many stereotypes about people who sexually abuse children, but the reality is that they may be friends, family members, or other trusted people. Including this context in your reporting helps the public understand the need for policies that support prevention and make it more difficult for someone to abuse a child.

Youth who abuse other children

People who sexually abuse children may be adults or other children. Youth who abuse other children often do not commit other offenses and generally respond well to treatment¹⁷. The root causes of sexual behavior problems in children could include¹⁸:

• Experiencing traumatic events or violence
• Seeing adult sexual content, including in the media
• Lacking impulse control
• Not having rules about privacy or appropriate boundaries at home

Child sexual abuse and technology

Technology can play a role in the sexual abuse and exploitation of children. Nearly 17% of young adults ages 12-21 experienced sexual harassment online¹⁹.

Sextortion, or the threat of posting a sexual image of someone to blackmail them, also affects children — one in four victims of sextortion were 13 years old or younger²⁰.

People who sexually abuse children may use the internet to find and groom children in order to carry out sexual abuse in person, or they may coerce a child to send sexual messages or images. While the term “child pornography” has been used in the past, “child sexual abuse material” is a more accurate description as it portrays real-life abuse. Within the past 15 years, there’s been a 15,000% increase in reports of child sexual abuse material²¹. Because child sexual abuse material on the internet can spread so quickly, victims are likely to experience retraumatization whenever the images resurface.  
Some signs of online grooming include:

• Asking a child to keep their online conversations secret
• Asking a child to send photos or videos of themselves
• Sending online gifts

 Learn more about recognizing and preventing online grooming. 

News coverage of child sexual abuse

Research from the Berkeley Media Studies Group (BMSG) on how child sexual abuse is covered in the news found that language is often vague, solutions are rarely mentioned, and most reporting failed to address social stigma and other barriers to prevention. By focusing primarily on child sexual abuse through reports to law enforcement and the criminal justice process, the public learns very little about prevention from news coverage. Reporters can expand their stories by²²:

• Bring in solutions. Reporters should ask: What are local communities doing to prevent child sexual abuse? What is working? What do advocates think should be done? Could it be done in this community? If so, why hasn’t it happened here?
• Use precise descriptions of child sexual abuse. Reporters should work with advocates and other professionals to identify appropriate and precise language to describe incidents of sexual abuse. Euphemisms and vaguely worded stories about scandal obscure the public’s understanding of the depth and nature of the problem. Precise language can include: forced oral or genital contact, unwanted sexual touching, and rape.
• Looking beyond the criminal justice response. Often, news covers the legal consequences faced by those who commit child sexual abuse, and rarely are the consequences for victims and their families recognized. Going beyond this to talk about the consequences for victims, perpetrators, their families, and communities helps the public understand the social consequences of child sexual abuse and the recovery process.
• Identify relationships and power dynamics. Clearly identifying the relationship between the child and the adult who has committed abuse helps the public understand abuses of power and counters the myth of “stranger danger.” The majority of children are sexually abused by someone they know such as a family member, coach, or teacher. Naming these relationships solidifies the public’s understanding of grooming, how people may abuse their positions of trust or authority, and the wide range of people who commit abuse.

Footnotes

¹Pereda, N., Guilera, G., Forns, M., & Gómez-Benito, J. (2009). The prevalence of child sexual abuse in community and student samples: A meta-analysis. Clinical Psychology Review, 29, 328–338. doi:10.1016/j.cpr.2009.02.007

²Finkelhor, D., Turner, H., Ormrod, R., Hamby, S., & Kracke, K. (2009, October). Children’s exposure to violence: A comprehensive national survey (NCJ 227744). Juvenile Justice Bulletin. U.S. Department of Justice, Office of Justice Programs. https://www.ojp.gov/pdffiles1/ojjdp/227744.pdf

³Centers for Disease Control and Prevention. (2017). Sexual violence in youth: Findings from the 2012 National Intimate Partner and Sexual Violence Survey. U.S. Department of Health & Human Services. https://stacks.cdc.gov/view/cdc/137394

⁴Ibid.

⁵“About Adverse Childhood Experiences.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/aces/about/index.html. Accessed 14 Oct. 2024.

⁶Finkelhor, D., Hammer, H., & Sedlak, A. J. (2008). Sexually assaulted children: National estimates and characteristics (NCJ 214383). U.S. Department of Justice, Office of Justice Programs. https://www.ojp.gov/pdffiles1/ojjdp/214383.pdf

⁷Stop It Now! (n.d.b). Tip sheet: Defining and understanding child sexual abuse [Webpage]. https://www.stopitnow.org/ohc-content/tip-sheet-defining-and-understanding-child-sexual-abuse

⁸Putnam, F. W. (2003). Ten-year research update review: Child sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 42(3), 269-278. https://doi.org/10.1097/00004583-200303000-00006

⁹Darkness to Light. (n.d.a). Child sexual abuse statistics. http://www.d2l.org/wp-content/uploads/2017/01/all_statistics_20150619.pdf

¹⁰Stop It Now! (n.d.c). Tip sheet: Warning signs of possible sexual abuse in a child’s behavior [Webpage]. https://www.stopitnow.org/ohc-content/warning-signs-possible-abuse

¹¹Finkelhor, op.cit.

¹²Smith, S. G., Chen, J., Basile, K. C., Gilbert, L. K., Merrick, M. T., Patel, N., Walling, M., & Jain, A. (2017). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010-2012 state report. U.S. Department of Health & Human Services, Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/pdf/NISVS-StateReportBook.pdf

¹³Kann L., Olsen, E. O., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., Queen, B., Lowry, R., Chyen, D., Whittle, L., Thornton, J., Lim, C., Yamakawa, Y., Brener, N., & Zaza, S. (2016). Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9–12 – United States and selected sites, 2015. Morbidity and Mortality Weekly Report, Surveillance Summaries, 65(9), 1–202. https://doi.org/10.15585/mmwr.ss6509a1

¹⁴Darkness to Light. (n.d.b). Grooming and red flag behaviors. https://www.d2l.org/child-grooming-signs-behavior-awareness/

¹⁵Stop It Now! (n.d.a). Behaviors to watch out for when adults are with children [Webpage]. https://www.stopitnow.org/ohc-content/behaviors-to-watch-out-for-when-adults-are-with-children

¹⁶Finkelhor, D., & Shattuck, A. (2012). Characteristics of crimes against juveniles. University of New Hampshire, Crimes Against Children Research Center. http://unh.edu/ccrc/pdf/CV26_Revised%20Characteristics%20of%20Crimes%20against%20Juveniles_5-2-12.pdf

¹⁷National Juvenile Justice Network. (2014). Youth who commit sex offenses: Research update. https://www.njjn.org/uploads/digital-library/Registries-Youth-Who-Commit-Sex-Offenses_Nov2014.pdf?phpMyAdmin=14730ab3483c51c94ca868bccffa06ef

¹⁸The National Child Traumatic Stress Network. (2009). Understanding and coping with sexual behavior problems in children. https://www.raliance.org/wp-content/uploads/2019/09/Understanding-and-Coping-with-SBP-in-Children-NCTSN-NCSBY.pdf

¹⁹Taylor, B. G., Liu, W., & Mumford, E. A. (2021). Profiles of youth in-person and online sexual harassment victimization. Journal of Interpersonal Violence, 36(13-14), 6769-6796. https://doi.org/10.1177/0886260518820673

²⁰Thorn. (n.d.). Sextortion: Summary findings from a 2017 survey of 2,097 survivors. https://www.thorn.org/wp-content/uploads/2019/12/Sextortion_Wave2Report_121919.pdf

²¹Christina. (2020, July 21). The road to safer: Equipping industry to end CSAM [Blog post]. Thorn https://www.thorn.org/blog/announcing-safer-built-by-thorn-eliminate-csam/

²²Berkeley Media Studies Group. (2011). Issue 19: Case by case: News coverage of child sexual abuse. http://www.bmsg.org/resources/publications/issue-19-case-by-case-news-coverage-of-child-sexual-abuse/