The issue of organized sexual abuse is complex, making a precise definition difficult. Complexities arise from the different forms of organized sexual abuse, and silence and disbelief are central features in the debate on organized sexual abuse. While there is far more professional knowledge about child sexual abuse than in the past, silence remains a significant component for individuals directly involved. Neither victim nor abuser is usually willing to disclose the secret, and secrecy is essential for the abuser to continue his or her practices. Another difficulty is that visible signs of sexual abuse are not likely to be seen without medical investigation. In addition, a key issue associated with ritualistic sexual abuse is whether children's disclosures are reliable. Professionals who work with survivors of organized sexual abuse realize that survivors may be victims as well as perpetrators, and this blurs the distinction between the powerful abuser and the powerless victim. Future theorizing and intervention should recognize that organized sexual abuse often confounds existing belief systems about the goodness of communities, families, and women and refutes easy categorization of victims and perpetrators. 32 references and 2 notes