The specific legal definition of sexual assault varies from state
to state. Generally, sexual assault is forced sexual contact without
consent. Sexual assault occurs along a continuum from unwanted touching
and fondling of sex organs to forced penetration (oral, anal, or
vaginal). Fingers or objects (such as broomsticks, bottles, or knives)
could be used instead of, or in addition to, a penis as a weapon
of choice. Drugs such as gamma-hydroxybutyric acid (GHB), Rohypnol
(flunitrazepam), or ketamine are known as date rape or club drugs.
They can be used to disable the victim prior to a sexual assault.
Alcohol has also been used as a date rape drug.
Recent studies show that 13 to 18 percent of women and 3 percent
of men have experienced an attempted or completed sexual assault
in their lifetime.1 FBI and crime statistics grossly underestimate
the incidence since only 16 percent of sexual assaults are reported
to police.1 Approximately 300,000 to 700,000 adult women
are victims of sexual assault annually in the United States, with
40,000 victims treated in Emergency Departments.1,2
Sexual assault is not generally a crime among strangers. Most
women (78 to 82 percent) are sexually assaulted by someone known
to them.1,3,4 The assailant may include a spouse, boyfriend,
family member, coworker, or neighbor. More than 50 percent of rape
victims over the age of 30 are sexually assaulted by an intimate
partner.5 The offender may be someone the victim knows
less well, such as a contractor or package delivery person.
There is not a typical profile of a victim, although adolescent
girls and young women face particularly high rates of sexual assault.6 Victims
have been reported in all age groups. Sexual assault occurs across
all socioeconomic groups, all racial backgrounds, and all ethnic
backgrounds. Up to 39 percent of women will be raped more than once
during their lifetime.1
Some victims will not identify themselves as victims of sexual
assault. They may be ashamed or fearful to disclose what happened.
They also may be experiencing the rape trauma syndrome, a special
category of posttraumatic stress disorder. The use of screening
questions, as used for domestic violence, and a high index of suspicion
is necessary in identifying these patients. There is a significant
increase in the utilization of medical resources after a sexual
The Emergency Department visit of a
sexual assault victim plays a vital role in assuring proper medical
care, evidence collection, and treatment. The proper follow-up plans
and referrals to local rape crisis centers and/or hotlines
are crucial to the mental and physical recovery of victims. The initial
treatment in the Emergency Department will strongly influence whether
the patient will get follow-up care and pursue the case through
legal avenues. It is critical to not revictimize the patient and
make them feel responsible for the sexual assault....