Journal of Current Forensic Science Research, 2015, 1, 00-00 1 © 2015 Revotech Press Forensic Medical Examination in Female Children Alleged to have Sexually Abused I.D.G. Kitulwatte 1,* , H.P. Wijewardena 2 , P.A.S. Edirisinghe 1 and U.D. Senarathne 2 1 Department of Forensic Medicine, Faculty of Medicine, University of Kelaniya, Ragama and 2 North Colombo Teaching Hospital, Ragama, Sri Lanka Abstract: Introduction: Child sexual abuse is a global public health problem and the medico legal examination is directed to provide an objective, unbiased opinion on alleged sexual contact. There are many factors influencing such opinion. Objective: The aim was to study the factors influencing the medico legal opinion in female children who alleges sexual abuse. Methodology: A retrospective descriptive study was done based on medico-legal case records of female children who had been referred for medico legal examination following alleged sexual abuse during past 3 years to the Teaching Hospital Ragama, Sri Lanka. Data analysis was done with Statistical Package for Social Sciences (SPSS). Results: We studied the records of 353 child victims for this research. The main presenting complaint was concerns of the guardian 168 (48%). Majority, 261 (74%) presented for medico legal examination 72 hours after the incident. The perpetrator was known to the victim in 339 (96%) cases. Recent injuries were observed only in 40(11%) victims while there were 184(52%) victims with old injuries. 122 (73%) out of 168 victims who were brought due to concerns of the guardians had genital injuries and of them only 11 (9%) had recent injuries. Psychological impacts were observed among 149 (42%) children. Out of the 74 victims who had experienced physical threats, only 12 (16%) had supportive injuries. Firm positive medico legal opinion as per the complaint was given in 218 (62%). Conclusions: Paucity of medical evidence is well observed in child sexual abuse and is a challenge to the medical expert. The mere absence of physical findings does not necessarily exclude the allegations of sexual abuse. Proper insight in to the presentation, pattern and factors influencing medical opinion is needed for proper administration of justice. Keywords: Female children, Sexual abuse, Medical evidence, Injuries, Opinion. 1. INTRODUCTION World statistics reveal that approximately 7.9% of boys and 19.7% of girls globally experienced sexual abuse prior to the age of 18 [1]. Sexual abuse is usually underreported and child sexual abuse is even less reported. Across all studies it is clear that only about half of the young victims disclosed the abuse to anyone [2]. The aim of forensic medical examination and evi- dence collection in a case of sexual assault is to docu- ment an alleged physical or sexual contact between individuals and to corroborate the victim's and the assailant's history. Even if physical signs of sexual abuse are rare, proper documentation is essential in assisting the crim- inal justice system. Presence of an injury influences decision making throughout the criminal justice process. Child sexual abuse is a unique phenomenon; the presentation and pattern often vary to that of adult * Address correspondence to this author at the Department of Forensic Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka; Tel: + 94112961000; E-mail: indiradgk@yahoo.com sexual abuse. Definitive signs of genital trauma are seldom seen in cases of child sexual abuse, as phys- ical force is rarely involved [3]. Due to characteristics specific to child sexual abuse, the correct medico legal interpretation of minimal genital findings in children requires specialist skills. It is generally believed and clinicians are in agree- ment that false allegations by children are very rare [4]. However, the forensic expert must always be objective and have an open mind towards the allegations. The opinion he makes should be based on scientific evi- dence. The findings must be in accordance with basic principles of pathology and pathophysiology. Balanced and reasonable evidence based opinion of a forensic expert can contribute immensely to the criminal justice system. Therefore to provide an insight into the presentation, pattern and prevalence of genital injuries among the Sri Lankan female child victims of sexual abuse at forensic medical examination and to fulfill the gaps in our knowledge on different variables that can influence the medico legal opinion on genital as well as non-genital injuries, we designed a retrospective