The signs of sexual abuse in children may include physical injuries, behavioral changes, and mental health difficulties.
Sexual abuse in children is a disturbing and sensitive issue that requires immediate attention and intervention.Because children may not have the vocabulary to express what is happening to them, it is essential for adults to be aware of the potential indicators of sexual abuse. These signs can vary widely and may manifest physically, behaviorally, and mentally, depending on the child’s age, personality, and the specifics of the abuse.
Recognizing these signs and responding immediately and appropriately can significantly affect a child’s life. This article will explore the various signs of sexual abuse in children, actions to take in response, and support resources.
Content warning
This feature mentions experiences of trauma and sexual abuse. Please read at your own discretion.
Physical signs of sexual abuse can include a range of symptoms and injuries without an obvious cause. These symptoms and injuries can include:
- Bruises, bleeding, or swelling in the genital or anal areas: These symptoms can indicate that a child has experienced inappropriate physical contact. Such signs can be a direct result of physical trauma and require immediate investigation.
- Pain or discomfort when sitting or walking: Children may show signs of pain or discomfort in their lower body when performing routine activities such as sitting or walking due to injuries from abuse.
- Frequent urinary or yeast infections: An unusual frequency of urinary tract infections or yeast infections can be suggestive of sexual abuse. These infections, especially if recurrent, should prompt a thorough evaluation to determine the cause and rule out abuse.
- Torn, stained, or bloody underwear: Finding such evidence can be a clear indication of sexual abuse.
Behavioral changes can be the first indicators that a child has experienced a trauma. Children experiencing sexual abuse may exhibit a variety of behaviors, such as:
- Sudden changes in progress at school: A child may stop progressing academically or may show sudden signs of decline. This can manifest as a lack of interest in schoolwork, grades dropping, or disciplinary issues.
- Withdrawal from friends, family, or activities: A noticeable withdrawal from social interactions and activities the child once enjoyed can indicate distress. The child may be trying to avoid situations that remind them of the trauma or to protect themselves from further harm.
- Regression to earlier behaviors: Resuming behaviors such as bedwetting, thumb-sucking, or other actions typically associated with younger age groups can suggest a child is under severe stress or has experienced trauma. Regression can be a coping mechanism to deal with overwhelming emotions.
- Excessive fear of a particular person or place: If a child exhibits an intense fear of a specific individual or location, it may be because the child associates that person or place with the abuse. This fear can manifest in avoidance behaviors or extreme anxiety.
- Sexual behavior or knowledge inappropriate for the child’s age: Children displaying sexual behavior or knowledge beyond what is typical for their age may have experienced exposure to sexual content or experiences. This can include sexual language, play, or drawings.
Sexual abuse can have profound effects on a child’s mental health. Some potential signs to be aware of include:
- Depression or anxiety: Depression or persistent sadness, withdrawal from previously enjoyed activities, and pervasive feelings of hopelessness are common. Anxiety may present as constant worry, panic attacks, or seemingly irrational fears.
- Nightmares or trouble sleeping: Disturbed sleep patterns, including frequent nightmares or difficulty falling and staying asleep, can indicate trauma. Children may wake up screaming or refuse to go to bed due to fear.
- Low self-esteem or feelings of worthlessness: A significant drop in self-esteem or expressing feelings of being unworthy or unlovable can be signs of abuse. This can manifest in self-criticism, self-hatred, or a lack of confidence.
- Sudden changes in appetite or eating habits: Abuse can lead to changes in eating behaviors, such as loss of appetite, overeating, or the development of eating disorders such as anorexia or bulimia. Changes in eating behaviors can be a child’s way of exerting control over their bodies.
- Self-harming behaviors or thoughts of suicide: Self-injury, such as cutting or burning, can be a coping mechanism for dealing with emotional pain. Suicidal thoughts or suicide attempts are indicators of severe distress and require immediate intervention.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
An adult who knows or suspects a child is experiencing abuse must take immediate and appropriate action.
If a child reports sexual abuse
If a child opens up, the first step is to listen to them without judgment or disbelief. Providing a safe and supportive environment for the child to speak can help them feel more comfortable sharing their experiences.
Reassuring the child that they are not to blame and did the right thing by telling someone is crucial. It is important to affirm their bravery and ensure they understand that the abuse is not their fault.
If a person suspects abuse
There may also be situations where a person has significant evidence or reason to be concerned without the child disclosing the abuse. In these cases, the person should still take immediate action. Depending on the person’s role in the child’s life and the state where they live, they may be legally obligated to report these suspicions.
Experts recommend sensitively speaking with the child in a nonthreatening environment before reporting. It is important to put the child at ease and may be best to ask questions using the child’s own vocabulary, such as “Has someone been touching you?”
How to report
Guidance suggests it is best that a person tell the child they are going to talk to someone who can help before reporting. If there are fears that the person abusing the child will do them further harm if they learn about the report, the person should clearly communicate this to the appropriate authorities, such as child protective services or local law enforcement.
These authorities have the expertise to investigate the situation and take necessary actions to protect the child. Because reporting agencies can vary from state to state, people may also wish to visit the Rape, Abuse & Incest National Network’s state law database for more information.
Acting quickly and responsibly can help protect the child from further harm and initiate healing. It is essential to continue providing ongoing support and reassurance to the child throughout this difficult time.
A child who has experienced sexual abuse is likely to require medical and psychological support. A medical professional can assess and treat any physical injuries, while a mental health professional can provide emotional support and therapy to help the child cope with the after effects of trauma.
Numerous organizations and resources can support children who have experienced sexual abuse and their families. People can contact the groups below for help or information:
- National Sexual Assault Hotline: This hotline offers confidential support 24/7. People can call 1-800-656-4673 or start an online chat to receive immediate assistance and connect with local resources.
- Childhelp National Child Abuse Hotline: This hotline provides 24/7 crisis intervention, information, and referrals to thousands of emergency, social service, and support resources. A person can call or text 1-800-422-4453 or chat to someone online.
- Stop It Now!: This organization offers a confidential helpline (1-888-773-8368) and an online chat service for individuals seeking advice on preventing child sexual abuse or addressing suspicions.
- Child Advocacy Centers: These centers provide a coordinated, multidisciplinary approach to the investigation, prosecution, and treatment of child abuse. At a center, a child can receive medical exams, therapy, and support services.
Mental health resources
Visit our dedicated hub for more research-backed information and resources on mental health and well-being.
Recognizing and responding to the signs of sexual abuse in children is a critical responsibility for adults.
Being aware of the physical, behavioral, and mental health indicators and knowing how to act can allow caregivers and professionals to help protect children and support their recovery.
Accessing the appropriate resources and support systems is essential in ensuring the child’s safety and well-being.