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Indications of childhood sexual abuse: Know the warning signs

When someone has been sexually abused as a child, there are classic warning signs, many of which may not appear until adulthood. Amelia presents a comprehensive list of the symptoms of sexual abuse.
Childhood sexual abuse is drastically different from any other type of abuse. While an adult or child would very likely remember being hit or yelled at by an abuser, and while an adult would likely remember being raped or sexually violated in any way, the memories of a child who has been molested may be very dim. Perhaps there are no concrete memories whatsoever.

Sometimes a child-victim grows up with no recollection of the abuse, and then memories suddenly start to surface when something unexpectedly triggers a flashback later in life. Other child-victims may be well aware of what happened; a day doesn't go by without reminders of what happened (or still continues to happen). Just because a child remembers being attacked, however, does not mean that he or she understands what took place.

While any adult would be terribly frightened by a sexual attack, this is not always the case with children. Although an older child may know that it is wrong, and even a younger child may have a gut-reaction of fear or disgust, there is, unfortunately, an even uglier side to the sexual abuse of children. An abuser may be gentle and seem affectionate. The child may not understand what is happening and may enjoy how it feels. If the abuser is a relative or family-friend, the child may trust the abuser and even, for a time, look forward to what he or she does not realize is abuse.

When a child finally realizes that what has happened to him or her is horribly wrong, or when repressed memories begin to surface later in life, the former child-victim can suffer a plethora of consequences unknown to the victims of any other type of abuse. There are many lists of such consequences (symptoms) available online and in books, but the current body of literature seems to lack an exhaustive list. The purpose of the present text is to combine findings from as many credible sources as possible for the sake of compiling that much-needed, exhaustive list.

Below, you will find a list of symptoms that are common among people who have experienced sexual abuse in childhood. Not everyone experiences all of these symptoms, and it is highly possible that there are other symptoms that ought to be included in this list; it will continue to be updated as new information arises.

If you know that you have been a victim of childhood sexual abuse, try not to be afraid as you look at the list below. It can be very difficult to see so many of your symptoms in one place, but it can also provide validation of what you are feeling and/or additional insight into your situation. Try to find comfort in knowing that you are not crazy for having experienced so many mysterious "problems" that may have seemed completely unrelated until now. Others have experienced them too, and they understand what you are going through. You are not alone.

If you suspect that you may have been a victim but do not have any concrete memories of the abuse, please exercise caution in utilizing this list to probe your past, as you do not want to run the risk of creating false memories for yourself. That said, however, it is never wrong to trust your gut. If something is telling you that you have been abused, and if you see that you have experienced a substantial number of the symptoms listed here, it is never wrong to share your suspicions with a trusted and qualified person who can help you to sort through your experiences of those symptoms, and to help you see and interpret them in the proper context. Also, from the Christian standpoint, it is even more important to turn to God in prayer, and to ask Him to clarify things for you as you are ready. If there are in fact memories that you have repressed, do not be in a hurry to unearth them; God will always protect you from remembering what you cannot handle. Likewise, if there are memories that you do need to recover, He will reveal them to you in time—namely, when He sees, in His wisdom, that you are psychologically ready to handle them. Finally, remember that through Christ, all things are possible; it is not always necessary to re-live traumatic events in your mind in order to recover and heal from them fully.


Major indicators of childhood sexual abuse:
(present in adults and children)

  • Severe gag-reflex, even with nothing in or near mouth
  • Frequent or chronic severe nausea
  • Breathing and heart problems
  • Sleeping disorders (insomnia, hypersomnia, night terrors, constant nightmares)
  • Extreme startle-response (when touched, upon sudden loud noise, when someone enters room, etc.)
  • Chronic, unexplained pelvic pain
  • Chronic, unexplained gastro-intestinal problems
  • Chronic, unexplained headaches, backaches, and skeletal pain
  • Chronic, unexplained respiratory problems
  • In women: pseudocyesis (false pregnancy)
  • Addiction
  • Reluctance to follow good healthcare practices

  • Dissociation (unresponsiveness, detachment, confusion, staring blankly, unexplained crying, feeling of separation from reality, feeling of "floating," out-of-body experience, feeling that everyone but self is experiencing reality, or vice versa)
  • Feeling of choking or suffocating
  • Unexplained fear of water touching face (pool, shower, etc.)
  • Feeling dirty, disgusting, and/or damaged
  • Unexplained feelings of shame
  • Fear of extreme loss of control; extreme need to feel in control
  • Feelings of extreme vulnerability
  • Constant anticipation of pain
  • Suicidal ideation
  • Post-traumatic stress disorder (PTSD) or related symptoms: e.g., cycling back and forth from denial and repression to re-experiencing of traumatic event/s
  • Anticipation of early death
  • Panic disorder, panic attacks, and/or unmanageable anxiety
  • Extreme sensitivity and/or irritability
  • Difficulty regulating/processing emotions (emotional outbursts, disproportionate displays of anger, etc.)
  • Lack of confidence
  • Feelings of worthlessness and/or lack of self-respect
  • Intense fear of being wrong

  • Difficulty understanding what people mean
  • Difficulty answering simple questions (fear of misunderstanding and being tortured for "wrong answer")
  • Horrifying flashbacks (may be hazy or nonspecific)
  • Difficulty concentrating and/or learning

  • Self-injuring or self-mutilating behaviors (cutting, poking with pins, etc.)
  • Disordered eating (may or may not be related to body image disorders)
  • Suicidal gestures or attempts
  • Extreme responsibility and safety-consciousness, or extreme tendency to take risks
  • Criminal activity
  • Wearing excessively loose-fitting clothing, or more layers of clothing than weather requires

  • Unreasonable fear of abandonment
  • Extreme need to please others, or refusal to "connect" with others at all
  • Intense fear of intimacy, or constant quest for intimacy
  • Social withdrawal or difficulty relating to others
  • Seeks out or stays in abusive relationships, or avoids relationships altogether
  • History of ambivalent feelings toward relational partners
  • Little confidence, or else total trust, in others (unreasonable in both instances)
  • Fear of loss of control in relationships; intense need to be in control
  • Difficulty expressing feelings and/or intense desire to self-disclose
  • Problems with social boundaries
  • Excessive feelings of gratitude for kind but small gestures from others
  • Too much eye-contact, or complete avoidance of eye-contact
  • In parents: repulsed by caring for baby in certain ways (nursing, taking temperature rectally, uncomfortable with child's nudity)

  • Heightened sexual interest, or no interest at all
  • Promiscuity and/or prostitution
  • Recklessness
  • Compulsions
  • Sexual dysfunction
  • Unexplained pain
  • Flashbacks of abuse
  • Fantasies of raping or abusing others
  • Fantasies of being raped, tortured, tied, etc.
  • Exhibitionist-tendencies, or extreme fear of being seen nude

In medical situations
(Beyond typical person's fears of pain, needles, etc.)
  • Fear of medical and dental examinations, in general
  • Fear of having to lie down on exam-table or in dentist's chair
  • Extreme fear of being nude
  • Spontaneous tears when touched (silent crying, no sobs)
  • Irregular breathing during exam or treatment
  • Fear of aggression from doctors, nurses, medical professionals
  • Fear of or inability to tolerate having objects put in mouth (dentist's hands, tools, rubber dams, impression trays, x-ray bitewings, etc.)
  • Fear of dentist's hand over mouth or nose
  • Fear of suffocating
  • Fear of being unable to swallow
  • Unusually elevated levels of epinephrine and norepinephrine, which can interfere with effectiveness of certain anesthetics

Additional indicators specific to children:
  • Trouble walking or sitting
  • Pregnancy, STDs, or STD-like symptoms (itching, pain, foul odors, etc.) prior to age 14
  • Unexplained pain when using bathroom
  • Unexplained neurological damage
  • Undressing other children, or interest in watching them undress
  • Unwilling to undress in front of others when situationally appropriate (doctor, gym class, sports team, etc.)
  • Inappropriate touching of other children
  • Sexual aggression toward other children
  • Acting out sexual scenarios with pets or toys
  • Sexual advances or invitations toward adults
  • Unwilling to participate in physical activities (play games like Twister®, activities in gym class, etc.), or else extreme interest in them
  • Sexual knowledge inappropriate for age (evidenced by interest, explicit language, and/or references to sexual scenarios using childlike language)
  • Seductive behavior in general
  • Promiscuity in pre-teen and teenage years (may include prostitution)
  • Acceptance of sexual victimization by others
  • Enuresis (involuntary passage of urine by a toilet-trained child; includes bed-wetting)
  • Encopresis (involuntary passage of stool by a toilet-trained child)
  • Sudden regression to infantile behaviors (rocking, throwing tantrums, sucking thumb, etc.), or sudden but false sense of maturity (taking care of parents, other children, etc.)
  • Sudden refusal to be left alone
  • Excessive fears, in general
  • Sudden fear of and intense effort to avoid certain person (abuser) and/or certain place (location of abuse), etc.
  • Sudden fear of people of same gender/race/profession/etc. as abuser
  • Grades slipping
  • New behavior problems (especially fire-setting, cruelty to animals)
  • Running away
  • Truancy from school
  • Social problems
  • Behavioral extremes (excessively compliant or rebellious, excessively passive or aggressive, etc.)
  • Parent or family that is secretive, socially isolated, and/or unduly restrictive
  • Any mention of or implication toward sexual abuse