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During the year 2014, two hundred and seventy (270) victims of sexual assaults had been medico-legally examined in the Teaching Hospital Anuradhapura. Twenty seven (27) were males and two hundred forty three (243) were females. Retrospective study was done by collecting data from medico-legal reports of all alleged sexually assaulted female survivors. Eleven different categories were identified among alleged sexual assault cases according to the main complaint of the victims. They are:-(1) Eloped with boyfriend before the age of 16 years (age for consenting sex)- 108, (2) Consenting sexual intercourse – 41, (3) Fondling/ Touching– 31, (4) Alleged rape and attempted rape (non-consensual sexual intercourse)- 30, (5) Intercrural intercourse (thigh intercourse)- 18, (6) Anal intercourse- 5, (7) Verbal abuse- 5, (8) Abduction-(parents suspected sexual assault)- 3, (9) Fingering-1, (10) Exhibition of genitalia- 1, (11) Naked photographs taken after intercrural intercourse-1. During the year 2014, females between the age of 4 and 78 were sexually assaulted in Anuradhapura district. The age range varies with different sexual assaults. The participation in eloping is seen among females between the ages of 12and 17 years with the maximum number at 15. Consenting sexual intercourse is seen between 12 and 32 years with the maximum number at 15. Fondling and touching were reported between 5 and 42 years with maximum cases at 14. Alleged rape and attempted rape cases are reported between 11 and 78 years with maximum numbers at 13 and 14 years. Intercrural intercourse cases are reported between 4 and 19 years with maximum number at 14 years. Anal intercourse is reported between 5 and 29 years. Sexual verbal abuse is seen at the age of 16 and 18 years. Only case of fingering reported was of a 9 year old, the exhibition case was of 12 year old and the naked photographs taken was of 11 year old. When examining the victims of sexual assaults of fondling / touch, intercrural intercourse, verbal abuse, abduction and exhibition, physical injuries were not expected and none was found. With regards to victims of elope and consensual sexual intercourse, hymeneal tears were the only findings, except in one case which showed a vulval contusion at 6 o’clock position without hymeneal tear. Single hymeneal tear is the commonest type of genital finding and it is commonly situated at 6 o’clock position. Where there were two hymeneal tears, they were not symmetrically distributed around 6 o’clock position. Bodily injuries were seen only in 5 cases of alleged attempted rape category out of two hundred and 270 alleged sex assaults. Absence of bodily injuries cannot be used to suggest consent or to exclude the victims clinical history in relation to sex assaults during court trials. Awareness programs to encourage victims to report to police soon after sexual assaults, clinical forensic medicine specialists for major medico-legal units, colposcopic examination of vagina and devices to detect deep skin contusions are the improvements needed.

Age and injury patterns of female survivors of different alleged sexual assaults examined in the Teaching Hospital Anuradhapura, Sri Lanka