Childhood Sexual Abuse: A Call To Action In Pediatric Primary Care

* Abbreviations:\n ACE — : adverse childhood experience\n CSA — : childhood sexual abuse\n\n“Every one of my doctors failed me.” The impact of her words rippled through the auditorium on a rainy morning during my first year of medical school, where my fellow medical students and I were engaged in a panel discussion featuring survivors of childhood sexual abuse (CSA). Palpable unease permeated the room as the guest speaker spoke about her repetitive abuse at the hands of a family member throughout her childhood. As a young girl, she had visited doctors repeatedly for recurrent urinary tract infections, but, with each visit, she was lectured on proper hygiene and sent home without further investigation. This woman now stood fearlessly before 200 earnest medical students, and we listened in devastated silence as she shared her story. Would we fail our future patients in the same way?\n\nThe US Department of Health and Human Services defines CSA as “involvement of [a] child in sexual activity to provide sexual gratification or financial benefit to the perpetrator, including contacts for sexual purposes, molestation, statutory rape, prostitution, pornography, exposure, incest, or other sexually exploitative activities.”1 The scope of CSA is notoriously difficult to assess because of the multitude of … \n\nAddress correspondence to Lea Ghastine, BSPH, College of Medicine, The Ohio State University, 370 W 9th Ave, Columbus, OH 43201. E-mail: lea.ghastine{at}osumc.edu