How many children experience child sexual abuse (CSA) in the United States? This question has been difficult for researchers to answer definitively, in part due to delayed disclosure arising from trauma, shame, and humiliation. For over 20 years, various organizations including CHILD USA have reported that 1 in 4 girls and 1 in 6 boys will experience CSA, citing the 1998 Adverse Childhood Experiences (ACEs) Study. (1) CHILD USA’s Social Science Department did a lengthy literature review and consulted leading experts to conclude that 1 in 5 girls and 1 in 13 boys (roughly 20% and 8%) are likely to experience CSA. The majority of CSA perpetrators are family members and acquaintances. (2) Let’s take a look at how we arrived at those numbers and how the child protection field can do better in understanding CSA prevalence.
Research methods and approaches vary widely across the field.
A consensus view does not yet exist on the most accurate way to assess the prevalence of CSA; research since the 1998 ACEs study has resulted in a wide range of estimates. There are several important differences in research designs that produce this variability:
- Sampling – Studies that draw a large, random, and representative sample from the general population are likely to produce lower estimates (albeit likely more accurate) than those that use smaller “convenience samples” or include individuals from clinical settings.
- Data collection – Researchers can use questionnaires, phone interviews, or in-person interviews to ask individuals about their experiences with CSA, and they can rely on adult retrospective reports or study the experiences of children in late adolescence (in the 14 to 17 age range). Alternatively, researchers may utilize official reports of child sexual abuse from Child Protective Services, which tend to severely underestimate incidence of CSA.
- Definitions of CSA – Research employing a narrow definition of CSA seeks information on categories of contact-based abuse (e.g. fondling, penetration, etc.) at the hands of adult perpetrators or those who are at least 5 years older than the victim. A broad definition expands the abuse to include sexual assault by peers and non-contact abuse (e.g. exposure to pornographic materials). Furthermore, states have differing legal definitions of child sexual abuse which may inform a researcher’s conceptualization.
These are just a few of the differences found across the developing CSA research literature. At this time, it is difficult to reach a definitive answer on the question of prevalence. However, we can cautiously draw conclusions based on studies that look at the literature as a whole and account for the variation in sampling methods, data collection procedures, and definitions.
A wide-ranging literature review offers more clarity.
Table 1 below summarizes three studies that systematically reviewed the CSA prevalence literature and reported averaged rates. We have chosen to rely on rates based on North American samples. In addition to reporting these rales of prevalence, Moody and colleagues also report ranges of rates to reflect the considerable variation across studies. The ranges include 7.5% to 29.8% for overall prevalence; 13.2% to 33.6% for females; and 4.3% to 21.0% for males. CHILD USA’s conservative estimate of 1 in 5 girls is supported by the work by Stoltenborgh et al. (2011) and Moody et al. (2018), and the estimate of 1 in 13 boys is supported by both Pereda et al. (2009) and Stoltenborgh et al. (2011). 
Current research presents prevalence by gender in a non-binary world.
Although CHILD USA has chosen to communicate estimates separately for girls and boys, we acknowledge that this conclusion is simplistic. For example, it assumes that individuals fall into a binary construct of gender. Current research identifies this binary construct as an inadequate representation of gender, which has complications for further understanding CSA. Individuals identifying as transgender, non-binary, genderqueer or gender non-conforming are significantly more likely to experience abuse during childhood. (6) Without considering those whose gender identity does not conform to their sex or gender assigned at birth, researchers are missing important subpopulations who are particularly vulnerable to CSA. While we currently rely on studies that utilize a binary gender construct given the current state of research, we recommend that future inquiries into CSA prevalence expand this approach to specifically include individuals who identify as transgender and genderqueer so that prevention efforts can be implemented appropriately.
There are other lenses through which we can examine prevalence: race and disability.
Researchers should also attempt to comprehensively study the experiences of other subpopulations based on racial and ethnic identity, socioeconomic status, and sexual orientation (as distinct from gender identity). A 2006 study of women growing up in two-parent households showed that African American women were 1.75 times more likely to have experienced CSA compared to White women. (7) Children with intellectual and developmental disabilities are also at a heightened risk for abuse. For example, one study of child maltreatment reports found that children with learning disabilities were 2.5 times more likely to be associated with a sexual abuse allegation compared to peers without learning disabilities. (8) Most researchers studying CSA prevalence do not directly address populations with learning challenges or developmental delays. Including vulnerable groups in prevalence studies can only improve prevention strategies.
- Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M… & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245-258.
- Gewirtz-Meydan, A., & Finkelhor, D. (2020). Sexual abuse and assault in a large national sample of children and adolescents. Child Maltreatment, 25(2), 203-214.
- Pereda, N., Guilera, G., Forns, M., & Gómez-Benito, J. (2009). The prevalence of child sexual abuse in community and student samples: A meta-analysis. Clinical Psychology Review, 29(4), 328-338.
- Stoltenborgh, M., van Ijzendoorn, M. H., Euser, E. M., & Bakersman-Kranenburg, M. J. (2011). A global perspective on child sexual abuse: Meta-analysis of prevalence around the world. Child Maltreatment, 16(2), 79-101.
- Moody, G., Cannings-John, R., Hood, K., Kemp, A., & Robling, M. (2018). Establishing the international prevalence of self-reported child maltreatment: A systematic review by maltreatment type and gender. BMC Public Health, 18(1), 1164.
- Tobin, V., & Delaney, K. R. (2019). Child abuse victimization among transgender and gender nonconforming people: A systematic review. Perspectives in Psychiatric Care, 55(4), 576-583.
- Amodeo, M., Griffin, M. L., Fassler, I. R., Clay, C. M., & Ellis, M. A. (2006). Childhood sexual abuse among black women and white women from two-parent families. Child Maltreatment, 11(3), 237-246.
- Helton, J. J., Gochez-Kerr, T., & Gruber, E. (2017). Sexual abuse of children with learning disabilities. Child Maltreatment, 23(2), 157-165.
