Study of Victims of Alleged Sexual Assault

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INTRODUCTION

Generally sexual assault includes all cases involving unwanted sexual contact occurring between the victim and assailant. Sexual assault is one of the most underreported offences to the law enforcement agencies. Such offences are multi-faceted and certain details of the offence may be hard to be unearthed even after a thorough investigation [1] A review of previous studies only adds on to the existing elementary findings.

Sexual assault has been a major concern to our society. Laws have been amended and awareness among the public has been created to prevent such incidents. As per Sec 375 IPC a person is said to commit “penetrative sexual assault” if:

• (a) he penetrates his penis, to any extent, into the vagina, mouth, urethra or anus of a child or makes the child to do so with him or any other person; or
• (b) he inserts, to any extent, any object or a part of the body, not being the penis, into the vagina, the urethra or anus of the child or makes the child to do so with him or any other person; or
• (c) he manipulates any part of the body of the child so as to cause penetration into the vagina, urethra, anus or any part of body of the child or makes the child to do so with him or any other person; or
• (d) he applies his mouth to the penis, vagina, anus, urethra of the child or makes the child to do so to such person or any other person.

However such cases continue to happen and they are under reported too considering the social stigma. [2] There is paucity of literature regarding details of reporting and referring of such cases to hospital and the law enforcement agencies and also examination findings of victims of sexual assault. Hence present study was carried out to know the ways and means of reporting of sexual assault cases and to correlate findings with the alleged history.

AIMS OF THE STUDY

1. To study characteristics of the victims of sexual assault and factors associated with reporting of sexual assault cases.
2. To correlate and interpret local genital examination findings with the information provided by the victim or the referring authority.

MATERIALS AND METHODS

The present prospective cross sectional study was conducted in the Department of Forensic Medicine, M. S. Ramaiah Medical College Bangalore from January 2018 and December 2020. The approval was taken from the institutional ethics committee. All victims of alleged sexual assault brought for medical examination to the Department of Forensic Medicine were interviewed through a detailed questionnaire after taking consent. The age of the victims was considered based on the documents supporting their claim like school certificate, Voter ID, Aadhar card, driving license etc. in correlation with the dental and physical examination. Only the minor victims were subjected for radiological examination apart from dental and physical examination to confirm the age. Relevant information was sought from the victim and the consent/assent from victims. Descriptive statistics for qualitative type of data were summarized using frequency and percentage.

RESULTS

During the study period from January 2018 and December 2020, 82 victims those who had come to or brought by the parents or guardian or police with alleged history of sexual assault were subjected for medical examination. All of them were females except two victims. These two victims were less than 12 years of age. Majority of the victims (N=71, 86.5 %) were less than 18 years of age and were considered as juvenile/ minors under Indian law. (Table No 1)

 

Table 1. Distribution of cases based on age

Age	Frequency	Percent
< 12 years	7	8.3
12–18 yrs	54	64.3
18–25 years	12	14.3
> 25 years	10	11.9
Total	83	98.8

 

Either the victims or their parents reported to the police in most of the cases (N=76, 92.7 %). In 6 cases, neither the victim nor the parents reported to the police. (Table No 2) These victims came to hospital through a non government organization (NGOs) and subsequently the jurisdictional police were intimated by the hospital authorities. All victims were subjected for examination either by the Forensic Medicine expert (in presence of a female attendant) in adult victims or by a female resident doctor in cases of minor victims. They were accompanied by their parents or NGO representative. A formal requisition from the police was received to examine all victims. All the 10 victims who reported to the police by themselves were majors. None of the minor victims reported to police by themselves alone.

 

Table 2. Distribution of cases based on source of referral

Guide side	Frequency	Percent
Non Govt. Org.	6	7.3
Family	55	67.1
Family & Self	11	13.4
Self	10	12.2
Total	82	100.0

 

In majority (N=44, 53.65 %) of the cases the alleged assaults were reported to the police after 3 days of alleged recent sexual assault. (Table 3)

 

Table 3. Distribution of cases based on Time of reporting

Time between assault and reporting to police	Frequency	Percent
< 6 hr.	11	13.35
6–24 hr.	18	22
1–3 days	9	14
> 3 days	44	53.65
Total	82	100.0

 

In most of the cases (N=74, 90.25 %) the victim appeared normal. Only in 9.75 % (N=8) of cases the victim appeared sad, depressed or worried. (Table No 4)

 

Table 4. Distribution of cases based on appearance of the victim

Appearance of victim at examination	Frequency	Percent
Normal	74	90.25
Worried- depressed	8	9.75
Total	82	100.0

 

In majority (N=49, 59.75%) of the cases the purpose of reporting to the police was because of honour or pride of the parents/guardian. In 16 cases (19.51%) the victim wanted the assailant to be punished either for cheating (in cases where the assailant refused to marry after the intercourse) either because of difference in caste or the status of the families. In 14 cases (17.07%) the victim still wanted to marry the assailant in cases where the assailant had sexual intercourse upon promise of marriage or had promised her of marriage after the alleged sexual assault. Two cases were reported for the monetary gain and one case was reported for taking political mileage over the assailant. (Table No 5)

 

Table 5. Distribution of cases based on the intention behind reporting to police/law enforcement

Intent of victim to report to police	Frequency	Percent
Marry assailant	14	17.07
Punish assailant	16	19.51
Honour/ pride	49	59.75
Monetary gain	2	2.43
Political pressure	1	1.22
Total	82	100.0

 

It was observed that only in 4 cases there were positive findings of recent penetrative sexual assault in the form of fresh hymeneal tears or presence of spermatozoa in the swabs taken during genital examination. (Table No 6) This is because of delay in reporting to the police there by leading to delayed examination, hence the most of the recent evidences would have been lost. In 6 cases of recent alleged sexual assault the assailant had used condom, thus spermatozoa could not be detected.

 

Table 6. Distribution of cases based on local genital findings of the victim

Genital examination Findings for recent intercourse	Frequency	Percent
Positive(Fresh hymeneal tears/Spermatozoa/pregnancy)	4	4.88
Negative(Intact hymen/no other injuries/spermatozoa)	78	95.12
Total	82	100

 

DISCUSSION

A total of 82 victims of alleged sexual assault received are at M.S. Ramaiah Medical College & Hospital between January 2018 and December 2020. All the cases were examined for evidence of sexual assault after having received a formal requisition from the police and obtaining an informed written consent from the victims and assent of parents in cases of minor victims.

Section 375 of Indian Penal code defines Sexual Assault as introduction by a man of his penis/ part of his body/ any object into the vagina or anus or urethra of a woman or child. It is considered as sexual assault even if there is no complete penetration or ejaculation.

In the present study, 97.5 % were females except for 2 boys who were less than 12 years. 86.5 % of them were minors under Indian law. In a similar study in Delhi, 97.4 % of the victims were females. More than one-third of the victims (37.2%) were minors. [3] The percentage of male victims was low at approximately 5% of all victims in a study by Hiddink-Til. [4]

92.6% of them were referred to the Dept. of Forensic Medicine by the police and the remaining 6 cases were directly brought by a NGO to the hospital emergency and police were intimated later by the Emergency Medicine Physician. In only 12 % of the cases, victims voluntarily gave statement to the police regarding the sexual assault incident. In the rest of the cases, it was the parents or the relatives who approached the police. In a study at Netherlands, the percentage of self-referrers increased from 10% to 30% in recent years. [4]

Only one was coerced to consume alcohol and assaulted later. There was no other drug/ intoxicating agent detected in the victims. Hiddink-Til observed the decrease of use of psychotropic drugs among victims from 24% to 11%.[4] Use of alcohol or intoxicating agent was too low compared to other studies as majority of the victims in our study were minors.

53.65 % of them presented to the hospital after 3 days. In the current study there are a high percentage of minors who might not report until the parents notice the condition. In others, the delay could be attributed to fear of embarrassment or social stigma. In 17 % of the cases, victims were in relationship with the assailant and were courting and having consensual sexual intercourse on the pretext of getting married. Subsequently there was breach of promise of marriage which forced the victim to approach legal authorities. Consent obtained for sexual intercourse based on a false promise to marry is invalid under Indian Law and the accused would not be excused from the charges of sexual assault. Tolu LB reports an average duration of the presentation to the hospital as 98 hours. [5] In a study by Rathi A, majority of cases (64.3%) studied had been reported late; only 35.7% of cases were reported within 24 hours of the crime. One-fourth of the cases were reported after a year of crime. [3]

On examination 8 of them appeared to be in trauma, worried and depressed while remaining 74 of them were appeared normal during examination. However all victims were offered Psychiatric evaluation and counselling. In 59.75 % of the cases, intention behind reporting to the police was issues concerning honour and pride of the parents or the relatives of the victims. However few victims (19.51 %) had the intention of getting the assailant punished and some of them (17.07%) in deed wanted to get into marital relationship with the assailant.

75 (91%) victims reported peno-vaginal penetration, 2 minor boys were made to touch assailants’ penis. Scherer S observed 123 of 184 victims reported penile penetration; of which 66 % had penetrated vagina only. [6]

No injuries were observed over the victim’s body in our study. However, Scherer S observed lesions in 145 (79%) victims. Of these, 59 had body lesions only, 28 had genito-anal lesions only, whereas 58 had both body and genito-anal lesions. [6]

Recent signs of sexual intercourse like evidence of spermatozoa and fresh hymen tears were seen only in 3 of the cases and one was 10 weeks pregnant at the time of examination. This suggest that in majority of the cases intercourse was either consensual or they were reported late. Minimal physical force was used as there were no physical injuries in majority of the cases. Force may not be required and intercourse will be consensual if there is a promise of marriage; breach of promise of marriage is the most important reason for reporting to the law enforcement authorities. Consensual sexual intercourse with minors (86.5 % of the victims) was still considered as sexual assault as consent was invalid. In contrast Tolu LB reported that 93.0% had one or more physical examination findings at presentation, the commonest being genital injury in 72%, vaginal bleeding in 30.5%, and genital discharge in 30%. [5]

High vaginal swabs were taken in all cases and evidence of spermatozoa was seen in only 3 of the 82 cases. Sexually transmitted diseases were not detected in any of the cases. 34% of the survivors had a genital/anal swab taken for the demonstration of sperm cells by Tolu LB. [5] Among those evidence of sperm cells was reported in 39.2% of the cases and signs of genital infection in three of the cases. Delay in presentation to the hospitals, use of condoms by the assailants, change of clothes and douching by the victims can all result in very low positivity rate for detection of spermatozoa.

CONCLUSION

Majority of the victims of alleged sexual assault were minors. Only 12 % of them reported to the law enforcement directly without anybody persuading. More than 50% of victims presented to the hospital after 3 days of the alleged sexual assault. In most of minor victims the sexual intercourse was consented, but it was invalid since the girl below 18 years cannot consent for sexual intercourse. Majority of adult victims had consented for sexual intercourse on promise of marriage. In view of these, no physical injuries were seen on victims and positive evidence of sexual assault was detected only in 5% of cases.

ADDITIONAL INFORMATION

Funding source. This study was not supported by any external sources of funding.

Competing interests. The authors declare that they have no competing interests.

Authors’ contribution. All authors made a substantial contribution to the conception of the work, acquisition, analysis, interpretation of data for the work, drafting and revising the work, final approval of the version to be published and agree to be accountable for all aspects of the work. B.S. Hugar, J.S. Hosahally, Y.P. Girish Chandra, S. Praveen — carried out the examination; J.S. Hosahally — compiled the data and reviewed the literature.

About the authors

Basappa S. Hugar

M.S. Ramaiah Medical College

Email: bshugar2007@gmail.com
ORCID iD: 0000-0002-4470-0549

MBBS, MD (Forensic Medicine), Professor

India, Bangalore

Jayanth S. Hosahally

Dr. Chandramma Dayananda Sagar Institute of Medical Education and Research, Dayananda Sagar University

Author for correspondence.
Email: veejay02@gmail.com
ORCID iD: 0000-0001-5209-1133

MBBS, MD (Forensic Medicine), Associate Professor

India, Harohalli, Kanakapura, Karnataka

Y. P. Girish Chandra

M.S. Ramaiah Medical College

Email: girishchandra14@gmail.com
ORCID iD: 0000-0002-5446-8114

MBBS, MD (Forensic Medicine), Professor & HOD

India, Bangalore

Shivarama Praveen

M.S. Ramaiah Medical College

Email: praveenreddy.doc@gmail.com
ORCID iD: 0000-0002-4335-0671

MBBS, MD (Forensic Medicine), Professor

India, Bangalore

References

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