Child Sexual Abuse

What is childhood sexual abuse?

Childhood Sexual Abuse. What health workers need to know.

Childhood sexual abuse (CSA) happens when any person exploits a child in any activity intended to lead to the sexual arousal or other forms of gratification of that person or any other person(s), including organised networks.

CSA can take different forms which may include:

  • being touched in a sexual manner
  • showing children pornography
  • talking to children in a sexually explicit way
  • masturbating
  • forcing children to have intercourse

As with other forms of GBV, men are the main perpetrators (90%), although women also carry out abuse.

It is often committed by someone known and trusted to the child such as fathers, step-fathers, other family members or friends.

Who is at risk?

CSA crosses all boundaries of class, sex, ethnicity, religion and disability.  Whilst prevalence studies indicate that girls are more likely to be abused than boys, a significant percentage of boys do experience CSA.

  • Abuse of children in care homes and religious institutions is increasingly coming to light
  • Many of these victims are male
  • Early abusive experiences may increase vulnerability to abuse in adult life
  • Studies show a high incidence of women working in prostitution have experienced childhood sexual assault
  • Almost 60% of women referred to NHS Lanarkshire’s rape and sexual assault advocacy project were for historical CSA or for women who had more than one experience of violence across their lifespan.

Health impact

CSA can affect people to varying degrees but can have lasting, serious and wide ranging effects.

Research indicates that people experiencing mental health problems are more likely than others to report a history of CSA.

Some of the signs to look out for include:

  • Medically unexplained symptoms especially for chronic pain and gastrointestinal disorders
  • Anxiety, depression, panic attacks, flashbacks, dissociation
  • Self-harm, attempted suicide, risk taking behaviour
  • Severe substance misuse
  • Genital and anal damage, STIs, possible pregnancy
  • Gynaecological problems
  • Irritable Bowel Syndrome
  • Sexual dysfunction

Your role as a health worker

As a health worker you are in a unique position to identify adult survivors of CSA.  No matter how much time has passed, it is never too late to offer support.  CSA is a serious health issue and you have a duty of care to those affected.  If you intervene sensitively and appropriately you could improve long-term health and wellbeing.

  • Being aware that CSA is a possibility
  • Recognising signs and symptoms
  • Initiating discussion
  • Finding out what the patient needs from you
  • Providing clinical care if required
  • Assessing safety
  • Documenting your findings (not in handheld notes)
  • Giving correct information about sources of help

Further information on what to look for and what you can  do to help can be found in the guidance.

If the abuser is still in contact with the patient, check whether they have any contact with children and assess the level of risk.  If you have concerns, follow your local child protection procedures.

Help and Information

Rape Crisis Scotland Helpline:
08088 01 03 02 (daily 6pm – midnight)

Survivor Scotland:
for adult survivors of childhood sexual abuse

Survivors UK National Helpline:
for male survivors of rape and childhood sexual abuse
0845 122 1201

Women’s Support Project:
0141 552 2221

The National Association of Services for Male Sexual Abuse Survivors

Yes You Can…
for people working with survivors of childhood sexual abuse

Support for Survivors

If you are looking for support for your own experiences of GBV you can call:

Scottish Domestic Abuse Helpline
0800 027 1234

Rape Crisis Scotland
08088 010302

or click on:

Scottish Womens Aid

Survivor Scotland

Galop National LGBT Domestic Abuse Helpline


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