------------------------------------------------------------------------------------------------------------------ January 2008| Volume I Issue I
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Medical Evidence in Child Sexual Abuse Cases - UPDATE
Why are physical signs so infrequently found in children who have been sexually abused? The reasons are rather straightforward and logical. A pedophile generally does not want to physically injure or cause pain for the victim and may go to great lengths (such as grooming the victim over a period of time and slowly increasing the intimacy of the acts involved) to continue the “relationship”.

Many of the abusive activities that pedophiles inflict on children do not involve injury to the genital or anal tissues. For example, the circular muscles surrounding the anus commonly allow for non-traumatic penetration because of their ability to stretch without tearing when gentle pressure is exerted.

Even when an injury does occur, the genital and anal tissues have an excellent blood supply so that many wounds heal rapidly and without visible changes such as scars.

Once a girl has begun going through puberty, the hormonal changes that prepare her genitalia for sexual intercourse and birthing also significantly decrease the possibility of injury as a result of child sexual abuse.

In all children, the possibility of a physical sign of injury from child sexual abuse is more likely if the child experienced bleeding or complained of painful sensations following the abuse. Statistically, however, almost 95 percent of children who have been sexually abused will have no physical signs of the abuse.

Although positive findings are uncommon, the physical examination of the child who has disclosed or is suspected to have been sexually abuse is essential to determine if physical evidence of the abuse exists, document any forensic physical findings, treat any health problems, assure the victim and caretaker of the child’s health and “wholeness”, and begin the family’s psycho-social healing process. (Return to front page)

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