Forensic Perspectives on Child Sexual Abuse Disclosure in Greece: A Retrospective Study.

Purpose: Child sexual abuse (CSA) is a major public health and forensic concern, often involving delayed disclosure that limits evidence collection and affects judicial outcomes. This study analyzed disclosure patterns, victim-perpetrator characteristics, and forensic findings in CSA cases evaluated in Greece, contributing to the limited Southern European evidence base. Material and Methods: A retrospective review of 89 CSA cases (2014-2024) examined by a certified forensic physician at the Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, was conducted. Data from official medico-legal reports included demographics, abuse context, forensic findings, and disclosure interval. Statistical analyses explored factors associated with delayed disclosure (>7 days). Results: Victims were predominantly female (69.7%) with a mean age of 9.8 years. Most perpetrators were adult males, and over half of cases (53.9%) involved intrafamilial abuse. The mean delay in disclosure was 79 days; only 29.2% reported within one week. Recurrent abuse correlated with delayed disclosure (p = 0.006), while early disclosure was associated with biological evidence collection (p < 0.001). Physical injuries were observed in 23.6% of victims, genital findings in 17%, and anal findings in 3.4%. Conclusions: Delayed disclosure was common and significantly reduced the likelihood of identifying forensic evidence. The early application of trauma-informed examinations, which adopt a child-centered approach emphasizing safety, emotional regulation, and the prevention of re-traumatization, is essential for the medical and forensic evaluation of abused children. Adopting hospital-based multidisciplinary units could improve forensic documentation, interagency coordination, and psychosocial care in Greece.