Heavy Threads: Remnants of Sexual Abuse
Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: January 19, 2026
Fact checked
Quick Summary
  • Sexual abuse is a term used to categorize any form of non-consensual sexual contact, mostly to gain power over others.
  • Whether it is a one-time encounter or a persistently occurring experience, sexual abuse can lead to a crisis that can impact mental and physical health in the short and long run.
  • Immediate crisis assistance becomes necessary for all the victims and can prove invaluable and even life-saving in some situations.
Reading time: 10 min

Sexual abuse is a term used to categorize any form of non-consensual sexual contact, mostly to gain power over others. Whether it is a one-time encounter or a persistently occurring experience, sexual abuse can lead to a crisis that can impact mental and physical health in the short and long run. Immediate crisis assistance becomes necessary for all the victims and can prove invaluable and even life-saving in some situations. Most victims also require long-term therapy to overcome the lingering effects and symptoms.

Sexual abuse is any action that coerces or pressures an individual to perform a sexual act they do not wish to do. It also encompasses behaviors that impact someone’s ability to control their sexual activity or the circumstances in which the sexual contact occurs, such as rape, oral sex, or restriction of access to birth control.  Some common sexual abuse examples include the following:

  • Unwanted touching or kissing
  • Rape or attempted rape
  • Unwanted violent or rough sexual activity
  • Keeping an individual from protecting themselves from sexually transmitted infections (STIs)
  • Pressuring or threatening someone into unwanted sexual activity
  • Sexual activity with someone who is drugged, unconscious, drunk, or clearly unable to give consent.

If you are concerned that someone around you is suffering from sexual abuse, asking them directly is the best way to help them get the treatment and support they need. Additionally, you may consider looking out for the following signs of sexual abuse:

  • Low self-esteem
  • Avoiding specific places or people
  • Anxiety about certain situations that did not prompt anxiety before
  • Disturbed sleep
  • Frequent nightmares
  • Persistent depression or sadness
  • Suicidal thoughts
  • Self-harming behaviors
  • New sexually transmitted infections
  • Numbness to any shocking or traumatizing incident

Unfortunately, the prevalence of sexual abuse is very high and continues to rise with each passing day, especially for girls and women. In the United States alone, one in five girls and one in twenty boys experience child sexual abuse at some point. Sexual abuse in young and adults can occur in the form of different crimes, such as:

Rape

Forced sexual contact with someone who does not consent is known as rape. It also includes forcing sex upon someone who does not wish for it or indulging in it with someone intoxicated or not legally old enough to consent. Date rape is another subcategory of this term which indicates sexual abuse in relationships. The exact definition of rape and what it entails vary from one state to another. (source: WHO, 2021)

Child Molestation

Child molestation refers to a type of sexual contact with a minor. Many children who experience molestation are too young to know what’s happening and may be unable to fight back. In other cases, abusers gain a child’s cooperation to continue their activity without harming them. Some examples of child molestation include demanding sexual favors from a minor or fondling them.

Incest

Incest indicates sexual contact between family members too closely related to being married to each other. While incestuous activity can occur between two adults with consent, this act is not too common. Most cases of incest include child abuse and victims under the age of 18 years which a family member abused. Incest remains to be one of the most underrated types of sexual abuse.

Non-Consensual Sexual Contact

This category includes unwanted sexual touching, such as pinching and groping. Another example of non-consensual sexual contact is attempted rape.

Non-Contact Sexual Abuse

Not all types of sexual abuse fit into their common psychological or legal definitions. For example, parents who make sexually inappropriate jokes with their children are also considered among the examples of sexual abuse. Additionally, the so-called revenge pornography websites that publish nude photos and videos of people without their consent also come under sexual abuse. (source: RAINN, n.d.)

The laws that govern sexual abuse are constantly evolving, and for this reason, professionals working with sexual abuse survivors rely on their patients’ feelings instead of laws to determine if what they have experienced is sexual abuse or not. For example, marital rape is a deeply traumatic experience that can present as sexual abuse. However, it did not become a crime until the 1970s and remained a challenging offense to prosecute.

After a sexual assault, survivors may feel as if their bodies are not their own. They also report feeling guilt, terror, or shame and may continue blaming themselves for the assault. Most people who have experienced sexual abuse are also at risk for developing certain health conditions due to the negative emotions and trauma linked to their experience. Some of these health side effects include:

Depression

The loss of bodily autonomy is very hard to cope with as it leads to feelings of despair or hopelessness. It may also negatively affect a victim’s sense of self-worth and lead to depressive feelings, which may be mild and fleeting or intense and long-lasting.

Anxiety

Anxiety is another common consequence of losing bodily autonomy secondary to sexual abuse. Survivors may constantly worry about getting attacked once again and can experience panic attacks in anticipation. Others experience strong agoraphobia and become too afraid to leave their homes. Some people develop a chronic fear of the type of individual who harmed them; for example, if the perpetrator was a tall, blue-eyed man, a victim may avoid all people that match this description. (source: APA, 2017)

Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) commonly develops in people who survive a sexual assault or abuse. The disorder is characterized by intense memories of the abuse and disruptive flashbacks that may cause survivors to lose track of their surroundings. Some people also develop a related condition called complex posttraumatic stress disorder that includes a chronic fear of abandonment in addition to the characteristic signs and symptoms of PTSD.

Personality Disruptions

Sexual abuse sometimes triggers personality disruptions, making survivors susceptible to borderline personality disorder and similar issues. Their behavior linked to a personality disruption is often an adaptation to the abuse they suffered. For example, the fear of abandonment as a symptom of borderline personality disorder might be a protective mechanism for someone to protect themselves from sexual abuse as a child.

Attachment Issues

Many people with lingering signs of sexual abuse find it challenging to establish healthy relationships and attachments with others. This is particularly true for those who have encountered child sexual abuse. Adults who were abused in childhood have insecure attachment patterns and often struggle with intimacy or seem too eager to form close relationships with others.

Addiction

Research suggests that survivors of abuse are up to 26 times more likely to indulge in the use of alcohol and drugs. This behavior mostly attempts to cope with the negative emotions and memories attached to the experience. (source: NIMH, 2024)

Physical Consequences

Sexual abuse can do much more than leave psychological scars. They can have long-lasting health consequences in many cases. For example, someone who has been assaulted may sustain cuts and bruises, while others may have more serious injuries like broken bones, knife wounds, or damaged genitals. Some people end up developing chronic pain without any obvious physical cause.

Some survivors of sexual abuse experience fertility issues and sexual dysfunction, while others catch sexually transmitted infections. Some female victims may also become pregnant, which only adds to their physical and psychological trauma.

Treatment for sexual abuse primarily comprises a combination of psychotherapy and medications to manage symptoms.

Psychotherapy

Experts use different types of sexual abuse therapy to help survivors of sexual abuse. One of the most common ones includes trauma-focused cognitive behavioral therapy or TF-CBT, which has been found to be effective in managing the symptoms of depression, PTSD, and anxiety related to sexual abuse. It also helps address a victim’s underlying fears and thoughts related to the trauma they experienced. (source: MedlinePlus, 2024)

CBT also addresses any negative feelings or thoughts that a sexual abuse survivor might be harboring. A therapist will work closely with these patients to work through these feelings while addressing any undesirable behaviors the patient might be engaging in to cope with, such as substance abuse.

In addition to CBT, both children and adult survivors may benefit from prolonged exposure therapy (PET), eye movement desensitization and reprocessing (EMDR), and cognitive processing therapy (CPT). The aim of sexual abuse therapy is to enable patients to handle situations that may have previously triggered them while reframing their negative beliefs into positive outlooks.

Medication

An expert may also prescribe medication alongside regular psychotherapy sessions to improve the overall treatment outcome. One of the most common medications prescribed to the survivors of sexual abuse includes selective serotonin reuptake inhibitors or SSRIs, a class of antidepressant medicines that effectively reduce the symptoms of anxiety and depression in users. SSRIs are more commonly prescribed to adult patients; however, children may also benefit from them, especially if they suffer from a co-existing mental health issue, such as PTSD. Sometimes, anti-anxiety medication may also be added to the treatment regimen of a sexual abuse survivor.

FAQs

How common is sexual abuse?

Sexual abuse or violence has recently become a pervasive problem with high prevalence. In the United States, one in three women and one in four men experience some type of sexual violence in their lifetimes, as mentioned by the National Institute of Health. Moreover, experts believe these statistics are misleading as many people fail to report crimes of sexual violence out of fear and guilt. (source: ACOG, 2019)

What does covert sexual abuse mean?

Covert sexual abuse refers to a type of trauma inflicted through surreptitious methods of harassment and assault instead of using outright sexual violence. While overt sexual abuse may include sexual assault, rape, incest, and sexual harassment, covert sexual abuse is more secretive. Some examples of covert sexual abuse include slut shaming, body shaming, unsolicited nude imagery, verbal sexual harassment, and early exposure to explicit content or pornography. These examples may not seem as harsh as overt sexual abuse; however, they can be equally debilitating and traumatizing.

What is the profile of a sexual abuser?

Most perpetrators of sexual abuse tend to know the victim or have been involved in some sort of crime or an act of aggression in the past. Most of them are adults, and some may struggle with some type of mental health issue, such as antisocial personality disorder. Because there are many aspects that define or affect the personality of a sexual abuser; hence, it is impossible to develop a singular profile for such people.

Are people more likely to receive sexual abuse from someone they know?

According to the Rape, Abuse, and Incest National Network, approximately 80 percent of sexual assaults and abuse are committed by someone the victim knows, such as a family member, neighbor, or romantic partner. This may make it extremely difficult for the survivor to come out and report the crime, especially if their perpetrator is someone well-respected in the family, as they fear that others may judge them or call them a liar.

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