Consequences of Childhood Sexual Abuse Similar for Both Sexes
July 11, 2005
by Laurie Barclay, MD

July 11, 2005 — Childhood sexual abuse (CSA) is common for both boys and girls, and the long-term consequences are similar for both sexes, according to the results of a retrospective cohort study published in the July issue of the American Journal of Preventive Medicine. Women were identified as perpetrators in a significant percentage of cases.

"Although most studies on the long-term consequences of CSA have focused on women, sexual abuse of both boys and girls is common," write Shanta R. Dube, MPH, from the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, in Atlanta, Georgia, and colleagues. "For both genders, CSA risk is correlated with family-related factors such as divorce and domestic violence, and having members who abuse substances or who are emotionally unavailable."

Between 1995 and 1997, 17,337 adult health maintenance organization (HMO) members in San Diego, California, completed a survey about abuse or household dysfunction during childhood, and multiple other health-related issues. Multivariate logistic regression determined the relationships between sex of the CSA target; severity of CSA (intercourse vs no intercourse); long-term health and social problems, such as substance use and abuse and mental illness; and current problems with marriage and family. Models controlled for exposure to other concurrent forms of adverse childhood experiences.

In this survey, 16% of males and 25% of females reported contact CSA. Men reported CSA by female perpetrators in nearly 40% of cases, and women reported CSA by female perpetrators in only 6% of cases. CSA significantly increased the risk of negative outcomes, with a similar increase in risk for both men and women. Compared with those not reporting CSA, those who reported CSA had more than twice the risk of a history of suicide attempt (P < .05), a 40% increased risk of marrying an alcoholic, and a 40% to 50% increased risk of reporting current marital problems (P < .05).

"In this cohort of adult HMO members, experiencing CSA was common among both men and women," the authors write. "The long-term impact of CSA on multiple health and social problems was similar for both men and women. These findings strongly indicate that boys and girls are vulnerable to this form of childhood maltreatment; the similarity in the likelihood for multiple behavioral, mental, and social outcomes among men and women suggests the need to identify and treat all adults affected by CSA."

Study limitations include retrospective design and difficulty recalling childhood events.

"Emphasis on a clearer understanding that children and adolescents of both genders are vulnerable to CSA is needed so that healthcare practitioners can meticulously screen for their occurrence in the pediatric setting," the authors conclude. "From a social dynamic perspective, the recognition that both females and males perpetrate CSA is also needed; this type of information helps to clarify characteristics related to this form of childhood maltreatment, especially in the development of prevention programs and interventions."

The Centers for Disease Control and Prevention supported this study and one of its authors, and the study is currently funded by a grant from the Garfield Memorial Fund at Kaiser Permanente. The authors report no financial conflict of interest.

Am J Prevent Med. 2005;28:430-438