Sexual Assault: Forensic Examination in the Living and Deceased

Medico-legal study of the hymen

BACKGROUND

The study of hymen morphology and injuries is critical in forensic medicine, particularly in Iraq and other Asian countries. Problems with the hymen can have serious social consequences.

AIM OF THE STUDY

The aim of this study is to shed light on various hymen's variants, as well as the possible causes of their injuries and their medicolegal significance.

METHOD

This study was carried out at Baghdad's medico-legal directorate (M.L.D.) from January 1st to March 31st, 2017. There were 127 cases in total. They ranged in age from two to sixty. The morphology of the hymens, their injuries, and other relevant details were documented using a specific questionnaire.

RESULTS

Compared to other varied examinations undertaken, such as infertility, impotence, and others, the examination of the hymen made up (5.1%) of all examinations conducted in the Medico-Legal Directorate (M.L.D.) clinic in Baghdad. The majority of the women tested were over the age of 14. The annular hymen was the most common variant (57.3%). The elastic hymens percentage was 14.6% while the Imperforated variant had the lowest prevalence (0.8%). The majority of the properties of the examined hymens were smooth free edge, medium consistency, and medium sized hymen opening. The majority of the cases involved female children (prepubertal girls) who were accidently injured, followed by sexual assaults and wedding night doubts. The majority of hymen tears (40.2%) were old. Multiple tears (47.5%) outnumbered single tears (37.3%). Fresh tears were only observed in adult girls.

CONCLUSION

The annular variant of the smooth free edge, average consistency, and average hole size is the most common hymens. The elastic hymens were a main reason for the referral of cases for medical examination due to wedding night doubts. In more than half of the cases, the hymens were smooth with no transection or deep notches.

Comparative Study of Acute Anogenital Injury Between Consensual and Nonconsensual Postmenarche Adolescents

ABSTRACT

In Thailand, sexual activity involving those under the legal age of consent may be legally and medically problematic, even if it is consensual. Thus, differentiating anogenital injury characteristics that occur during consensual versus nonconsensual acts with adolescent female subjects could aid legal advocates and improve health care and social support for these patients. Our study included postmenarche female patients having acute anogenital injuries after consensual and nonconsensual penetration. We found that nonconsenting patients had more cases of anogenital injury than consenting (69.8% vs 55.5%), with at least 1 abrasion, contusion, laceration, labia major or minor injury, and external or internal site injury. Both consensual and nonconsensual cases had the same common sites for injury type, reflecting the same injury mechanism; prior sexual intercourse was a significant protective factor against some anogenital injury prevalence, types, and sites for both groups. Adolescents forced into nonconsensual acts had more nonanogenital injuries. Looking at factors such as age, prior sexual activity history, and use of condom and/or contraceptive pills, it is very clear that early sexual education, particularly around consent, is critically needed in Thailand for the best interests of adolescents and children so that they and/or their guardians can access the health and legal resources required.