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Management and sequelae of sexual abuse in children and adolescents

Kirsten Bechtel, MD
Berkeley L Bennett, MD, MS
Section Editors
Daniel M Lindberg, MD
Amy B Middleman, MD, MPH, MS Ed
Jan E Drutz, MD
Deputy Editor
James F Wiley, II, MD, MPH


Sexual abuse occurs when a child engages in sexual activity for which he or she cannot give consent, is unprepared for developmentally, and cannot comprehend. This includes fondling and all forms of oral-genital, genital, or anal contact with the child (whether the victim is clothed or unclothed), as well as non-touching abuses, such as exhibitionism, voyeurism, or involving the child in pornography [1-3].

The management and sequelae of childhood sexual abuse will be reviewed here. The epidemiology, evaluation, and differential diagnosis of childhood sexual abuse and human sex trafficking are discussed separately. (See "Evaluation of sexual abuse in children and adolescents" and "Human trafficking: Identification, evaluation, and management in the health care setting".)


The management of sexual abuse involves prevention of sexually transmitted infections (STI) and pregnancy. Psychosocial support and anticipatory guidance should also be offered to the victims and their non-offending caregivers.

Although evaluation and management of sexual abuse should be performed by an experienced child abuse team, including a child abuse specialist or clinician with similar experience, whenever possible, urgent evaluation is necessary under the following circumstances and typically occurs in an emergent setting (see "Evaluation of sexual abuse in children and adolescents", section on 'Evaluation'):

The alleged abuse occurred within the previous 72 to 96 hours, depending upon jurisdiction

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Literature review current through: Nov 2017. | This topic last updated: Oct 13, 2017.
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