Patterns of Hymenal Tears in Sexual Assault Victims at a National Referral Hospital in Indonesia: A Cross-Sectional Study

Abstract

Evidence of sexual intercourse in long-past sexual assault cases based solely on hymenal tears. In long-standing cases of sexual assault, hymenal tears were often the only available evidence to prove sexual intercourse. This study aims to explore the characteristics of sexual assault victims and the patterns of hymenal injuries. This a descriptive research design with a cross-sectional study was conducted at  Dr. M. Djamil General Central Hospital, Padang, Indonesia. A total of 60 medical records were consecutively selected based on inclusion criteria of samples. The researcher obtained permission to conduct the study, once approval was received from the hospital management, medical records of sexual assault victims from the Department of Forensic Medicine and Medicolegal at Dr. M. Djamil General Central Hospital, Padang, Indonesia were collected. The majority of the sample consisted of adolescents aged 13–18 years (55%), with most being students (59%). In terms of educational background, the largest group had completed elementary school (37%), followed by junior high school graduates (23%). Signs of external violence outside the genital area were absent in 82% of cases. A history of prior intercourse was reported by 50% of the sample, with 40% having experienced it more than once. Forced intercourse was reported in 38% of cases. The most common hymenal tears were at the 3 o'clock and 9 o'clock positions, with 59% of tears not reaching the base, and 84% classified as old tears. The majority of sexual violence victims were school-aged children, with incidents involving forced intercourse. Most victims had a prior history of sexual activity. The most frequent hymenal tears were classified as old tears, predominantly located in the lower posterior region, between the 3 o'clock and 9 o'clock positions.