The FAR is always the first person to contact in a sexual abuse case as mandated by Navy instruction. Common sense and sensitivity dictate the medical examination in a child sexual abuse case. Sexual abuse of children does not always involve physical trauma. The history as obtained from parents, guardians, or authorities should provide some guidance to the medical officer's decision regarding extent and degree of physical examination. Any and all acute injuries should be appropriately and carefully treated and documented.
Physical evidence is critically important in sexual abuse cases.
A sexual assault kit and other specimens should be obtained with the assistance of appropriate authorities, including the FAR if the last known sexual contact with the child was less than 72 hours. Detailed physical examination of the genital area can also reveal evidence of chronic sexual abuse, but this should be performed by a pediatrician or other practitioner with expertise in this area whenever possible. Consultation is certainly indicated if chronic or repeated trauma to the genital area is in question. The child's statements in sexual abuse investigations are very important. Extensive questioning, when possible, should be done by a professional trained in sexual abuse interviews.