"When I was a child, the doctor advised me to have sex more gently": The perceptions and experiences with the healthcare system as conveyed by adult survivors of child sexual abuse.

Rationale: Extensive findings have illuminated the implications of child sexual abuse (CSA) for mental and physical health. Attention has been dedicated to the discrepancy between the high prevalence of CSA, and the lack of adequate CSA screening and trauma-informed care within healthcare systems.

Objective: This study was designed to examine this discrepancy by providing CSA survivors' perspectives. Specifically, this study aims to uncover the perceptions and experiences of female survivors of CSA concerning their encounters with the healthcare system.

Methods: Written narratives were collected from 53 female survivors of CSA as part of the Israeli Independent Public Inquiry into CSA, which were analyzed guided by an inductive thematic analysis.

Results: This study's findings portrayed a complex scenery in which female survivors of CSA are concurrently dependent on healthcare services due to the CSA-related morbidity, yet they are hesitant and have difficulty approaching healthcare services. Additionally, the findings showed that the survivors of CSA described being perceived as mentally ill and distrustful; they also were encouraged to take excessive medication by healthcare providers, which resulted in many survivors of CSA avoiding further treatment. Furthermore, the survivors of CSA conveyed several clear messages to the healthcare system, all of which called for the urgent need to implement trauma-informed care.

Conclusions: These findings underline the necessity of a paradigm shift in which health and illness are viewed in light of personal, interpersonal, and social contexts. Simply put, it is time for trauma-informed care to be extensively implemented in healthcare services.