Physical signs of child sexual abuse

Book cover of The Physical signs of CSA

This review and guideline for best practice is a revision of the 1997 Royal College of Physicians publication 'Physical Signs of Sexual Abuse in Children'. Based on the best available evidence, it has been produced by the Royal College of Paediatrics and Child Health in collaboration with the Royal College of Physicians of London and its Faculty of Forensic and Legal Medicine.

The handbook focuses on evidence for the physical signs of child sexual abuse (CSA) in the following areas: female genitalia; male genitalia; anal signs; oral signs; and sexually transmitted infections.

See a list of reviewers


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The literature search was updated and an interim statement summarising the findings is available to download: CSA Interim statement (PDF, 53KB, 6 pages)

A second edition will be published in early 2015. This will include new sections on healing, the causes of vaginal bleeding, and accidental/non-intentional injuries.

Other child protection publications

Please note: The RCPCH, Association of Chief Police Officers and Faculty of Forensic and Legal Medicine have recently updated the document, 'Guidance for best practice for the management of intimate images that may become evidence in court'.

View this and other child protection publications

Get a copy

The publication is available free of charge to all designated and named doctors. To receive your copy, please email

If you are not eligible for a free copy, you may purchase a copy through the Lavenham Group. Charges include shipping and handling:

  • FREE to designated and named doctors
  • Delivery within the UK: £31.06
  • Delivery to Europe: £40.06
  • Delivery to the rest of the world: £46.06

Purchase online

Cheques may be made payable to 'Lavenham Group plc' and posted to: Lavenham Group plc, Arbons House, 47 Water Street, Lavenham, Suffolk CO10 9RN