Physical signs of child sexual abuse - evidence-based review

Guidance for best practice and issues for clinical practice to aid clinical decision-making in examining children referred for evaluation of possible sexual abuse. You can request or purchase a print edition. You can also download additional information related to the review's publication and update.

How to order

Free for named and designated doctors

This review is provided free of charge if you are a named or designated doctors for safeguarding children who are members of the RCPCH, FFLM, RCP or BAPS, and involved in the forensic medical examination of children for suspected CSA.

To received your copy, please contact us on

Available for purchase for others

Otherwise, you may purchase a copy through our stockists, Lavenham Press.

  • Members of RCPCH, American Academy of Pediatrics, Royal College of Physicians, British Association of Paediatric Surgeons and The Faculty of Forensic & Legal Medicine Members must confirm their membership status on the online delivery form to receive the member price - £35 plus delivery (Members must confirm their membership status on the online delivery form to receive the member price)
  • Non-members - £49 plus delivery

To pay by cheque, please contact our stockists on / 01787 249 290. You can make the cheque payable to 'Lavenham Press Ltd' and post to Lavenham Press Ltd, Arbons House, 47 Water Street, Lavenham, Suffolk CO10 9RN


In 2015 the RCPCH, in collaboration with the American Academy of Pediatrics (AAP), the Royal College of Physicians of London (RCP) and The Faculty of Forensic and Legal Medicine (FFLM), updated the 2008 RCPCH publication entitled ‘The Physical Signs of Child Sexual Abuse’ based on the best available evidence.

The publication updates previous evidence and includes new reviews including:

  • anogenital signs of accidental injuries in girls and boys
  • genital bleeding in prepubertal girls
  • healing in anogenital injuries.

Downloads - additional information

Summary of changes by chapter.pdf

Data extraction and quality standard forms.pdf

Included studies in the evidence base section - by chapter.pdf

Literature searches.pdf