Objective: The purpose of this study was twofold. First, we determined whether sexually abused adolescent boys or girls were more likely to have internalizing behavior scores in the clinical range. Second, after determining boys were more likely than girls to have an internalizing behavior problem, we tested whether this relationship would persist after several other variables were accounted for: characteristics of the sexual abuse, exposure to domestic violence, self-efficacy, and their peer and caregiver relationships. Methods: A national probability sample of children investigated by child protective services for child maltreatment was used. The sample consisted of 127 girls and 31 boys, ages 11-14. Results: Sexually abused boys were more likely than girls to have an internalizing behavior problem in the clinical range even after controlling for several variables. Exposure to domestic violence, more severe sexual abuse, sexual abuse by a non-relative, and the amount of autonomy support provided by caregivers also increased the likelihood internalizing problem. Conclusions: During early adolescence, sexually abused boys may be more likely than sexually abused girls to have a clinically significant internalizing behavior problem. Researchers need to continue to investigate whether sexually abused boys are as likely as girls or more likely than girls to have an internalizing behavior problem in later adolescence. Practice implications: Internalizing symptoms warrant careful screening and assessment with sexually abused boys and girls who experience more intrusive sexual abuse, who are sexually abused by a non-relative, who are exposed to domestic violence, and who receive lower autonomy support from their caregivers. (Contains 3 tables.)