This paper reviews the evidence on the relevance of gender to the prevalence and impacts of sexual abuse in childhood, and to the interaction between adults with a history of child sexual abuse (‘survivors’) and services. It is widely acknowledged now that child sexual abuse increases the risk of a range of problems in adult life, that a wide range of services can offer reparative experiences, and that there is also a risk of retraumatization if the dynamics of abuse are replicated. Points where gender may affect whether experiences of service provision are reparative or retraumatizing include disclosure, allocation of workers and group work. In a context in which the voluntary sector plays a significant role in provision, the potential gains and losses in the current trend for formerly single-sex specialist voluntary organizations to ‘go mixed’ are discussed. The paper suggests that the politics of recognition adds a useful frame for considering survivors’ needs and the relevance of gender to their experiences