Physical forensic signs of sexual torture in children. A guideline for non specialized medical examiners.

Proper forensic documentation of sexual torture in children is crucial. Informed consent for examination and documentation must be sought from the child/accompanying person and the examination conducted in a sensitive and respectful manner. Time should be given to the child to relate the history of torture and the examiner should start with open ended questions. The history of torture should be recorded verbatim as much as possible. The words used to describe the anatomy and the forensic findings have to be precisely defined. The child should be examined from head to toe and should be left partially clothed. Penile, digital or object penetration of the vagina does not always lead to injuries even if the child is seen very soon after the abuse. Genital injuries heal rapidly and can leave no scars. Penile, digital or object penetration of the anus does not always lead to injuries even if the child is seen very soon after the abuse. Sexual torture cannot be disproved by the absence of injuries or scars.