Our meta-analyses of the relations between CSA and adjustment in both the national samples and college samples showed that CSA is statistically significantly related to poorer adjustment; however, this relationship is small. For boys, CSA accounted for only one half of one percent of the adjustment variability, while for girls, it accounted for only 1%. These small effect sizes are inconsistent with the assumption that CSA produces intense effects. The examination of self-perceived effects and reactions contradict the assumption that CSA has pervasive effects. Analyses of self-perceived effects, as well as the role that family environment plays in the CSA-adjustment relationship, do not support the assumption that CSA typically causes harm. There is support from these data that CSA causes harm in specific cases, but the evidence speaks against harm resulting in the typical case. Finally, a clear and strong difference emerged between how boys and girls respond to experiences classified as CSA. Only a minority of boys react negatively or feel harmed by these episodes; the reverse holds for females. In the college samples, boys who were willing participants in their CSA episodes showed no evidence of impairment, which was not the case for girls. These results strongly suggest that the assumption that boys and girls react in an equivalent manner to CSA should be abandoned.

Regarding the differences between how boys and girls react, it is worth reviewing what some of the authors of the college studies had to say. Schultz and Jones noted that males tended to see these sexual experiences as an adventure and as curiosity-satisfying, while most females saw it as an invasion of their body or a moral wrong. West and Woodhouse observed that females’ reactions at the time were "predominantly of fear, unpleasant confusion, and embarrassment...[while men’s] remembered reactions were mostly either indifference, tinged perhaps with slight anxiety, or of positive pleasure, the latter being particularly evident in contacts with the opposite sex."

These gender differences in reactions to CSA experiences are consistent with more general gender differences in response to sex among young persons.

For example, boys and girls report very different reactions to their first experience of sexual intercourse, with girls predominantly reporting negative reactions such as feeling afraid, guilty, or used, and boys predominantly reporting positive reactions such as feeling excited, happy, and mature. It is important to add that males and females may react differently to CSA because they tend to experience different kinds of CSA episodes. Baker and Duncan commented that girls in their national survey in Great Britain may have found their CSA experiences to be more damaging than boys did because they had more incestuous CSA and experienced CSA at younger ages. College males and college females also tended to have different CSA experiences; females experienced incest more than twice as often as males and experienced force about twice as often.

A few additional comments about causality are also in order. The finding that family environment was 10 times more important than CSA in accounting for current adjustment in the college population is consistent with the results of several recent studies using subjects from noncollege populations. In one study conducted by Eckenrode and his colleagues published in 1993, the researchers categorized children and adolescents obtained from a large representative community sample in a small-sized city in New York state into six groups: not abused, CSA, physical abuse, neglect, CSA and neglect, and physical abuse and neglect. They found that CSA children and adolescents performed as well in school as nonabused controls in all areas measured, including standardized test scores, school performance, and behavior. Neglect and physical abuse, on the other hand, were associated with poorer performance and more behavior problems.

In another study conducted by Ney and his colleagues published in 1994, the researchers separated their mostly clinical sample of children and adolescents into categories of CSA, physical abuse, physical neglect, verbal abuse, emotional neglect, and combinations of these. They found that the combination of abuse that correlated most strongly with adjustment problems was physical abuse, physical neglect, and verbal abuse. In the top 10 worst combinations, verbal abuse appeared seven times, physical neglect six times, physical abuse and emotional neglect five times each, whereas CSA appeared only once.

These results jive well with the conclusion of Wiesniewski that we presented before. Again, she studied 32 samples of college students across the U.S. chosen to be representative of the U.S. college population. She concluded that, when taking other forms of abuse into account, CSA was not related to adjustment problems. It was instead, she noted, maltreatment such as physical abuse that directly impacted on adjustment.

In the U.S., in 1974 the Child Abuse Prevention and Treatment Act was passed by Congress. Its original focus was on doing something about the problems of physical abuse and neglect. This initiative set up what became, as many have called it, the child abuse industry, which continues to this day and has spread to other countries around the world. Within a few years of its passage, however, the focus of this act shifted predominantly to CSA. This occurred for a number of reasons. One was that the women’s movement in America had begun raising consciousness about rape and incest in the early 1970s. A second reason was that taboo sex is much more of an emotionally-grabbing issue than physical abuse or emotional neglect. As such, CSA got more media and political attention, and eventually more funding and a much greater following in child-protection circles. The results of our research, as well as those of others just mentioned, suggest that this major shift of attention away from physical abuse and neglect to CSA may have been misdirected.