Resources for Victims of Child Sexual Abuse and Their Families

Child sexual abuse (CSA) is a prevalent issue worldwide. Although it’s a difficult occurrence to measure because of lack of reporting, RAINN (The Rape and Incest National Network) estimates that a case of CSA is substantiated every nine minutes in the US. A staggering 34% of survivors are under 12, while 66% are between 12-17.1

The trauma of CSA often leads survivors to experience long-lasting mental, physical, and emotional health issues. It’s important to be able to spot signs of CSA and know what to do if a child discloses abuse to you.

This guide provides information on CSA, including risk factors, reporting methods, and ways to cope. It’s never too late to get the help you need to recover from CSA.

Child sexual abuse (CSA) is defined as any sexual encounter with a minor. No matter the circumstance or intent, children cannot consent to sexual activity. This ranges from sexual conversations that are not age-appropriate to pornographic images of children to oral, vaginal, and anal sex. As a bottom line, any level of sexual activity that involves a minor is CSA, even if it does not involve physical touch. Research shows that CSA has long-lasting physical and psychological consequences for the child.2

Unfortunately, children can be abused by any adult in any kind of setting. These include relatives, caretakers, family friends, and adults they may know from school, the community, or places of worship. Despite the fear surrounding children being abducted and hurt by strangers, children are more likely to be abused by someone they know, and one-third of abusers are relatives.3

We often think of child sexual abuse occurring between an adult and a child. While this does happen, it’s essential to remember that CSA can also happen between minors, specifically minors of different ages. For example, an older sibling may sexually abuse a younger sibling. Even children of the same age may engage in harmful sexual activities with each other.4 No matter the perpetrator, experiencing sexual abuse can impact the survivor’s mental state for many years, including higher incidences of depression, PTSD, addiction issues, and suicide.5

Legal definitions of what constitutes CSA vary by state. You can use the Rape, Abuse & Incest National Network (RAINN) State Law Database to find the legal definition of CSA in your state and get assistance with reporting or seeking other help.

If you have thoughts of suicide, reach out to a friend or relative. You can also call the National Suicide Prevention Hotline at 1-800-273-8255 or 911.

Child sexual abuse (CSA) is a worldwide issue. It impacts children and families regardless of race, ethnicity, nation of origin, religion, or socioeconomic status. Here are some facts and statistics about CSA to help you gain a deeper understanding of this issue.

• In 2020, the World Health Organization (WHO) found that around 20% of girls and 14% of boys in North America had experienced some form of sexual abuse.6
• The WHO also estimates that 150 million girls and 73 million boys experience CSA worldwide. This statistic includes 1.2 million victims of child trafficking and 1.8 million children forced into prostitution or pornography.7
• In a survey of 34,000 Americans, 10.14% had experienced CSA before age 18. Of the respondents, 75.2% were women, and 24.8% were men.8
• Disclosure impacts the estimates of CSA prevalence. Many children who experience CSA don’t report it until adulthood. In one study, about 43% of survivors disclosed CSA within one month, 31% within one year, and 26% never reported the abuse to anyone.9
• Children are most vulnerable to CSA between the ages of 7 and 13.10
• Some noted risk factors make children more susceptible to CSA. These include living with only one parent or living in homes marked by conflict, violence, or divorce.10

We know that many survivors of CSA never report the abuse. Shame, fear of retaliation, and the uncertainty of what might happen if they disclose abuse often keep children in the dark.20 But adults should stay vigilant and look for signs that a minor has been abused. These signs can range from physical to psychological symptoms, including:11

• Inappropriate sexual behavior or language
• Knowledge of sex that isn’t age-appropriate
• Withdrawing affection from family members
• Self-harm
• Substance use
• Disordered eating
• Expressions of anxiety, depression, or low self-worth
• Pain, injuries, or bleeding in the genital area
• Negative changes to academic performance
• Hygiene changes, such as refusing to bathe or bathing more frequently
• Avoidance behaviors around certain adults
• Separation anxiety

Some situations and qualities make a child more likely to experience abuse. For example, girls are more likely to experience CSA than boys. And children with intellectual disabilities or those who have previously been victims of physical or emotional abuse are more likely to experience sexual violence. Other qualities that predispose a child to CSA include:11

• Coming from a divorced family
• Living with a step-parent
• Being in the foster care system
• Living in a low-income neighborhood
• Being from a rural area
• Spending time alone with authority figures

Here are some resources that can help you prevent abuse and recognize abuse signs:

• CDC: Preventing Child Sexual Abuse
• The Importance of Knowing Child Sexual Abuse Symptoms in the Elementary Teacher’s Work
• National Library of Medicine: Sexual Abuse in Children - What to Know
• Prevent Child Abuse America
• Stop It Now!: Warning Signs of Possible Sexual Abuse In A Child’s Behaviors

Like any form of abuse, CSA can have long-lasting mental, emotional, and physical consequences for survivors. Even if a child reports the abuse and receives help immediately, they may still live with long-term effects into adulthood. The most common impacts include substance abuse, PTSD, depression, and anxiety. Survivors can also develop chronic health conditions like hypertension, irritable bowel syndrome, fibromyalgia, and obesity.12

Here is some information from scientific studies performed about CSA’s long-term effects:

• A 2022 study of male CSA survivors showed that experiencing CSA affects the autobiographical memory function in the brain.13 Another study in 2021 showed that CSA negatively impacted male survivors’ working memory.14
• A 2021 study showed that survivors of CSA had a lower health-related quality of life as adults than those who had not been abused. Compared with subjects who did not experience CSA, more survivors reported their general health as poor and experienced more mentally and physically unhealthy days per month.15
• Adult survivors of CSA are at a higher risk of intimate partner violence and sexual assault in their adult years.12

If you’re a teen or adult survivor of CSA, resources are available to help you cope. Research reveals that experiencing CSA can lead to emotional, psychological, and physical repercussions that can follow survivors into adulthood. Utilizing the resources in this guide and elsewhere can help survivors move forward from CSA and lead healthy, well-adjusted lives.

• The Substance Abuse and Mental Health Services Administration (SAMHSA) created these documents to help survivors of CSA: A Recovering Woman’s Guide to Coping With Childhood Abuse Issues and A Recovering Man’s Guide to Coping With the Effects of Childhood Abuse.
• After Silence is an online community for sexual abuse survivors that provides a support group, message board, and chatroom in addition to other resources.
• 1 in 6 is an organization that helps male survivors of sexual abuse by providing testimonials, suggested literature, and an online chat. MaleSurvivor empowers male CSA survivors through forums, chat, and therapy support.
• The Lamplighter Movement helps survivors of incest and sexual abuse lead happier, healthier lives.
• RAINN’s page on Recovering from Sexual Violence offers information and tips for survivors and families.
• The National Runaway Safeline is for children and teens in crisis. You can call the hotline at 1-800-RUNAWAY to speak with a crisis counselor or visit the website for chat, forum, and email options.

Other resources

• Adult Survivors of Child Abuse
• The Blue Ribbon Project
• Childhelp
• ChildUSA
• National Sexual Violence Resource Center
• Saprea
• Survivors Chat
• Survivors of Incest Anonymous

Parents, caregivers, guardians, teachers, and other loved ones and family members may also seek advice when they suspect a child is a victim of CSA or if a child discloses abuse. It is a heavy responsibility to suspect or know that a child has been abused, and you may wonder how to handle your own emotions while caring for the child. You may also wonder how to report the abuse, get help for the child, or move forward. The resources below can help you get started.

• RAINN’s page entitled Help for Parents of Children Who Have Been Sexually Abused by Family Members offers information on managing emotions and reporting abuse. RAINN also provides a state-by-state database of CSA service providers.
• The Childhelp National Child Abuse Hotline (1-800-422-4453) can help parents and survivors understand abuse, report it, and cope with emotions.
• The National Child Traumatic Stress Network provides a booklet entitled Caring for Kids: What Parents Need to Know About Sexual Abuse that includes tips on disclosure, prevention, and incest.
• Stop It Now! is an organization committed to ending CSA. They offer a list of Resources for Parents of Children Who Have Been Sexually Abused.
• The Child Welfare Information Gateway provides Parenting a Child or Youth Who Has Been Sexually Abused: A Guide for Foster and Adoptive Parents.
• What’s OK? offers education on consent and healthy sexual relationships for children and teens through online resources and text, call, chat, or email services.

Other resources

• American Academy of Pediatrics
• American Professional Society on the Abuse of Children
• Association for the Treatment of Sexual Abuse
• Coalition for Children
• Darkness to Light
• The International Society for the Prevention of Child Abuse & Neglect
• National Children’s Advocacy Center

If a child or teen discloses sexual abuse, you may wonder what to do next. Reporting CSA to the authorities is an important step in keeping the survivor safe and demonstrating your support. But definitions of what constitutes CSA vary by state, and there are multiple ways to report abuse. Luckily, online resources are available to help you figure out the best way to advocate for the survivor in your life.

• RAINN’s State Law Database helps you understand CSA laws in your state. It also provides information about consent, mandatory reporting, and other related topics.
• The National Center for Missing and Exploited Children’s CyberTipline provides both a phone number (1-800-THE-LOST) and an online form you can use to report CSA.
• RAINN’s National Sexual Assault Hotline (1-800-656-HOPE) provides a phone number and a live chat to connect you with a counselor.
• The Child Welfare Information Gateway provides a state-by-state list of Child Abuse and Neglect Reporting Numbers.
• Stop It Now! provides a list of information about Reporting Child Sexual Abuse, including info about Child Protective Services and mandated reporters.

When we think of child sexual abuse, we may think of it happening in the home or at a place familiar to the child, like school or a place of worship. But another facet of CSA is child trafficking, which involves forcing or coercing a child to leave home and then exploiting the child.

Child trafficking occurs for various reasons, including sexual exploitation, but traffickers may also force children into labor, crime, or slavery. Sexual, physical, and emotional abuse are often used to control victims.16 Human trafficking has been reported in all 50 U.S. states,17 and 25% of the more than 40 million people trafficked yearly are children.18

There are some warning signs for spotting a child or teen that is being trafficked, including if they:16

• Aren’t sure where they’re from or who their parents are
• Spend a lot of time indoors or doing household chores
• Can’t or won’t share information about their living situation
• Appear to respond in ‘scripts’ when asked about their family or parts of their pasts
• Have unexplained signs of physical harm (bruises, cuts, malnourishment, burn marks)
• Avoid eye contact or appear afraid around other adults
• Spend a lot of time with one or two specific adults
• Don’t attend school and are seen more often in a workplace

If you suspect that a child is a victim of trafficking, there are numerous organizations you can consult for more information.

• Coalition to Abolish Slavery & Trafficking
• National Human Trafficking Hotline: (1-888-373-7888)
• National Society for the Prevention of Cruelty to Children
• Office on Trafficking in Persons
• Polaris
• Shared Hope International
• UNICEF

A CSA survivor has many options to help them move forward from abuse trauma. If the abuse is disclosed and reported in childhood, a general practitioner can connect parents and guardians with other healthcare professionals to help survivors and their loved ones recover. Treatments may involve:

• Therapy
• Support groups
• Medication
• Self-care

Therapy for survivors of CSA ideally includes trauma-informed care. This type of care acknowledges the trauma, helps patients feel safe, involves them in the healing process, cultivates resilience and strength, and honors their identity.19 Therapists may also suggest that survivors and their loved ones participate in group therapy to help them tell their stories and receive support.

Children may be hesitant to share their experiences in therapy. It’s normal to worry about getting into trouble or feeling judged. But aiming to be honest — and staying open to receiving support — is one of the best ways to move forward and heal. Therapists are mandated reporters and are required to report acts of physical or sexual abuse to their state’s protective services if disclosed by a child.

A qualified mental health professional can properly assess symptoms and make a working diagnosis. They may also prescribe survivors medications for depression, anxiety, or other mental health issues.

Lastly, survivors can engage in self-care to mitigate the effects of trauma. This could include journaling, exercising, reaching out to friends and family, reading books to better understand your trauma, and many other activities.