Chapter objectives

1. Understand the purpose of a forensic rape exam

2. Be able to perform a forensic rape exam

3. Be able to provide high quality medical care for a victim of sexual assault

4. Provide resources for both immediate referral and continued learning by the health care professional

The sexually assaulted patient

Sadly, it is guaranteed that every physician will work with a patient who has been sexually assaulted. It is commonly estimated that around 20 percent of women and 3 percent of men will be sexually assaulted during their lifetime. Sexual assault occurs worldwide, with youth, poverty, and living in a conflict area contributing to the risk of being victimized. Depending on your specialty you may treat victims acutely or in follow-up. Even if you never perform a forensic rape exam immediately following the attack, it will be helpful to know what the exam entails and how it may impact your patient. If you are an emergency physician, ob/gyn, or pediatrician, you may be called upon to collect forensic evidence as part of the acute care of a sexual assault victim. The quality of the care you provide can have far-reaching effects for the patient – physically, legally, and psychologically. There is evidence that the patient's experience of the health care interaction can impact the development of post-traumatic stress disorder (PTSD) in the future.

Reviews of the National Ambulatory Care Database illustrate the need for better training and management in the care of sexually assaulted patients.