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IICSA published its final Report in October 2022. This website was last updated in January 2023.

3.2 The effects of child sexual abuse

The Inquiry has heard that child sexual abuse can have wide-ranging and serious consequences.[1] For some victims and survivors these effects endure throughout adult life. Child sexual abuse can affect psychological and physical well-being, family and intimate relationships, faith, and education and career. Victims and survivors can also be two to four times more likely to become victims of sexual, physical or emotional abuse again in their lifetime.[2]

Effect on interpersonal relationships

One of the most profound effects of child sexual abuse is the damaging impact it can have on the ability to form and maintain close, loving relationships ‒ both intimate and platonic. It can affect the relationships that victims and survivors have at the time of the sexual abuse and for the rest of their lives. They may find it difficult to talk to partners, family and friends about the sexual abuse, preventing others from being able to help and offer support. 42% of victims and survivors who participated in the Truth Project have said that child sexual abuse has adversely affected the relationships they have with others.

Intimate relationships

Child sexual abuse can cause difficulties in forming intimate and trusting relationships.[3] Relationships can remind victims and survivors of the sexual abuse, and there may be emotional barriers that make it difficult to talk about sexual abuse with partners.

Because when I talk about it I can see it, feel it, hear it and taste it … I try to say the words. I feel dirty inside, I feel more dirty telling you about it because it hurts me inside, it really hurts.

Victim and survivor, the Truth Project

Around a third (28%) of victims and survivors have told the Truth Project that they have had difficulties with trust and intimacy. Responses to the Inquiry’s online consultation and discussion at the Forum focus groups also echoed this.

I’ve been embarrassed all my life over this. I’ve never, ever told any of my family. I told my wife last year, about 66, 67 ‒ 70 years later, I told my wife. To be honest with you, when I got married, for the first two years, instead of going to bed and making love to my wife, I used to go down to the hotel and get drunk and come home and go to bed, because every time I had sex with my wife, I used to think about [the woman who sexually abused him], and it’s upset me all my life.

A witness and former child migrant who was sent to Australia

Relationships with parents and siblings

The Inquiry has heard that some victims and survivors feel that the child sexual abuse they suffered has damaged their relationships with their parents or siblings. This may be because the perpetrator was a family member or a close friend of the family, or they may have disclosed the abuse they suffered to a family member or sibling and felt that they were not believed.

I came out of care … I tried to tell my mum what ­happened. She just slapped me from one end of the room to the other and said it didn’t happen. I went to bed, and I’d locked it away. I didn’t remember from that day. My mind had totally closed up … Like I said, my mum just slapped me and said it didn’t happen; so, it didn’t happen.

Victim and survivor, the Truth Project

The effects child sex abuse has had on me and my family is, me being ostracised by my family therefore it's caused a big family argument where I am not believed. Still to this day my brother says we won't talk about your 'illness' but now I know why.

Victim and survivor, the Truth Project (‘Have your say’)

The Inquiry has heard that this can make victims and survivors feel responsible for changes to family dynamics and the well-being of family members. It can also disrupt friendship groups and lead to bullying or being talked about by peers, causing loneliness and isolation.

Dorothy didn’t play with other children at school, she didn’t think it was safe for them to be friends with her. The playground supervisors would ask her why she didn’t want to play with the others but she just said she wanted to be left alone and refused to say anything.

An anonymised summary from a victim and survivor, the Truth Project

Some victims and survivors have seen their familial relationships suffer because their parents, siblings or other relatives knew sexual abuse was taking place but failed to intervene.

Gabriela is sure her mother knew her father was abusing her because before her mother left she took her into her parents’ bedroom, showed her a large heavy ornament and said to her ‘if anybody tries to do anything to you, hit them with this’. She thought it was a strange thing to say but realised her mother knew what her father might do. Gabriela is angry with her mother about that; that she didn’t protect her and her siblings from their father’s abuse.

An anonymised summary from a victim and survivor, the Truth Project

Child sexual abuse can also affect the parents of victims and survivors.[4] The mental health of parents can be affected because they feel responsible for having been powerless and unable to protect their child.

My mum’s mental health is still really bad, yeah, we have reconciled but the long-lasting effects on her have been significant … it affects her ability to be the, sort of, grandma figure as well doesn’t it because that limits you.

Victim and survivor, the Truth Project

Relationships with children and grandchildren

Perhaps one of the saddest consequences of child sexual abuse is the damaging effect it can have on parenthood. Some victims and survivors fear that the sexual abuse they suffered as a child will mean that they will not be safe parents ‒ or that others will consider them to be a danger to their own children. Some victims and survivors have talked about not being able to change nappies or even hug their own children.

Personally, I didn't want to report because I'd read years ago that if you've been abused, you will abuse, and when I actually disclosed to a counsellor, I begged and pleaded first, ’I promise you, I've done nothing to my children’, and I was literally ‒ oh, it was horrific, because I was panicking if I came out with my story that they were going to take my children away from me.

Victim and survivor, criminal justice system seminar

And the trust issues that have come from that: I hated anybody touching me. I couldn’t hug my kids …

Victim and survivor, the Truth Project

Child sexual abuse can also lead some victims and survivors to be especially protective of their own children and grandchildren.[5] They are determined to make sure that their children and grandchildren feel loved and cared for, and that their own abuse will not have a negative effect on them.

In other ways I’m overcompensating because I’ve thought, ‘Well this is not going to stop me getting on’ … I know what it is to care for a child, I know how children should be cared for and nurtured …

Victim and survivor, the Truth Project

Effect on emotional well-being and mental health

Victims and survivors of child sexual abuse cope and respond to abuse in different ways, and their response can change over time.[6] For some, the psychological harm can be at least as severe ‒ and at times more enduring ‒ than the physical injuries sustained during the sexual abuse.

Around the time of sexual abuse, children can experience a range of emotions, including fear, sadness, anger, guilt, self-blame and confusion.[7], [8] Victims and survivors can feel humiliated or self-conscious, and will often not feel equipped or able to talk about what has happened.

... I became very wary and withdrawn. I think it affected the rest of my life. I was worried and anxious all the time. I didn’t make friends or talk with anyone and I was always watchful for people who might hurt me. Lots of them did hurt me all through my childhood.

A witness and former child migrant who was sent to Australia in the 1940s at the age of ten

The Inquiry has been told that child sexual abuse can have a profound psychological effect that lasts into and throughout adult life. Existing research has linked child sexual abuse with low self-esteem and mental health conditions.[9] The accounts provided to the Truth Project have supported this: victims and survivors have reported a range of mental health issues that are a result of the sexual abuse they suffered.

The most common issues reported were depression (33%), lack of trust in authority (32%), thoughts of suicide (28%), anxiety (28%), self-harming (22%) and attempted suicide (22%). Participants in the online consultation said that they were most likely to experience anxiety and fear, depression, self-harm and thoughts of suicide. Panic attacks, low self-confidence, obsessions, eating disorders, and alcohol and drug use were also reported by Forum members.

Flashbacks are so real in your head, I could literally feel him on top of me and smell his breath, and wake up and be trying to push him off. And that was years after.

Victim and survivor, the Truth Project

It's historic ‒ sexual abuse, yes, it's physical, but the mental abuse lasts forever. The physical abuse comes and goes, kind of. You forget the pain of the physical side of it, but the mental abuse until the day I die ‒ until the day I die, I ‒ I'm a victim, if you like, because it doesn't matter what situation I'm in ‒ I could be in a party and having the best time of my life, but I could smell something or somebody could say something or somebody could touch me and I'm right back to the abuse, and until the day I die that's never going to change.

Victim and survivor, criminal justice system seminar

I still have nightmares and have to sleep with the light on. I was already like that by the time I left Clontarf, a nervous wreck. Twice I was admitted to the infirmary with something I now think were panic attacks.

A witness and former child migrant who was sent to Australia in the 1950s

However, the Inquiry has also been struck by how victims and survivors have been proud of their resilience and powers of recovery. Many go on to lead successful lives ‒ but have said that they never fully leave the abuse they experienced behind and will go through tough periods in their lives as a result. These periods of negative emotions can be triggered by known dates or events, or be quite random and entirely unpredictable. Research shows that particular aspects of life ‒ most notably childbirth[10], [11] and sexual activity[12] ‒ are frequent triggers.

Julia stated that she has had thoughts of suicide over the years as a means of escape and it came to a head when she had postnatal depression after the birth of her children, this triggered thoughts about the abuse and caused a deeper depression, it was only her thoughts about and her love for her children that kept her alive.

An anonymised summary from a victim and survivor, the Truth Project

Many victims and survivors seek therapy or counselling, but have reported severe difficulties in accessing services and treatment. Where support and treatment have been accessed, accounts from victims and survivors are mixed. It is clear that the right support or treatment at the right time is hugely beneficial to victims and survivors, but some have reported receiving unhelpful or inappropriate responses from professionals.

You know, because there was nothing … I was taken to see a child psychologist and they said, ‘Is there anything that you’d like to talk about?’ And I said, ‘Well, what do you mean?’ … I just, kind of, crammed up and said nothing. And I was, kind of, just moved away.

Victim and survivor, the Truth Project

She’s just been fantastic, absolutely fantastic … the first time I’d had – she got me right back to a child and it was so hard. This was three years ago, been seeing her for three years now … I’ve definitely got the right support … she’s just amazing … so unlike any of the NHS people I’ve ever dealt with.

Victim and survivor, the Truth Project

Supportive and positive responses from families, friends, caregivers and professionals have been found to help recovery.[13] Participants in the online consultation indicated the importance of being believed and respected when accessing support. However, when a victim and survivor discloses the child sexual abuse they suffered and receives a lack of support, this can increase feelings of guilt and shame and deter them from seeking support in the future.

There are also concerns that many services are being withdrawn and the cost of treatment is often high, which can be a very real barrier for those without a job or on low incomes. The availability of support and treatment is a significant issue and this is considered in more detail later in this report (see Chapter 6 for more information).

Effect on physical health

Research shows that victims and survivors of child sexual abuse may have poorer physical health than those who have not been abused.[14]

Children can sustain physical injuries during sexual abuse. Victims and survivors who engaged with the Truth Project reported that they experienced a physical injury (12%) such as internal damage as a result of the sexual abuse. Children can also contract sexually transmitted diseases as a result of the abuse.[15]

There are also long-term effects of child sexual abuse that include a range of illnesses and disabilities. Hypertension, chronic fatigue, malnutrition, mobility, and problems with reproductive systems and childbirth are all linked to child sexual abuse.[16]

Well, when I was young, I overused alcohol and I had eating disorders, which I still have difficulty with, not to the same extent, but what they have created in me are many intolerances and difficulties around food. I can’t drink alcohol at all now because I can’t metabolise it. And other things: my whole physical health has been highly compromised by various ways … and my understanding of the way my body has seized up is very much related to the fact that I was holding something down that I didn’t ‒ couldn’t put a name to …

A witness and former child migrant who was sent to Southern Rhodesia (now Zimbabwe) in the 1950s at the age of nine

Ten percent of female victims and survivors told the Truth Project that they became pregnant as a result of the sexual abuse.

The abuse had got progressively worse and when I was 14, the group, eight of them … and they all had sex with me, and they made me deliberately pregnant with a baby.

Victim and survivor, the Truth Project

Effect on religion and faith

When considering the effect child sexual abuse has on a victim and survivor’s religion or spiritual beliefs, two particular themes have been highlighted to the Inquiry through the Truth Project. Victims and survivors may question their religion and spiritual beliefs, particularly where the perpetrator was connected to their religion or faith. They may also use religion and faith as a coping mechanism for resilience and recovery.

Research suggests that it can be common for victims and survivors to feel disillusioned with religion and spiritual beliefs after they have been sexually abused.[17] They can feel abandoned or punished by a god and begin to question their understanding of the world. Studies show that this is particularly likely when the perpetrator is someone who represents God in the eyes of the victim,[18] or has used religion or spiritual beliefs to justify the sexual abuse.

I think the other bit I’d really like on record is how much harm it’s done to my faith, you know. … I also can’t go into church because I’ve lost all my faith, I don’t even know anymore whether I believe in a god.

Victim and survivor, the Truth Project

Screening of those wishing to enter the priesthood and become vicars is very important ‒ a person with good interpersonal skills can get in anywhere. A dog collar is like a key to everyone's front room in the parish.

A recommendation from a victim and survivor, the Truth Project

The Inquiry has heard that some victims and survivors continue to practise their religion or spiritual beliefs to ensure that their children grow up having faith. Others try to use their religion or spiritual beliefs as a way of dealing with the sexual abuse they suffered as a child but can find it challenging and be left feeling disillusioned.

I do go to church and I'm asking for the power of religion for help and believe you me it is a painstakingly slow process for healing.

Victim and survivor, the Truth Project (‘Have your say’)

Effect on education and later life

The Inquiry has heard that victims and survivors respond to child sexual abuse in different ways. Some victims and survivors have explained that their education provided a coping strategy for dealing with – or escaping from – the sexual abuse. However, for others, their attainment at school, college and university suffers and their employment prospects are affected. This is consistent with the findings of relevant research.[19][20]

Some victims and survivors have told the Truth Project that they have struggled and disengaged at school and that they feel as though their futures were stolen. Some were unhappy at school (16%) or had academic difficulties (16%) and others left school early (8%).

I told them I wasn’t happy with things but they just said it’s cos I was struggling in school, which I wasn’t. I was actually quite smart but I couldn’t concentrate, so that’s why I was failing. I think by the time I left I had the same, you know, the, like, level system? They used to level 1, 2 and 3. I was at the same level when I left at 16 as I was when I was eight. Before that I was actually I think a year ahead … so, basically you may as well say I wasn’t educated from the age of eight till 16.

Victim and survivor, the Truth Project

Responses to the Inquiry’s online consultation also indicated that victims and survivors have been affected by low educational attainment, unemployment and financial difficulties as a result of sexual abuse.

Child abuse has lifelong far reaching consequences. After over a year of repeated sexual abuse by a paedophile who masqueraded as a family friend. I became a shy withdrawn introvert. This caused me to get bullied at school where I also under achieved in all subjects. I have trouble still forty years later, with men I don't know. I don't like male company. My school under achievement affected my employment prospects and earning potential for the rest of my life.

Victim and survivor, the Truth Project (‘Have your say’)

Research has associated child sexual abuse with increased unemployment, increased receipt of state benefits, reduced income and greater financial instability.[21] Research[22],[23] and victim and survivor accounts suggest that poor physical or mental health may be the reason for this since it can affect education and attaining qualifications, difficulties coping with the normal daily routine of life, getting involved in criminal behaviour, or not having somewhere safe and stable to live.[24]


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