What to do when a child reports sexual harassment and sexual assault to a medical professional.

Global exposure of children to sexual abuse is widespread. Disclosure may be extremely upsetting for both families and medical professionals. This review provides medical practitioners with practical tips for a stepwise approach of the child who discloses sexual abuse. Having secured a private examination room, the physician should approach the child and caregivers separately to determine the level of concern for abuse and the urgency of the situation. The medical evaluation is based on the information gathered, including a complete physical examination, inspection of the genitalia, collection of forensic evidence, and testing for sexually transmitted diseases. On a case-by-case basis, the need for surgical intervention, prophylactic treatment, and immunization is discussed. Finally, important questions for the medical team to address are outlined with the goal of supporting the child and his/her family and ultimately stopping the abuse.