Sexual Violence Against Children and Adolescents

A German Nationwide Representative Survey on Its Prevalence, Situational Context, and Consequences

Background: Sexual violence against children and adolescents is widespread around the world. Current knowledge about the extent of this often concealed problem and the situational contexts in which it occurs is insufficient, not only in Germany.

Methods: A representative sample of the German population aged 18 to 59 was selected for this survey with the aid of Infratest dimap (a private polling company). The participants were asked to fill in a combination of written postal and online questionnaires in a mixed-mode design from January to October 2024.

Results: 10 000 people were contacted in writing (response rate: 30.2%). 12.7% [11.5; 13.9] stated that they were affected by sexual violence, including 20.6% of all women and 4.8% of all men. Men had more frequently experienced sexual violence in sports and leisure facilities, in a church context, and in the setting of government-provided child, youth, and family services. 37.4% [32.6; 42.2] of the affected persons had not previously reported the crime to anyone. 31.7% [30.0; 33.4] of respondents reported sexual violence via the internet and social media. The mental health of affected persons was poorer than that of unaffected persons.

Conclusion: Many cases of sexual violence go unreported. The different settings in which these offenses are committed, e.g., the preponderance of male victims in institutional settings, further imply a need for differentiated protection strategies, addressing both potential victims and potential perpetrators.

Cite this as: Dreßing H, Hoell A, Scharmann L, Simon AM, Haag AC, Dölling D, Meyer-Lindenberg A, Fegert JM: Sexual violence against children and adolescents: A German nationwide representative survey on its prevalence, situational context, and consequences. Dtsch Arztebl Int 2025; 122: 285–91. DOI: 10.3238/arztebl.m2025.0076

Sexual violence against children and adolescents is a serious problem in terms of healthcare, since the physical health effects can be substantial (1). However, current knowledge regarding the number of unreported cases remains insufficient. Prevalence studies found rates of 11.3–24% among girls and 4.1–7.6% among boys (2, 3, 4, 5).

German nationwide studies reported lifetime prevalence rates of sexual violence of 12–14%, with women being significantly more frequently affected (up to 20%) (6, 7, 8, 9).

In terms of different situational contexts, the Catholic and Protestant churches have hitherto been the primary focus of research (9, 10, 11). However, to date, there are no reliable estimates of the number or unreported cases of sexual violence against children and adolescents in other situational contexts (12). Sampling through residents’ registration offices is well suited to the purposes of drawing a representative sample within specific age groups (13). This procedure ensures that, in the case of a high response rate such as that achieved in the present study, rigorous scientific research can be effectively implemented in survey practice with a high level of population accuracy. It is for that reason that this time-consuming and resource-intensive procedures was chosen for the present study. The sample was generated in collaboration with Infratest dimap. A particular focus of this study was on the hitherto insufficiently researched area of collecting data on exposure to sexual violence initiated or committed on the internet and social media. In view of the UN’s Sustainable Development Goal 16.2, “End abuse, exploitation, trafficking and all forms of violence and torture against children,” oversampling was carried out in the 18–29 age group based on indicator 16.2.3 (14).

Methods

In collaboration with Infratest dimap, a representative sample of the German population aged 18–59 years was drawn for this survey from selected residents’ registration offices. The survey itself was conducted with a mixed-mode design comprising written postal and online questionnaires. Participants were informed by letter that data were being collected on the extent of sexual violence.

The survey was based on a structured questionnaire (eQuestionnaire) made up of established and internationally used instruments as well as instruments developed in-house (15, 16, 17, 18). Sexual violence was defined as follows: any sexual act committed against a person under 14 years of age or against the will of a person under 18 years of age. This includes any act with and without physical contact, for example, sexual harassment, sexual assault, and attempted or actual penetration.

Data analysis included descriptive and inferential statistical methods applied to person-weighted data. The lifetime prevalence of sexual violence in childhood and adolescence was determined and two groups formed: “Affected by sexual violence in childhood/adolescence” and “Unaffected.”

Group differences were analyzed using either unpaired t-tests or χ² tests, and a 95% confidence interval [95% CI] was constructed.

The analysis was performed using SPSS Statistics 29 (IBM Corporation, Armonk, NY, USA). (See eMethods for a detailed description).

Results

Sample

A total of 10 000 individuals were contacted in writing, of which n = 3016 took part in the survey (362 individuals from the pilot phase and 2654 individuals from the main phase). This corresponded to a response rate of 30.2%. In all, n = 3012 datasets were included in the analysis; the internal consistency of four datasets was insufficient.

The sociodemographic data of the total sample, broken down according to those affected and those unaffected by sexual violence, are given in Table 1. Of the total sample, 49.0% [47.2; 50.8] of respondents were female; the average age was 39.9 years (SD = 12.2 years; range: 18–59 years). The sample was representative of the selected age cohort of the German population in terms of gender and age. The total percentage of individuals affected by sexual violence in the overall sample surveyed was 12.7% [11.5; 13.9]. Of these, 54.1% [49.1; 59.1] had been affected by sexual violence once and 45.9% [40.9; 50.9] multiple times. Women were more likely to be exposed to sexual violence. The rate of those affected was 20.6% [18.5; 22.7] among women and 4.8% [3.7; 5.9] among men. In addition, 16.4% [13.6; 19.2] of 18- to 29-year-olds and 11.5% [10.2; 12.8] of 30- to 59-year-olds reported having experienced sexual violence. When the two age groups were differentiated by gender, it was also found that 27.4% [22.5; 32.3] of women and 5.0% [2.7; 7.3] of men in the younger age group reported having been affected by sexual violence. In the older age group, this share was 18.8% [16.5; 21.1] for women and 4.2% [3.1; 5.3] for men.

Table 1

Sociodemographic data of the total sample at the time of the survey, differentiated according to those affected and those not affected by sexual violence (weighted case numbers)

Although there were no group differences between those affected and those not affected in terms of school-leaving qualifications, differences were found with regard to vocational training qualifications and how respondents supported themselves financially. Individuals exposed to sexual violence were less likely to be able to support themselves financially through their own employment.

Affected individuals also had higher total Childhood Trauma Screener (CTS) scores [t = –11.83; df = 448.4; d = 0.77] compared to unaffected individuals, suggesting that they had experienced more extreme or more frequent trauma in childhood. Total WHO-5 scores, on the other hand, were significantly lower for affected individuals (t = 8.04; df = 465.9; d = 0.48), indicating lower subjective well-being.

Compared to unaffected individuals, those affected were more likely to report being aware of help centers that they could turn to in the event that they experienced sexual violence themselves or learned of sexual violence against other; overall, however, almost 50% in both groups stated that they had no knowledge whatsoever of support services.

In total, 31.7% [30.0; 33.4] of those surveyed reported having been exposed to technology-facilitated sexual violence. Women were more commonly affected than were men, with 34.9% [32.5; 37.3] of women and 28.2% [25.9; 30.5] of men reporting technology-facilitated sexual violence. Of those affected, 61.9% [57.0; 66.8] also reported having experienced technology-facilitated sexual violence before the age of 18 years. Similarly, of those who stated in their self-assessment that they had not experienced sexual violence, 27.3% [25.6; 29.0] reported incidents of technology-facilitated sexual violence.

Information on the characteristics of those affected at the time of the offense and the distribution of the years in which the first offense took place can be found in Table 2. The average age of affected individuals at the time of the first offense was 11.2 years (SD = 3.7 years; range: 2–20 years). Around half of affected individuals experienced sexual violence once, the other half multiple times. Furthermore, the group of individuals who were under 14 years of age at the time of the offense were more likely to be the victims of multiple episodes than were the group that were older at that time. In the case of individuals who were exposed to multiple episodes, the abuse lasted an average of 3.4 years, with a high standard deviation from the mean (SD = 9.4 years) Multiple-episode victims were on average 15.4 years old (SD = 4.3 years) at the time the offenses ceased. The distribution of years in which the first episode took place shows that most episodes took place between 1980 and 2019, with a preponderance in the 2000s.

Table 2

Age of affected individuals at the time of the first offense, single or repeated exposure to sexual violence, and year of the first offense, differentiated by gender (weighted case numbers)

Perpetrators and types of offenses

Table 3 provides information on perpetrators as well as the types and contexts of offenses, differentiated by gender and age of the victims at the time of the survey. A large proportion of affected individuals reported the perpetrator to be male, while 4.5% reported a female perpetrator. Including abuse by peers, the average age of those accused was 32.5 years (SD = 16.8 years), and excluding abuse by peers, this was 38.0 years (SD = 15.1 years). Approximately one in four individuals experienced sexual violence committed by a person of a similar age to them (abuse by peers).

Table 3

Information on perpetrators, acts of abuse, and contexts, differentiated by gender and age at the time of surveying affected individuals (weighted case numbers)

Figure 1 presents the contexts of offenses, differentiated according to gender and age at the time of the survey. Affected individuals most frequently reported having experienced sexual violence either within the family or by relatives (females: 35.3%; males: 18.8%), followed by friends (females: 24.6 %; males: 26.7%). Males were more likely to experience sexual violence in sports and leisure facilities, in a church context, and in the setting of government-provided child, youth, and family services. Females, on the other hand, more frequently reported sexual violence within the family or by relatives as well as in the workplace.

Figure 1

Settings in which offenses are comitted

Differences between the 18- to 29-year-olds and the 30- to 59-year-olds at the time of the survey were particularly evident in two settings of abuse. The older group were more likely to report sexual violence in healthcare and treatment centers, while the younger group more often reported abuse in the setting of child, youth, and family welfare services. Moreover, the younger age group more frequently reported online-only contact with the perpetrator.

Conduct leading up to the offense (grooming)

Victims most frequently cited the following methods of grooming: exploiting a personal relationship (28.1%; [23.6; 32.6]), flattery and compliments (24.6%; [20.3; 28.9]), and perpetrators taking advantage of their personal authority (24.4%; [20.1; 28.7]). Promises (18.6%; [14.7; 22.5]) and threats (15.5%; [11.9; 19.1]), as well as taking advantage of professional authority and making justifications (10.4% each; [7.3; 13.5]), were cited somewhat less frequently. Other modi operandi, such as force (5.0%), were rarer.

Acts of abuse

Most of those affected reported sexual violence in the form of hands-on acts only, with around one in four reporting penetration (Table 3). Respondents aged 18–29 years at the time of the survey were more likely to report penetration compared to those aged 30–59 years.

As shown in Figure 2, the most frequently reported forms of technology-facilitated sexual violence experienced included unwanted contact with sexual or pornographic material online (18.3%; [16.9; 19.7]), as well as unwanted requests for sexual information (10.2%; [9.1; 11.3]) and unwanted conversations with sexual content (9.5%; [8.5; 10.5]). Other forms of technology-facilitated sexual violence online are presented in Figure 2.

Figure 2

Types of technology-facilitated sexual violence, differentiated according to the frequency of occurrence on the individual level

Disclosure

In total, 56.2% [51.2; 61.2] of victims reported to a third party that they had experienced sexual violence. Taking into account those who assumed that no third party had hitherto been aware of the incident, 37.4% [32.6; 42.2] of affected individuals reported sexual violence for the first time in this survey.

A total of 7.4% [4.8; 10.0] of victims reported that criminal charges had been filed against at least one perpetrator. Of those affected, 14.1% [10.6; 17.6] reported having already been in psychotherapy as a result of sexual violence. In total, 2.3% [0.7; 3.8] of victims received some form of compensation for the sexual violence they had experienced.

Discussion

The aim of this study was to gather representative data on the number of unreported cases of sexual violence against children and adolescents as well as the settings in which these offenses are committed. The results suggest that there is a significant number of unreported cases.

In fact, 37.4% of victims reported that they had never previously spoken to anyone about the sexual violence they had experienced. It is remarkable that despite public-awareness and prevention campaigns, the reason often given for this was a sense of shame and the assumption that they would not be believed.

Our data show that exposure to sexual violence is independent of school attainment—it can happen to anyone. Häuser et al. reported comparable findings (8). Due to methodological differences between the studies available to date, they are difficult to compare, meaning that it is not possible to draw conclusions as to whether prevalence has increased or decreased, particularly in light of the growing awareness of this issue. Therefore, this research needs to be continued using the same methodology.

Witt et al. (14) reported slightly different prevalence rates in the 18- to 29-year-old group (women, 26.1%; men, 6.1%), although the differing methodology (random route approach) needs to be taken into account.

The serious consequences of sexual violence have been extensively described. Although support in the form of therapy has improved in recent years, the group of affected individuals showed poorer psychological well-being, as measured by the WHO Well-Being Index. Social media and the internet have created a multitude of new possibilities for committing acts of sexual abuse. The prevalence and dynamics of this problem have not been well investigated as yet, making it difficult to develop suitable prevention strategies (16, 19, 20).

For 2023, The German Federal Criminal Police Office (Bundeskriminalamt) documented 6091 cases of sexual abuse via the internet (Sections 174, 176, 184 (1) No. 1 of the German Criminal Code [StGB]) (21). In this regard, our data point to a large number of unreported cases. In our overall sample, respondents most frequently reported unwanted contact with sexual or pornographic content on the internet (18.3%), unwanted requests for sexual information (10.2%), and unwanted conversations with sexual content (9.5%).

Our results show that particularly in this area, we need to intensify our efforts in terms of raising awareness and developing suitable prevention concepts.

With regard to the contexts in which sexual violence occurs, our data show that the contexts most frequently cited for these offenses are family and friends. However, sexual violence is also committed in institutions such as the Catholic and Protestant churches (4.2%), sports clubs (8.6%), and in the workplace (8.0%). This highlights the need to develop specific preventive and interventional concepts for the different situational contexts. It was striking that men experienced sexual violence more frequently in institutional settings. The preponderance of male victims is clearly not exclusive to the church context, where is has been documented in many studies (10), but is also found in other institutional settings. Females are more likely to experience sexual violence within the family and outside institutions, for example, at the hands of perpetrators in their neighborhood. These differentiated results make it possible for members of the medical profession to identify, in a more nuanced manner, relevant childhood traumas experienced by their patients.

It is concerning that both affected and unaffected individuals have little knowledge of the support available. Although the figures recorded in this study are higher than those of the 2021 Forsa survey (22), in the present study, a mere awareness of the support services available was counted as a positive response. Nevertheless, our data also indicate that efforts to raise awareness should be intensified, since even when affected individuals are aware of the support available, many do not take advantage of this help due to their feelings of shame or concerns that they will not be believed.

Limitations

Studies on sexual violence based on self-reported data harbor the risk that respondents tend to give socially desirable responses. Individuals probably also have a clearer recollection of episodes of sexual violence that happened more recently. However, by oversampling in the 18- to 29-year-old cohort, efforts were made to minimize this limitation. In principle, it is not possible to rule out false-positive results. However, since the sample of registered residents systematically excludes residents in care homes—and there is evidence that this group is more likely to experience sexual violence compared to the general population (23)—the prevalence rates found in this study are more likely to be too low than too high, despite the possibility of some false positives. It cannot be ruled out that the reference to sexual violence in the survey cover letter led to greater participation among affected individuals.

Acknowledgments

This study received funding from: WEISSE RING Stiftung, Eckiger Tisch, and the German Children Protection Association (Kinderschutzbund).

Thanks also go to the scientists and experts on the study’s advisory board.

Conflict of interest statement
JMF received research funding from the EU, the German Federal Ministry of Health (Bundesministerium für Gesundheit, BMG), the German Ministry of Education and Research (Bundesministerium für Bildung und Forschung, BMBF), the German Federal Ministry for Education, Family Affairs, Senior Citizens, Women and Youth (Bundesministerium für Familie, Senioren, Frauen und Jugend, BMFSFJ), the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG), the Innovation Fund of the German Federal Joint Committee (Innovationsfonds des Gemeinsamer Bundesausschuss), the state ministries of Baden-Württemberg and Saarland, the Baden-Württemberg State Foundation (Landesstiftung Baden-Württemberg), the Ingrid & Frank Foundation, the the German Cancer Aid Foundation (Stiftung Deutsche Krebshilfe), the Auxilium Foundation, the Vector Foundation, the Evangelical-Lutheran Church in Württemberg, and the Porticus Foundation.

He also received travel grants, honoraria as well as sponsoring for conferences and medical training from APK, Adenauer and Ebert Foundation, The German World Service (Deutschlandfunk), der DFG (German Research Foundation, the German Youth Institute (Deutsches Jugendinstitut), the German Children Protection Association (Kinderschutzbund), Infectopharm, med update, UNICEF, professional associations, as well as German federal and state ministries.

The remaining authors declare that that they have no conflicts of interest.

Manuscript received on 14 January 2025, revised version accepted on
16 April 2025.

Translated from the original German by Christine Rye.

Corresponding author:
Prof. Dr. med. Harald Dressing

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