Men with a self-reported history of child sexual abuse (CSA), defined as sexual experiences before the age of 16 with someone older by 5 or more years, seeking treatment at two mental health clinics in a large metropolitan city in the western United States were invited to participate in the study. The 67 participants completed a questionnaire that assessed sexual abuse frequency, duration, types of sexual acts, age of onset, relationship to perpetrator, sex and age of perpetrators, and the number of perpetrators. Other questions pertained to physical abuse history and the presence of parental alcoholism during childhood. The mean were also asked to report on their current sexual orientation. The Problem Checklist was developed for this study to measure specific areas of impairment hypothesized to result from child sexual abuse. Men who had been sexually abused by their mothers (n=17) had more self-reported problems in several domains than men who had not been abused by their mothers. Problems included sexual dysfunction, dissociation, aggression, interpersonal problems, and total symptoms. Men with a history of mother-son incest also reported more symptoms of posttraumatic stress disorder than abused men who had not experienced any parental incest. Men were more likely to report a heterosexual orientation if they were abused by their mother, or females in general, than those who were abused only by male perpetrators. Twenty-seven men recalled positive or mixed initial perceptions of the abuse, including about half of the men who had been abused by their mothers. These men reported more adjustment problems than the men who recalled only negative initial perceptions. 3 tables, 1 figure, and 27 references