The signs of sexual abuse can be physical, behavioral, and emotional.

Sexual abuse is more common than many realize. RAINN reports that on average, 463,634 people ages 12 years and older are sexually assaulted in the United States each year.

According to the Centers for Disease Control and Prevention (CDC), child sexual abuse affects about 1 in 4 girls and 1 in 13 boys in the United States. These statistics include all children under age 18.

Many people who experience sexual abuse struggle to seek help. Their abusers might convince them that nobody will believe them, or that the abuse is their fault. Shame, fear, and confusion may prevent people from disclosing their experiences.

It’s not always possible to detect when others have been sexually abused; sometimes, there are no noticeable signs. But learning to recognize the signs of sexual abuse can help you proactively look out for your loved ones and intervene when necessary.

The signs of sexual abuse can vary depending on the person and their circumstances.

However, some general indicators may be present across all ages.

For example:

Another sign of sexual abuse is an inexplicable urinary tract infection (UTI) or sexually transmitted infection (STI).

A UTI can cause:

  • frequent urination, at times only releasing small amounts
  • a strong, persistent urge to urinate even after going to the bathroom
  • burning during urination
  • urine that’s cloudy or discolored

STIs can cause:

  • bleeding from genitals
  • itchiness around the genitals
  • painful or swollen testicles
  • painful urination
  • sores, bumps, or rashes on or around the genitals, anus, buttocks, thighs, or mouth
  • unusual discharge from the genitals

The presence of one or more of these signs doesn’t definitively indicate sexual abuse. Some of these signs might result from other personal challenges, health conditions, or traumas.

However, if you do notice these signs in someone, consider checking in with them. Offer your support. They may need a judgment-free, compassionate space to talk about what they’re going through — whether it’s sexual abuse or something else.

Many people may not realize that sexual abuse can be perpetrated by an intimate partner, whether it’s a spouse, girlfriend, boyfriend, or other sexual relation.

A person who is being sexually abused by a partner may display the following signs:

  • having unexplained bruises, burn marks, or bite marks
  • justifying or dismissing concerning behaviors by a partner
  • seeming fearful or anxious about a partner’s reactions
  • significant changes in behavior, such as losing interest in their usual activities
  • sudden alterations in personal style, such as wearing markedly different clothing
  • withdrawing from loved ones

Sexual abuse in an intimate relationship can be difficult to recognize — even for the person experiencing it. Sometimes, abusers coerce or manipulate people into doing certain sexual acts. Because these acts are coerced, it’s not consensual. Therefore, it’s sexual assault.

The following are signs that your partner is sexually abusing you:

  • You’re too scared to reject their sexual advances.
  • At times when you’ve tried to reject them, they’ve made you feel afraid, guilty, or embarrassed.
  • In intimate situations with them, you feel powerless or fearful.
  • They have disregarded or mocked your sexual boundaries in the past.
  • Looking back, they’ve tended to get their own way with sex, even when you didn’t want to do what they wanted.
  • They have said, or implied, that they will leave you or cheat on you if you don’t do certain sexual acts.
  • They have said, or implied, that it’s your duty to allow them to have sex with you whenever they please.

Sexual violence also includes a partner interfering with, or controlling, your use of contraception. Likewise, revenge “porn” — sharing explicit pictures or videos of you without your consent — is a form of sexual abuse.

Being in an intimate relationship with someone does not entitle them to sexual contact with you. Even if you have consented to sleeping with someone in the past, that does not mean you always have to consent to having sex with them.

Young children who experience sexual abuse often don’t have the knowledge and vocabulary to fully process and express what they’ve been through.

Because of this, it’s especially important that anybody who has close contact with kids — including parents, other family members, and professionals who work with minors — learn the signs of sexual abuse in young children.

The signs of sexual abuse in young children include:

  • a sudden decline in communication or overall talking
  • behavioral changes, like becoming more compliant or rebellious than usual
  • clinging to certain people more than usual
  • excessive discussion, curiosity, or knowledge about sexual topics
  • losing interest in school, friends, or hobbies
  • not wanting to be left alone
  • reluctance to change clothes or partake in activities that require changing

Sexual abuse can also affect a child’s physical health. For example, they may contract an STI. Research shows that 2–12% of children who experience sexual abuse develop gonorrhea, and up to 10% develop chlamydia.

Be on the lookout for unexplained symptoms and signs or complaints of pain that could be attributed to an STI.

Teenagers may experience sexual abuse from adults and peers.

In addition to the signs mentioned above, the signs of sexual abuse in teens include:

  • an increase in rebellious or risky behavior
  • changes in personal hygiene habits, such as showering excessively or not at all
  • changes in social habits and friend groups
  • showing little to no enthusiasm for previous interests
  • significant weight changes
  • unexplained bruises or injuries
  • using alcohol and other substances

Teenagers may also develop infections or become pregnant due to sexual abuse. Be aware of the early symptoms of pregnancy and the signs of STIs.

Seniors, especially those with disabilities, can also be vulnerable to sexual abuse. Perpetrators may target older adults with dementia and other cognitive conditions, especially if they have difficulties with communication.

The signs of sexual abuse in older adults include:

  • anxiety or fears about bathing or using the restroom
  • bruises or signs of trauma around the genitals, buttocks, and thighs
  • increased difficulty walking or sitting for a long time
  • suddenly developing a fear of specific places or people
  • unexplained blood on clothing, linen, or furniture
  • unexplained changes in personality or behavior
  • withdrawing from others, especially specific people

As with other age groups, STIs and UTIs may be a sign of sexual abuse in older adults.

Recognizing the signs of sexual abuse is the first step in seeking help. The next step depends on a person’s age and specific circumstances.

In most U.S. states, you’re legally obligated to report child sexual abuse or suspected child sexual abuse. This includes any sexual abuse of anyone under 18 years old.

People of all ages may need your help with:

  • Finding immediate safety: If they’re currently in an unsafe space, consider calling 911 or the National Sexual Assault Telephone Hotline at 800-656-HOPE (4673) for help.
  • Reporting the abuse: Adults can decide for themselves if they want to report their sexual assault. Try not to make them feel pressured either way, but support them through the process.
  • Physical medical needs: They may need to be assessed for physical conditions, including STIs. If there’s a possibility that they were exposed to HIV, a medical professional might prescribe postexposure prophylaxis (PEP) to prevent HIV transmission.
  • Mental health needs: Healing from sexual abuse can be a long and difficult journey. Therapy and support groups can be helpful. Support from their loved ones — which may include you — can also be very helpful.

You may benefit from the following resources:

  • You can find local child abuse reporting hotlines on the Child Welfare website. You can also call the Childhelp National Child Abuse Hotline at 800-4-A-CHILD (800-422-4453).
  • If an older adult or adult with intellectual disabilities needs to be placed somewhere safe, use the National Adult Protective Services Association’s Get Help tool to find assistance.
  • If you or someone you know is experiencing domestic violence, including intimate partner sexual abuse, you can contact the National Domestic Violence Hotline at 800-799-SAFE (7233).
  • The RAINN website has many educational and supportive resources on the topic of sexual assault and abuse.

Discovering that someone has been sexually abused can be upsetting and traumatizing for you, too. Be sure to take care of yourself and seek mental health help if you need it.

Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.