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Child sexual abuse has been known to cause a wide variety of psychological sequelae in the child victims that often continue throughout adult life. These include affective disorders, anxiety disorders and posttraumatic stress disorder (PTSD), and anger and impulsivity (Briere and Runtz, 1988; Finkelhor and Browne, 1986; Kiser et al., 1988). Other symptoms, such as eating disorders (Root and Fallon, 1988), substance abuse (Herman, 1981), and borderline personality disorder (Herman et al., 1989) first appear in adolescence or in adult life. Childhood sexual victimization also may produce pathological alterations in sexual behavior, including hypersexuality and premature sexual arousal (Yates, 1982) or heightened phobic defenses against sexuality (Tsai et al., 1979). Finkelhor's “traumagenic” theory of child sexual abuse attributes deviant sexual behavior to “traumatic sexualization” (Finkelhor and Browne, 1986) referring to a process in which a child's sexual feelings and attitudes are shaped in a developmentally inappropriate and dysfunctional fashion due to the misconceptions and confusions about sexual behavior transmitted to the child by the offender. Confusion about sexual identity, and pathological sexual behavior, including changes in sexual object choice may be a product of traumatic sexualization occurring before the completion and consolidation of gender identity and sexual orientation in childhood and adolescence. This article will focus on the impact of child sexual abuse on gender identity and sexual object choice in males and females during childhood, adolescence, and in adult life.
Aoisa-Karpas et al. (1991) documented problems of gender identity in adolescent girls aged 12 to 19 who had been victims of sexual abuse. These girls demonstrated significantly greater gender