This study examined associations between child sexual abuse (CSA) survivors' self-definition status (i.e., whether or not survivors self-identified as sexually abused) and multiple measures of psychopathology, self-system functioning, and risk behaviors. We evaluated the hypothesis that survivors with concordant abuse perceptions (i.e., individuals who reported objective CSA and self-defined as sexually abused) would evidence more pronounced adjustment difficulties in young adulthood than survivors with discordant perceptions (i.e., individuals who reported objective CSA but did not self-define as sexually abused). In this large and ethnically diverse college student sample (N = 2,195; 63.8% female, 36.2% male; 83.3% nonwhite), objective experiences of CSA were associated with increased psychopathology, decreased self-system functioning, and increased risk behaviors, but the magnitude of these effects varied by survivors' selfdefinition status. Relative to their nonmaltreated peers, survivors with concordant abuse perceptions evidenced the largest elevations in psychopathology and risk behaviors, whereas survivors with discordant abuse perceptions evidenced the largest deficits in self-system functioning. These findings indicate that standard screening criteria may misidentify a sizable group of CSA survivors because these individuals do not perceive their experiences as "abuse." Efforts to understand the meaning ascribed to CSA experiences may profitably guide clinical interventions to enhance specific domains of functioning.