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The effects of child sexual abuse

Child sexual assault presents a serious risk to the survivor’s mental health, both during childhood and into adulthood.  For many children, the effects continue long after the abuse has ended and/or disclosure of the abuse.  Following is a list of some of the common behavioral and physical effects of sexual abuse on a child.  It is important to note that almost all of the signs listed are general indicators that a child is under stress.  A child exhibiting these symptoms has not necessarily been sexually abused.  The symptoms are warning signs that require further inquiry.

Young Children (Infancy to Five Years)

Sudden weight loss or gainAbdominal pain, vomiting, and/or urinary tract infectionsPerineal bruisingSexually transmitted infectionsSleep disturbances and nightmaresCompulsive masturbationPrecocious sex playLoss of toilet training or other regressive behaviorFrequent bathingCrying with no provocationFearfulness and anxietyHeadachesDisclosures about sexual abuseSudden rejection of normal physical affectionSudden reluctance to be with a specific person or go to a specific placeExtraordinary fear of males (or females)Art work or drawings with sexual images
Latency-Age Children (Six to 11 Years)Children over the age of five may exhibit any or all of the behaviors and symptoms described above for younger children, plus:Perfectionism, over-achievementOverzealous cleaningSilence and/or acting as if nothing is happeningHealth problems with no explanationsEating disorders
Adolescents (12 to 18 Years)Adolescents may show the behaviors and symptoms indicated for younger children above and may also exhibit:DepressionInsomniaSudden school failureTruancyRunning away from homeCriminal behaviorsDrug problemsPromiscuity, prostitutionSelf-injury/self-destructive behaviors and/or suicide attemptsCompulsive behaviorsSudden mood and behavioral shiftsSexually aggressive behaviorsAggressiveness and bullyingWithdrawal from family/friendsPregnancy

The emotional consequences of abuse impact each child differently, depending on a wide variety of factors, including the age of the child, the child’s relationship to the perpetrator(s), frequency of abuse, and¬†specific type of abuse.¬† Some of the common feelings experienced by sexually abused children include: guilt, betrayal, shame, self-hatred, fear, anxiety, identification with the perpetrator, a need to maintain control, depression, numbing of emotions, denial, distrust of self or others, rage, helplessness, repression, confusion about sexual issues/identity/norms, alienation from others, and loneliness.

This material was excerpted from Supporting Survivors of Sexual Assault: A Journey to Justice, Health, and Healing.  A Publication of the Massachusetts Department of Public Health in Collaboration with The Massachusetts Coalition Against Sexual Assault.

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