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  • Beverly Engel L.M.F.T.

What Constitutes Child Sexual Abuse?

People can be sexually abused in childhood without realizing it.

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  • People often have misconceptions about what childhood sexual abuse (CSA) actually is.

  • Subtle forms of CSA, such as nudity or disrobing, are often overlooked.

  • It is important to connect CSA with problems like alcohol and drug abuse and self-destructive or self-sabotaging behavior.

As a psychotherapist with nearly 40 years of experience, I am always saddened by how many people were sexually abused in childhood or adolescence without realizing it. Many people don’t label what happened to them as abuse. Others minimized what happened to them and told themselves it was no big deal. Still, others blame themselves or tell themselves they asked for it.

The sad truth is that unless we acknowledge a problem, we can’t heal it. For example, many suffer from symptoms including alcohol and drug abuse, eating disorders, self-destructive behavior, self-sabotaging behavior, sexual aversion, sexual dysfunction, and repeated sexual victimization without making the connection between what happened to them as children and the problems they currently suffer. For this reason, I believe it is important to be open to the possibility that the trauma of childhood sexual abuse may have caused your current issues.

Even though child sexual abuse is being talked about today more than ever before, many people are still misinformed as to what child sexual abuse actually is. Many think of childhood sexual abuse as an adult having intercourse with a child. But childhood sexual abuse is not limited to intercourse. In fact, most sexual abuse of a child does not involve intercourse.

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Others don’t realize they were sexually abused because they were an adolescent who was older than 13 years old when the act or acts occurred. But sexual abuse includes an adult having sexual contact with an adolescent.

Defining Child Sexual Abuse

Let’s begin by defining child sexual abuse. Child sexual abuse includes any contact between an adult and a child or an older child and a younger child for the purposes of sexual stimulation of either the child or the adult or older child, and that results in sexual gratification for the older person. This can range from non-touching offenses, such as exhibitionism and child pornography, to fondling, penetration, incest, and child prostitution. A child does not have to be touched to be molested.

Many people think of childhood sexual abuse as an adult molesting a child. But childhood sexual abuse also includes an older child molesting a younger child. By definition, an older child needs to be two years or older than the younger child, but even an age difference of one year can have tremendous power implications. For example, an older brother is almost always seen as an authority figure, especially if he is left “in charge” when their parents are away.

The younger sibling tends to go along with what the older sibling wants to do out of fear or out of a need to please. There are also cases where the older sister is the aggressor, although this does not happen as often. In cases of sibling incest, the greater the age difference, the greater the betrayal of trust, and the more violent the incest tends to be.

What constitutes child sexual abuse?

Below is a comprehensive list of the various forms of childhood sexual abuse, taken from my most recent book, Freedom at Last: Healing the Shame of Childhood Sexual Abuse.

Child sexual abuse can include any of the following:

  • Genital exposure.

  • Kissing.

  • Fondling.

  • Masturbation.

  • Fellatio.

  • Cunnilingus.

  • Digital (finger) penetration of the anus or rectal opening.

  • Penile penetration of the anus or rectal opening.

  • Digital (finger) penetration of the vagina.

  • “Dry intercourse.” (A slang term describing an interaction in which the adult rubs his penis against the child’s genital-rectal area or inner thighs or buttocks.)

  • Penile penetration of the vagina.

  • Pornography.

  • Nude photography.

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More Subtle Forms of Childhood Sexual Abuse

Even if someone wasn't sexually abused in any of the above-mentioned ways, there is still a possibility that they may have been a victim of child sexual abuse and may be suffering from damaging after-effects. Below is a description of the lesser-known, more hidden forms of sexual abuse. These forms of abuse can be just as shaming and damaging as the more obvious, overt forms.

Subtle forms of sexual abuse can include any of the following. Keep in mind that it is the intention of the adult or older child while engaging in these activities that determine whether the act is sexually abusive.

  • Nudity. The adult or older child parades around the house in front of the child.

  • Disrobing. The adult or older child disrobes in front of the child, generally when the child and the older person are alone.

  • Observation of the child. The adult or older child surreptitiously or overtly watches the child undress, bathe, excrete, or urinate.

  • Inappropriate comments. The adult or older child makes inappropriate comments about the child’s body. This can include making comments about the child’s developing body (e.g., comments about the size of a boy’s penis or the size of a girl’s breasts). It can also include asking a teenager to share intimate details about her or his dating life.

  • Even back rubs or tickling, in rare cases, can have a sexual aspect to them if the person doing it has a sexual agenda.

  • Emotional incest. Emotionally incestuous parents turn to their child to satisfy needs that should be satisfied by other adults–namely: intimacy, companionship, romantic stimulation, advice, problem-solving, ego fulfillment, and/or emotional release. Parents who have been divorced or widowed sometimes attempt to replace the lost spouse with their own child. Emotional incest also occurs when a parent “romanticizes” the relationship between herself and her child, treats the child as if he or she were her intimate partner, or when a parent is seductive with a child. This can also include a parent “confiding” in a child about his or her adult sexual relationships and sharing intimate sexual details with a child or adolescent.

  • Approach behavior. Any indirect or direct sexual suggestion an adult or older child makes toward a child. This can include sexual looks, innuendos, or suggestive gestures. Even if the older person never engaged in touching or took any overt sexual activity, the child picks up the sexual feelings that are projected.

Hopefully, the above lists have helped further educate people on what constitutes sexual child abuse. Survivors may be surprised to discover that behaviors they thought were normal can actually be considered abusive and can cause considerable damage to a child’s psyche, in addition to causing great shame in a child.

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It can be painful and disorienting to come to the realization that you were, in fact, sexually abused, but please, believe me, it is better to know than to remain in the dark. When we are unaware of what has happened, we are extremely vulnerable to being manipulated or re-victimized and surprised and even damaged by our own behavior.

When someone knows what happened to them, it may be easier to connect the dots between the abuse they experienced and their current problems. If someone learns that what happened to them is considered sexual abuse, they can reach out for help. Individual and/or group therapy can help heal the shame, pain, sense of betrayal, feelings of powerlessness, and feelings of anger felt due to the victimization.

RAINN (the Rape, Abuse and Incest National Network) offers a free 24-hour crisis line (1-800-656-4673).

Beverly Engel L.M.F.T. - website - books


Engel, Beverly. (2022) Freedom at Last: Healing the Shame of Childhood Sexual Abuse. New York: NY: Prometheus Books.


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