Childhood sexual abuse (CSA) is shockingly common, pervasively underrecognized. Many suffer in silence, behind a veil of shame, disgust, and hatred, often self-directed, though some have less difficulty. Often, worse than the original abuse is the way family reacted—with disbelief, counteraccusation, and allegiance to the perpetrator, a deep-wounding betrayal. Thankfully, courageous high-profile individuals have opened up publicly about their own experience of abuse, and survivors and professionals have labored for years to bring awareness and change.

CSA is defined by the World Health Organization as “the involvement of a child (person less than 18 years old) in sexual activity that the child does not fully comprehend, cannot give consent, or violates the laws or social taboo of society”. Researchers estimate worldwide rates of CSA for girls to be between 12.7 and 18 percent and for 7.8 percent for boys. Rates in the United States are estimated to be 5 percent and vary in other countries, often being significantly higher. Of course, when people don't disclose history, reported rates are lower than actual frequency..

In the U.S., out of every 20 people you meet, on average one will have experienced CSA. They will not necessarily have post-traumatic stress disorder (PTSD) or any other mental or physical health problems as a result. However, as with other adverse childhood experiences (ACEs), the risk is significantly increased for various problems, including depression, anxiety, post-traumatic stress disorder, psychotic experiences, eating disorders, somatic or conversion problems affecting the body including medically-unexplained symptoms, substance misuse, suicidal thinking and self-defeating behaviors, problems from inappropriate or risky sexual behavior, and relationship difficulties.

Non-disclosure of the experience is uniquely associated with negative outcomes. Study authors note that in addition to delaying access to recovery resources and impeding recovery for people who may be in treatment but not addressing CSA directly, non-disclosure may interfere with law enforcement investigation, leaving abusers uncharged or not convicted; it perpetuates a........

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