Physical evidence of rape against children and adolescents in Brazil: Analysis of 13,870 reports of sexual assault in 2017

Abstract

Introduction: The medical literature reports child and adolescent maltreatment since the 8th century. Unfortunately, even today, the incomplete knowledge of this event persists. Several forms of violence are applied to children and adolescents, mainly sexual violence including rape and sexual assault. Forensic medical examinations routinely include the genital area, anus, and the body of the victims for signs of a recent or old injury. The main goal of this study is to show the results of physical and sexual examinations regarding confirmation of rape in children and adolescents, based on the medicolegal reports. Methods: We made a descriptive cross-sectional study conducted by collecting data from Medicolegal Institute (IML-São Paulo, Brazil) in 2017. We examined 13,870 reports of sexological examinations of victims of the alleged rape. The variables analyzed were age; sex; physical examination; sexological examination; and direct search for sperm in the vaginal, anal, or oral cavity. We selected 11,725 reports from victims under 18 years. Results: As for the medical-legal findings, only 1735 reports (14.8%) confirmed sexual abuse. The most affected ages were between 3 and 5 years in the male group and 11 to 14 years in the female group. The most frequent injuries were bruises and abrasions, fissures in the anal region. In 96.2% of the examined males and 85.8% of the females under 14 years old, the examination was inconclusive, and somebody cannot prove the alleged rape. Only 1735 reports (113 from men and 1622 from women) concluded beyond any doubt the alleged rape (14.8%). The search for sperm was positive in only 1582 cases (13.5%). Conclusion: This study shows that the results of the medicolegal examinations were quite limited in recording evidence. Sexual violence against children and adolescents reaches mostly females under 13 years of age. Besides, it is a complicated crime to prove, as 85.8% of female examinations and 96.2% of male exams revealed: “no supporting elements” or “undetermined” to characterize the felony. Therefore, to prevent it, the communication of the alleged rape must be made as quickly as possible.

Forensic Aspects of Male Child Rape and How We Can Prove It

“…Finally, we have to make an anal smear and an anal swab to search for sperm. However, in our previous study [10], this search resulted negatively in most cases, as we pointed out above.…”

“…Ideally, this collection should occur within the first 72 h after the alleged rape, which is not always the case. The ideal collection time is forty-six hours for anal swabs [10].…”

“…However, in the study mentioned above, despite bruises, abrasions, or fissures in the anal region, in 96.2% of the examined males under 14 years old, the examination was inconclusive, and somebody could not prove the alleged rape. Besides, the search for sperm was positive in only 13.5% of the cases, including boys and girls [10].…”

“…Recently, we published a study in which 13,870 reports of sexual assault in Brazil in 2017 were analyzed [10]. This descriptive cross-sectional study selected 11,275 reports from victims under 18 years.…”

“…Thus, evidence of injury to the anal region in this group of children is of "particular significance in the clinical evaluation of child sexual abuse" [16]. Some authors consider anogenital findings consistent with acute sexual abuse in male children to perianal swelling, marginal hematomas, radial fissures, dilated anus, and linear skin abrasions [10]. However, many of these findings are questionable.…”