Child sexual abuse is any form of sexual activity with a child by an adult, or by another child where there is no consent or consent is not possible; or by another child who has power over the child. By this definition, it is possible for a child to be sexually abused by another child who is younger than they are.

Sexual abuse includes, but is not limited to, showing a child pornographic materials, placing the child’s hand on another person’s genitals, touching a child’s genitals, and/or penetration of any orifice of a child’s body (mouth, vagina, anus) with a penis, finger, or an object of any sort. Penetration does not have to occur for it to be sexual abuse.

Who are the Perpetrators?

Perpetrators are most often someone the child knows and trusts. As far as we know, perpetrators, are most often male relatives, including fathers, brothers, grandfathers, uncles and cousins; friends of the family; or neighbours. Perpetrators can also be female, including mothers, sisters, aunts, babysitters, and grandmothers.

Usually the perpetrator has easy access to the child because s/he has sole responsibility for the child, or takes care of or visits the child, and is trusted by the child’s parents.

Where Does Sexual Abuse Occur?

Sexual abuse or incest can occur anywhere, at any time, including in front of other people who do not, or choose to not see. I have heard many stories of children being abused while other people were in the next room, in a car with them, or sitting at a dinner table.

Who is Sexually Abused?

All children are vulnerable to sexual abuse. Sexual abuse and incest occur in every race, class, religion, culture, and country.

Once a child has been sexually abused, and has not received appropriate help, support, and understanding for what has happened, s/he can be particularly vulnerable to being sexually abused again by another perpetrator. This is not the fault of the child. This is due to the fact that she has learned that sexual abuse is something that people will and can do to her/his body.

Children whose emotional needs are not met–who are emotionally deprived, or otherwise abused–can also be more vulnerable because they need attention and some perpetrators exploit that need. Again, this is not the child’s fault. The child did not create the fact that her/his needs were not met, nor the fact that someone exploited that need.

Homophobia puts lesbian and gay youth at risk of sexual abuse. Many gay youth are forced to go to adult clubs, bars and other settings in order to explore their sexuality and to meet other prople who are gay. By being in an adult setting they are more likely to be exploited (just as heterosexual girls would be at risk in an adult heterosexual setting). Also, it is unlikely that gay youth will tell anyone if they are abused because they would have to reveal that they were in a gay setting. With little or no access to information about gay sexuality, many youth misinterpret abuse experiences as representing what it means to be gay. This puts them at further risk.

Different Effects and Coping Strategies of Child Sexual Abuse

The effects of child sexual abuse are wide ranging, and vary from survivor to survivor depending on a number of different factors such as the age of the victim, the duration of the abuse, the number of perpetrators, the nature of the relationship with the perpetrator, and the severity of the assault.

I always hesitant to write that last one–the severity of the assault–because all abuse is traumatic and harmful to victims. I have known women quite traumatized by their breasts being repeatedly grabbed when they were a child. While this may not be as severe as some other forms of abuse, it can have strong and long-lasting effects. It’s important to remember that while being assaulted in a more violent manner does have its own specific effects, it in no way minimizes the reality and experience of others who have not experienced that kind of violence.

Emotional Effects

Includes feelings of: confusion, powerlessness, helplessness, pain, betrayal, sadness, grief, loss, feeling dirty, shame, vulnerable, unsafe, scared, terrified, horrified, depressed, angry, numb from feelings and body, suspicious, untrusting, tortured, sensitive, emotional, hurt, panic, anxiety, and feeling miserable.

Beliefs About Self

Beliefs about one’s self include: “I am bad, no one loves me, no one could love me, I am unlovable, I am dirty, it’s my fault, I’m stupid, I should have done something, I should have told someone, I hate myself, I must be bad, I must have wanted it, I must have done something, I’m being punished, I deserve to die, I don’t want to be me, why do these things happen to me, I must have deserved it”

Minimizing Beliefs

Survivors are confronted with overwhelming pain. In order to cope with extreme and intense emotions, the details of what happened, and who hurt them, they may try to convince themselves “it wasn’t so bad, it didn’t really hurt them, others have been hurt much more” etc. This is a form of self-protection. It did hurt, it still hurts but it may be too hard or scary right now to face it all.

As a form of self-protection, minimizing may help slow the process down which may be what the survivor needs from time to time. As a constant way of coping however, minimization leads to self-blame and self-hatred which is not helpful and hurts a great deal.


Suvivors need to protect themselves from the truth of the situation, after all someone they trusted, and perhaps loved, hurt them very badly. Rationalization is when a survivor explains the abusive behavior away–“he didn’t know what he was doing, he was abused himself as a child, he thought he was showing me love, she was really messed up, she didn’t mean to hurt me.” The survivor is trying to protect her/himself from the horrible truth of the situation.


Denial is recognizable by a survivor saying, “it didn’t happen; I must be making it up; after all how can I be sure anything actually happened; and what if I’m wrong; it probably didn’t happen; it couldn’t have happened.”

In my experience, some denial even as an adult can be helpful. Denial can help slow the process down. We know denial helps a child to survive. We cannot expect someone to simply abandon their hard earned coping strategies even if they are safe now. Safety is not only an external reality it is an internal one as well. Many survivors do not feel safe and may need some denial to cope with how they feel.

Too much denial leads to all sorts of problems as the abuse is not addressed. This kind of denial is harmful and is fuelled in part by the denial of the “False Memory Syndrome” Foundation and other parts of society who would rather deny than face the reality of child sexual abuse.

Dissociation, DID, MPD, and Multiplicity

We all dissociate to some extent or another. Babies do it quite regularly. It is a natural physiological response to being overwhelmed. Children who are sexually abused are extraordinarily overwhelmed. Dissociation allows the child to literally take a break from the abuse, to distance her/himself from what is going on, and ultimately to survive.

Some survivors describe dissociation as feeling as though they were not really there during the abuse, but were far away perhaps watching from a distance. Some survivors describe it as they split off from the abuse, and floated up to the ceiling or into a crack in the wall. Some survivors go really far away, deep inside themselves, and create different personalities to deal with the abuse. Multiple personalities are usually formed in the context of more extreme, frequent, or sadistic abuse.

Dissociation occurs on a continuum from the far left where someone is not present in the moment and is off somewhere else, they may or may not feel spacey–everyone does this at one time or another. Further along the continuum people feel split, or like they are not one person inside, usually there is an adult and a really vulnerable or hurt kid. Further along, survivors have a few dissociated personalities. Even further toward the right of the continuum, people have many different personalities, identities, parts, fragments, and/or different groups of parts inside. These personalities may or may not have names. Survivors near the right end may not have fully formed personalities, but lots of highly fragmented parts. At the far right end, survivors lose time which they may or may not be aware of. They may find themselves places, and not remember how they got there and have the experience of living different “lives”.

In addition to a continuum of dissociation and multiplicity, there is a continuum of co-consciousness–the degree to which parts inside are aware of each other, and communicate and cooperate with one another. Achieving co-consciousness is an important step in the healing process. For help responding to different parts inside and developing internal cooperation see my article DID, MPD, or Multiplicity: Responding to Parts Inside With a Focus on Kids

Problems with Boundaries

Because a survivor’s boundaries were not respected–they were utterly violated–s/he may have a lot of difficulty knowing where her/his boundaries are, how to maintain them, and how to protect her/himself from those who do not respect or try to violate her/his boundaries. This leaves many survivors vulnerable to further abuse.

Trusting Others

It can be very difficult for a survivor to trust anyone. It can be even harder when that person is close to them, and cares for them. Often the abuser was that–someone who had a close and trusting relationship with them. Adult relationships, particularly sexual ones, can be quite challenging and triggering for survivors. At the same time, they can be a source of great love, safety, and healing too.

Relationship With One’s Body

Since the abuse took place on and in the body, the body can become the enemy. After all many survivors’ carry a great deal of pain and memories in their bodies. Desperately needing ways to cope with this pain can lead to a variety of coping strategies including eating disorders, self-injurious behaviors, numbing, inability to enjoy sex, having lots of sex, poor body image, a generalized separation from and disregard for one’s body, dissociation, and gender-identity issues.

Coping Behaviors

There are a whole range of behaviors that survivors may engage in that come from having been sexually abused. They include: addictions, prostitution, isolation, frequent sexual activity, avoidance of sex, over-working, inability to work, high-functioning, low-functioning, argumentativeness, avoiding conflict, perfectionist, and wanting to please others.

All of these behaviors were learned in response to abuse and served an important purpose–staying sane and alive. It is important to not judge your or anyone else’s ways of coping–you’re here because of them.

Other effects

These may include nightmares, insomnia, panic attacks, flashbacks, anxiety attacks, terror, inability to go outside, afraid being alone, afraid being with other people, numerous trigger-responses, headaches, and physical problems (yeast infections, bladder infections, anal bleeding, etc.)

A Final Thought

While it may be tempting to focus on how awful it is to be abused, it’s important to not lose sight of the reality that survivors are full human beings with many gifts and talents to offer the world. Some of the most sensitive, intuitive, deep, profound, creative, and hopeful people I’ve known are incest/child sexual abuse survivors. They were able to be that way by not losing touch with their humanity–their soulfulness–in the face of others’ inhumanity. We can all learn a great deal from survivors.