Child psychiatrists play an increasingly important role in the forensic, evaluative, and medical aspects of child sexual abuse. Many states have enacted specific statutes that allow the testimony of mental health professionals as a surrogate for the child's own testimony. Consequently, the clinician needs to provide the most accurate and objective assessment of the weight of evidence both for and against the allegation of abuse, to resist all pressures to err on the side of the alleged offender or of the child, and to acknowledge explicitly the limits that current clinical acumen and the lack of empirical research impose on the mental health professional's capacity to respond to hard questions asked under difficult circumstances. 83 references