Related Editorial. Child victims of sexual abuse may present with physical findings that can include anogenital problems, enuresis or encopresis. Behavioral changes may involve sexual acting out, aggression, depression, eating disturbances and regression. Because the examination findings of most child victims of sexual abuse are within normal limits or are nonspecific, the child's statements are extremely important.
Evaluating the Child for Sexual Abuse - American Family Physician
While there is a large body of evidence on the effectiveness of Pap smears for cervical cancer screening and on screening for cervical gonorrhea and Chlamydia, there is sparse evidence to support other portions of the pelvic examination and little guidance on examination logistics. Maximizing comfort should be the goal; lubrication use and careful speculum selection and insertion can ease this intrusive procedure. This is particularly important in adolescent and menopausal women, sexual minorities, obese women, women with disabilities, and women with a history of trauma or prior instrumentation affecting the genitalia. We review the evidence and provide guidance to minimize physical and psychological discomfort with pelvic examination. Pelvic examinations are performed to evaluate pain, bleeding, and vaginal discharge and to screen for cervical cancer and sexually transmitted infections. Little attention has focused on the mechanics of pelvic examination technique, yet the examination is an intrusive experience for many women who feel exposed and lack control.
Relationship of Genital Injuries and Age in Adolescent and Young Adult Rape Survivors
During adolescence, teenagers begin the process of developing a sexual self-concept, which involves the combination of physical sexual maturation, age-appropriate sexual behaviors, and formation of a positive sexual identity and sense of well-being. In early adolescence, boys might become preoccupied with body changes, become interested in sexual anatomy and sex, compare changes in their body with others, and explore touching and mutual masturbation. Later, male adolescents begin to test their ability to attract others through dating and sexual behavior.
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