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Sexual Abuse

Types of abuse

There are 2 different types of child sexual abuse. These are called contact abuse and non-contact abuse.

Contact abuse involves touching activities where an abuser makes physical contact with a child, including penetration. It includes:

  • sexual touching of any part of the body whether the child's wearing clothes or not
  • rape or penetration by putting an object or body part inside a child's mouth, vagina or anus
  • forcing or encouraging a child to take part in sexual activity making a child take their clothes off, touch someone else's genitals or masturbate.

Non-contact abuse involves: non-touching activities, such as grooming, exploitation, persuading children to perform sexual acts over the internet and flashing. It includes:

  • encouraging a child to watch or hear sexual acts
  • not taking proper measures to prevent a child being exposed to sexual activities by others
  • meeting a child following sexual grooming with the intent of abusing them
  • online abuse including making, viewing or distributing child abuse images allowing someone else to make, view or distribute child abuse images showing pornography to a child
  • sexually exploiting a child for money, power or status (child exploitation)

Possible signs and indicators

Sexualised behaviour suspect child maltreatment, and in particular sexual abuse, if:

a prepubertal child displays or is reported to display repeated or coercive sexualised behaviours or preoccupation (for example, sexual talk associated with knowledge, drawing genitalia, emulating sexual activity with another child).

a child or young person’s sexual behaviour is indiscriminate, precocious or coercive.

if a prepubertal child displays or is reported to display unusual sexualised behaviours. Examples include:

  • oral–genital contact with another child or a doll
  • requesting to be touched in the genital area
  • inserting or attempting to insert an object, finger or penis into another child’s vagina or anus.

Anogenital symptoms and signs suspect sexual abuse if:

a girl or boy has a genital, anal or perianal injury (as evidenced by bruising, laceration, swelling or abrasion) and the explanation is absent or unsuitable.

a girl or boy has a persistent or recurrent genital or anal symptom (for example, bleeding or discharge) that is associated with behavioural or emotional change and that has no medical explanation.

a girl or boy has an anal fissure, and constipation, Crohn’s disease and passing hard stools have been excluded as the cause.

a gaping anus in a girl or boy is observed during an examination and there is no medical explanation (for example, a neurological disorder or severe constipation).

a girl or boy has a genital or anal symptom (for example, bleeding or discharge) without a medical explanation.

a girl or boy has dysuria (discomfort on passing urine) or anogenital discomfort that is persistent or recurrent and does not have a medical explanation (for example, worms, urinary infection, skin conditions, poor hygiene or known allergies).

there is evidence of one or more foreign bodies in the vagina or anus.

Foreign bodies in the vagina may be indicated by offensive vaginal discharge.

Sexually transmitted infections consider sexual abuse if:

a child younger than 13 years has hepatitis B unless there is clear evidence of mother-to-child transmission during birth, non-sexual transmission from a member of the household or blood contamination.

a child younger than 13 years has anogenital warts unless there is clear evidence of mother-to-child transmission during birth or non-sexual transmission from a member of the household.

a child younger than 13 years has gonorrhoea, chlamydia, syphilis, genital herpes, hepatitis C, HIV or trichomonas infection unless there is clear evidence of mother-to-child transmission during birth or blood contamination.

a young person aged 13 to 15 years has hepatitis B unless there is clear evidence of mother-to-child transmission during birth, non-sexual transmission from a member of the household, blood contamination or that the infection was acquired from consensual sexual activity with a peer.

a young person aged 13 to 15 years has anogenital warts unless there is clear evidence of mother-to-child transmission during birth, non-sexual transmission from a member of the household, or that the infection was acquired from consensual sexual activity with a peer.

a young person aged 13 to 15 years has gonorrhoea, chlamydia, syphilis, genital herpes, hepatitis C, HIV or trichomonas infection unless there is clear evidence of mother-to-child transmission during birth, blood contamination, or that the sexually transmitted infection (STI) was acquired from consensual sexual activity with a peer. †

a young person aged 16 or 17 years has hepatitis B and there is no clear evidence of mother-to-child transmission during birth, non-sexual transmission from a member of the household, blood contamination or that the infection was acquired from consensual sexual activity and a clear difference in power or mental capacity between the young person and their sexual partner, in particular when the relationship is incestuous or is with a person in a position of trust (for example, teacher, sports coach, minister of religion) or concern that the young person is being exploited.

a young person aged 16 or 17 years has anogenital warts and there is no clear evidence of non-sexual transmission from a member of the household or that the infection was acquired from consensual sexual activity and a clear difference in power or mental capacity between the young person and their sexual partner, in particular when the relationship is incestuous or is with a person in a position of trust (for example, teacher, sports coach, minister of religion) or concern that the young person is being exploited.

a young person aged 16 or 17 years has gonorrhoea, chlamydia, syphilis, genital herpes, hepatitis C, HIV or trichomonas infection and there is:

  • no clear evidence of blood contamination or that the STI was acquired from consensual sexual activity and a clear difference in power or mental capacity between the young person and their sexual partner, in particular when the relationship is incestuous or is with a person in a position of trust (for example, teacher, sports coach, minister of religion) or concern that the young person is being exploited.

Pregnancy consider sexual abuse if:

a young woman aged 13 to 15 years is pregnant.

a young woman aged 16 or 17 years is pregnant and there is: a clear difference in power or mental capacity between the young woman and the putative father, in particular when the relationship is incestuous or is with a person in a position of trust (for example, teacher, sports coach, minister of religion) or concern that the young woman is being exploited or concern that the sexual activity was not consensual.


Further information:

Radford, L., Richardson Foster, H., Barter, C., and Stanley, N. (2017). Rapid Evidence Assessment: What Can Be Learnt from Other Jurisdictions About Preventing and Responding to Child Sexual Abuse. . Independent Inquiry into Child Sexual Abuse, London

Thomas, M., and Speyer, E. (2016). I Never Spoke About It’... Supporting sexually exploited boys and young men in Wales http://www.barnardos.org.uk/17595_bs_i_never_spoke_about_it_cse_report_e.pdf (Accessed 29/7/2019) (copy and paste this URL into a browser)

Care and Social Services Inspectorate Wales. (2017). Child Exploitation: Multi-agency working where children are placed in residential placements out of county, go missing and are at risk of child sexual exploitation, (Accessed 29/7/2019)

Clutton, S., and Coles, J. (2008). "Child Sexual Exploitation in Wales: 3 years on. Policy and Practice Briefing No.3. "(eds.). City: Barnardo's.

Fisher, C., A, G., Hurcombe, R., and Soares, C. (2017). The Impacts of Child Sexual Abuse: A Rapid Evidence Assessment. Independent Inquiry into Child Sexual Abuse, London

Hallett, S. (2015). Child Sexual Exploitation: Problems and Solutions from the perspectives of young people and professionals. Cascade Research Briefing No 3., Children's Social Care Research and Development Centre - Cardiff University,

Hughes, C., and Thomas, M. (2016). 'You Can Trust Me': Young people going missing and at risk of, or abused through, child sexual exploitation in North Wales. Barnardo's, http://www.barnardos.org.uk/17312_cse_you_can_trust_me_report_lr.pdf. (Accessed 29/7/2019) (copy and paste this URL into a browser)

NSPCC Signs Indicators and Effects of Child Sexual Abuse, (Accessed 29/7/2019)

NHS Spotting signs of child sexual abuse and child sexual exploitation, (Accessed 29/7/2019)