Forensically trained nurses often treat sexual assault survivors. They're responsible for identifying genital injuries, and their documentation of those injuries is often used during legal proceedings. The authors of a recent literature review sought to examine whether it can be determined that female genital injuries are a result of consensual or nonconsensual intercourse.

The review included only 13 articles. In the eight studies that examined nonconsensual sex, genital injury occurred at frequencies ranging from 20% to 81%, with the highest rate in women who experienced forced digital penetration. The determination and definition of injury varied across studies. Injury was more often noted in patients who were virgins and in women examined within 24 hours of intercourse. Similarly, fewer injuries were identified from examinations conducted after longer intervals, the duration of which varied by study.

Three articles outlined results of examinations after consensual intercourse, with two reporting an overall genital injury rate of 55%. Although the third paper didn't provide a rate, the study found that the injury surface area reduced significantly 24 hours after an initial evaluation.

Two articles included women examined after either consensual sex or nonconsensual intercourse; the data for both were based on a single sample of approximately 100 patients. Injury rates in both groups were similar: 30% in the consensual group and 32% in the nonconsensual group. The authors noted that although women in the nonconsensual group were more likely to have multiple injuries-such as tears, abrasions, and bruising-these studies lacked sufficient power.

After examining the limited data, the authors conclude that because genital injuries can occur after both consensual and nonconsensual intercourse, and studies have been unable to definitively identify injuries that are specific to each, nurses examining these patients should continue to document injuries for the medical record but "should refrain from documenting or testifying in a courtroom setting that the injuries occurred as a result of nonconsensual sex."

Reference