When sexual abuse is first reported, medical staff should determine when and where the medical evaluation should be conducted. Some communities have a single program or facility that provides evaluations for all victims regardless of when the abuse occurred, whereas other communities have one program for victims with recent or acute injuries and another for victims who were abused several days or more prior to their clinical presentation. Victims of recent abuse are likely to require forensic evidence collection, photo documentation, or treatment for injuries. Victims of chronic or remote abuse usually do not have emergent medical or forensic needs and their medical evaluations can occur in an outpatient setting. Child advocacy centers and outpatient facilities often provide a child-friendly, calm, safe, and supportive setting for non-emergent medical evaluations, victim assistance, counseling, and other services.
Some experts are questioning the need for a medical examination. The majority of examinations for sexual abuse result in normal findings, especially when the last incident of abuse may have occurred some time previously. There are several reasons why the medical assessment is recommended.
— The child may not provide a full disclosure of the abusive acts and the examination may reveal evidence of penetrative trauma.
— The child and family are often concerned about whether the child’s body is normal, and more specifically, whether the hymen is undamaged.
— Reassuring the child and family that the examination findings are normal may reduce anxiety and make the child feel less stigmatized by the abuse.
— In court proceedings, jurors and judges may perceive the lack of a medical assessment as an incomplete investigation, negating the importance of the victim’s statement.
— Some children are victims of repeated sexual abuse. Examinations with photo-documentation allow for detection and comparison of changes that can occur over time.
— The presence of a previously undiagnosed sexually transmitted infection (STI) such as venereal warts may be detected.
We hope to provide professionals who work with victims of assault and abuse with the most up-to-date information when confronted with abusive situations. Read more about medical examination procedures in Medical Response to Child Sexual Abuse. For more information on what we do, visit our website or subscribe to our newsletter.