The current study used a national probability sample of 8618 Icelandic youth between the ages of 16 and 20 to examine the impairments associated with childhood sexual abuse for male and female victims. The dimensions of impairment were: general anxiety, eating anxiety, depressed mood, theft, and violent behavior. Overall, our results suggest that gender differences in impairment may depend on the particular outcome measured: (1) females were approximately three times more likely than males to experience childhood sexual abuse; (2) the association between childhood sexual abuse and subsequent depressed mood and general anxiety varied significantly by gender, with females more likely to experience these impairments; and (3) the associations between childhood sexual abuse and subsequent eating anxiety, theft, and violent behavior did not vary by gender.