Child sexual abuse--an increasing rate of diagnosis

In 2 years in Leeds, two paediatricians diagnosed sexual abuse in 94 boys and 243 girls. 38% were under 5 at diagnosis and the mean age was 8.0 years. 39% presented following disclosure by the child. 83% of boys and 25% of girls had anal signs and 58% of girls had genital signs. 60% of abusers were related to the child and half of these were natural fathers. 25% of all abusers were teenagers and 5% were women. The abuser was convicted in 25% of cases and protective legal orders were sought in 36%. Sexual abuse is emerging as a major child and mental health problem that requires new resources in training and personnel.