This Blog Sup­ports Try­ing to True Cases of End Child Sex­ual Abuse

One of the scari­est types of cases to defend even in my expe­ri­ence, even over that of a death penalty case, is a case where actual pen­e­tra­tion of an infant’s or near infant’s gen­i­tals is thought to have occurred.  These types of cases often­times involve some­one who can­not speak or tes­tify or is legally deemed incom­pe­tent to tes­tify due to age.  Many times these cases have lit­tle or no mean­ing­ful foren­sic sci­ence, but rely strictly on the fact that there is dam­age to the per­ineal area.

As a result some­times even seemly expe­ri­enced physi­cians or pathol­o­gists can eas­ily mis­take or make a hasty deci­sion that the dam­age to the per­ineal area or genital-urinary appa­ra­tus can only come from inten­tional sex­ual abuse.

Who reports child abuse

There are many causes that may present con­sis­tent with what one may find in abuse but instead are con­gen­i­tal prob­lems in the per­ineal area or genital-urinary appa­ra­tus such as peri­urethral bands, labial adhe­sion, vagi­nal ridges, ure­thral dilata­tion and ery­thema of the vestibule.  There are even many case reports reported in the medico-legal world that con­clude that there is an acci­den­tal mech­a­nism of cause for the injury.  These events include aggres­sive stretch­ing dur­ing inno­cent play, motor vehi­cle acci­dents, falls from medium height, bicycle-related acci­dents (which were reported as “preva­lent” in those under the age of 9 years old, playground-related equip­ment and even inten­tional child self-mutilation dur­ing “nor­mal” explo­ration of themselves.

Who is accused to be the per­pe­tra­tor of the child sex­ual abuse

The foren­sic com­mu­nity relies heav­ily on the “inves­ti­ga­tion” of the cir­cum­stances and espe­cially does so in the case of lack of phys­i­cal evi­dence.  In the police sci­ence inves­ti­ga­tory realm, the inves­ti­ga­tors are taught to closely ques­tion the care­taker or per­son of sig­nif­i­cant oppor­tu­nity  to look for:  min­i­miza­tion of the injuries, min­i­miza­tion of the person’s care­tak­ing role, reports of sub­stance abuse by the care­taker, men­tal ill­ness in the care­taker, other signs of neglect/malnourishment/other phys­i­cal abuse in the child, attempts to min­i­mize the nature or seri­ous­ness of the injury, not hav­ing vac­ci­na­tions up-to-date and finally my favorite either a “lack of sig­nif­i­cant protest that there was abuse” or “too much con­cern that there may have been abuse while reg­u­larly protest­ing that they are the perpetrator.”

Also, they are tasked to exam­ine a “change in the child’s behav­ior” such as sleep­ing, eat­ing or social inter­ac­tion (e.g., extreme with­drawal or aggres­sive­ness or self-destruction, or inap­pro­pri­ate sex play or pre­ma­ture under­stand­ing of sex).

One of the most use­ful aspects that one who accepts the chal­lenge of exam­in­ing the Government’s accu­sa­tion that there was in fact abuse is to under­stand very basic anatomy (the study of form and func­tion, in plants, ani­mals, and other organ­isms, or specif­i­cally in humans) and anthro­pom­e­try (refers to the mea­sure­ment of the human indi­vid­ual for the pur­poses of under­stand­ing human phys­i­cal vari­a­tion).  It basi­cally asks:  Is this story even phys­i­cally possible?

In girls under 6 years of age car­nal pen­e­tra­tion is impos­si­ble for anatomic rea­sons: the sub­pu­bic angle is still very acute and there­fore cre­ates a true bone bar­rier which obstructs pen­e­tra­tion by the penis.  In girls between the ages of 6 and 11 years, because of the dis­pro­por­tion in size of the gen­i­tal organs, car­nal pen­e­tra­tion causes seri­ous tears with seri­ous bleed­ing to the vulvo-vaginal walls, to the per­ineum, and to the rec­tal walls.  From 11 years of age until menar­che there is hymenal lac­er­a­tion and min­i­mal trauma to the gen­i­tal and par­a­gen­i­tal areas. In adult vir­gins, pen­e­tra­tion can cause only hymenal alter­ation depen­dent on the anatom­i­cal vari­a­tions of the mem­brane, unless there is par­tic­u­lar vio­lence used.

Num­bers of reported sex­ual abuse cases

While no one can pos­si­bly con­done child abuse and it is truly an abom­i­na­tion against human­ity, we need to be dili­gent in our inves­ti­ga­tion to make sure that such a seri­ous accu­sa­tion is indeed sup­ported by the sci­en­tific, anatom­i­cal and anthro­po­met­ric real­ity of human beings.