Consensual Sexual Intercourse Research Articles

Evaluation of incest cases in Sivas: Ten‐year retrospective study

AbstractAlthough incest is generally perceived as all kinds of verbal, non‐verbal, physical and visual sexual behaviour of family members and close relatives toward children, it is also a special type of sexual abuse defined as consensual sexual intercourse between close relatives or between minors who are legally prohibited from marrying. This study aimed to analyse the sociodemographic data, physical‐mental examination and laboratory findings of the incest cases. Incest cases among sexual abuse and sexual assault cases sent to Sivas Cumhuriyet University Hospital Forensic Medicine outpatient clinic for examination between 2012 and 2021 were evaluated. Statistical analysis of the data was performed using the SPSS 23.0 program. P‐values below 0.05 were considered significant. The records of 61 incest victims were retrospectively analysed. The cases were examined in terms of age, gender, incident, perpetrator, type of abuse, examination findings and mental status. Fifty‐four (88.5%) of the incest victims were female, and the highest rate (n = 9, 14.8%) was 16 years old. Most of the victims were high school graduates (29%), 56% were in a nuclear family 57.4% of the assailants were family members, most of the case reports (73.8%) were made by the victim herself/himself, and the most common place of incident (70.3%) was the victim's home. In this study, the clinical, social and forensic outcomes of incest cases, which have many causes and tragic consequences, were investigated, and it was aimed to contribute to the solution of the problem by discussing the literature.

Menstrual Patterns and Age of Menarche in Young Women from the United States

Background Menarche is a salient event for adolescents that marks the beginning of reproductive life and the commencement of menstrual cycles. Despite this, much less is known about how the timing of menarche is related to menstrual patterns. Methods To that end, a cross-sectional sample of 523 young women in college from the United States provided data on menarcheal age, menses and cycle length, blood loss during menses, dysmenorrhea, and menstrual cycle regularity. Sociodemographic data such as age of first sexual intercourse, presence of biological father while growing up, self-reported body weight, and urban versus rural place of residence were also obtained. Results Mean menarcheal age was 12.89±1.31-years. Regarding cycle length, 42 (8.2%) of the women had cycles shorter than 21-days, 402 (78.2%) between 21 and 35-days, and 70 (13.6%) had cycles longer than 35-days. Concerning menorrhagia, 61 (11.8%) reported a small quantity of blood loss, 363 (70.1%) a medium quantity, and 94 (18.1%) reported a large loss of blood (menorrhagia). Duration of menstrual bleeding also showed variability with 33 (6.4%), 280 (54.2%), and 204 (39.5%) reporting menstrual bleeding lasting less than 3-days, 2 to 5-days, and greater than 5-days, respectively. The overall prevalence of dysmenorrhea was 61.7% (n=319) of the sample, while 36.3% (n=187) reported irregular menstrual cycles. Logistic regression indicated that early menarche, long menses duration, large self-reported amount of blood loss, and early age of first sexual intercourse were significant predictors of dysmenorrhea, while women with small self-reported amount of blood loss, a short menses duration, and long cycles were less likely to have dysmenorrhea. Concerning the timing of menarche, participants who were over-weight, grew up in urban environments, had dysmenorrhea, had early first consensual sexual intercourse, and grew up without a biological father, were more likely to have early menarche. Conclusion These findings suggest that menstrual disorders are common among a sample of young women from the United States and also identify sociodemographic variables that are related to menarcheal age.

Basic Considerations of Judges in Imposing Criminal Code Article 81 Paragraph 2 of the Child Protection Law Against Children Who Have Sexual Intercourse on the Basis of Consent

In this study, the author raises the issue of the basis of the judge's consideration in imposing punishment on children who commit Copulation on the basis of mutual consent. This is motivated because it is not clearly regulated in the Child Protection Law regarding the crime of sexual intercourse committed by a child if the sexual intercourse is carried out on the basis of mutual consent without any element of violence or persuasion from the perpetrator to the victim, causing a vacuum of norms. The formulation of this problem is How is the evidentiary arrangement of the case of sexual intercourse committed by a child on the basis of mutual consent in Indonesia and What is the basis for the judge's consideration in imposing a criminal decision based on Article 81 paragraph (2) of the Child Protection Law against children who have sexual intercourse on the basis of mutual consent. The objectives in this study are (1) To know and analyze the criminal proof of sexual intercourse committed by children on the basis of mutual consent in Indonesian criminal law enforcement. (2) To know and analyze the basis of the judge's consideration in handing down a verdict against minors who have consensual sexual intercourse. To analyze this problem, the theories that will be used as guidelines for analysis are the theory of evidence, the theory of justice, expediency and legal certainty. This type of research uses normative legal methods consisting of a statutory approach (statue approach), conceptual approach (conceptual approach) and case study approach (case law). The results of this study, the author concludes that the Child Protection Law does not recognize the term consensual because the position in child sexual intercourse against children who are consensual, children are seen in the position of victims. Although in the proof the act is done consensually or child fornication. The criminal regulation is regulated in Article 81 of Law Number 35 of 2014 concerning Child Protection

Anogenital injury following sexual assault and consensual sexual intercourse: a systematic review and meta-analysis

Sexual violence is a grave human rights violation and a serious global public health challenge. Rates of reporting of sexual violence and subsequent passage of cases through the criminal justice system are poor all over theworld. The presence or absence of anogenital injury following sexual assault may influence survivors in their willingness to report a crime, and law enforcement officers and jurors in their decision making regarding the laying of charges and/or conviction of offenders. The aim of this systematic review was to compare rates of identification ofanogenital injury (AGI) in women following sexual assault and consensual sexual intercourse using the same examination techniques. In this systematic review and meta-analysis, Medline, Embase and Google Scholar were searched for relevant studies (in any language, with no age or sex criteria) published between February 25, 1993, and February 25, 2023, that directly compared AGI between individuals after either sexual assault or consensual sexual intercourse. Abstracts, conference proceedings, and case reports were excluded. The primary outcome of interest was any form of detected AGI. The Mantel-Haenszel method was used for meta-analysis using random effects modelling to determine the risk ratio (RR) of AGI between sexual assault and consensual sexual intercourse. Quality assessment was undertaken using the Newcastle-Ottawa scale tool. The I2 statistic was used to determine heterogeneity among studies. An I2 >75% was considered high heterogeneity. Funnel plots were used to assess the risk of publication bias, by determining any visually apparent asymmetry. This analysis is registered with PROSPERO, CRD42023402468. We included 10 studies, accounting for 3165 study participants. All participants were female. AGI was detected in 901 (48%) of 1874 participants following sexual assault and 394 (31%) of 1291 participants following consensual sexual intercourse. Meta-analysis of all included studies demonstrated that the presence of AGI was significantly more likely for participants following sexual assault than consensual sexual intercourse (RR 1.59 (95% CI 1.21, 2.09); p<0.001). There was a significant heterogeneity among studies and funnel plots suggest that this RR may be an over-estimation. Subgroup analysis including only high-quality studies showed no significant difference between groups. Although AGI was significantly more likely to be detected after sexual assault than consensual sexual intercourse, more than half of survivors of sexual assault have no detectable injuries. The presence of AGI, therefore, does not prove there has been sexual violence and absence of injury does not refute that sexual assault has occurred. The University of Birmingham.

Vaginal injuries after consensual sexual intercourse — a survey among office-based gynecologists in Hamburg, Germany

Studies on the occurrence of injuries following consensual sexual intercourse (CSI) among patients treated by office-based gynecologists are lacking. This survey aimed to assess the presence and medical relevance of vaginal injuries after CSI in gynecological office-based practice, associated risk factors, and their significance for forensic medical assessment practice. All office-based gynecologists in Hamburg, Germany (n = 316), were asked to fill in a one-page questionnaire via a fax survey. The questionnaire covered various aspects such as having observed CSI-related injuries, injury severity, risk factors, and concomitant factors (bleeding, need for surgical care, hospitalization). Response rate was 43.2% (n = 115). Overall, 83.5% of office-based gynecologists reported having observed vaginal injuries after CSI at least once and 59.1% repeatedly. Regarding maximum injury severity, 52.1% observed mucosal erosions, 32.3% mucosa penetrating injuries, and 14.6% injuries penetrating the vagina. Having observed bleeding was reported by 56.3%, 28.1% had to perform surgical suture care, and hospital admission was initiated by 20.8%. Menopause (37.5%), use of objects (19.8%), alcohol, and/or drug use (16.7%) were reported as the most frequently observed associated risk factors. Vaginal injuries after CSI have been observed by the majority of office-based gynecologists in Hamburg involving a wide spectrum of severity, including the necessity of surgical care and hospital admission. Complementing published work in clinical and emergency medicine, these findings are highly relevant to the forensic evaluation of injuries in an allegation of sexual assault, as the severity of a vaginal injury in this setting does not necessarily support a conclusion on the issue of consent.

Consensual coital vaginal laceration in hypovolaemic shock: A report of two cases

Background: Certain life-threatening complications and morbidities may occur following consensual sexual intercourse which may not be commonly experienced in clinical practice. One of such complications is hypovolaemic shock resulting from profuse bleeding.&#x0D; Methods: Two cases of vaginal laceration complicated by hypovolaemic shock following consensual sexual intercourse are presented.&#x0D; Results: Both patients had resuscitation with intravenous fluid, blood transfusion and subsequent examination under anaesthesia with repair of laceration in theater. Post-operative recovery period was uneventful and they were both discharged after proper counselling.&#x0D; Conclusion: Bleeding from coital laceration could be life threatening. Prompt treatment should be instituted in such cases.

Non-Obstetric Traumatic Vulvar Hematomas in Premenarchal and Postmenarchal Girls

Traumatic non-obstetrical hematomas of the vulva are rare, and most reports only involve adult patients. There are no data on presentation, management, and outcomes from either conservative or surgical management in pediatric and adolescent patients. The objective of this project was to compare the etiology, treatment, and outcomes of traumatic vulvar hematomas occurring in premenarchal and postmenarchal young women. A retrospective chart review was performed on females aged 0-24 years seen at a tertiary care academic center using ICD 9 and 10 codes for traumatic vulvar hematoma from 2006-2019. Data describing their clinical presentation and course were collected. IRB approval was obtained. Twenty patients, aged 3-23 years (median age of 13.5 years) were identified. All 8 premenarchal patients presented with a straddle injury, whereas only 50% of postmenarchal patients were found to have a straddle injury. Other etiologies among postmenarchal patients included consensual sexual intercourse and recent vulvar surgery. Hematoma diameter ranged from 1-3 cm in premenarchal patients and 0.4-7 cm in postmenarchal patients. Associated perineal lacerations were reported in 50% of the premenarchal girls and 8% of postmenarchal young women. Of the 8 premenarchal patients, 5 were managed conservatively, and 3 were taken to the operating room for repair of perineal lacerations; 1 patient also underwent evacuation of a 3-cm hematoma. Of the 12 postmenarchal patients, 5 had surgical intervention, 2 for pain secondary to large 7-cm hematomas and 3 for suspected vulvar abscesses, which were identified as hematomas after drainage. One patient in each group required a Foley catheter for comfort. Two postmenarchal patients required a second surgery for further wound management. One premenarchal patient with surgical treatment required a follow-up exam under anesthesia. Four patients were admitted for pain and postoperative observation, 1 of whom was premenarchal. Eleven patients were seen for follow-up, and 10 were doing well. One postmenarchal patient in the conservative management group returned to the Emergency Department with continued pain 10 days later. In this study that examined traumatic vulvar hematomas in premenarchal and postmenarchal young women, the only mechanism of injury in premenarchal girls was straddle injury, and surgical intervention was usually needed only for repair of perineal lacerations, not a primary hematoma. In the postmenarchal patients, surgical intervention was undertaken for larger hematomas and suspected vulvar abscesses. Our study suggests that most hematomas up to 3 cm in premenarchal patients and up to 6 cm in postmenarchal patients can be managed conservatively.

Understanding Sexual Health Indicators During Adolescence: A Study to Consider Time Since Sexual Debut When Exploring Multiple Sexual Partners.

Understanding risky sexual behaviors among adolescents is key in efforts devoted to reducing the health burden related to sexually transmitted infections and unintended or unplanned pregnancies. The aims of this study were to understand the association between number of lifetime sexual partners and time since sexual debut (TSSD) among adolescents and to determine whether sex modified this association. Data were drawn from the 2018-2019 COMPASS-Quebec study, a cohort study conducted in secondary schools in the province of Quebec, Canada. Of 18,467 respondents aged 14years and older, 6991 (37.9%; mean age 15.3) reported consensual sexual intercourse and answered questions on their age at sexual initiation and number of lifetime sexual partners. Multilevel Poisson regressions with robust standard errors were estimated to adjust for covariates and produce adjusted group mean differences. The adjusted mean number of lifetime sexual partners ranged from 1.5 for those who had recently begun sexual activity (< 12months) to 4.0 for those who had been active for > 35months, an average rise of about 0.6 per year. Females-to-males adjusted mean differences showed that males reported more sexual partners than females at all time points, but the differences were only significant at the shorter (< 12months) and longer (> 35months) time spans. This study highlights the importance of taking into account TSSD when using and interpreting the number of lifetime sexual partners as risky sexual behavior among adolescents. Sex did not have a significant modifying effect on the relationship between number of lifetime sexual partners and TSSD.

Female genital injury\u2014which findings have to be considered physiological using colposcopy with and without toluidine blue dye?

This study aimed to assess the validity and efficacy of blue dye in colposcopic assessment of genital injury in pre- and postmenopausal women with and without history of consensual sexual intercourse. Two hundred women were prospectively enrolled and examined colposcopically with and without toluidine blue dye in order to detect and categorize genital lesions (laceration, bruise and abrasion). Examination of genital trauma was accomplished in a standardized way and findings were photo documented. A wide range of influencing factors with a potential impact on prevalence and nature of genital injury was recorded beforehand using a questionnaire. The frequency of diagnostic injury differed substantially depending on the examination technique, ranging from 9% using colposcopic magnification only to 28% with the additional use of toluidine blue dye. A vertical laceration affecting the posterior fourchette was the most frequent lesion detected (17%, n = 32). Menopausal status seems to have significant impact on genital injury prevalence (p = 0.0165), as 42% (16/ 38) of postmenopausal compared to 24% (36/ 151) of premenopausal women had at least one genital lesion. Furthermore, vaginal medication (p = 0.0369), vaginal dryness (p = 0.0228), dyspareunia (p = 0.0234) and low frequency of sexual intercourse (p = 0.0022) were found to significantly correlate with the presence of genital lesions. According to our findings, standardized colposcopy in combination with toluidine blue dye facilitates accurate assessment of genital lesions. Genital trauma situated at another site than the posterior part of the vaginal introitus seems to be uncommon after consensual intercourse.

192 Non-Obstetric Vulvovaginal Lacerations: Evaluation and Emergency Management

Non-obstetric trauma is gradually becoming a common cause of vulvovaginal lacerations. Consensual and nonconsensual sexual intercourse have been reported to be possible causes of these injuries, but their contribution to traumatic lesions is not well known. The aim of this community-based study was to analyze the clinical features, treatment modalities, and the outcome of lacerations to the female genital tract.

Sexual Rights of the Psychiatric Patients, Consenting Capacity and Contradiction with Local and National Policies and the Law of Sri Lanka: A Case Report

Legally, consensual sexual relationships between adults are a right in our society. However, sexual activity is often prohibited by-laws for psychiatric patients in Sri Lanka. Unless medically contraindicated, all people, whether competent or incompetent or, single or married, should have the right to engage in consensual sexual activities. A 32-year-old female who was on regular treatment and follow-up in the clinic for fifteen years for epilepsy and psychosis was admitted to a tertiary care hospital with a sudden loss of consciousness following severe vomiting. Her medical findings confirmed a 23 weeks intrauterine live foetus. She lived in a separate home for the last three years and had consensual sexual intercourse with her sound-mind long-term partner for one year. Medico-legal investigations excluded the physical forces or donations as contributory factors to request consent for sex, and the circumstantial evidence confirmed that the patient had consented sex. However, the psychiatrist’s opinion was that she had severe mental retardation and had no capacity to give consent for sex. According to the law, after the clinical forensic examination, the assailant was arrested and remanded. The sexual rights of the psychiatric patients in Sri Lanka are discriminatory and there is the legal vulnerability of partners who engaged in sex with psychiatric patients. Therefore, local and national policies should be created to provide sexual and reproductive health, education, counselling, and family planning among psychiatric patients. Similar to other countries, the laws of Sri Lanka should be amended with the help of medical professionals and other stakeholders.

Half and Divided Consent: Analysing Rape

This article argues for categorization of rape cases and for the relabeling of some conduct that is currently viewed as rape. The focus is on two types of case: (1) sexual intercourse where there is ‘half consent’ to the sexual act; and (2) consensual sexual intercourse that causes or risks causing collateral consequences such as a sexually transmitted disease (STD). While rape cannot be partly justified/excused, when sexual intercourse is at least half consensual it should be labelled as second-degree rape. By contrast, consensual sexual intercourse with collateral consequences should be punished by separate offences addressing those consequences.

Ambiguous Sex in Critical Receptions to Ari Aster’s Midsommar

A critically acclaimed horror film, Midsommar has been the topic of considerable debate because of its central sex scene. While most reviewers, who acknowledge the scene, claim it is “unorthodox” or “weird” as far as sex sequences go, a small subset of critics have labelled it as depicting rape. The ambiguous nature of this scene may be viewed as problematic because it blurs the line between consent and sexual assault. In this paper, we provide a detailed description of the scene in question. Then, we elucidate a host of reasons why the scene may be construed as an example of non-consensual or consensual sexual intercourse. Finally, we conclude by discussing the scene’s implications in terms of contemporary Western understandings of consent, sexual assault, and (male) rape myths.

Discriminating between consensual intercourse and sexual assault: Genital-anal injury pattern in females

BackgroundAssessment of genital-anal (GA) injuries following sexual assault promotes health and assists prosecutors to build a case. The pattern of injuries may help differentiate between consensual and non-consensual intercourse, bolster the survivors' credibility, and increase prosecutions in sexual assault cases. ObjectivesTo identify the constellation of G-A injury-related characteristics that most effectively discriminated between consensual sexual intercourse and sexual assault in females when controlling for intercourse-related variables. MethodsWe employed a comparative study with two groups: a prospective cohort group with consensual participants and a group derived from an existing sexual assault registry. In the prospective cohort, we performed a sexual assault forensic examination at baseline and following consensual sexual intercourse with females ≥21 years. We compared their injury patterns to the injury records of females ≥21 years who were sexual assaulted. ResultsWe enrolled a sample of 834 females: 528 consensual (63.3%) participants and 306 non-consensual (36.7%) registry cases. After controlling for race/ethnicity, age, and time between intercourse and examination, logistic regression analyses showed that the presence of an external genital tear increased the odds of non-consensual intercourse more than two times (adjusted odds ratio [AOR] = 2.70, 95% CI = 1.28–5.56). Logistic regression analyses also showed that the odds of non-consensual sexual intercourse were significantly greater with a lower prevalence and frequency of external and internal genital redness, lack of condom use and lubrication, and presence of anal penetration. Latent class analysis identified high and low G-A injury prevalence subgroups among both consensual and non-consensual samples. One subset of results emerged that may be indicative of non-consensual as compared to consensual intercourse: a higher prevalence of external genital and anal tears. ConclusionExternal genital tears occurred more frequently in the non-consensual sample and increased the odds of non-consensual intercourse more than two times. Anal tears, swelling, and ecchymosis and anal penetration were markers for non-consensual intercourse and should increase suspicion for lack of consent.

Vaginal Injuries Following Consensual Sexual Intercourse and Trauma- A Case Series

Vaginal injuries following consensual intercourse are commonly encountered in clinical practice. They cause significant morbidity among sexually active women. Consensual vaginal intercourse may lead to minor hymenal or vaginal tears to rectovaginal fistula and in some cases severe haemorrhage shock can occur. It commonly results due to inadequate foreplay prior to penetration. Hereby, authors present four cases of vaginal lacerations of different age groups. The first patient bled profusely from the laceration and was haemodynamically stable; the second patient bled profusely and went into shock; the third patient presented with rectovaginal fistula who was newly married; and fourth patient was 13-year-old girl with third degree tear following trauma. The various risk factors for vaginal injury following consensual sexual intercourse are lack of foreplay, rigid perineum, vaginal atrophy and hindrance from partner. This case series highlights need of clinicians for proper and prompt diagnosis of condition and early surgical intervention in the management of the injuries and giving proper sexual education for the women.

Consensual Sexual Intercourse among children Vs Current Legal Provisions under POCSO: A Scientific Review with Prospective Quantitative Analytical Study

Background: Prevention of Children from Sexual Offences (POCSO) act criminalizes all acts of sexual intercourse and does not differentiate acts of consensual sexual intercourse from provisions of the said act. Aim: To find incidence and demography of victims and accused in cases of consensual sexual intercourse registered as cases of alleged sexual assault under POCSO Material and Method: Current study was conducted at B J Government Medical College Pune on alleged cases of sexual assault brought for examination during November 2015 to September 2017, with cases of female child with history of consensual sexual intercourse being the inclusion criteria. Result: A total of 174 (32.58%) cases of consensual sexual intercourse was examined with the majority being from the age group of 16-17 years (36.78%). Out of 174 cases, 24 were pregnant. In all only 02 were completely illiterate. Among accused majority were from the age group of 22-24 years (40.23%). Conclusion: Consensual sexual intercourse among children is known and different entity and should be treated separately from the purview of POCSO, but should also maintain the letter and spirit of the law.

Cognitive dissonance and false rape allegations: A case study

Summary Aims Studies showed that consensual sex can be regretted, and may lead to a false allegation of rape. However, none of the previous researches concerning regret as a false allegation of rape described the psychological process as to why the alleged victim might experience regret. Method We report a case of false rape allegation motivated by regret of a young woman who had consensual intercourse with an elderly man. Results None of the causes of regret mentioned in the literature until then could explain the deceitful report (e.g. misunderstanding, blurred line of consent, or relabelling). In this case, the alleged victim stated that she has experienced regret following inconsistency between her freely consensual intercourse and her religious attitudes and other facts and perceptions regarding this act. Conclusion We propose the mental state of cognitive dissonance as a source of her regret. Dissonance reduction strategies were identified, as the victim denied her responsibility and changed the nature of the consensual act (from a consensual sexual intercourse to a rape), and filed a deceitful complaint stating that she was actually raped.

Re-Defining The Role Of Indian Legislature In Regulating Consensual Sex Between Minors

The role of legislator is not simply confined to making laws, but they also play a significant role in development of society as a whole as they escalate or attenuate this process of development by the quality of laws they make. The age of consent laws made by the legislator are one set of laws that are working in contradiction of the aims and objectives for which they were enacted and are rather being criticized. The term „age of consent‟ is itself controversial and it has been suggested what is created is an „age of liability‟ for the offender rather than an age of consent.1It has been argued that „age of consent‟ is an establishment of age at which the law of a country decides that a child is allowed to have sexual intercourse and it has very less to do with consent. Much of the behaviour caught within the web of Rape of a child between 16-18 years of age involves the cases of consensual sexual intercourse, thus involving the adolescent youth of the country who are being prosecuted. This necessitates the need to stop this never-ending web of accusations against the boys who are being prosecuted for having sexual intercourse notwithstanding the involvement and consent of the girl to the fullest. The paper is shared out in four sections. In the first section, the author delves into the theme of statutory rape law and POCSO Act to critically analyse its utility in protecting children from consensual sexual acts. In the second section, the author attempts to examine the legislative intent behind setting such a higher age of consent from a historical perspective and brings to the surface a critique of legislative intent and acts. In the third section, based on a critique of traditional ideology and dearth in approbation of principles of criminalization, the author explains the need of decriminalizing consensual sexual acts among adolescents (between 16 to 18 years of age). In fourth section, the author attempts to conclude by quoting suggestions to frame the best practice paradigm to implementing Statutory Rape law in Indian Legal System.

The stratified biomedicalization of HIV prevention in Mexico City

ABSTRACTIn the late 1990s antiretroviral pharmaceuticals began to be used in the United States and Western Europe to prevent HIV infection in contexts of occupational exposure. One decade later, the application of Post Exposure Prophylaxis (PEP) and Pre-Exposure Prophylaxis (PrEP) had been extended to include cases of exposure to sexual assault, injection-drug use, and consensual sexual intercourse deemed at high risk. This article explores the implementation of biomedicalized HIV prevention protocols at a public healthcare clinic in Mexico City, building on sociological-feminist approaches in Science and Technology Studies (STS) and drawing on interviews with key actors, as well as digital ethnography. We emphasise the stratified biomedicalization or, said otherwise, the differences in PEP and PrEP accessibility and consumption among different populations and groups. We also describe the fragile grip of institutionalised biomedical solutions when alternative ‘moral economies’ intersect with them, particularly in contexts like Mexico, where governmental funding for experimental research on biomedical innovations has been limited. This text reveals both the existence of contrasting technoscientific interventions along class and gender differences, and the multiple and vivid ways by which individuals appropriate and interpret global biomedical practices.

Understanding rates of genital-anal injury: Role of skin color and skin biomechanics

PurposeA series of studies suggest that non-Hispanic White women have significantly more injuries than non-Hispanic Black women after sexual assault and consensual sexual intercourse. One explanation for this difference is that the degree of skin protection may vary as skin mechanics and skin pigmentation vary. The aim of the study was to determine the association among genital-anal injury, skin color, skin viscoelasticity and skin hydration in women following consensual sexual intercourse when controlling for age, smoking history, body mass index (BMI), sun exposure, and health status. ProceduresWe employed a prospective cohort study design to enroll women 21 years of age or older at two study sites. They underwent two data collection sessions, baseline and follow-up after consensual sexual intercourse. Baseline genital-anal injury identification occurred with a standard forensic examination (direct visualization, nuclear staining with toluidine blue contrast, and colposcopy examination) and measurements of other variables (skin color, skin viscoelasticity, skin hydration, age, smoking history, body mass index [BMI], sun exposure, and health status). Participants were then asked to have consensual sexual intercourse with a male partner of their choice and to return for a second forensic examination for injury detection. Genital-anal injury was regressed on skin color, skin viscoelasticity, skin hydration, age, smoking history, BMI, sun exposure, and health status. FindingsWe enrolled 341 participants, 88 non-Hispanic White (25.8%), 54 non-Hispanic Black (15.8%), 190 Hispanic/Latina (55.7), and 9 Other Identities (2.6%). At baseline the genital-anal injury prevalence was 57.77% and at follow-up after consensual sexual intercourse, injury prevalence was 72.73%. External genital injury prevalence was associated with increased L* (lightness) values (Adjusted Odds Ratio [AOR] = 1.98, 95% Confidence Interval [CI] = 1.03, 4.04) and decreased skin elasticity (AOR = 0.96, 95% CI = 0.93, 0.99) at baseline. Increased skin hydration was associated with a significantly higher frequency of external, internal, anal, and total genital-anal injuries (Adjusted Rate Ratio [ARR] > 1.27) at follow-up. Also at the follow-up examination, Hispanic/Latina participants had significantly lower external genital and total genital-anal injury prevalence and frequency as compared to non-Hispanic White participants (AOR < 0.40). ConclusionsOur findings provide qualified support for the importance of skin color during the forensic examination. Women with lighter skin tones may have skin that is more easily injured than women with darker tones. In contrast, external genital injuries may be more easily identified in women with light as compared to dark skin, a situation that is important in both the health care and criminal justice systems. Additionally, women with decreased viscoelasticity and increased hydration may be more easily injured. These findings support the need to develop forensic procedures that are effective in people across the range of skin colors and to interpret forensic findings considering the innate properties of the skin.