A history of sexual abuse can cause long-term health problems, both psycholgocial and physical. With recent discoveries of biological pathways in the field of psychoneuroimmunology and with myriad medical studies involving cortisol, stress, and NK cells, physical and psychological disease are now linked with the trauma of sexual abuse. Felitti et al, reviewed over 9,500 questionnaires sent to their patients in the Kaiser Permanente HMO in San Diego and collaborated with the Center for Diseases Control in the analysis of the data. This spawned over 40 articles confirming the significant relationship between adverse childhood experiences (ACE) and leading causes of death in the USA. Interestingly, eight percent of the respondents in the ACE survey did not answer the questions on sexual abuse - by far the largest number to avoid completing a section. Yet, 22 percent of those who fully completed the questionnaire reported having been sexually abused. It’s a good bet that the actual percentage was higher.

Adults victimized in their youth may not volunteer their childhood trauma to their physicians. One study of women in Seattle found that most of the women believed it was appropriate for their physicians to ask about sexual abuse but only 4% said that they had ever been asked about this. Of this group, 37% reported having been sexually abused in childhood.

Since SA can lead to significant mental and physical disease, it is important for medical schools to include training in this field for their students. Physicians can help their patients by asking about prior sexual abuse and by directing the abused into appropriate agencies or programs to help prevent future episodes of disease. A simple question on the medical history such as, "Have you ever been abused?," may elicit meaningful information regarding diagnosis and treatment. Since many SA survivors may still be reluctant, asking this question in a nonjudgmental fashion may bring forth more significant history. If the answer is affirmative, Dr. Felitti suggests asking the patient, “How did the abuse affect you later in life?” Such a nonjudgmental question can reveal pertinent health information and perhaps be the spark to start the healing process for the survivor.