Despite the awareness of the necessity to look from a cultural perspective, few studies have examined how cultural factors influence psychological change after child sexual abuse (CSA) in the Chinese population. This study examined 830 posts on a Chinese online Q&A forum and used thematic analysis to extract important themes and reveal the impacts of child sexual abuse and discuss related cultural values. Three main themes were identified: Forces Making CSA Unspeakable, Long-term Impacts of CSA, and Disillusionment with the Full Recovery. This study suggested that CSA can lead to Dilemmas in Interpersonal Relationships, Self-alienation, Beliefs in Irreparableness of the Damage, and Limited Coping Methods. It also explored how cultural factors such as Sexual Objectification of Women, Patriarchy and Familism, and Minimalization of Non-penetrative Abuse exacerbate these challenges. The contribution of this study is its thorough analysis of the impact of CSA within the context of Chinese culture, along with its novel insights into the role of online posting in the psychological recovery of survivors. Professionals should consider the cultural backgrounds of survivors’ distress, coping, and recovery-related beliefs to develop models of culturally responsive care for survivors.