Child sexual abuse is defined as the involvement of children in sexual activities that they cannot understand, are not developmentally prepared for, cannot give informed consent to, and that violate societal taboos. “Sexual abuse” is a general term that includes a broad range of activities, including noncontact activities (e.g., pornography, either in its production or in its viewing; inappropriate observation of the child while dressing, toileting, or bathing; and perpetrator exhibitionism directed at the child) and contact activities. Sexual abuse frequently occurs over time as the perpetrator gains the trust of the child, and it can progress from noncontact to contact forms of abuse.

Child sexual abuse can have various presenting signs and symptoms. The following are physical signs associated with sexual abuse and the differential diagnosis for each.

A few diagnoses are commonly mistaken for sexual abuse and deserve comment.