OBJECTIVE: The aim of the study was to determine whether sexual
victimization of children by young aggressors differs from adult
aggressors. METHOD: A case review was performed on medical records of
children less than 12 years of age referred in 1992 to the Child
Protection Clinic at a tertiary care pediatric hospital. RESULTS:
Medical evaluation for sexual abuse was carried out on 316 children,
79% girls, 21% boys, mean age 6 +/- 2.7 years. Among known
perpetrators, 39 were less than 16 years and 15 were between 16 and 19
years old. Young aggressors were more likely to abuse older female
victims (p = .0009). They also were reported to engage in more
genital/genital and genital/anal acts (p < .001). The aggressor's
young age was found to be an important determinant related to a
history of penetrative forms of sexual abuse (OR = 4.015, 95%
C.I. 2.0581; 7.8319). Genital examination was specific for abuse
(Adam's Class IV or V) in only 6.3% of victims, but significantly more
often when the perpetrator was between 16-19 years old (p =
.003). CONCLUSIONS: Adolescent aggressors appear to engage in more
genital/genital and genital/anal sexual abuse than older
aggressors. Victims of aggressors age 16 to 19 had a higher risk of
having specific findings on the anal/genital examination.