The study compared four aspects of childhood sexual abuse (CSA) traumatization: definitions, characteristics, long-term negative and long-term positive consequences of the experience. Two-hundred and ninety CSA Israeli survivors were recruited from private clinics over a period of six years, divided into four groups: females sexually abused by male perpetrators (159), females sexually abused by female perpetrators (34), males sexually abused by male perpetrators (58), and males sexually abused by female perpetrators (39). These four groups differed in abuse characteristics (e.g. age at abuse, sexually abusive behavior conducted, and perception of the abuse) and in its long-term effects (e.g. levels of posttraumatic stress, dissociative, and posttraumatic growth reactions). These results indicate the need to develop diverse and more sensitive means of identifying and treating the various forms of CSA.