The relationship between the transverse hymenal orifice diameter by the separation technique and other possible markers of sexual abuse

Objective: To evaluate the relationship between the transverse hymenal orif ice diameter as measured by separation technique (THODST), using a method t hat maximized the diameter of the hymenal orifice, and other possible marke rs of sexual abuse in girls from 3 through 12 years old. Methods: Over a 10-year period, clinical information was recorded on girls referred to the WakeMed Child Sexual Abuse Team in Raleigh, NC at the time of examination. The study population comprised 1975 girls of the 2058 evalu ated for sexual abuse. The girls were interviewed, examined, and tested for sexually transmitted diseases. Information from referral sources, accompan ying guardians, and previous recent physical examinations was recorded. The girls were assigned to three groups based upon their risk of being sexuall y abused. Linear regression was pet-formed to evaluate how well the THODST distinguished between the risk groups, as well as how it was correlated wit h individual established markers of sexual abuse. Results: The size of the THODST did not distinguish between the three risk groups, nor did it correlate with any potential or established markers of s exual abuse other than three potential markers of hymenal trauma: narrowing of the posterior hymenal rim, hymenal tears and lacerations, and hymenal c lefts between 5 and 7 o'clock in the supine position. Conclusion: Thus, we found the THODST as we measured it to have no value fo r answering the question, "Was this child sexually abused?" (C) 2001 Elsevi er Science Ltd. All rights reserved.