The study included 269 children who were examined medically for sexual abuse. The adult bringing the child to the examination reported that the child had made a statement alleging sexual abuse. More frequent abuse, more perpetrators, physical injury, and more severe sexual acts reportedly described by the children prior to the medical examination were variables significantly correlated with increased emotional distress during medical examinations. Reported threats of physical harm during the sexual abuse and mothers' belief that sexual abuse occurred both correlated significantly with anogenital abnormalities consistent with sexual abuse. These results indicate that, if children are more emotionally distressed during the medical examination and have abnormal anogenital findings consistent with sexual abuse, then they possibly have experienced more extensive and aggravated events during the sexual abuse. These results may help determine which children need more preparation for a medical assessment and which children are more likely to have sexual abuse related anogenital findings. Tables, references