Child sexual abuse (CSA) involving sexual contact between an adult (usually male) and a child has been reported by 20% of women and 5 to 10% of men worldwide (1–3). Surveys likely underestimate prevalence because of underreporting and memory failure (4–6). Although official reports have declined somewhat in the United States over the past decade (7), close to 90% of sexual abuse cases are never reported to the authorities (8).