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Child Sexual Abuse

Carol D. Berkowitz MD1
 1 Associate Chair, Department of Pediatrics, Professor of Clinical Pediatrics, UCLA School of Medicine, Harbor/UCLA Medical Center, Torrance, CA.

Child sexual abuse has been recognized with increasing frequency since the early 1980s, a trend attributable to a number of factors. Increased public awareness has led to programs, particularly in schools, facilitating disclosure by children about abuse. Likewise, parents are more likely now than previously to believe allegations children make about being abused by trusted extrafamilial friends and advisors. Additionally, the medical community is more knowledgeable about both the behaviors that may indicate abuse and the possible physical changes in the anogenital area of sexually abused children.

Definition

Child sexual abuse is the involvement of children and adolescents in sexual activity that they do not understand and to which they cannot give consent by virtue of their developmental level. There is chronological and developmental asymmetry between the individuals, and the activity is for the sexual gratification of the older individual. Incest involves sexual activities between individuals in whom such activity is prohibited by virtue of societal taboos. These restrictions involve individuals related by blood or by marriage.

Sometimes physical abuse may result in injuries in the genital area. Such injuries are not sexual in intent.

Epidemiology

More than 2 million cases of child abuse are reported annually. Approximately 40% of these cases involve sexual abuse.




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