GENITAL INJURIES FOLLOWING SEXUAL ASSAULT OF WOMEN WITH AND WITHOUT PRIOR SEXUAL INTERCOURSE EXPERIENCE

Background: The literature on sexual assault has not directly addresse d the question of genital injuries in women without prior sexual inter course experience. Given the paucity of research and the current impor tance of physical evidence in the criminal justice system, this study was designed to document the type and site of genital injuries from se xual assault in women without and with prior sexual intercourse experi ence. Methods: The charts were reviewed of 132 women who had been sexu ally assaulted and had sought medical treatment at the Sexual Assault Care Centre (SACC), Women's College Hospital, Toronto, within 10 days after the assault. Half (66) of the women reported that, at the time o f the assault, they had no prior sexual intercourse experience.The Sex ual Assault Evidence Kit in each patient's file was reviewed to ascert ain the type and location of genital injuries. Types of injuries were classified into 3 categories (nonperforating soft-tissue injuries, lac erations or current bleeding) and locations into 6 categories (labia m ajora and minora, posterior fourchette and introitus, hymen, vagina, c ervix, and anus). Results: Significantly more women without than with prior sexual intercourse experience had visible genital injuries (65.2 % v. 25.8%, p < 0.01). However, of the women without prior experience, only 9.1% had hymenal perforation. Analyses of the data for only wome n with genital injuries indicated no difference between those without and those with prior sexual intercourse experience in the overall mean number of injured sites (1.65 and 1.47 respectively) or in the mean n umber of sites with nonperforating soft-tissue injuries (0.349 and 0.7 06), lacerations (0.953 and 0.471) and bleeding (0.279 and 0.294). Int erpretation: The results suggest that genital injuries are more common in women without prior sexual intercourse experience but that substan tial proportions of all women, regardless of their prior sexual experi ence at the time of assault will not have visible genital injuries. Em ergency department staff and members of the criminal justice system ne ed to be aware of the variable presentation of genital trauma related to sexual assault in women with and without prior sexual intercourse e xperience.