Sexual abuse in girls and adolescents. Medicolegal considerations

Sexual abuse affects 23% of girls in Spain, although only 7% of this abuse comes to public light. All health professionals should be trained to appropriately interview and examine prepuberal and adolescent girls that may have experienced sexual abuse. Thorough history-taking and physical examination (general and gynecologic) are essential to this task. Relevant factors are hymenal findings, as well as other anogenital signs suggestive of sexual abuse. Nevertheless, normal findings on genital examination do not rule out the possibility of sexual abuse. Prevention of sexually-transmitted diseases and pregnancy is also highly important, as is completion of the mandatory medical report. Finally, we describe current legislation, which allows the physician to be aware of the biological features of interest to the forensic physician, thus guiding the collection of medical evidence to be used in the resolution of these serious medical problems, which have juridical-penal repercussions.