Childhood sexual abuse can affect a person for decades. Large research reviews have linked it to higher rates of depression, anxiety, post-traumatic stress, eating and sleep disorders, and some chronic physical conditions in adulthood. These are associations across large groups, not predictions about any one person, and many survivors live full lives with or without treatment. Maryland also now allows a civil claim at any age, as our Child Victims Act guide explains.
This page summarizes what the research shows, why effects often surface years later, and where survivors in Maryland can find support. It is general information, not medical or legal advice.
Effects on mental health
A 2010 systematic review and meta-analysis published in Mayo Clinic Proceedings (Chen and colleagues) pooled decades of studies and found that a history of sexual abuse was associated with a higher lifetime rate of diagnoses including:
- Depression and anxiety disorders
- Post-traumatic stress disorder
- Eating disorders
- Sleep disorders
- Suicide attempts
Survivors also describe effects that are not diagnoses at all: shame and self-blame, difficulty trusting people, trouble with intimacy, and a sense of being different from others. Substance use is sometimes a way of coping with those feelings, and it responds to treatment like the rest.
If you are having thoughts of suicide, call or text 988, the Suicide and Crisis Lifeline, at any hour. If you are in immediate danger, call 911.
Effects on physical health
The effects are not only psychological. A 2009 systematic review in JAMA (Paras and colleagues) associated a history of sexual abuse with functional gastrointestinal disorders, chronic pain and chronic pelvic pain. A 2010 meta-analysis in the Journal of Pediatric Psychology (Irish and colleagues) found associations with poorer general health and with gastrointestinal, gynecologic, pain and cardiopulmonary symptoms, as well as obesity.
The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study, first published in 1998, looked at sexual abuse alongside other childhood adversity. It found that the more adverse experiences a person had in childhood, the higher their risk of several leading causes of illness in adulthood, including heart disease and lung disease.
Researchers think chronic stress in childhood, and the coping behaviors it can lead to, help explain these links. That is also why trauma-informed medical care, from a provider who knows the history, can make a real difference.
Why the effects often surface years later
Many survivors do not tell anyone for years, and some do not connect what happened to how they feel until adulthood. Common triggers include becoming a parent, a child reaching the age the survivor was, news coverage of abuse at an institution, or the death of the person who caused the harm.
Delayed disclosure is the normal pattern rather than a weakness in a claim. When the Supreme Court of Maryland upheld the 2023 law, it pointed to delayed reporting as the legitimate purpose behind it.
Where survivors in Maryland can find support
- The national sexual assault hotline is 800-656-4673, available at any hour, free and confidential. It can connect you with a local sexual assault program.
- Maryland's sexual assault programs. The Maryland Coalition Against Sexual Assault (MCASA) lists the rape crisis and recovery centers that serve each county, many offering counseling to adult survivors of childhood abuse.
- A trauma-informed therapist. Approaches such as trauma-focused cognitive behavioral therapy and EMDR are commonly used for post-traumatic stress. Ask any therapist directly about their experience with childhood trauma.
- Your primary care provider. Telling a doctor about the history, if and when you choose to, can change how chronic pain or other symptoms are assessed.
Talking to a hotline, a counselor or a friend is a legitimate first step and forecloses nothing. If you want to understand reporting options first, our page on how to report sexual abuse walks through them.
Legal options for adult survivors in Maryland
Since October 1, 2023, there has been no statute of limitations for civil claims based on sexual abuse of a minor, and the change is retroactive, so claims the old deadlines had closed are open again. A claim can be brought against the person who committed the abuse, and against an organization whose negligence made it possible.
A civil claim can pay for therapy and medical care, including care that continues for years. You do not need a criminal conviction, or even criminal charges, to bring a civil claim. Our child sexual abuse page explains how those claims work, and revived claims carry damages caps that our Child Victims Act guide sets out.
Speaking with us is confidential and does not start a case. We do not name individuals on this website, and we do not publish clients' stories.
Common questions
Is it normal to feel the effects of childhood abuse only as an adult?
Yes. Many survivors describe effects that appear or intensify in adulthood, often after a life event brings the memory back. Delayed disclosure and delayed effects are both common.
Can childhood sexual abuse cause physical illness?
Research has found associations between childhood sexual abuse and conditions such as chronic pain, gastrointestinal disorders and poorer general health. An association across a large group does not mean abuse caused any one person's condition, which is a question for a treating doctor.
Can a civil claim pay for counseling?
Yes. Past and future treatment costs are part of what a civil claim can recover, along with the harm itself. If we take your case, we work on a contingency fee: no fee unless we recover money for you, and we advance the case costs, repaid only from a recovery.
I am not ready to talk about details. Can I still ask a question?
Yes. The timing question can often be answered without details of the abuse. Say as much or as little as you want, in English, Korean or Spanish.
Attorney Advertising. Prior results do not guarantee a similar outcome. This article is general information about Maryland law, not legal advice about your situation.