• The long-term effects of childhood sexual abuse can be profound and varied

  • Counsellor Sally Edwards, who has specialist training in supporting survivors of CSA, outlines some of the common symptoms of this trauma

  • We have trauma-informed therapists available to support you here

Sexual abuse is a traumatic experience that can have profound and long-term effects on survivors. This article explores the psychological and physical consequences of sexual abuse, shedding light on the complex and varied ways it can impact people throughout their lives. It is important to note that the impact of sexual abuse can vary among individuals, and not all survivors will experience any or all of the same effects.

The ACE Study (Adverse Childhood Experiences Study, 1995) is a research study that explored the long-term impacts of childhood trauma on physical and mental health outcomes later in life. It examined the association between adverse childhood experiences and various health, psychological and social problems. Childhood sexual abuse is one of the ACEs measured in the study. 

The study emphasised that childhood sexual abuse can have profound and long-lasting effects on survivors' physical and mental wellbeing. People who experienced childhood sexual abuse, and other adverse experiences, were found to have an increased risk of various health problems, including mental health disorders, substance abuse, sexual risk behaviours, chronic diseases, and premature death. 

The psychological and physical effects of sexual abuse are numerous and some of the key ones are outlined below:

Psychological effects 

Emotional and psychological distress

Sexual abuse often leads to a range of emotional and psychological difficulties. Survivors may experience depression, anxiety, shame, guilt, and low self-esteem. They may struggle with regulating emotions and forming trusting relationships, leading to social isolation and difficulties with intimacy.

Post-traumatic stress disorder (PTSD)

Many survivors of sexual abuse develop symptoms of post-traumatic stress disorder. Flashbacks, intrusive thoughts, nightmares, hypervigilance, and avoidance of reminders of the trauma are common manifestations. 

The experience of trauma can significantly disrupt daily functioning and quality of life, necessitating professional support and therapeutic interventions. These symptoms can persist long after the abuse has ended and can significantly impact daily functioning.

Depression and anxiety

Survivors often experience depression and anxiety disorders. They may struggle with persistent feelings of sadness, hopelessness, guilt, shame, and fear. Anxiety disorders such as Generalised Anxiety Disorder, Social Anxiety Disorder, and panic disorder are common.

Trust and relationship issues

Sexual abuse can profoundly impact survivors' ability to trust others and form healthy relationships. They may struggle with issues of intimacy, fear of vulnerability, and difficulties establishing and maintaining boundaries.

Self-esteem and self-worth issues

Survivors often experience a negative impact on self-esteem and self-worth due to the abuse. They may internalise feelings of shame, guilt, and blame, leading to a diminished sense of self and self-destructive thoughts or behaviours.

Substance abuse and addiction

In an attempt to cope with the emotional pain and distress caused by the abuse, some survivors turn to substance abuse as a way to self-medicate. Substance abuse can develop as a maladaptive coping mechanism and may increase the risk of addiction.

Self-harming behaviours and suicidality

Survivors of sexual abuse are at an increased risk of engaging in self-harming behaviours such as cutting, burning, or other forms of self-injury. 

The trauma can also contribute to feelings of hopelessness and suicidal ideation.

Dissociation and fragmentation

Dissociation involves a temporary disconnection or detachment from our thoughts, emotions, sensations, or identity. It can serve as a protective mechanism to cope with overwhelming or traumatic experiences. 

Common signs include feeling numb or detached, having memory gaps or amnesia, and experiencing a distorted sense of time. Fragmentation refers to a disruption or fragmentation of our sense of self or identity, which can lead to difficulties in experiencing a stable and cohesive sense of self.

Physical effects

Chronic pain and physical health issues

Survivors of sexual abuse may experience increased vulnerability to various physical health issues due to the impact of chronic stress on the body. This can contribute to chronic pain conditions such as headaches, back and joint pain and gastrointestinal problems, and there is research that suggests it can also be related to chronic illnesses such as Myalgic Encephalomyelitis (ME), fibromyalgia, Chronic Fatigue Syndrome (CFS) and auto immune disorders. 

Disrupted sexual functioning and reproductive health problems

Sexual abuse can profoundly impact a person’s sexual identity and functioning. Survivors may experience difficulties with arousal, desire, sexual satisfaction, pain during intercourse, and gynaecological problems. 

They may also face challenges related to reproductive health, such as difficulties with fertility, sexually transmitted infections (STIs), and unwanted pregnancies.

Sleep disorders

Sleep disturbances, including insomnia, nightmares, and night terrors are common among survivors of sexual abuse. The trauma and associated psychological distress can disrupt healthy sleep patterns, leading to chronic sleep difficulties.

Eating disorders and body image issues

Sexual abuse can contribute to the development of eating disorders, such as anorexia nervosa, bulimia nervosa, or binge-eating disorder. 

Survivors may also struggle with body image issues and have a distorted perception of their own body.

Hope for healing from childhood sexual abuse

While the psychological and physical effects of sexual abuse can be profound and challenging, it's important to recognise that there is hope and potential for healing and recovery. 

Various therapeutic interventions, such as trauma-focused therapy, can be highly effective in addressing the effects of sexual abuse. Therapists who specialise in trauma provide a safe and supportive environment where survivors can explore and process their experiences, learn coping skills, and develop healthier ways of relating to themselves and others.

Many survivors of sexual abuse demonstrate remarkable resilience and strength in navigating the healing process. With appropriate support and resources, people can learn to cope with the impacts of the abuse and find new meaning and purpose in their lives. Some survivors may even experience post-traumatic growth, which involves personal growth, increased self-awareness, and the development of new strengths and perspectives.

Engaging in self-care practices is an essential aspect of healing from the effects of sexual abuse. Prioritising self-care activities, such as engaging in hobbies, practicing mindfulness, seeking out pleasurable experiences, and taking care of our physical health can contribute to overall well-being and help survivors reclaim a sense of agency and empowerment.

Building and nurturing supportive relationships can be instrumental in the healing journey. Trusted friends, family members, support groups, and empathetic professionals can provide invaluable support, acknowledgement, and understanding. These relationships can help survivors feel heard, validated, and less alone in their experiences, promoting healing and resilience.

While the effects of sexual abuse are undoubtedly challenging, some survivors find meaning and purpose in their experiences by using their own healing journey to help others. Through advocacy work, supporting fellow survivors, or becoming involved in community initiatives, survivors can find personal growth, contribute to positive change, and create a sense of meaning from their experiences.

The long-term effects of sexual abuse are significant and can impact multiple aspects of survivors' lives. It is important to remember that healing from the effects of sexual abuse is possible with appropriate support, therapy, and self-care. 

Seeking professional help from therapists specialising in trauma and abuse can provide survivors with the tools and strategies necessary to address and overcome the long-term impacts of the abuse. It's essential to remember that healing is a unique and individual process, and the pace and trajectory of recovery may vary for each person. 

Sally Edwards is a verified Welldoing counsellor in Kent and online

Further reading

Trauma responses: Understanding your window of tolerance

Intrusive thoughts: What they are and how to manage them

Polyvagal theory, dissociation, and trauma: Healing through embodiment

Numbness: What does it mean to feel numb, and how can counselling help?

Borrowed shame: Is there any way out?