The Medical Exam for Sexual Assault

January 14, 2020
During the medical exam following sexual assault, the most important thing is to ensure the integrity of the victim. 

Sexual assault is considered a medical emergency in most healthcare centers. Therefore, they evaluate and assist the victim immediately. All of the protocols designed for a situation of this nature are put into practice when examining a victim of sexual assault.

In all cases, it’s essential to take the appropriate psychosocial approach. The first thing they do is inform the victim of their rights. They explain the steps that they will take and get the victim’s consent to offer medical care.

Women are often the victims of sexual assault. If a man is a victim of sexual assault, the perpetrator is almost always another man. In both cases, the psychological effect is severe. However, males are more prone to developing long-term trauma.

What is the medical exam like for sexual assault?

The concept of sexual assault is broad. Therefore, it can be vague. In general terms, it involves any type of sexual violence committed against a person that harms their autonomy and integrity.

It ranges from physical abuse, kissing or caressing, to actual rape, which involves forced vaginal, anal, or oral penetration. Therefore, not all forms of sexual assault are subject to a medical examination.

In all cases, sexual assault creates negative consequences for the victim on a psychological and social level. However, it does not always cause physical injuries. The medical exam following a sexual assault is typically only carried out when there is a physical injury.

Read: The Differences between Sexual Abuse and Rape

Why doctors perform a medical examination

The medical examination following a sexual assault is a medical-legal assessment to establish the physical and mental state of the victim. Also, they use it to determine the type of injuries the attacker caused and to get evidence for the judicial process.

From a strictly medical point of view, the examination following a sexual assault is aimed at giving attention to acute injuries and assessing the physical consequences of the act. From a legal perspective, the purpose is to document the findings, evidence, and conclusions for judicial use.

The exam must provide elements to prosecute and punish sexual offenders. However, we must never forget that the most important thing is to preserve the physical and psychological well-being of the victim. Otherwise, revictimization could occur.

What does the medical examination after a sexual assault consist of?

sexual assault medical exam

The examiner should perform the exam as soon as possible. The value of the evidence decreases if it is collected more than 72 hours after the abuse occurred. That’s the normal range of time that the perpetrator’s biological material is in the body of the victim. The exam should include:

  • Evaluation of the victim.  First, the professional must receive the informed consent of the victim. This determines if there are acute injuries that require immediate treatment.
  • Immediate medical care. This involves guaranteeing the safety and privacy of the victim, handling intoxication (if any), and managing of accompanying reactions, such as panic attacks.
  • Identifying pregnancy risk and sexually transmitted illnesses. Doctors determine this by taking samples.
  • Medical history. This provides more information regarding the general health status of the victim.
  • Details of the assault. A forensic doctor questions the victim to establish the facts of the sexual assault.
  • Thorough and complete physical examination. This involves analyzing the victim’s body and collecting possible evidence for the case.

Take a look at this article: Nine Signs of Abuse in Children

How it’s performed

The medical exam following a sexual assault must follow a set of procedures. It goes from the head down. First, the head and face are examined, along with the hair. They pay special attention to the oral cavity and the eyes.

Also, they need to evaluate the nails, the middle region of the hand and the forearm when evaluating extremities. This is where there are usually traces of self-defense. Likewise, it’s common to find signs of aggression in the shoulders and wrists. Next, they should explore the legs and feet.

Finally, the doctor examines the genitals and the anal region in detail. First, the doctor checks the external genitalia. Then, they examine the internal genitalia. The examiner must take tests before inserting any instruments.

The doctor must be very careful when collecting the evidence to avoid contamination.

Finally, to make a report, the doctors analyze and evaluate all of the results.

  • Montoya, D., Díaz, R., Reyes, F., Abusleme, C., & Garrido, J. (2004). Peritaje médico legal en delitos sexuales: una pauta práctica para su correcta realización. Revista chilena de obstetricia y ginecología, 69(1), 55-59.
  • Rodríguez-Almada, H. (2010). Evaluación médico-legal del abuso sexual infantil: revisión y actualización. Cuadernos de Medicina Forense. https://doi.org/10.4321/S1135-76062010000100011
  • Guillet-May, F., & Thiebaugeorges, O. (2005). El médico frente a las agresiones sexuales y a la violación. EMC – Tratado de Medicina. https://doi.org/10.1016/S1636-5410(05)70342-1