Sexual Abuse Examination
Shawn Wygant, Demosthenes Lorandos, Tonya Craft & Nancy Aldridge
Shawn Wygant, Ph.D. cand.
Demosthenes Lorandos, Ph.D., J.D.
Perhaps one of the most difficult subjects lawyers, judges and experts face, in order to properly diagnose (or rule out) child sexual abuse, two distinct sets of skills and knowledge are required: those for the forensic interview (covered in Chapter 23 Child Sexual Abuse Interviews) and those for the physical examination–the topic of this chapter. Trying both emotionally and professionally, child sex abuse is so challenging to properly diagnose for a variety of reasons, including that (1) normal anatomy can look as if it’s been injured; (2) injuries from other causes can be mistaken for abuse; and (3) the vast majority of child sex abuse victims show no physical injuries.
To help attorneys and judges navigate this quagmire, this Sexual Abuse Examination chapter, written from an evidentiary perspective, provides detailed guidance from the foremost authorities in this sub-field in medicine and forensic medicine. Particular topics include:
Detailed protocols for conducting an examination and documenting and collecting evidence, including DNA evidence
Comprehensive treatment on the import of the absence of physical findings
A primer on the unique specialty of sexual abuse physical examination and the knowledge and skill required to perform it properly
Detailed discussion of the pitfalls of misused statistics in diagnosing child sexual abuse, with real world examples to illustrate complex principles
Detailed guidance on the requirements, nature, purpose, methodology & timing of the exam
Comprehensive discussion of the requirements to properly interpret medical findings (and avoid erroneous interpretations)
Guidance on what comprises definitive findings
