Disclaimer: We acknowledge that there are many different words that individuals use to describe themselves after experiencing sexual assault. In this article we use the term ‘survivor’ for the sake of consistency. We acknowledge that there are many different ways of processing sexual violence, and believe each individual person should choose the language that they are most comfortable with.
Childhood sexual abuse (CSA) can be defined as exposing a child to inappropriate sexual material or sexual contact. This includes oral sex, vaginal sex, anal sex, sexual fondling, and molestation, as well as coercing a child into non-contact acts, such as exposure or voyeurism. Forcing a child to pose for child pornography is also encompassed in this term.
Childhood sexual abuse is common around the world, and it occurs across cultural backgrounds and socioeconomic classes. In the United States, a child is sexually molested every eight minutes.1 In 93% of child sexual abuse cases in the U.S., the perpetrator is not a stranger, but rather a close friend or family member. While the statistics for the prevalence of child sexual abuse are uncertain, researchers estimate that approximately 12-40% of children in the United States have been subjected to sexual abuse.2
Adults who experience early sexual abuse are often affected by it long after their childhood is over. Numerous studies have shown that survivors of CSA usually experience difficulties in their mental and sexual health during adulthood. These difficulties most often include physical, emotional, psychological, and sexual effects.3
Research shows that there is no specific set of symptoms that occur in survivors of childhood abuse. Doctors believe that physical symptoms of CSA are often representative of the coping mechanisms that victims use to deal with traumatic childhood experiences, which often arise from survivors’ need to protect themselves from overwhelming emotions or further abuse. These physical effects include, but are not limited to the following:
- Gastrointestinal and digestive distress
- Chronic headaches/backaches
- Musculoskeletal distress
- Asthma and other respiratory ailments3
Physical symptoms of CSA are often misdiagnosed as other health problems due to the immense variety of symptoms that occur in abuse survivors. A CSA survivor experiencing one or more of these symptoms should seek professional medical care from their physician.4
When trauma occurs in childhood, the resulting stress can influence the development of the brain. Brain development continues throughout childhood, and may be altered or changed based on the environment that the child lives in. In cases of CSA, trauma and stress may permanently change the connections in the brain, resulting in emotional behaviors unique to survivors of sexual abuse.5 These negative emotions include (but are not limited to) grief, guilt, anger, and low self-esteem.
Many survivors of CSA deal with an underlying sense of grief in their daily lives. Experts speculate that this grief results when adult survivors feel as though they were prematurely forced into adulthood. Sexual assault destroys childhood innocence, thrusting a minor into the adult world of sexuality and depriving them of a normal childhood.4 Survivors of sexual abuse often mourn the loss of safety and trust, and have difficulty overcoming the intensity of these emotions. Survivors also tend to experience tremendous guilt in their lives and relationships, sometimes blaming themselves for the abuse and how they might have prevented it. Some adults experience guilt because they believe that they deserved the abuse they experienced.2 Many survivors (typically men) display anger and rage in adulthood as a way of coping with the intense trauma. Lastly, survivors may battle with negative self-esteem and body image issues throughout adolescence and adulthood. The verbal and physical abuse of childhood causes adults to have skewed perceptions of their self-worth, which often leads them to avoid intimacy with other people.6
Eighty percent of child sexual abuse survivors meet the diagnostic criteria for a psychiatric disorder by age 21. The most common psychopathological disorders in survivors include depression, anxiety, eating disorders, and post-traumatic stress disorder (PTSD).7 Depression and anxiety in adulthood often results from the suppression of sexual trauma experienced in childhood. Research shows that discussing child experiences of abuse with a psychologist, psychiatrist, or loved one can alleviate the depressive and anxious symptoms of CSA. Higher rates of depression and anxiety were found in survivors who did not discuss or disclose their experience with others.8
Many survivors battle with eating disorders, such as bulimia, anorexia, or binge eating disorder in their adult years. Experts speculate that avoiding food or overeating may emerge as a coping mechanism for the trauma that initially gives the survivor relief from abuse, but manifests itself as a fully developed disorder later in life. Eating disorders usually coincide with poor self-esteem and body image, and survivors of CSA may experience both in their daily lives.9
Most often, adult survivors of childhood sexual abuse are diagnosed with post-traumatic stress disorder. PTSD symptoms include withdrawn behavior, obsession with their own childhood trauma, and avoidance of environments and circumstances reminiscent of their abuse. Those who suffer from PTSD are often psychologically hyperactively responsive to changes in their surroundings and environment, making them prone to disorders like depression and anxiety. There is debate in the psychological community over the validity of these diagnoses, as many professionals believe that diagnostics jump to PTSD as it encapsulates the trauma that victims experienced in childhood. These professionals deem that PTSD is over diagnosed and should be examined more closely to maximize psychological treatment. Some psychologists believe that diagnoses should be more specific to anxiety, depression, etc. while others readily diagnose PTSD. Despite this debate, it is evident that childhood sexual abuse is psychologically debilitating for the survivor.10 While specific symptoms may vary greatly between individuals, survivors of CSA should consider seeing a therapist or psychologist if they are dealing with one or more of these challenging disorders.
The sex lives of adult survivors of CSA are often painful, negative, or nonexistent. Due to the premature introduction of sexuality into their life, a childhood sexual assault victim forms intense impressions about sex early in their lifetime. As each individual copes with trauma in a unique way, early abuse may make individuals hypersexual, sexually avoidant, or sexually abstinent. Some survivors report high levels of promiscuity, high numbers of sexual partners, and little regard for STI transmission and pregnancy. Psychologists and professionals believe that this trait emerges in adulthood as a result of fixation occurring in childhood, forcing the survivor of CSA to only be able to communicate through sexuality and seduction. In other cases, the premature introduction of sexuality causes CSA survivors to avoid sex partially or entirely due to the emotional and/or physical pain they experience during sex. In both extremes, survivors do not typically have “normal” sex lives, and may struggle with seeing themselves as sexy or lovable. If a survivor is feeling discouraged or ashamed of their sexuality or sex life, they can always seek professional help in a psychologist or sex therapist.2
Supporting a Survivor of CSA
If a friend or family member is a survivor of childhood sexual abuse, it is important that they find help as soon as possible. Many survivors avoid any sort of dialogue about their childhood trauma as they may feel it is wrong to expose their perpetrator or feel a taboo around the subject. It is important to remember that sexual abuse is a criminal offense, and survivors deserve to talk about and recover from their experiences. If a survivor reveals their traumatic past, it is important to make them feel comforted instead of isolated or alone.
Sometimes, the support of friends and family is not enough to bring a survivor who is struggling with past abuse to recovery. In these cases, one may offer their support in helping the survivor find a therapist or psychologist that they can trust and confide in. Professional help may help victims overcome all of the effects listed in this article, including (but not limited to) depression, eating disorders, sexual issues, and physical symptoms.
No two survivors of childhood sexual abuse have experienced identical traumas, and none will have identical paths to recovery. It is important to remember the extremely wide range of effects that CSA causes, and that treatment should look different for everyone. Survivors may have unbelievably painful and traumatic pasts, but it is never too late to find help. Recovery is possible with the support of loved ones and health professionals. Every survivor deserves support and recovery.
- United States Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. Child Maltreatment Survey, 2012 (2013).
- “Adult Manifestations of Childhood Sexual Abuse." ACOG. The American Congress of Obstetricians and Gynecologists, Aug. 2011. Web. 25 Feb. 2017.
- "Adult Manifestations of Childhood Sexual Abuse." American Academy of Experts in Traumatic Stress. AAETS, n.d. Web. 25 Feb. 2017.
- Sivrais, Jamie. "Signs of Childhood Sexual Abuse in Adult Survivors." A Voice for the Innocent. N.p., 28 Dec. 2015. Web. 25 Feb. 2017.
- Severson, Mariesa R. "Long-term Health Outcomes of Childhood Sexual Abuse." American Nurse Today. American Nurses Association, 29 Oct. 2014. Web. 25 Feb. 2017.
- "6 Ways Molestation Affects Adult Survivors." Keep Kids Safe. N.p., 30 June 2016. Web. 26 Feb. 2017.
- "What Are the Long Term Effects of Childhood Sexual Abuse?" Abramson Smith Waldsmith LLP. N.p., n.d. Web. 26 Feb. 2017.
- Yuan, Nicole P., Mary P. Koss, and Mirto Stone. "The Psychological Consequences of Sexual Trauma." VAWnet. National Resource Center on Domestic Violence, Mar. 2006. Web. 26 Feb. 2017.
- Thompson, Joyce A. "Residual Effects of Childhood Abuse in Female Adult Survivors." GoodTherapy.org. N.p., 20 Nov. 2013. Web. 26 Feb. 2017.
- Babbel, Susanne. "Trauma: Childhood Sexual Abuse." Psychology Today. N.p., 12 Mar. 2013. Web. 26 Feb. 2017.
Last Updated: 26 February 2017.