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This text integrates past research in review chapters which pose important questions for researchers and therapists in the field of child sexual abuse. In addition, seven major research studies are reported; five undertaken in Canada, one in Britain, and one comparing sexually abused adolescents in both countries. The groups studied include adults in the general population recalling abuse in childhood; mothers of abuse victims; adolescents in residential care; and adolescent prostitutes. These studies indicate that child sexual abuse frequently has a major, negative and long term impact in terms of impaired mental health. This remains true when a range of other factors (physical and emotional abuse, and family disruption) are taken into account.