Diagnosing sexual abuse (excluding forensics)

Child sexual abuse (CSA), both contact and non-contact is common, with 15% of women and 6% of men reporting contact CSA retrospectively. Medical practitioners are key in recognizing risk or signs of CSA, although abnormal genital signs are rare. This article reviews the definition of and the evidence base for physical signs of CSA as well as the differential diagnosis and clinical management. As CSA is increasingly recognized, it is hoped that this knowledge will improve prevention.