Derivation of the Genital Injury Severity Scale (GISS): A concise instrument for description and measurement of external female genital injury after sexual intercourse

Kelly, Dana; Larkin, Hillary J.; Cosby, Cecily D.; Paolinetti, Lauri A.

doi:10.1016/j.jflm.2013.04.012

Cited by 14 publications

(11 citation statements)

References 31 publications

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“…This may be because most facilities did not have a colposcope due to its immense expense and maintenance and the required additional physician training for proper handling (24). A colposcope is an instrument with binocular magnification capabilities (minimum 2.5x power) that also allows for pictures to be taken from a mounted camera (24, 35).…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Injury Patterns in Consensual and Nonconsensual Sex: Is It Possible to Determine if Consent was Given?

Song

Fernandes

2017

Academic Forensic Pathology

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Matters of sexual consent and sexual assault are hotly debated issues among professionals and laypersons alike. A widespread misconception of sexual assault is that most victims of sexual assault sustain significant physical trauma. It is the purpose of this review article to compare the patterns of physical injury (both genital and extragenital) in victims of sexual assault and participants of consensual sex to conclude if physical injury alone can indicate whether consent was given. Interpretations of injury have great forensic significance as it can influence the outcome of sexual assault cases. Several articles indicate that extragenital injuries are commonly found in sexual assault victims (46%-82%) and that most of such injuries are deemed minor. Articles report a wide range of genital injury detection rates in both sexual assault victims (6%-87%) and consensual sex participants (6%-73%). Usage of different examination techniques may partly explain the wide range of detection rates reported. Out of all those who sustained genital injuries, only a small portion of people required hospitalization. In both consensual and sexual assault cases, genital injuries in the 6 o'clock position were most common. Studies of genital injury lacked standardization of factors that significantly influence the results, such as time to examination after sex, examination techniques, and injury severity scales. Therefore, medicolegal personnel should be aware that sexual assault victims can present with a wide range of physical trauma and should avoid relying on physical trauma alone to conclude whether consent was present.

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Section: Discussionmentioning

confidence: 99%

“…and consensual intercourse participants in meta-analyses of the sexual assault literature (35). At the time of the writing, the GISS has not been validated for widespread adoption in the literature.…”

Section: Review Articlementioning

confidence: 99%

Comparison of Injury Patterns in Consensual and Nonconsensual Sex: Is It Possible to Determine if Consent was Given?

Song

Fernandes

2017

Academic Forensic Pathology

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“…These variations demonstrate the difficulty of interpreting the findings in a group of victims, and it is even harder to try to compare them. 15 Therefore, I will focus the analysis on genital and/or anal injuries only. The prevalence of genital injuries reported after sexual assault ranges between 5 and 87%, according to a metaanalysis conducted by Kennedy.…”

Section: Evidence About Genital Injuries In Sexual Violencementioning

confidence: 99%

Genital Injuries: Are They Telling us Something about Sexual Violence?

Orellana-Campos

2020

Rev Bras Ginecol Obstet

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Genital injury has a forensic relevance after a sexual assault and it has been discussed and investigated among professionals who work in this field. To analyze the studies published in the last decades, the present review examines different factors that may influence this finding, first clarifying terms of the forensic field, such as the peculiarity of the legal medical examination, and the distinction of the terms “legal” and “anatomical” vagina. Finally, it analyses if it is possible that the existence of these injuries in victims explain the lack of consent in sexual contact, and to clarify the meaning of the absence of injuries.

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“…Including only the skin-breaching symptoms that obey our definition of CW (Box 1), such as mucus lesions, abrasions, or lacinations, CW was found in 10% -52% of the examined women (Astrup et al 2012;Lincoln et al 2013). However, a standard classification of genital injury after sexual intercourse was not available until recently (Kelly et al 2013). Variation in CW between studies will therefore include actual variation between populations, but also variation as a result of different methodologies.…”

Section: Cw In Humans With a Note On Its Medical And Legal Significamentioning

confidence: 99%

“…Nonconsensual sex was found to result in much, moderately, or not significantly more female genital injuries compared with consensual sex (Edgardh et al 1999;Jones et al 2003;Anderson et al 2009;Lincoln et al 2013). However, the lack of a classification scheme of female genital injuries until recently (Kelly et al 2013) and the occurrence of genital wounds after consensual sex made a recent review conclude that "the presence or absence of genital injury should not be used to render an opinion regard-ing consent to sexual intercourse" (Anderson and Sheridan 2012). We do not discuss this topic in more detail as such cases usually represent situations in which human males use sex as a weapon (Geist 1988).…”

Section: Male Injuries During Consensual Intercoursementioning

confidence: 99%

Copulatory Wounding and Traumatic Insemination

Reinhardt

Anthes

Lange

2015

Cold Spring Harb Perspect Biol

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Copulatory wounding (CW) is widespread in the animal kingdom, but likely underreported because of its cryptic nature. We use four case studies (Drosophila flies, Siphopteron slugs, Cimex bugs, and Callosobruchus beetles) to show that CW entails physiological and lifehistory costs, but can evolve into a routine mating strategy that, in some species, involves insemination through the wound. Although interspecific variation in CW is documented, few data exist on intraspecific and none on individual differences. Although defensive mechanisms evolve in the wound recipient, our review also indicates that mating costs in species with CW are slightly higher than in other species. Whether such costs are dose-or frequencydependent, and whether defense occurs as resistance or tolerance, decisively affects the evolutionary outcome. In addition to sexual conflict, CW may also become a model system for reproductive isolation. In this context, we put forward a number of predictions, including (1) occasional CW is more costly than routine CW, (2) CW is more costly in between-than within-population matings, and (3) in the presence of CW, selection may favor the transmission of sexually transmitted diseases if they induce resource allocation. Finally, we outline, and briefly discuss, several medical implications of CW in humans.

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Derivation of the Genital Injury Severity Scale (GISS): A concise instrument for description and measurement of external female genital injury after sexual intercourse

Cited by 14 publications

References 31 publications

Comparison of Injury Patterns in Consensual and Nonconsensual Sex: Is It Possible to Determine if Consent was Given?

Comparison of Injury Patterns in Consensual and Nonconsensual Sex: Is It Possible to Determine if Consent was Given?

Genital Injuries: Are They Telling us Something about Sexual Violence?

Copulatory Wounding and Traumatic Insemination

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