Child sexual abuse isn't always easy to spot. The perpetrator could be someone you've known a long time or trust, which may make it even harder to notice. Consider the following warning signs: Physical signs: Bleeding, bruises, or swelling in genital area Bloody, torn, or stained underclothes Difficulty walking or sitting Frequent urinary or yeast infections Pain, itching, or burning in genital area Behavioral signs: Changes in hygiene, such as refusing to bathe or bathing excessively Develops phobias Exhibits signs of depression or post-traumatic stress disorder Expresses suicidal thoughts, especially in adolescents Has trouble in school, such as absences or drops in grades Inappropriate sexual knowledge or behaviors Nightmares or bed-wetting Overly protective and concerned for siblings, or assumes a caretaker role Returns to regressive behaviors, such as thumb sucking Runs away from home or school Self-harms Shrinks away or seems threatened by physical contact
