What are the signs and symptoms of sexual abuse?

Sexual abuse is a deeply painful and personal experience that is much more common than many people realize. According to RAINN, the nation’s largest anti-sexual violence organization, someone is sexually assaulted every 68 seconds in the United States.

Many people who experience sexual violence or abuse struggle to get the support they need. So learning how to recognize the signs and symptoms of sexual abuse can help make a meaningful difference in your life or the life of a loved one. 

What is sexual abuse, and how often does it occur?

Sexual abuse is a broad term that refers to any sexual activity that occurs without a person’s consent. Legally, sexual abuse is defined as an act of sexual contact that a person suffers or submits to due to force, fear, or threats of harm. Sexual abuse can take many forms, including inappropriate touching, sexually explicit comments or innuendos, child pornography, forced oral sex, and rape. 

Sexual abuse is prevalent in the U.S., affecting millions of adults and children each year. According to the Centers for Disease Control and Prevention, approximately 1 in 4 girls and 1 in 20 boys will experience child sexual abuse, though rates are likely higher. Some counts estimate that 90% of child sexual abusers know their victims, and most cases are never reported. 

Signs and symptoms of sexual abuse

The signs and symptoms of sexual abuse vary based on a person’s age and the type and frequency of abuse. Here are some potential mental, behavioral, and physical indicators of abuse across different age ranges.

How to spot sexual abuse in children

Young children who experience sexual abuse may not have the understanding or awareness to share what they’ve been through, but there are usually signs and symptoms that point to incidents of sexual abuse. 

Mental and behavioral signs:

• Changes in eating or sleeping habits, including nightmares and bed-wetting
• Changes in mood, becoming more anxious, irritable, withdrawn, or clingy 
• New fear of bathing or undressing
• Inappropriate sexual behavior or language
• Avoiding certain places or people 
• Trouble at school, including difficulty concentrating and learning
• Asking questions like, “Do people have to keep secrets?”

Physical signs: 

• Bruises, especially on the buttocks or thighs
• Health problems, including sexually transmitted infections and soreness in the genital and anal areas or throat
• Difficulty with certain movements like sitting or walking
• Unexplained bleeding or discharge in the genital or anal regions

How to spot sexual abuse in adolescents

Adolescents may understand that what they’re experiencing is wrong. But they may not understand how to end the cycle of abuse or get the help they need. 

Mental and behavioral signs:

• Anxiety, depression, or sudden mood swings
• Increase in drug or alcohol use 
• Withdrawal from social interactions
• Self-harm and suicidal behaviors 
• Risky sexual behaviors 
• Changes in appetite, sleep habits, or appearance (clothes, hairstyle) 
• Poor academic performance 

Physical signs: 

• Unwanted pregnancy
• Bruised or bleeding genital area
• Pain, itching, or burning in the genital area
• Frequent yeast infections, urinary infections, or sexually transmitted infections 

How to spot sexual abuse in adults 

Many adults have a hard time talking about sexual abuse. Often, feelings of shame, fear, or confusion prevent them from reporting their experiences. And for some people, the sexual abuse is done by an intimate partner, which can make the experience more confusing to identify and understand.

Mental and behavioral signs:

• Anxiety, depression, or sudden mood swings
• Emotional trauma, including intense feelings of shame, guilt, or self-blame
• Withdrawal from social interactions
• Changes in sexual behavior, such as loss of interest in sexual activity or hypersexual behavior
• Fear of intimacy 
• New or worse irritability or angry outbursts

Physical signs: 

• Unwanted pregnancy
• Bruised or bleeding genital area
• Pain, itching, or burning in the genital area
• Frequent yeast infections, urinary infections, or sexually transmitted infections 
• Chronic pain, headaches, or other unexplained physical symptoms

Consequences of sexual abuse

Experiencing sexual abuse at any age can have a negative impact on a person’s health and well-being. 

Sexual abuse is associated with an increased risk of mental health conditions, including depression, anxiety disorders, eating disorders, sleep disorders, and post-traumatic stress disorder (PTSD). Physically, sexual abuse can lead to long-term health problems, including chronic pain, gastrointestinal disorders, and gynecological problems. 

Data also show that experiencing childhood sexual abuse increases a person’s risk of additional abuse later in life. For example, people who experienced sexual abuse during childhood have double the risk of experiencing non-sexual intimate partner violence. 

And adults who experienced sexual abuse as children are more than three times as likely to experience sexual re-victimization than adults without a history of sexual abuse. Additionally, research has found that men who experience sexual abuse as children are more likely than those who did not experience abuse to become perpetrators themselves. Sexual abuse may also increase a person’s risk for harmful substance use, self-harm, and suicidal ideation.

Treatment options for sexual abuse

Recovering from sexual abuse is often a painful and complex process. Whether it occurred once or was an ongoing experience, sexual abuse can leave you feeling scared, isolated, and ashamed. 

Here are some of the leading treatment options to help people create space for hope and healing:

• Talk therapy: Therapy helps people learn how to cope with difficult emotions, overcome emotional trauma, and regain a sense of control in their lives. There are several therapeutic approaches commonly used for survivors of sexual abuse, including trauma-focused cognitive behavioral therapy (TF-CBT), eye movement desensitization and reprocessing (EMDR), and psychodynamic therapy.

• Holistic therapy: In addition to traditional therapeutic approaches, therapists may use alternative methods to help treat trauma from sexual abuse. For example, art therapy offers people a creative outlet to express their trauma and pain. And music therapy uses activities like singing and listening to music to improve emotional awareness and distress tolerance. Other techniques include rhythmic movement, mindfulness, and meditation. 

• Education and social support: Experiencing sexual abuse can be isolating, but it’s important to remember that you’re not alone. Many people benefit from joining support groups where they can share their experiences and connect with others who understand their struggles. Additionally, there are many advocacy organizations dedicated to educating people about the effects of trauma and empowering them to heal and rebuild after experiencing sexual violence.

These organizations include:

• The National Domestic Violence Hotline
• The National Sexual Assault Hotline
• Crisis Text Line
• Childhelp
• Safe Horizon

Find care with Rula

Sexual abuse isn’t easy to talk about, but when left unaddressed, it can have lasting consequences for your mental health and quality of life. The good news is that working with a therapist is an effective way to cope with difficult emotions, rebuild your self-esteem, and learn to heal.

At Rula, we’re here to make it easier to access trauma-informed care to help you feel your best. Using our simple therapist-matching tool, you can find a therapist who takes your insurance and can meet with you as soon as tomorrow. 

Find a therapist with Rula