Learning Objective #1: Discuss the historical difficulties in establishing the relationship between genital injuries and non-consensual sexual intercourse

Learning Objective #2: Identify the usefulness of the Genital Injury Scoring Scale (GISS) in assessing genital injuries after reported sexual assault

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Estimates of annual sexual assaults in the US are in the millions, with rates increasing. Sexual assailants are known to be repeat offenders and identification and successful prosecution of perpetrators is one step toward decreasing these alarming statistics. Perpetrators often claim the activity was consensual and limited data exist documenting typical patterns of genital injury purported to be caused by either consensual or non-consensual sexual activity. Successful prosecution of alleged sexual assailants is currently inextricably linked to the medical examination and is impacted by ongoing questions as to the validity of patterns of genital injury associated with sexual assault. This pilot study looks at genital findings consistent with consensual sexual activity in order to refute or confirm the association between genital trauma and non-consensual sex that exists in the current literature. No standardized, tested tool to grade genital injuries previously existed. As part of this study, a Genital Injury Scoring Scale (GISS) is also developed and tested. Comparisons of genital findings within and beyond 72 hours of consensual vaginal intercourse in a cohort of 40 women found no significant difference in genital injury scores using the GISS. These findings were significantly different when compared to the higher GISS results obtained from existing sexual assault data base cases.