The patient may be ashamed and unwilling to give a clear history, precisely when such a history is critical for timely treatment and forensic documentation. Clinicians often simultaneously are advocates for the patient and agents of the state. It is vital to the continued well-being of the patient and society that the physician has clear knowledge of how to proceed in such cases. It is virtually certain that many more assaults occur than are ever reported because of emotional stress and misplaced shame on the victim. Current projections indicate that 1 in 4 women will be the victim of a sexual assault.
Injuries occurring during the assault can cause any degree of morbidity or result in death.
Sexual assault victimizes members of all racial groups. Although the most sexual assaults involve women, men also may present as victims of sexual assault. This should include last menstrual period, birth control method, and time of last consensual intercourse. Look for evidence of other injuries and diseases during the ED examination and address them if found. Obtain urine or serum pregnancy tests in women of childbearing age.