Childhood sexual abuse is associated with a broad, dose-responsive elevation in long-term psychiatric and physical-health risk — depression, anxiety, PTSD, suicidality, and substance dependence among them — and the strongest designs (umbrella reviews, longitudinal cohorts, discordant-twin studies) indicate the association is at least partly causal and not merely a product of shared family confounding; nonetheless many survivors show resilience and no measurable lasting impairment.