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The transitional period of adolescence is characterized by a number of changes and challenges that occur both within and outside the individual. Many developmental events occur during adolescence that have a significant impact on an adolescent’s functioning, including a variety of physical, cognitive, emotional, behavioral, and social changes. In addition, adolescents may experience a variety of other important events, such as peer group changes, school moves, changes in family structure or functioning, and alterations in societal and community expectations (Hansen, Giacoletti, & Nangle, 1995; Peterson & Hamburg, 1986). Unfortunately, many adolescents are further challenged by being a victim of sexual abuse. The widespread prevalence of sexual abuse and the numerous problems and consequences associated with it have been increasingly recognized in recent decades (e.g., Browne & Finkelhor, 1986; Faller, 1993; V. V. Wolfe & Wolfe, 1988). In addition, much has been learned about the treatment of sexually abused children and adolescents during that time (e.g., Hansen, Hecht, & Futa, 1998; O’Donohue & Elliot, 1992). Given that victims of sexual abuse are at risk to develop sexualized behaviors, and that adolescents, for a variety of reasons (e.g., puberty, peer influences) are likely to begin engaging in sexual acts, this population needs special attention to help prevent the intergenerational transmission of abuse. This chapter addresses sexual abuse of adolescent victims and intergenerational issues in sexual abuse. The problem of sexual abuse is described, including historical background and epidemiological information. The potential impact and correlates of sexual abuse are discussed, including characteristics of adolescent victims and their families. The assessment and treatment of sexually abused adolescents is described, with attention to issues of prognosis and clinical management.