The ways medical professionals behave when faced with victims of sexual violence are important. Their responses vary dramatically over time as well as according to victim characteristic such as age, gender (including transgender), disability (e.g. Alzheimer sufferer) and minority status (e.g. African American, Latino, indigenous, refugee, sex worker), as well as the financial status of the medical service. Physicians’ behaviour, particularly scepticism about the veracity of the complaint, exerts a powerful pressure on levels of reportage.
If victims (or their caretakers) report the offence to the police, they are asked to consent to undergo a medical examination. Victims routinely claim that this is the most distressing part of reporting a sexual assault, yet medical evidence of assault and marks of violence are crucial for any successful prosecution. Physicians need to decide whether to prioritise medical assistance over the collection of evidence to present at court. Forensic sciences have dramatically altered practices and policies.
Physicians are also required to medically examine alleged perpetrators of sexual violence. How do police doctors reconcile the tension between health care and defence/prosecution requirements? In cases of alleged child sexual abuse within the home and ‘institutions of care’, how do medical practitioners evaluate ‘private’ needs (family, care-givers) versus ‘public’ justice (child protection)?