Despite the psychological impact of child sexual abuse, many victims do not acknowledge that their experiences were "abuse." This study sought to identify factors that predict how women label their own experiences of childhood sexual abuse. This cross-sectional study was conducted in a family medicine clinic with adult female patients. Subjects completed structured interviews about their childhood environment and their sexual abuse history. Logistic regression analysis showed that labeling of abuse was dependent upon intercourse (beta = 7.43, p = 0.006), the frequency of abuse by the first perpetrator (beta = 5.08, p = 0.024), and paternal overprotection (beta = 6.69, p = 0.010). Findings suggest that the severity of abusive acts is most important and an over-protective father may enhance the victim's acknowledgment that sexual touching is abusive. (Contains 3 tables.)