In discussing the effects of incest on the child victim, the author advises that the way to understand the impact of sexual abuse is to view it as an "impingement," in which the child's unconscious mind is penetrated, regardless of what happened in the actual sexual abuse, i.e., what happened to their bodies. In the external world, the child must handle a split. The apparently normal, perhaps caring adult, and the bizarre experience of the intrusion, the secrecy, the fear, and the lack of acknowledgment of what is happening produces a split in the child's mind. Brief sexual abuse by a relative or family friend may not cause too much distortion in a child's psychosexual development, provided the child has had good parenting early on, and there is a reasonable degree of integration. Still, there are almost invariably changes in self- esteem, in the level of functioning, and in the capacity to relate to others and establish intimacy. Children may become aggressive and defiant or timid, isolated, and withdrawn. Many children are profoundly traumatized and need specialist help. They present serious management problems. These are the children whose lives were in emotional chaos due to persistent emotional abuse, deprivation, or neglect. In these cases, the sexual abuse may have been violent or long-lasting, or both. This paper also discusses the impact of incest on sense of gender identity. The paper concludes by stating that an understanding of the power and intensity of sexuality, conscious and unconscious, can make sense of the extent of the splitting denial, projection, and omnipotence that are the familiar dynamics that take over the families and then the professional network.