Many American women who were sexually abused as children seek mental health services to help them heal from their abuse. An appreciation of the varied sources of trauma that may stem from a sexual abuse experience may guide clinicians in facilitating a meaningful discussion with survivors of the ways in which their childhood development and their current lives have been influenced by their sexual abuse. Therefore, the goal of this study was to provide a beginning delineation of possible sources of trauma in the abuse situation, based on the retrospective reflections of women who have survived abuse. One hundred and eighty-six survivors were asked to identify the most traumatic aspects of their abuse experience. A content analysis was performed on their written responses, and the following eight categories, reflecting different sources of trauma, were identified: abandonment, powerlessness, violence, betrayal, guilt and shame, loss of self, loss of childhood, and impact on sexual adjustment. Possible treatment implications and suggestions for future research are discussed.