To increase understanding of childhood sexual abuse, we reviewed the hospital records of 113 girls and 17 boys who were the victims of sexual offenses. They were two to 16 years of age and seen in an 18-month period. Thirty had had medical or social problems. Four had previously been raped. Children under eight years old were more likely to know the assailant, to be victims of recurrent sexual or physical abuse, to report crimes without intercourse, and to present with an abused sibling (P<0.05). Incest victims were younger than other victims (P<0.05). Forty-three children had physical trauma. No pregnancies occurred, although diethylstilbestrol was not routinely used. Three girls had gonorrhea. Seventy-two patients were referred to hospital social services, and 41 to 17 other agencies. Victims and their siblings are at high risk of repeated abuse. Antibiotics and diethylstilbestrol are not routinely indicated. Follow-up may be best achieved by a central agency. (N Engl J Med 302:319–323, 1980) ALTHOUGH physicians have become aware of physical abuse as a common and complex problem of children, the scope of sexual offenses against children and adolescents is still largely unappreciated. Kempe1 has recently pointed to the gaps in our understanding of the incidence, clinical effects, and management of this form of child abuse. Previous studies of sexual crimes against children have been hampered by small size,2,3 limited data,4,5 and failure to study the pediatric population as a group separate from adults.6,7 To define sexual abuse of children more clearly, we undertook a retrospective review of the records of all children who.
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