Signs of the sexual abuse of a child are not likely to be noticed without an examination of the genital area. These signs include:

• Bruises, scars, chafing, or bite marks in the genital area.
• Discharge from the vagina or penis.
• Rectal or genital bleeding.
• Anal tears or dilation.
• Symptoms of a developing sexually transmitted disease (STD), such as gonorrhea, syphilis, chlamydia, genital herpes, hepatitis B, trichomoniasis, or human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS).

Sexual abuse may not be detected with a physical exam, especially if enough time has lapsed to allow tissue to heal. Also, some types of sexual abuse, such as fondling or oral contact, usually do not leave any physical signs.