Tammy Lerner grew up in a big, close-knit family in central Pennsylvania. Everyone lived near one another, celebrated holidays together, and respected the elders as the strong-willed heads of the extended household.

When some family members heard allegations that young Tammy and a couple of cousins were being sexually abused by two of their uncles, they protected their kin.

The accused abusers, that is.

"My story is not exceptional," said Lerner, now 41 and vice president of the Bryn Mawr-based Foundation to Abolish Child Sex Abuse.

Families riven by possible child molestation - when accuser and accused are related - often wrap themselves in secrecy. They hush accusations, experts say, to avoid social stigma or keep the family intact. Relatives take sides, creating divisions that inflict an additional layer of pain.

That pain has been intensified for many families as child-molestation allegations proliferate - with accusations against former Penn State assistant football coach Jerry Sandusky, ex-Daily News sportswriter Bill Conlin, Ukrainian hockey coach Ivan Pravilov, and the long-running abuse scandal in the Catholic Church.

"There's so much agony and frustration over what happened to their children that it's almost palpable. It hits you in the chest, in the gut," says Mary, a Delaware County mother of abuse victims.

Mary asked that her full name not be used. The Inquirer does not identify sex-abuse victims; identifying the mother would identify the victim.

She described a support group she participated in for parents of sexually abused children: "I drove home that first night after the group and I probably sat in front of my house for an hour, tearful. The pain overwhelmed me that night."

Abuse within families is more common than people realize - research shows that 90 percent of child sexual abuse is committed by a relative.

"A lot of families have someone they know not to hang out with," said Ted Glackman, executive director of the Joseph J. Peters Institute, a Philadelphia mental health agency that serves sexual abuse victims and offenders. "There's an incredible amount of shame, which usually leads to some secrecy."

In Sandusky's case, Penn State officials acted like family, circling its own when it learned of possible abuse.

"They're concerned about reputation or image and we know that happens whether it's within a family or within an organization," said Cindy McElhinney of the South Carolina-based nonprofit Darkness to Light, which works with adults to prevent child sexual abuse.

Conlin's alleged victims in the 1970s, when the assaults were said to have occurred, were relatives and friends of his children. The youngsters went to their parents with the accusations against Conlin, but rather than go to authorities, the adults only told Conlin to stay away from their children or kept them away from him.

"I'm really sorry that I didn't do something more at the time," Barbara Healey told The Inquirer regarding her response to hearing accusations years ago that Conlin had molested her son and daughter. "Call the police is what I should have done."

Lerner, decades after her abuse, has no contact with most of her family and only occasionally sees her parents. It hurts them, she says, to know she feels they betrayed her by not protecting her from her uncles.

One of the uncles was never charged because the statute of limitations had run out by the time Lerner and her older cousins went to authorities. The other pleaded guilty to a misdemeanor charge of indecent assault and paid a $250 fine in 1994 after a younger cousin filed a complaint within the required time, said Union County District Attorney D. Peter Johnson.

Doing more at that moment is trickier than it seems it should be. That may be why the Twitter hashtag #ididnotreport is so popular worldwide. A typical tweet: "#ididnotreport because I was a child and had no idea what to say."

For a parent, facing the physical and emotional injuries your child may have suffered can be paralyzing.

"It's hard that this happened to their child. They have been tricked, too, and feel anger and shame for letting this child in their house go over to Uncle Bob's house - aside from if there is an investigation by law and child protective services, potentially getting someone close within the family in trouble," said Pat Kosinski, executive director of Family Support Line in Delaware County.

"Most people can't make the leap from fear to reporting such suspicions to authorities," said Jenny Coleman, who runs a telephone help line for Stop It Now!, a national child-abuse prevention group based in Massachusetts.

Many need to go slowly and learn what could happen if they take the next step.

Mary, the Delaware County woman, remembers a parent from a support group who was overwhelmed with frustration one night. The woman needed a parent who had already dealt with child sex abuse to " 'tell me my daughter is going to be all right, because right now, I can absolutely not see the future without any kind of pain or frustration,' " Mary recalled.

Child sexual abuse was even more difficult to confront in the 1990s and earlier than it is now, said Chris Kirchner, executive director of the Philadelphia Children's Alliance, a nonprofit organization that helps investigate those cases.

"I do think in that era, they didn't quite know what they were dealing with," Kirchner said. "They didn't know this wasn't a one-time thing."

Now, national and local groups, including the Family Support Line, the Peters Institute, and Darkness to Light, train adults to prevent child sexual abuse by recognizing the warning signs - among them an adult giving gifts to one child in the family or seeking ways to be alone with the child.

No matter how fraught acknowledging abuse suspicions is, silence should not trump protecting children, said Coleman, of Stop It Now!

"Don't let it stop there."

Contact Carolyn Davis at 215-854-4214, at cdavis@phillynews.com or @carolyntweets on Twitter.