Am Fam Physician. 2010;82(10):1239-1240
What sexual behaviors in children are normal?
Most children up to 13 years of age display sexual behaviors at some time. It is not unusual for children to engage in sexual behaviors after a change in the family (for example, a new sibling or separation of the parents) or in day care arrangements. The types of behaviors and how often they appear depend on the age of your child.
Younger children (two to five years of age) are more likely than older children (six to 12 years of age) to touch their genitals, try to touch adults' genitals or breasts, and try to see people undressing. Older children are more likely to hide sexual behaviors. They are also more likely to show interest in the opposite sex, look at pictures of naked people, and talk about sex.
When should I be worried about these behaviors?
Sexual behavior that is not appropriate for your child's age, or that causes emotional problems or physical pain, is not normal. These behaviors may be associated with or caused by other problems, such as abuse or neglect, family violence, serious illness in a family member, seeing sexual materials or acts, or conduct or aggression disorders.
Examples of problems that need further evaluation are:
Forcing another child to engage in a sexual act
Sexual behavior that involves another child of a very different age or stage of development
Becoming emotionally upset during the behavior or when an adult tries to redirect the behavior
Asking an adult to perform a sexual act
Sexual behavior that involves oral-genital contact
Putting objects into the vagina or rectum
What should I do if I'm worried about my child's sexual behaviors?
Talk to your child's doctor. He or she may ask you to describe the following:
The behavior and how often your child does it
When the behavior started
Stressors or changes in the family or day care arrangements
Your child's potential access to sexual materials or nudity
Other behavior changes in your child, such as aggression
Concerns about abuse or neglect
Based on this information, the doctor may want to evaluate your child or refer him or her to a specialist.
How can I manage these behaviors?
It is important to figure out if there is something causing your child to touch his or her genitals or buttocks. Insect bites, sensitivities to soaps, or dried urine and feces can cause irritation and itching. If your child does not have any irritation and the behavior is normal for the child's age, then gentle verbal redirection of the behavior may be all that is needed. For example, you could ask your child to hold your hand or to look for an item. This can prompt your child to stop the behavior.
What should I do if I think my child has been abused?
If you think your child has been abused, call a child protection agency or the police. All states require that you report abuse and neglect. See http://www.childwelfare.gov/systemwide/laws_policies/statutes/repproc.cfm for more information.