While further research would be valuable in specific areas, overall the evidence is compelling that CSA is associated with an increased risk of adverse outcomes in almost every sphere of victims and survivors’ lives, and that this risk can persist across their lifespan. This harm also has knock-on impacts for family members of the victims and survivors, and for wider society in both financial and less tangible ways. It is apparent from the evidence reviewed, however, that sustained adverse outcomes are not inevitable. Both resilience and recovery are possible for victims and survivors, and a number of protective factors have been identified which increase their likelihood. These include the receipt of effective support services and a positive and sensitive response from family, friends and professionals following disclosure of CSA.

In spite of the extent of the available evidence on this issue, this review has nonetheless identified a wide range of gaps in knowledge about the impacts of CSA, the way in which those impacts differ for various groups of victims and survivors, and the risk and protective factors which can impede or promote resilience and recovery.

In the view of the authors of this review, and in relation to the research questions stated in Chapter 1, the key evidence gaps include:

Impacts of CSA

• the impacts of CSA on younger (pre-adolescent) and older (65 plus) victims and survivors, as well as on black and minority ethnic (BME), lesbian, gay, bisexual and transgender (LGBT) and disabled people
• the impacts of CSA on male victims and survivors, and on the non-abusing fathers of victims and survivors
• the impacts of CSA on siblings, partners and children of victims and survivors
• the impacts of online-facilitated CSA, particularly cases involving online grooming, the live streaming of abuse, and the creation and distribution of indecent images online
• any differences in the impacts of institutional CSA and/or CSA in which there has been an institutional failing, compared with CSA in which institutional failings are not involved
• any differences in impacts following CSA perpetrated by peers (‘peer abuse’) compared with that perpetrated by adults
• victim and survivor trajectories requiring longitudinal research, which follows victims and survivors over the long term and collects data on their circumstances and outcomes at key points in their life course

Risk and protective factors

• the neurobiological mechanisms that influence resilience following CSA
• the relative influence of different risk and protective factors following CSA on resilience and recovery, and if and how that relative influence differs for different groups of victims and survivors and at different life stages
• the ways in which individual risk and protective factors interact
• the most effective ways for society to support resilience and recovery among victims and survivors of CSA by minimising risk factors and maximising protective factors

There is also a general paucity of high-quality studies which use random probability samples and matched comparison groups to draw conclusions about the relative prevalence of outcomes of interest among victims and survivors, compared with the general population. Further studies of this type, along with longitudinal studies which allow the trajectories of victims and survivors across their life course to be explored, would add significant value to the evidence base on the impacts of CSA.